Abstract
Background: Assessing traditional neuromuscular fall risk factors (i.e., balance, gait, strength) in the elderly has so far mainly been done independently. Functional and integrative testing approaches are scarce. The present study proposes an agility course for an integrative assessment of neuromuscular and also cardiocirculatory capacity in seniors – and tests its criterion validity and reliability.Methods: Thirty-six seniors (age: 69.0 ± 2.8 years; BMI: 25.4 ± 3.5 kg/m2; sex: 19 males/17 females; weekly physical activity: 9.4 ± 5.5 h) participated. They completed four trials of the Agility Challenge for the Elderly (ACE)-course in two sessions separated by 1 week. The course consists of three segments focusing on different agility aspects. Cardiovascular capacity was assessed by 6-min walk test (6MWT), neuromuscular capacity by static, dynamic and perturbed standing balance tasks, habitual gait speed assessment, and rate of torque development testing. Parameters’ predictive strength for the ACE performance was assessed by regression analysis. Reliability was calculated with intraclass correlation coefficients and coefficients of variation.Results: Men completed the course in 43.0 ± 5.7 s and women in 51.9 ± 4.0 s. Overall and split times were explained by 6MWT time ( = 0.38–0.44), gait speed ( = 0.29–0.43), and to a lesser extent trunk rotation explosive strength ( = 0.05–0.12). Static and dynamic balance as well as plantar flexion strength explained the performance in some segments to a very small extent ( = 0.06–0.08). Good between- and within-day reliability were observed for total course and split times: The ICC for the between-day comparison was 0.93 (0.88–0.96) and ranged between 0.84 and 0.94 for split times. The within-day ICC was 0.94 (0.91–0.97) for overall time and 0.92–0.97 for split times. Coefficients of variation were smaller than 5.7% for within and between day analyses.Conclusion: The ACE course reflects cardiocirculatory and neuromuscular capacity, with the three ACE segments potentially reflecting slightly different domains of neuromuscular (static and dynamic balance, ankle, and trunk strength) performance, whereas cardiocirculatory fitness and gait speed contribute to all segments. Our test can detect changes in overall performance greater than 5.7% and can thus be useful for documenting changes due to interventions in seniors.
Highlights
30% of the population in western societies will be aged >65 years until the end of the 21st century (Lutz et al, 2008)
The present study investigated whether and to which extent traditional neuromuscular and cardiocirculatory performance variables relate to overall time and split time of this novel agility testing course in community-dwelling seniors
Y-balance composite score was discarded from this analysis because it was not part of the strongest model according to Akaike’s information criterion (AIC)
Summary
30% of the population in western societies will be aged >65 years until the end of the 21st century (Lutz et al, 2008). In addition to extrinsic factors (e.g., poor lighting, bumps, ice, footwear) intrinsic factors, such as declines of lower limb strength (maximal and explosive strength) (Doherty, 2003) and impaired balance and gait performance (under single and dual task conditions) (Hytonen et al, 1993; Granacher et al, 2011a,b) contribute to increased individual fall risk These intrinsic fall risk factors have mostly been assessed independently (Miyamoto, 2008; Avelar et al, 2016; Donath et al, 2016a). The limitations of independently assessing different fall risk factors might be overcome if accelerations, decelerations, stop and go patterns, change in directions, eccentric and rotational movements and demanding spatial orientation tasks are integrated into a testing protocol. The present study proposes an agility course for an integrative assessment of neuromuscular and cardiocirculatory capacity in seniors – and tests its criterion validity and reliability
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