Mobility Improvement After an Exercise Program for Older Adults

Abstract

Basic mobility tasks are often used to assess improvement in response to physical activity interventions for older adults. However, it can be argued that if strength and endurance capacities are adequate prior to engaging in a program of exercise, further increases in capacity are not expected to alter basic tasks. Usual Gait Speed (UGS), 6 Minute Walk (6MW), and Timed Up and Go (TUG) are often used in research evaluate the efficacy of an exercise training program for older adults. However, the change in these measures has not been evaluated in relation to initial mobility. PURPOSE: To evaluate the improvement in basic mobility tasks in response to a ten-week community based exercise program for older adults with high or low functional ability. METHODS: Sixty-one older adults (age= 72.7 yrs+7.9); BMI=32.3+7.2) completed the 10-week Physical Activity for Seniors for Life (PALS) group exercise and lifestyle behavior change program. TUG (time in seconds to rise from a chair, walk 3 meters, return to chair and sit), 6MW (distance covered in 6 minutes), and UGS (meters/second to walk 6 m distance) were measured before and after the exercise program. Participants were divided into upper and lower functional groups based on the median for each mobility task. Repeated measures ANOVA and Effect Size (Cohen’s d) were used to examine mean differences within the two groups. RESULTS: After the exercise program, the lower functional group showed significant improvement in all basic mobility tasks (p<0.001). The upper functional group showed significant improvement in 6MW (p<0.001) and TUG (p=0.006), with no significant change in UGS (p=0.816). Importantly, the lower functional group demonstrated much higher effect sizes in all three tests (6MW: 763 vs 1121 feet, d=0.936; TUG: 13.3 vs 11.2 seconds, d=0.858; UGS: 6.3 vs 5.4 seconds d=0.800), pre, post respectively, while the higher functional group showed only moderate or low effect sizes, 6MW (1414 vs 1522 feet, d=0.562), TUG (9.1 vs 8.3 seconds d=0.577), UGS (4.65 vs 4.62 seconds d=0.041) pre, post respectively. CONCLUSION: These results suggest that UGS may be better suited for use with a frail population, while TUG and 6MW may be useful across a wider range of functional ability in older adults.