Functional Performance Tests Research Articles

Balance and its Clinical Assessment in Older Adults - A Review.

Human beings rely on multiple systems to maintain their balance as they perform their activities of daily living. These systems may be undermined functionally by both disease and the normal aging process. Balance impairment is associated with increased fall risk. This paper examines the dynamic formulation of balance as activity and reviews the biological mechanisms for its control. A "minimal-technology" scheme for its clinical evaluation in the ambulatory care setting is proposed. The PubMed, Scopus and CINAHL databases were searched for relevant articles using the following terms in combination with balance: aging, impairment, control mechanisms, clinical assessment. Only articles which describe test procedures, their psychometrics and rely exclusively on equipment found in a regular physician office were reviewed. Human bipedal stance and gait are inherently low in stability. Accordingly, an elaborate sensory apparatus comprising visual, vestibular and proprioceptive elements, constantly monitors the position and movement of the body in its environment and sends signals to the central nervous system. The sensory inputs are processed and motor commands are generated. In response to efferent signals, the musculoskeletal system moves the body as is necessary to maintain or regain balance. The combination of senescent decline in organ function and the higher prevalence of diseases of the balance control systems in older adults predisposes this population subset to balance impairment. Older adults with balance impairment are likely to present with "dizziness". The history should concentrate on the first experience, with an attempt made to categorize it as a Drachman type. Since the symptomatology is often vague, several of the recommended physical tests are provocative maneuvers aimed at reproducing the patient's complaint. Well-validated questionnaires are available for evaluating the impact of "dizziness" on various domains of patient's lives, including their fear of falling. Aspects of a good history and physical examination not otherwise addressed to balance function, such as medications review and cognitive assessment, also yield information that contributes to a better understanding of the patient's complaint. Ordinal scales, which are aggregates of functional performance tests, enable detailed quantitative assessments of balance activity. The integrity of balance function is essential for activities of daily living efficacy. Its deterioration with aging and disease places older adults at increased risk of falls and dependency. Balance can be effectively evaluated in the ambulatory care setting, using a combination of scalar questionnaires, dedicated history-taking and physical tests that do not require sophisticated instrumentation.

A clinical observational study on patient-reported outcomes, hip functional performance and return to sports activities in hip arthroscopy patients

ObjectivesTo describe data of short- and midterm results of hip arthroscopy patients based on patient-reported hip function, hip functional performance and return to sports activities. DesignObservational cohort study. SettingSports medical center. Participants37 recreational athletes (21 men) at least six months after finishing rehabilitation for hip arthroscopy. Main outcome measuresInternational Hip Outcome Tool 33 (IHOT-33), Pain Visual Analogue Scale (VAS), Global Perceived Effect Scale (GPE), sports questionnaires and hip functional performance tests. ResultsAt a mean follow-up time of 2.3 years, 81% of participants reported improvement on the GPE and 84% returned to sports activities. The mean IHOT-33 score was 69.3; the mean VAS score was 35.0. Range of motion (ROM) and strength were within the 90% Limb Symmetry Index (LSI) limit, except for hip internal rotation ROM. A full recovery of hip functional performance, as measured with balance and hop tests, was established based on the 90% LSI limit. ConclusionsThe overall short- and midterm results of these follow-up data show good recovery of hip arthroscopy patients on patient-reported outcomes, functional performance and return to sports activities. The functional performance tests used in this study seem adequate for measuring recovery in hip arthroscopy patients.

A Cross-sectional Examination of Vitamin D, Obesity, and Measures of Pain and Function in Middle-aged and Older Adults With Knee Osteoarthritis.

The prevalence of knee osteoarthritis (OA) is increasing with the aging population and is exacerbated by the growing numbers of obese older adults. Low levels of vitamin D, measured by serum 25-hydroxyvitamin D (25(OH)D), in older adults and obese individuals are correlated with several negative health conditions, including chronic pain. This cross-sectional study sought to examine the interactive influence of 25(OH)D levels and obesity on knee OA pain and functional performance measures. The sample consisted of 256 (63% female) racially diverse (55% black/African Americans) middle-aged and older adults (mean age 56.8 y). Blood was collected for analysis of 25(OH)D by high-performance liquid chromatography. Participants provided self-report regarding knee OA pain and underwent a lower extremity functional performance test. Results demonstrated that obesity was associated with lower levels of 25(OH)D. Participants with adequate 25(OH)D levels reported significantly less knee OA pain compared with participants with deficient or insufficient levels, regardless of obesity status. Furthermore, there was a significant interaction between obesity and 25(OH)D levels for lower extremity functional performance, such that obese individuals with adequate 25(OH)D levels demonstrated better performance than those obese participants with deficient or insufficient 25(OH)D levels. The mechanisms by which adequate 25(OH)D levels are associated with pain severity and improved function have not been completely elucidated. It may be that the pleiotropic role of biologically active 25(OH)D influences pain and pain processing through peripheral and central mechanisms. Alternatively, higher levels of pain may lead to reduced outdoor activity, which may contribute to both obesity and decreased vitamin D. Thus, investigating vitamin D status in obese and nonobese individuals with knee OA warrants further study.

실시간 인포그래픽을 위한 웹 기반의 시뮬레이션 프레임워크 설계

IoT 환경은 다양한 형태의 센서들에 의하여 서비스 규모가 결정된다. 다양한 센서의 정보를 중계하기 위한 센서 게이트웨이는 대표적인 미들웨어 시스템이며, 데이터와 그래픽을 이용하여 정보를 도시하는 인포그래픽은 실시간 정보를 효율적으로 전시하기위한 클라이언트 시스템이다. 대량의 정보를 효율적으로 전시하기 위한 실시간 인포그래픽을 개발하기 위하여 IoT 환경과 유사한 테스트 베드가 필요하다. 기존의 네트워크 시스템 개발 시 사용되던 테스트 도구들은 주로 단위 기능 테스트 및 성능 위주의 테스트에 적합하도록 구성되어 있다. 본 논문에서는 실시간 인포그래픽 개발에 필요한 의미 있는 다양한 정보를 생성 할 수 있는 웹 기반의 시뮬레이션 프레임워크를 제안하고, 기존의 네트워크 성능 테스트 도구들과의 테스트 기능 비교를 통하여 제안하는 시스템의 기능을 평가한다. The service size of an IoT environment is determined by the various types of sensors. A gateway for relaying sensor information from various sensors is a representative middleware system, and an infographics showing the information with a graphical presentation of data and information is a client system for representing real-time information efficiently, it is necessary a similar test bed with IoT environment to develop a real-time infographics displaying a large amount of information effectively. The testing tools used in developing the existing network systems are mostly made to be suitable for functional testing and performance testing of the driven unit. In this paper, we proposed a mean which is web-based simulation framework to create a variety of information required for real-time infographics development, and evaluate the function of the system proposed by the test function of the comparison with the previous network test tool.

Dizziness in community-dewelling older adults: a population-based study

AbstractDizziness is a common complaint among older adults. AimTo identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults. MethodsA prospective population-based study with a representative sample of older adults aged 65 years and over. A multidimensional questionnaire and a battery of measures were used for assessing physical function. ResultsThe prevalence of dizziness was 45%. Vertigo was found in 70.4% of older adults with dizziness and 43.8% of them referred vertigo crises along life. A significant association was found between dizziness and female gender (p=0.004), memory difficulties complaints (p=0.015), bad health perception (p=0.001), depression (p<0.0001), five or more comorbidities (p=0.021), self-reported fatigue (p<0.0001), recurrent falls (p=0.001), excessive sleepiness (p=0.003), fear of falling (p<0.0001), left leg unipedal stance (p=0.002) and Short Performance Physical Battery score (p=0.009). ConclusionDizziness is a common complaint among older adults and it is associated with limiting clinical conditions, such as depression, fatigue, excessive sleepiness and impaired memory. It is highlighted the association between dizziness and recurrent falls, fear of falling and lower performance in physical function tests, which can restrict independence. These data suggest the importance of a multifactorial approach to dizziness in older adults.

Validity of the Michigan Hand Outcomes Questionnaire in Patients With Stroke

ObjectiveTo investigate the measurement properties of the Dutch version of the Michigan Hand Outcomes Questionnaire (MHQ) in patients with stroke. DesignValidation study. SettingOutpatient rehabilitation clinic. ParticipantsConsecutive patients with stroke (N=51; mean age, 60±11y; 16 women [31%]). InterventionsPatients were asked to complete the MHQ (57 items) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Additional assessments included the Barthel Index and performance tests for hand function (Action Research Arm Test, Nine Hole Peg Test, Frenchay Arm Test, Motricity Index). Main Outcome MeasuresAssociations between the MHQ and other outcome measures were determined using Spearman correlation coefficients and the internal consistency of the MHQ using Cronbach α. Floor or ceiling effects were present if >15% of the patients scored minimal or maximal scores, respectively. Test-retest reliability was established by the intraclass correlation coefficient. ResultsThe mean MHQ total score was 70.0±22.4, with Cronbach α being .97. The MHQ total score correlated significantly with the physical component summary of the SF-36, the Barthel Index, and all hand function performance tests (P<.01). The MHQ total score showed no floor or ceiling effects. The test-retest intraclass correlation coefficient was .97. ConclusionsThis study provides preliminary evidence that the MHQ is an internally consistent, valid, and reliable hand function questionnaire in outpatients after stroke, although these results need to be further confirmed.

Serotonin and Histamine Therapy Increases Tetanic Forces of Myoblasts, Reduces Muscle Injury, and Improves Grip Strength Performance of Dmd(mdx) Mice.

Duchenne muscular dystrophy (DMD) is a recessive X-linked fatal disorder caused by a mutation in the dystrophin gene. Although several therapeutic approaches have been studied, none has led to substantial long-term effects in patients. The aim of this study was to test a serotonin and histamine (S&H) combination on human skeletal myoblasts and Dmdmdx mice for its effects on muscle strength and injury. Normal human bioartificial muscles (BAMs) were treated, and muscle tetanic forces and muscle injury tests were performed using the MyoForce Analysis System. Dmdmdx mice, the murine model of DMD, were administered serotonin, histamine, or S&H combination twice daily for 6 weeks, and functional performance tests were conducted once a week. The S&H combination treatment caused significant increases in tetanic forces at all time points and concentrations tested as compared to the saline controls. Dose response of the BAMs to the treatment demonstrated a significant increase in force generation at all concentrations compared to the controls after 3 to 4 days of drug treatment. The highest 3 concentrations had a significant effect on lowering contractile-induced injury as measured by a reduction in the release of adenylate kinase. Histamine-only and S&H treatments improved grip strength of Dmdmdx mice, whereas serotonin-only treatment resulted in no significant improvement in muscle strength. The results of this study indicate that S&H therapy might be a promising new strategy for muscular dystrophies and that the mechanism should be further investigated.

Functional performance of wheelchair basketball players with spinal cord injury

Spinal cord injuries affect people’s daily activities and limit their mobility and participation in the community. Adapted sports improve functioning because they supplement the rehabilitation of people who need a wheelchair for mobility. Objective: The aim of this study was to evaluate the functional performance of wheelchair basketball players with spinal cord injury. Method: This cross-sectional study was conducted with 12 athletes. To evaluate their functional performance the Modified Barthel Index, the adapted version of Texas Fitness test, and the medicine ball test were applied. The correlation of functional dependence with other functional performance tests was performed by the nonparametric Spearman test. Results: Six athletes were classified as moderately dependent and six as mildly dependent. The average time for the adapted version of Texas Fitness test was 27.3 ± 3.8 seconds. The average distance for the medicine ball test was 5.2 ± 0.9 meters. We observed a strong negative correlation between the Modified Barthel Index and the adapted version of Texas Fitness test (r = -0.9193, p &lt; 0.0001). Conclusion: The sample group presented as mildly to moderately dependent in carrying out the activities of daily living, with upper limb strength similar to what is described in the literature, but with less agility

Long-term survival and preprocedural predictors of mortality in high surgical risk patients undergoing percutaneous mitral valve repair.

To evaluate long-term survival in high surgical risk patients undergoing percutaneous mitral valve repair (MVR) using the MitraClip(®) system and to identify preprocedural predictors of long-term mortality. Data for long-term survival and preprocedural predictors of mortality after percutaneous MVR in high surgical risk patients are sporadic. From January 2009 to April 2013, 136 consecutive high surgical risk patients, with symptomatic moderate-to-severe or severe mitral regurgitation (MR), underwent percutaneous MVR using the MitraClip system. Cardiac and overall survival was determined at one and 2 years postprocedure. Univariate and multivariate analysis was performed to identify preprocedural predictors of long-term mortality. One year postprocedure, cardiac and overall survival was 86.7% and 84.6%, respectively and at 2 years cardiac and overall survival was 77.7% and 74.8%, respectively. In univariate analysis advanced age, lower body mass index, impaired renal function, elevated levels of log-N-terminal-pro-brain-natriuretic-peptide (log-NTproBNP), poor performance in functional tests (New York Heart Association (NYHA) class) and high logistic Euroscore (LES) and Society of Thoracic Surgeons (STS) score were identified as preprocedural predictors of long-term cardiac mortality. In multivariate analysis preoperative NYHA class III and IV, elevated levels of log-NTproBNP and advanced age predicted long-term cardiac mortality. Percutaneous MVR using the MitraClip system has favorable long-term survival rates in high surgical risk patients. Preprocedural NYHA functional class III and IV, elevated log-NTproBNP levels and advanced age predict higher long-term cardiac mortality and should be considered during patient selection.

Frail elderly people: Detection and management in primary care

The Spanish FISTERRA Clinical Guideline about the detection and management of frailty in primary care is shown. Frailty is a stage in which elderly people are more vulnerable to adverse health-related events, physical and functional decline, and death, because of decreased physiological reserves. According to the Fried phenotype, the prevalence of frail elderly people above 65 years of age is around 10%, higher in women and increasing with age. Different ways to detect frailty have been described and used: functional performance tests (widely recommended as the first choice), clinical phenotype (Fried criteria), short multidimensional indices, and assessment of instrumental activities of daily living (IADL), The comprehensive geriatric assessment (CGA) is probably the best option for characterising frailty but, due to several characteristics (length, specific training to carry out), in primary care it is used more as a method to confirm the status or to direct the management of elderly patients identified as frail, than as a screening tool. Various consensus documents recommend a systematic screening for frailty, generally from 70 years of age onwards. Others suggest more a case-finding approach. Exercise and physical activity is the primary recommendation in frailty interventions.

RELATIONSHIP OF EXECUTIVE FUNCTION, EDUCATIONAL STATUS AND QUALITY OF LIFE WITH THE FUNCTIONAL BALANCE IN OLDER ADULTS

Background: Balance is a complex construct which is affected by cognition. It is necessary to know the cognitive correlates of functional balance to design necessary interventions for the individuals with balance problems. Objectives: To determine the relationship of executive function, educational status and quality of life with the functional balance in older adults. Methodology: 120 healthy elderly subjects were taken for the study based on the inclusion criteria. Following the initial screening, the executive function, educational status and quality of life of the subjects were measured. Executive function performance test was used for measuring executive function. The quality of life was measured using SF36 questionnaire. The functional balance was measured using the berg balance scale and timed up and go test. The relationship among the outcome measure was found out using the Pearson correlation coefficient. Results: The results of the present study showed that EFPT and BBS are negatively correlated to each other with r-value -0.271. The educational status score showed a low positive correlation with functional balance with r-value 0.358. The quality of life did not show any significant correlation with functional balance. Interpretation & Conclusion: Executive function and functional balance showed a low correlation. This means that higher the executive function, better will be the functional balance of the individual. Moreover, educational status also affects the functional balance of the individual.

The Effects of Resistance Training on Physical Function and Quality of Life in Breast Cancer Survivors.

Breast cancer survivors (BCS) exhibit decreased physical function and quality of life (QOL) following cancer treatments. Resistance training (RT) may elicit positive changes in physical and mental well-being. This study assessed 27 BCS, pre-and post-intervention (six months) on the following variables: muscular strength (via one repetition maximum (1RM) of chest press and leg extension), physical function (via the Continuous Scale-Physical Functional Performance test) and QOL (via the Short Form-36 survey). RT consisted of two days/week of ten exercises including two sets of 8–12 repetitions at 52%–69% of their 1RM. A repeated measures analysis of variance revealed BCS significantly (p < 0.05) increased upper (71 ± 22 to 89 ± 22 kg) and lower body (74 ± 18 to 93 ± 24 kg) strength, total physical function (65.5 ± 12.1 to 73.6 ± 12.2 units) and the subcomponents of physical function: upper body strength (63.5 ± 16.3 to 71.2 ± 16.8 units), lower body strength (58.5 ± 14.9 to 68.6 ± 16.3 units), balance and coordination (66.5 ± 12.2 to 74.6 ± 11.6 units), and endurance (67.2 ± 12.0 to 75.0 ± 11.6 units). No changes were observed over time for subjective measures of physical function and QOL. Results showed RT could be an effective means to improve objective physical function in BCS. Further research is needed to clarify the effects of RT on subjective physical function and QOL.

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study.

During movement tasks, patients with medial compartment knee osteoarthritis use compensatory strategies to minimise the joint load of the affected leg. Movement strategies of the knees and trunk have been investigated, but less is known about movement strategies of the pelvis during advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. 57 patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. Patients had lower leg extension power than controls (20-39 %, P < 0.01) and used greater pelvic range of motion during stair and step ascending and descending (P ≤ 0.03, except for pelvic range of motion in the frontal plane during ascending, P > 0.06). Furthermore, an inverse association (coefficient: -0.03 to -0.04; R (2) = 13-22 %) between leg extension power and pelvic range of motion during stair and step descending was found in the patients. Compared to controls, patients with medial compartment knee osteoarthritis use greater pelvic movements during advanced functional performance tests, particularly when these involve descending tasks. Further studies should investigate if it is possible to alter these movement strategies by an intervention aimed at increasing strength and power for the patients.

Inter-rater reliability and face validity of the Executive Function Performance Test (EFPT)

Introduction Occupational therapists need an instrument to assess executive dysfunctions before patients are discharged from acute wards. The Executive Function Performance Test (EFPT) appears to be suitable, since it evaluates dysfunctions in complex activities. The aim of this study was to translate the EFPT from English into Swedish and to evaluate its properties when used with older persons with mild stroke in an acute setting. Method The study consisted of three parts: (1) a translation procedure using a forward and backward method; (2) evaluation of face validity; (3) inter-rater reliability by four raters (two pairs) who made 34 assessments in 17 older patients with mild stroke in an acute ward. Results The inter-rater reliability for the EFPT was good. The median was 88% of the percentage agreement. No occasional disagreement was found between the raters, but there was a systematic disagreement in one out of 20 items. The translation and face validity process resulted in further clarification of the semantic and cultural equivalence of the EFPT, and the manual was changed accordingly. Conclusion This study showed that inter-rater reliability was good and that the EFPT was found to be an interesting assessment, although further research is needed.

The Functional Classification and Field Test Performance in Wheelchair Basketball Players.

Wheelchair basketball players are classified in four classes based on the International Wheelchair Basketball Federation (IWBF) system of competition. Thus, the aim of the study was to ascertain if the IWBF classification, the type of injury and the wheelchair experience were related to different performance field-based tests. Thirteen basketball players undertook anthropometric measurements and performance tests (hand dynamometry, 5 m and 20 m sprints, 5 m and 20 m sprints with a ball, a T-test, a Pick-up test, a modified 10 m Yo-Yo intermittent recovery test, a maximal pass and a medicine ball throw). The IWBF class was correlated (p<0.05) to the hand dynamometry (r= 0.84), the maximal pass (r=0.67) and the medicine ball throw (r= 0.67). Whereas the years of dependence on the wheelchair were correlated to the velocity (p<0.01): 5 m (r= −0.80) and 20 m (r= −0.77) and agility tests (r= −0.77, p<0.01). Also, the 20 m sprint with a ball (r= 0.68) and the T-test (r= −0.57) correlated (p<0.05) with the experience in playing wheelchair basketball. Therefore, in this team the correlations of the performance variables differed when they were related to the disability class, the years of dependence on the wheelchair and the experience in playing wheelchair basketball. These results should be taken into account by the technical staff and coaches of the teams when assessing performance of wheelchair basketball players.

“Keeping Moving”: factors associated with sedentary behaviour among older people recruited to an exercise promotion trial in general practice

BackgroundSedentary behaviour is detrimental to health, even in those who achieve recommended levels of physical activity. Efforts to increase physical activity in older people so that they reach beneficial levels have been disappointing. Reducing sedentary behaviour may improve health and be less demanding of older people, but it is not clear how to achieve this. We explored the characteristics of sedentary older people enrolled into an exercise promotion trial to gain insights about those who were sedentary but wanted to increase activity.MethodParticipants in the ProAct65+ trial (2009–2013) were categorised as sedentary or not using a self-report questionnaire. Demographic data, health status, self-rated function and physical test performance were examined for each group. 1104 participants aged 65 & over were included in the secondary analysis of trial data from older people recruited via general practice. Results were analysed using logistic regression with stepwise backward elimination.ResultsThree hundred eighty seven (35 %) of the study sample were characterised as sedentary. The likelihood of being categorised as sedentary increased with an abnormal BMI (<18.5 or >25 kg/m2) (Odds Ratio 1.740, CI 1.248–2.425), ever smoking (OR 1.420, CI 1.042–1.934) and with every additional medication prescribed (OR 1.069, CI 1.016–1.124). Participants reporting better self-rated physical health (SF-12) were less likely to be sedentary; (OR 0.961, 0.936–0.987). Participants’ sedentary behaviour was not associated with gender, age, income, education, falls, functional fitness, quality of life or number of co-morbidities.ConclusionSome sedentary older adults will respond positively to an invitation to join an exercise study. Those who did so in this study had poor self-rated health, abnormal BMI, a history of smoking, and multiple medication use, and are therefore likely to benefit from an exercise intervention.Trial registrationISRCTN reference: ISRCTN43453770

Early functional outcome of two different orthotic concepts in ankle sprains: a randomized controlled trial.

Purpose of the study was the evaluation of the early functional outcome of patients with an acute ankle sprain treated either with a semirigid, variable, phase-adapted modular ankle orthosis or an invariable orthotic reference device. Forty-seven patients with acute ankle sprain grade II or more were included. In addition, 77 healthy controls as a reference were investigated. The injured subjects were treated with one of the two devices by random for 6 weeks. Ankle scores (FAOS, AOFAS) were taken at baseline after injury, 1 and 3 months after injury. Functional performance tests (balance platform, zig zag run, shuttle run, vertical drop jump) were performed at 1 and 3 months after injury. No significant score differences could be found between the two intervention groups except for achieving a preinjury activity level after 3 months only in the modular orthosis group. Postural functional performances (balance test) also showed no significant differences whereas the results of the agility tests revealed small but significant better results in the modular orthosis group in comparison to the invariable orthosis group. Cohen's effect sizes were high. Differences between the two intervention groups were marginal and very small but significant and--regarding Cohen's effect sizes--effective. Especially relating to functional performance, this might be a careful indication that a more effective strategy for promoting a protected, rapid recovery to physical activity after ankle sprains might be achieved by applying a phase-adapted ankle orthosis. Especially in athletic patients, phase-adapted orthosis should be further investigated and considered to ensure fully protected ligament healing as well as to regain early functional recovery.

A systematic review and comparison of functional assessments of community-dwelling elderly patients.

To provide advanced practice nurses in primary care with information about self-reported functional assessments and physical performance-based functional assessments of geriatric patients living alone within the community at greatest risk of functional decline. Databases searched include CINAHL, Healthsource: Nursing/Academic Edition, MEDLINE, PsycINFO, PsycARTICLES, Cochrane Library, and National Clearinghouse Guidelines. The review was limited to English, research, and the years 2000-2014. Key search words included geriatric, community-dwelling, functional assessment, activities and instrumental activities of daily living, Barthel Index, Katz Index, Lawton Scale, Vulnerable Elders Survey, Timed Up and Go Test, Gait Speed Test, Functional Reach Test, and primary care. Forty-three million individuals, age 65 and older, are currently living in the United States with numbers expected to double by 2050. Nurse practitioners will be at the forefront of assessing for functional decline and can use tools such as the Barthel Index and Gait Speed Test to improve elderly outcomes. Self-reported functional questionnaires and physical functional performance tests can quickly be completed in the office to track the risk of functional decline over time. Interventions, such as physical therapy or other community resources, can be initiated when needed to reduce negative outcomes of functional decline.

Limb and Medicine Ball Mass Effects on Seated Single Arm Shot Put Performance

Functional performance tests (FPT) are important tools to assess muscle strength and power before and after injury. In contrast to the lower extremity, there are fewer FPT for the upper extremity. The seated single arm shot put (SSASP) test has the potential to fill the void of upper extremity FPT however, the underlying mechanics have yet to be examined. PURPOSE: To examine the effects of upper extremity dominance, and medicine ball mass on the underlying SSASP projectile mechanics. METHODS: Thirty healthy, college-aged men and women (20.5±1.5yrs; 181.5±6.2cm; 84.7±8.7kg) performed dominant (DOM) and non-dominant (NDOM) SSASP trials using three .114m diameter medicine ball loads (1kg, 2kg, 3kg). Customized touch sensitive gloves, synchronized with kinematic data of the hands, signaled ball release so release height (RH), release angle (RA), and peak anterior (AV) and vertical (VV) velocity could be quantified for each trial. In addition, the horizontal distance (HD) from release to first floor impact was recorded. Statistical analyses included separate limb by mass (RH, RA, HD) and limb by mass by direction (VV, AV) analysis of variance. RESULTS: At each level of ball mass, DOM HD was significantly greater (P<.001, 1kg:10.7%, 2kg:8.4%, 3kg:7.0%) than NDOM. For both DOM (95% CIdiff:.68-1.18m) and NDOM (95% CIdiff:.54-1.07m), the HD decrease between 1kg and 2kg was significantly greater (P<.001) than between 2kg and 3kg. RA (P=.026, η2=.16) and AV (P<.001, η2=.58) decreased linearly with each subsequent ball mass increase, however VV was not significantly altered. Across both VV and AV, DOM was significantly greater than NDOM (P=.001, 95% CIdiff:.16-.57m/s). No significant results for release height were revealed. CONCLUSION: Based on the ball mass effects, it appears the SSASP should be conducted with the 1kg and 2kg medicine balls. We ascribe the peak velocity differences between the limbs to greater muscle strength and power for the DOM limb. Because no other limb differences were revealed for the underlying mechanics, by extension, the greater DOM HD can be attributed to the peak velocity differences. Thus, while these data further support the use of SSASP HD as FPT for the upper extremity, further research directly measuring muscle performance is needed to validate this interpretation.

Functional Performance Tests in an Adolescent Population with Chronic Ankle Instability

Functional Performance Tests in an Adolescent Population with Chronic Ankle Instability