400-m Walk Time Research Articles

Faster decline of physical performance in older adults with higher levels of baseline locomotive function

The purpose of this longitudinal study was to determine whether the rate of decline in community-dwelling older adults varies according to baseline locomotive function levels. This longitudinal study was conducted in community-dwelling older adults in Kyoto, Japan. In addition to information about falls, physical performance was assessed using a series of tests, including 10-m walking time, timed up and go (TUG) test, functional reach, one-leg stand test, and five chair stand test. The outcomes for each patient were measured once in 2009 and then followed up 1 year later. The change in physical performance was then determined. We divided the participants into tertiles (T1, T2, and T3) according to timed up and go test results, and the differences among the three groups were compared. Of the 252 individuals who were enrolled in the study, 231 (91.6%) completed the 12-month follow-up: 77 in the T1 group; 78 in the T2 group; and 76 in the T3 group. The T1 group showed a significantly larger decrease than the T2 and T3 groups in the 10-m walking time and TUG tests (P < 0.05). However, there were no significant differences in functional reach, one-leg standing test, or five chair stand test among the three groups. In the T1 group, the number of falls and elderly who had developed fear of falling increased during the study period. This study demonstrated that elderly with the highest baseline performances were more likely to show a greater decline in locomotive performance than the other groups. Further study is required to elucidate the mechanism of faster physical functional decline in robust elderly.

Effects of an Exercise Program on Balance and Trunk Proprioception in Older Adults with Diabetic Neuropathies

Diabetes is the most common cause of peripheral neuropathies. No definitive treatment for diabetic neuropathies has been reported, and very few studies have been published on the role of exercise in reducing either the symptoms or incidence of diabetic neuropathies. This study assessed the effects of an exercise program on balance and trunk proprioception in older adults with diabetic neuropathies. Thirty-eight patients with diabetes having peripheral neuropathies were enrolled, randomized, and subdivided in two groups: an experimental group of 19 participants with diabetes (72.9 ± 5.6 years old) and a control group of 19 participants with diabetes (73.2 ± 5.4 years old). Both groups received health education on diabetes for 50 min/week for 8 weeks. The experimental group practiced an additional balance exercise program for 60 min, two times a week. The exercise training was performed two times per week for 8 weeks. Results were evaluated by both static and dynamic balance and trunk proprioception. Postural sway significantly decreased (P < 0.05), the one-leg stance test significantly increased (P < 0.05), and dynamic balance from the Berg Balance Scale, Functional Reach Test, Timed Up and Go test, and 10-m walking time improved significantly after balance exercise (P < 0.05). Trunk repositioning errors also decreased with training (P < 0.05). The balance exercise program improved balance and trunk proprioception. These results suggested that a balance exercise is suitable for individuals with diabetic neuropathy.

Physical and Motor Skill Training for Children with Intellectual Disabilities

This study investigated the effectiveness of using special training machines for children with intellectual disabilities to strengthen their body's inner muscles and improve their ability to maintain standing posture and improve walking movement. The participants were 23 high school age boys with intellectual disabilities who had difficulties expressing greetings, and needed to be led by the hand when walking. Four special training machines were used for walking movements, for standing and walking balance, for leg-hip extension, and for ipsilateral movement in a sitting position. Each participant underwent 30 min. of training once a week over a 3-mo. period during school time. Body control ability required to perform each training exercise was improved over the training period. A significant improvement was observed in the 50-m dash, mean 10-m walk time, and 10-m obstacle course walk. The hip joint split angle showed a significant increase. Legal guardians all reported their child had "improved and/or progressed" for each of the targeted movements.

Constructing an index of physical fitness age for Japanese elderly based on 7-year longitudinal data: sex differences in estimated physical fitness age

A standardized method for assessing the physical fitness of elderly adults has not yet been established. In this study, we developed an index of physical fitness age (fitness age score, FAS) for older Japanese adults and investigated sex differences based on the estimated FAS. Healthy elderly adults (52 men, 70 women) who underwent physical fitness tests once yearly for 7 years between 2002 and 2008 were included in this study. The age of the participants at the beginning of this study ranged from 60.0 to 83.0 years. The physical fitness tests consisted of 13 items to measure balance, agility, flexibility, muscle strength, and endurance. Three criteria were used to evaluate fitness markers of aging: (1) significant cross-sectional correlation with age; (2) significant longitudinal change with age consistent with the cross-sectional correlation; and (3) significant stability of individual differences. We developed an equation to assess individual FAS values using the first principal component derived from principal component analysis. Five candidate fitness markers of aging (10-m walking time, functional reach, one leg stand with eyes open, vertical jump and grip strength) were selected from the 13 physical fitness tests. Individual FAS was predicted from these five fitness markers using a principal component model. Individual FAS showed high longitudinal stability for age-related changes. This investigation of the longitudinal changes of individual FAS revealed that women had relatively lower physical fitness compared with men, but their rate of physical fitness aging was slower than that of men.Electronic supplementary materialThe online version of this article (doi:10.1007/s11357-011-9225-5) contains supplementary material, which is available to authorized users.

Depressive Symptoms and Physical Performance in the Lifestyle Interventions and Independence for Elders Pilot Study

To determine whether the presence of high depressive symptoms (Center for Epidemiologic Studies Depression Scale (CES-D) score ≥ 14) diminished physical performance benefits after a comprehensive physical activity intervention in older adults. A post hoc analysis of data from the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study, a single-blind randomized controlled trial comparing a moderate-intensity physical activity intervention (PA) with a successful aging control (SA). Multicenter U.S. institutions participating in the LIFE-P trial. Four hundred twenty-four sedentary, noninstitutionalized adults aged 70 to 89. Depressive symptoms were assessed using the CES-D. Physical performance tests included the Short Physical Performance Battery (SPPB) and 400-m walk time (400 mw) at baseline and 6 and 12 months. Of the participants, 15.8% had high depressive symptom scores (CES-D ≥ 14). For participants with low depressive symptoms, SPPB scores improved more in the PA than the SA group over 12 months (adjusted score difference +0.70; P < .001 at 6 months and +0.58; P = .004 at 12 months), and 400 mw times improved in the PA group at 6 months (adjusted score difference -0.41 minutes; P = .02). For participants with high depressive symptoms, the difference in improvement fell short of statistical significance on the SPPB between the PA and SA groups (adjusted score difference +0.76 (P = .18) at 6 months and +0.94 (P = .12) at 12 months). The presence of high depressive symptoms did not substantially diminish physical performance benefits realized after a PA intervention in sedentary older adults.

Effects of 3D Visual Feedback Exercise on the Balance and Walking Abilities of Hemiplegic Patients

[Purpose] The purpose of this study was to determine the effects of 3-dimensional exercise with visual feedback on stroke patients. [Subjects] Twenty-two patients with hemiplegia were randomly allocated to either a 3D exercise group (3DG) consisting of 11 members or a weight shifting exercise group (WSG), also of 11 members. [Methods] The 3DG received neurophysiological treatment and performed 3D exercise and the WSG received neurophysiological treatment and performed weight shifting exercise, 5 times a week for 6 weeks. The Berg Balance Scale and 10m walking time were used to evaluate the patientsAf balance and walking abilities. [Results] Balance and gait abilities of patients improved in both the 3DG and the WSG. A comparison of the two groups found that the 3DG showed a greater improvement in balance ability than the WSG. [Conclusion] 3- dimensional exercise with visual feedback is effective at improving the balance and gait of stroke patients.

Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot

To determine whether participation in usual moderate-intensity or more-vigorous physical activity (MVPA) is associated with physical function performance and to identify sociodemographic, psychosocial, and disease-related covariates that may also compromise physical function performance. Cross-sectional analysis of baseline variables of a randomized controlled intervention trial. Four academic research centers. Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability (scoring <10 on the Short Physical Performance Battery (SPPB)) and able to complete the 400-m walk test within 15 minutes. Minutes of MVPA (dichotomized according to above or below 150 min/wk of MVPA) assessed according to the Community Healthy Activities Model Program for Seniors questionnaire, SPPB score, 400-m walk test, sex, body mass index (BMI), depressive symptoms, age, and number of medications. The SPPB summary score was associated with minutes of MVPA (ρ=0.16, P=.001). In multiple regression analyses, age, minutes of MVPA, number of medications, and depressive symptoms were associated with performance on the composite SPPB (P<.05). There was an association between 400-m walk time and minutes of MVPA (ρ=-0.18; P<.001). In multiple regression analyses, age, sex, minutes of MVPA, BMI, and number of medications were associated with performance on the 400-m walk test (P<.05). Minutes of MVPA, sex, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability.

Predicting the probability of falls in community-dwelling elderly individuals using the trail-walking test

Falling is a common problem in the fast-growing elderly population. Multitasking or engaging in two or more activities at the same time is common in daily living. To determine the usefulness of the trail-walking test (TWT) for predicting a fall in community-dwelling elderly individuals. This was a prospective study in which the TWT was used to evaluate the risk of falling among a group of community-dwelling elderly individuals (n = 171) with a mean age of 80.5±5.6years. The following tests were conducted: TWT, trail-making test (TMT), timed-up-and-go test (TUG), functional reach (FR) test, one-leg standing (OLS) test, and 10-m walking time test. Test-retest reliability was assessed by repeating the TWT within 2weeks of the first trial, and there was a 1-year follow-up. Stepwise logistic regression analysis was used to analyze whether the TWT, TMT, TUG, FR, OLS, or 10-m walking tests predicted falling. The test-retest reliability of TWT was high (intraclass correlation coefficient 0.945, p<0.001). Fifty-nine participants (34.5%) had reported a fall during the year preceding the 1-year follow-up. The stepwise logistic regression analysis revealed that only the TWT was significantly related to falling (odds ratio 1.160, 95% confidence interval 1.107-1.214; p<0.001). In total, 77.8% of cases were correctly classified. When reliability and validity were considered, the TWT was most useful test of those evaluated for assessing the risk of fall among our elderly cohort.

A Self-Report Measure of Physical Function in Older Adults using Computer Animation: The Virtual Short Physical Performance Battery (vSPPB)

PURPOSE: To examine the validity and test-retest reliability of the virtual Short Physical Performance Battery (vSPPB), a novel self-report measure of lower extremity physical function for older adults. METHODS: The actual SPPB consists of three tests that assess usual gait speed (a 4-m walk), time to perform five chair rises, and standing balance (feet together, semi-tandem stace, full tandem stance). Each component is scored 0-4 and summed to give a total score of 0-12. The computer-based vSPPB uses animation of these activities performed at performance levels corresponding to the quartiles of performance of the SPPB. The animated figure is a mannequin that is age, gender, body type, and race neutral. After viewing the animated video, the subject selects the level of performance which matches their perceived ability using a touchscreen monitor. The vSPPB, actual SPPB, 400-m walk, and the self-report Pepper Assessment Tool for Disability (PAT-D) were administered to 110 older adults (mean age = 80.6±5.2 yrs) from Winston-Salem, NC to assess validity and reliability. RESULTS: The SPPB (mean±SD = 7.7±2.8) and the vSPPB (mean = 7.7±3.2) were moderately correlated (r=0.572, P<.05). The vSPPB correlated moderately with 400-m walk time (r=-.224, P<.05) and the PAT-D (r=.546, P<0.05). The correlation between the walking component of the vSPPB and the 400-m walk time was higher (r=-.366, P<.05). Test-Retest reliability was examined in 30 participants (mean age=79.3±5.1 yrs) on two occasions 7.4 days (±2.2) apart. The SPPB (ICC=0.889, P<.05) and vSPPB (ICC=0.896, P<.05) were both highly reliable. CONCLUSIONS: The vSPPB appears to be a valid and reliable measure of lower extremity function in older adults. The vSPPB may be a useful surrogate to the SPPB in both the research and clinical settings. We are currently evaluating the predictive validity of the vSPPB in retirement communities.

Walking Index for Spinal Cord Injury Version 2 (WISCI-II) with Repeatability of the 10-m Walk Time

To demonstrate the inter-/intrarater reliability of the Walking Index for Spinal Cord Injury version 2 scale and the repeatability of the time to walk 10 m in chronic subjects. In this reliability study, 26 subjects from the United States and Italy with spinal cord injury/disorder were tested by two blinded raters on two separate days to determine self-selected and maximum Walking Index for Spinal Cord Injury levels and the time to complete a 10-m walk. Subjects were progressed from self-selected to maximum Walking Index for Spinal Cord Injury incrementally until they failed the higher level. Intraclass correlations were calculated for Walking Index for Spinal Cord Injury levels and repeatability coefficients for the 10-m time. Twenty-two of 26 subjects showed increases of one to eight levels from self-selected to maximum Walking Index for Spinal Cord Injury, whereas 10-m walking time remained relatively unchanged (n = 15) or increased markedly (n = 7). Inter- and intrarater reliabilities were 1.00 for the self-selected Walking Index for Spinal Cord Injury level. Intrarater reliability for the maximum level was 1.0; interrater reliability was 0.98. Repeatability coefficients for time to walk 10 m were smaller (better) at self-selected than at maximum Walking Index for Spinal Cord Injury and on the same day than on different days. On same-day assessments, repeatability coefficients were 18%-20% of 10-m walk time, excluding subjects with discrepant Walking Index for Spinal Cord Injury levels (n = 2). For different-day assessments, repeatability coefficients were 27%-35% of 10-m walk time. The determination of both self-selected and maximum Walking Index for Spinal Cord Injury levels is highly reliable, whereas 10-m walking time is more variable. Walking "profiles" of speed at self-selected and maximum Walking Index for Spinal Cord Injury may better characterize walking ability than a single Walking Index for Spinal Cord Injury level.

Association of Dynamic Joint Power With Functional Limitations in Older Adults With Symptomatic Knee Osteoarthritis

Segal NA, Yack HJ, Brubaker M, Torner JC, Wallace R. Association of dynamic joint power with functional limitations in older adults with symptomatic knee osteoarthritis. Objectives To determine which lower-limb joint moments and powers characterize the level of gait performance of older adults with symptomatic knee osteoarthritis (OA). Design Cross-sectional observational study. Setting University motion analysis laboratory. Participants Community-dwelling adults (N=60; 27 men, 33 women; age 50–79y) with symptomatic knee OA. Interventions Not applicable. Main Outcome Measures Physical function was measured using the long-distance corridor walk, the Short Physical Performance Battery, and the Late Life Function and Disability Instrument (LLFDI Function). Joint moments and power were estimated using an inverse dynamics solution after 3-dimensional computerized motion analysis. Results Subjects aged 64.2±7.4 years were recruited. Ranges (mean ± SD) for the 400-m walk time and the LLFDI Advanced Lower-Limb Function score were 215.3 to 536.8 (304.1±62.3) seconds and 31.5 to 100 (57.0±14.9) points, respectively. In women, hip abductor moment (loading response), hip abductor power (midstance), eccentric hamstring moment (terminal stance), and power (terminal swing) accounted for 41%, 31%, 14%, and 48% of the variance in the 400-m walk time, respectively (model R 2=.61, P<.003). In men, plantar flexor and hip flexor power (preswing) accounted for 19% and 24% of the variance in the 400-m walk time, respectively (model R 2=.32, P=.025). Conclusions There is evidence that men and women with higher mobility function tend to rely more on an ankle strategy rather than a hip strategy for gait. In higher functioning men, higher knee extensor and flexor strength may contribute to an ankle strategy, whereas hip abductor weakness may bias women with lower mobility function to minimize loading across the knee via use of a hip strategy. These parameters may serve as foci for rehabilitation interventions aimed at reducing mobility limitations.

Correlation Between Symptoms and Function in Older Adults with Comorbidity

To describe the relationship between symptom scores and mobility function measures, assess whether symptom scores and disease scores are similarly associated with mobility function, and identify clusters of symptoms that are most strongly associated with functional status in older adults. Secondary analysis of cross-sectional data from three cohorts. Academic medical center. One hundred ninety-five community-dwelling subjects with poor flexibility or cardiorespiratory fitness (fitness cohort), 211 female retirement community residents with vertebral fractures (VF cohort), and 61 subjects with Parkinson's disease (PD cohort). Twenty-item self-reported symptom scale, 17-item self-reported disease scale, Medical Outcomes Study 36-item Short Form Survey (SF-36) Physical Functioning Scale, 5-item Nagi Disability scale, 10-m walk time, supine to stand time. Symptom scores correlated with mobility function measures (Spearman correlation coefficients ranged from 0.222 to 0.509) at least as strongly as, if not more strongly than, did disease scores. Symptom scores remained associated with functional outcomes after controlling for disease score and demographic variables. Adding symptom scores to models that contained disease scores significantly increased the association with functional outcomes. In the fitness cohort, muscle weakness was the most explanatory single symptom, associated with an average decrease of 17.8 points on the Physical Functioning Scale. A model that included only muscle weakness, pain, and shortness of breath accounted for 21.2% of the variability in the Physical Functioning Score. Symptoms represent useful indicators of disability burden in older adults and are promising targets for interventions to improve function in medically complex patients.

Association Between Inflammatory Components and Physical Function in the Health, Aging, and Body Composition Study: A Principal Component Analysis Approach

In older adults, studies demonstrate an inverse relationship between physical function and individual inflammatory biomarkers. Given that the inflammatory response is a complex system, a combination of biomarkers may increase the strength and consistency of these associations. This study uses principal component analysis to identify inflammatory "component(s)" and evaluates associations between the identified component(s) and measures of physical function. Principal component analysis with a varimax rotation was used to identify two components from eight inflammatory biomarkers measured in 1,269 older persons. The study sample is a subset of the Health, Aging, and Body Composition study. The two components explained 56% of the total variance in the data (34%, component 1 and 22%, component 2). Five markers (tumor necrosis factor-alpha [TNF-alpha], sTNFRI, sTNFRII, interleukin [IL]-6sR, IL-2sR) loaded highest on the first component (TNF-alpha related), whereas three markers (C-reactive protein [CRP], IL-6, plasminogen activator inhibitor-1) loaded highest on the second component (CRP related). After adjusting for age, sex, race, site, sampling indicator, total lean and fat mass, physical activity, smoking, and anti-inflammatory drug use, knee strength and a physical performance battery score were inversely related to the TNF-alpha-related component, but not to the CRP-related component (knee strength: betaTNFalpha = -2.71, p = .002; betaCRP = -0.88, p = .325; physical performance battery score: betaTNFalpha = -0.05, p < .001; betaCRP = -0.02, p = .171). Both components were positively associated with 400-m walk time, inversely associated with grip strength, and not associated with 20-m walking speed. At least two inflammatory components can be identified in an older population, and these components have inconsistent associations with different aspects of physical performance.

Effects of Intensive Locomotor Treadmill Training on Young Children with Cerebral Palsy

To examine whether an intensive, short-term locomotor treadmill training program helps children with cerebral palsy (CP) younger than 4 years of age improve their gross motor skills related to ambulation, walking speed, and endurance. Six children with cerebral palsy, ages 2.5 to 3.9 years, participated in treadmill training 3 times per week for 1-hour sessions consisting of 2 individualized treadmill walks, for 4 weeks, and were tested before and after the intervention and at a 1-month follow-up. The outcome measures included the Gross Motor Function Measure-66, the Pediatric Evaluation of Disability Inventory, a timed 10-m walk test, and a 6-minute walk test. Significant differences were found in the Gross Motor Function Measure-66 Dimensions D and E, the Pediatric Evaluation of Disability Inventory Mobility Scales, over-ground walking speed, and walking distance. The results of this study provide preliminary evidence that children with CP younger than 4 years of age can improve their gross motor function, walking speed, and walking endurance after intensive locomotor treadmill training.

Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigation

This study examined the effects of androgen suppression therapy (AST) on upper and lower body muscle strength and a range of direct measures of physical performance using a cross-sectional design with 118 men (48 men undertaking AST for prostate cancer and 70 healthy aged-matched controls) from a single tertiary center. Primary end points included muscle strength for the upper- and lower-body; functional performance--repeated chair rise, usual and fast 6-m walk, 6-m backwards walk and 400-m walk time; and dual-energy X-ray absorptiometry assessment--whole body, regional soft tissue composition and bone mineral density (BMD). Men on AST had significantly reduced muscle strength for the upper- and lower-body and impaired functional performance compared to controls (P<0.05). As expected, AST patients had significantly lower whole-body and hip BMD and higher percent of body fat than controls (P<0.05), and tended to have lower whole-body lean mass (-2.3 kg, P=0.077). Appendicular skeletal muscle was positively associated with upper-body (r=0.400-0.606, P<0.001) and lower-body (r=0.549-0.588, P<0.001) muscle strength, and strength was related to functional performance. Men undertaking AST were consistently impaired across a broad range of physical and functional musculoskeletal performance assessments compared with their age-matched normal controls. These findings are relevant for those patients considering AST for subclinical disease management, but whose physical reserve is marginal. Strategies to counter these adverse effects of AST need to be initiated so that independent living and quality of life can be maintained.

Effects of Concurrent Strength and Endurance Training on Physical Fitness and Symptoms in Postmenopausal Women With Fibromyalgia: A Randomized Controlled Trial

Valkeinen H, Alén M, Häkkinen A, Hannonen P, Kukkonen-Harjula K, Häkkinen K. Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial. Objective To examine the effectiveness of concurrent strength and endurance training on muscle strength, aerobic and functional performance, and symptoms in postmenopausal women with fibromyalgia (FM). Design Randomized controlled trial. Setting Local gym and university research laboratory. Participants Twenty-six women with FM. Intervention Progressive and supervised 21-week concurrent strength and endurance training. Main Outcome Measures Muscle strength of leg extensors, upper extremities, and trunk; peak oxygen uptake (V o 2peak), maximal workload (Wmax), and work time; 10-m walking and 10-step stair-climbing time and self-reported functional capacity (Health Assessment Questionnaire); and symptoms of FM. Results After concurrent strength and endurance training, the groups differed significantly in Wmax ( P=.001), work time ( P=.001), concentric leg extension force ( P=.043), walking ( P=.001) and stair-climbing ( P<.001) time, and fatigue ( P=.038). The training led to an increase of 10% ( P=.004) in Wmax and 13% ( P=.004) in work time on the bicycle but no change in V o 2peak. Conclusions Concurrent strength and endurance training in low to moderate volume improves the muscle strength of leg extensors, Wmax, work time, and functional performance as well as perceived symptoms, fatigue in particular. Concurrent strength and endurance training is beneficial to postmenopausal women with FM without adversities, but more extensive studies are needed to confirm the results.

Effect of combined exercise training on bone, body balance, and gait ability: a randomized controlled study in community-dwelling elderly women

The purpose of this study was to investigate whether a 48-week multicomponent exercise program could improve the risk factors for fall and hip fracture. Fifty elderly women 65-70 years of age participated. These participants were divided into an exercise group (25 subjects) that attended an exercise program and a control group (25 subjects) that did not. The exercise program included stretching for 9 min, strength training for 10 min followed by 23 min of weight-bearing exercise at an intensity above 65%-75% of the maximal heart rate, and 18 min of balance and posture correction training. The program was conducted three times per week for 48 weeks. The 10-m maximal walk time, maximal step length, and eyes-open-one-legged-stand time in the exercise group improved significantly (P < 0.05). Concerning deoxypyridinoline, the exercise group achieved a significant improvement (P < 0.05) after the 48 weeks. Bone mineral density (BMD) of the femoral neck and trochanter in the exercise group was significantly increased after the exercise program; also body sway was significantly improved (P < 0.05). In conclusion, a multi-component exercise program with weight-bearing exercise at a moderate intensity and gait training may be effective in offsetting a decline in BMD and improving aggravation of bone resorption in this population. In addition, this program has a positive effect on postural stability and gait ability.

Outcomes After Metal-on-Metal Hip Resurfacing: Could We Achieve Better Function?

Newman MA, Barker KL, Pandit H, Murray DW. Outcomes after metal-on-metal hip resurfacing: could we achieve better function? Objective To report functional outcomes after metal-on-metal (MOM) hip resurfacing. Design A cohort of 126 MOM hip resurfacing operations were reviewed 1 year after surgery. Setting Hospital trust specializing in orthopedic surgery. Participants Sixty-seven right and 59 left hips were reviewed in patients (N=120; 71 men, 49 women; mean age, 56±9y; range, 24–76y). Interventions Not applicable. Main Outcome Measures Administered once at follow-up. Function was measured using the Oxford Hip Score (OHS), Hip disability and Osteoarthritis Outcome Score, and UCLA Activity Score. Complications, pain, range of motion, Trendelenburg test, strength, walking, single-leg stand, stair climbing, and 10-m walk time were assessed. Results Overall examination was satisfactory with few complications. High functional levels were reported. The median OHS was 15 and median UCLA Activity Score 7 (active). For 25%, outcome was poor with persistent pain, reduced hip flexion (mean, 94.46°±12.7°), decreased strength ( P<.001), restricted walking, and functional limitations. Conclusions Information about outcomes is important for patients undergoing surgery. Hip resurfacing remains an emergent technology, with further follow-up and investigation warranted. One explanation for suboptimal recovery may be current rehabilitation, originally developed after total hip arthroplasty. Rehabilitation tailored to hip resurfacing, paced for this active population and progressed to higher demand activities, may improve outcomes.

The Characteristic of a Simple Exercise Program under the Instruction of Physiotherapists -For General Elderly People and Frail Elderly People-

[Purpose] The purpose of this study was to validate the characteristic of an exercise program consisting of simple exercise methods under the instruction of physiotherapists for general elderly people living in a community (general elderly group) and a frail elderly group. [Subjects] The general elderly group consisted of 44 persons (74.2 ± 4.38 years old: 6 men, 38 women) and the frail elderly group, 30 persons (80.6 ± 6.12 years old: 10 men, 20 women). [Methods] The measurement items were weight, body fat percentage, grip strength, knee extensor strength, sitting trunk flexion, one leg standing, functional reach test, timed up and go test, 10-m walking time, TMIG Index of Competence, MOS Short-Form 36-Item Health Survey, and the Life-Space Assessment. In each group, group and individual exercises were provided by physiotherapists. All the exercises were easy to perform. [Results] Knee extensor strength of the frail elderly group improved to almost the same level of the general elderly group. There were significant improvements in balance, gait ability, social and psychological attitudes in both groups. [Conclusion] We think that muscle strengthening exercises without exercise tools as resistance under the instruction of physiotherapists would be effective for improving the muscle strength of frail elderly persons.

Effects of Strength Training and Reduced Training on Functional Performance and Metabolic Health Indicators in Middle-Aged Men

Changes in muscular fitness and metabolic health indicators were examined in 22 men (57.9 +/- 6.6 years, BMI 24.5 +/- 2.6 kg/m (2)) and 21 control men (58.2 +/- 6.1 years, BMI 25.4 +/- 2.8 kg/m (2)) during two consecutive 21-week periods: 1) whole body progressive strength training (ST: twice a week), and 2) continued reduced training (CRT: 3 ST sessions/2 weeks, n = 17 + 17). After the 21-week ST period, maximal strength of leg extensors increased in the ST group by 19.6 +/- 7.6 % vs. 2.8 +/- 4.4 % (p < 0.001) and also 10-m walking time and 10-step stair-climbing time shortened by - 17.2 +/- 7.6 % vs. 4.1 +/- 3.9 % (p < 0.01) and by - 8.2 +/- 6.8 % vs. - 3.0 +/- 6.8 % (p < 0.05) compared to the controls. Systolic blood pressure (BP) decreased in the ST group by - 4.4 +/- 6.7 % vs. 1.3 +/- 9.5 % (p < 0.05) compared to the controls after the ST period. Muscle strength as well as walking and stair-climbing times remained the same during the CRT. However, the changes in diastolic BP (- 8.9 +/- 8.7 % vs. - 1.0 +/- 6.6 %, p < 0.05) and fasting blood glucose concentrations (0.1 +/- 0.4 mmol/L vs. 0.3 +/- 0.4 mmol/L, p < 0.05) differed between the ST and control groups after the whole 42-week study period. Strength training has positive health effects in aging men by increasing maximal strength and functional performance and by decreasing resting blood pressure and high-intensity reduced strength training can maintain these health benefits.