Scale Physical Functional Performance Test Research Articles

A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure.

Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown. To determine whether an intensive PT program significantly improves long-term physical functional performance compared with a standard-of-care PT program. Patients who required mechanical ventilation for at least 4 days were eligible. Enrolled patients were randomized to receive PT for up to 4 weeks delivered in an intensive or standard-of-care manner. Physical functional performance was assessed at 1, 3, and 6 months in survivors who were not currently in an acute or long-term care facility. The primary outcome was the Continuous Scale Physical Functional Performance Test short form (CS-PFP-10) score at 1 month. A total of 120 patients were enrolled from five hospitals. Patients in the intensive PT group received 12.4 ± 6.5 sessions for a total of 408 ± 261 minutes compared with only 6.1 ± 3.8 sessions for 86 ± 63 minutes in the standard-of-care group (P < 0.001 for both analyses). Physical function assessments were available for 86% of patients at 1 month, for 76% at 3 months, and for 60% at 6 months. In both groups, physical function was reduced yet significantly improved over time between 1, 3, and 6 months. When we compared the two interventions, we found no differences in the total CS-PFP-10 scores at all three time points (P = 0.73, 0.29, and 0.43, respectively) or in the total CS-PFP-10 score trajectory (P = 0.71). An intensive PT program did not improve long-term physical functional performance compared with a standard-of-care program. Clinical trial registered with www.clinicaltrials.gov (NCT01058421).

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.

Determinants of Objectively Measured Physical Functional Performance in Early to Mid-stage Parkinson Disease

Parkinson disease (PD) may lead to functional limitations through both motor and nonmotor symptoms. Although patients with advanced disease have well-documented and profound functional limitations, less is known about the determinants of function in early to mid-stage disease where interventions may be more likely to benefit and preserve function. The objective of the current study was to identify motor, cognitive, and gait determinants of physical functional performance in patients with early to mid-stage PD. This was a secondary analysis of cross-sectional baseline data from a randomized clinical trial of exercise. The study was performed at a tertiary academic medical center. The study included 121 patients with early to mid-stage PD. Our functional performance outcomes included the following: the Continuous Scale Physical Functional Performance Test (CS-PFP; primary outcome); the Timed Up and Go test (TUG); and Section 2 (Activities of Daily Living) of the Unified Parkinson's Disease Rating Scale (UPDRS). Explanatory variables included measures of disease severity, motor function, cognitive function, balance, and gait. Stepwise linear regression models were used to determine correlations between explanatory variables and outcome measures. In our regression models, the CS-PFP significantly correlated with walking endurance (Six-Minute Walk Test; r(2)= 0.12, P< .0001), turning ability (360° Turn Test; r(2)= 0.03, P= .002), attention (Brief Test of Attention; r(2)= 0.01, P= .03), overall cognitive status (Mini-Mental State Examination; r(2)= 0.01, P= .04), and bradykinesia (timed tapping; r(2)= 0.02, P= .02). The TUG significantly correlated with walking speed (5-Meter Walk Test; r(2)= 0.33, P< .0001), stride length (r(2)= 0.25, P< .0001), turning ability (360° turn, r(2)= 0.05, P= .0003), and attention (r(2)= 0.016, P= .03). Section 2 of the UPDRS was significantly correlated with endurance (r(2)= 0.09, P< .0001), turning ability (r(2)= 0.03, P= .001), and attention (r(2)= 0.01, P= .03). Gait, motor, and cognitive function all contribute to objectively measured global functional ability in mild to moderate PD. Subjectively measured functional activity outcomes may underestimate the impact of both motor and nonmotor symptoms.

Effects of Class IV Laser Therapy on Fibromyalgia Impact and Function in Women with Fibromyalgia

This study evaluated the effects of Class IV laser therapy on pain, Fibromyalgia (FM) impact, and physical function in women diagnosed with FM. The study was a double-blind, randomized control trial. Testing was completed at the university and Rheumatologist office and treatment was completed at a chiropractic clinic. Thirty-eight (38) women (52±11 years; mean±standard deviation) with FM were randomly assigned to one of two treatment groups, laser heat therapy (LHT; n=20) or sham heat therapy (SHT; n=18). Both groups received treatment twice a week for 4 weeks. Treatment consisted of application of LHT or SHT over seven tender points located across the neck, shoulders, and back. Treatment was blinded to women and was administered by a chiropractic physician for 7 minutes. Participants were evaluated before and after treatment for number and sensitivity of tender points, completed the FM Impact Questionnaire (FIQ) and the pain question of the FIQ, and were measured for function using the continuous scale physical functional performance (CS-PFP) test. Data were evaluated using repeated-measures analysis of variance with significance accepted at p≤0.05. There were significant interactions for pain measured by the FIQ (LHT: 7.1±2.3 to 6.2±2.1 units; SHT: 5.8±1.3 to 6.1±1.4 units) and for upper body flexibility measured by the CS-PFP (LHT: 71±17 to 78±12 units; SHT: 77±12 to 77±11 units) with the LHT improving significantly compared to SHT. There was a time effect for the measure of FM impact measured by the FIQ, indicating that FM impact significantly improved from pre- to post-treatment in LHT (63±20 to 57±18 units), while no change was observed in the SHT (57±11 to 55±12 units). This study provides evidence that LHT may be a beneficial modality for women with FM in order to improve pain and upper body range of motion, ultimately reducing the impact of FM.

A combined aerobic and resistance exercise program improves physical functional performance in patients with heart failure: a pilot study.

Recent guidelines for exercise in patients with heart failure (HF) recommended aerobic and resistance exercise as being safe and effective; however, the clinical and functional significance of these combined training modalities has not been established. In this pilot study, combined aerobic and resistance training was hypothesized to improve physical function, muscle strength, and health-related quality of life (HRQOL) compared with an attention control wait list (ACWL). The 10-item Continuous Scale Physical Functional Performance Test (CS-PFP10), which simulates common household chores; muscle strength (handgrip and knee extension); and HRQOL (Kansas City Cardiomyopathy Questionnaire) were evaluated at baseline (T1) and at 12 weeks (T2). The home-based moderate-intensity walking and resistance training program was performed 5 days a week. Twenty-four New York Heart Association class II to III HF patients (mean [SD] age, 60 [10] years; mean [SD] left ventricular ejection fraction, 25% [9%]) were randomized to a combined aerobic and resistance exercise program or to an ACWL group. Of the total group, 58% were New York Heart Association class III HF patients, 50% were white, and 50% were female. The CS-PFP10 total scores were significantly increased in the exercise group, from 45 (18) to 56 (16). The Kansas City Cardiomyopathy Questionnaire overall summary score was significantly improved (P < .001) at T2 in the exercise intervention group compared with the ACWL group. Participants provided the home-based, combined aerobic and resistance exercise program had significantly improved physical function, muscle strength, symptom severity, and HRQOL compared with the ACWL group. The findings of this study must be interpreted cautiously owing to the limitations of a small sample, data collection from a single center, and differences between control and interventions groups at baseline. A combined aerobic and resistance exercise approach may improve physical function in stable HF patients, but further study in a larger, more diverse population is recommended. However, in this study, the CS-PFP10 instrument demonstrated its ability to identify functional health status in HF patients and thus warrants further testing in a larger sample for possible use in clinical practice.

Combined Aerobic and Resistance Exercise Program Improves Task Performance in Patients With Heart Failure

Gary RA, Cress ME, Higgins MK, Smith AL, Dunbar SB. Combined aerobic and resistance exercise program improves task performance in patients with heart failure. Objectives To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association (NYHA) class II and III patients and systolic heart failure (HF). Design Randomized controlled trial. Setting Home based. Participants Stable patients (N=24; mean age, 60±10y; left ventricular ejection fraction, 25%±9%; 50% white; 50% women) with New York Heart Association (NYHA) classes II and III (NYHA class III, 58%) systolic heart failure (HF). Intervention A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise. Attention control wait list participants performed light stretching and flexibility exercises. Main Outcome Measures A 10-item performance-based physical function measure, the Continuous Scale Physical Functional Performance test (CS-PFP10), was the major outcome variable and included specific physical activities measured in time to complete a task, weight carried during a task, and distance walked. Other measures included muscle strength, HRQOL (Minnesota Living With Heart Failure Questionnaire, Epworth Sleepiness Scale), functional capacity (Duke Activity Status Index), and disease severity (brain natriuretic peptide) levels. Results After the exercise intervention, 9 of 10 specific task activities were performed more rapidly, with increased weight carried by exercise participants compared with the attention control wait list group. Exercise participants also showed significant improvements in CS-PFP10 total score ( P<.025), upper and lower muscle strength, and HRQOL ( P<.001) compared with the attention control wait list group. Adherence rates were 83% and 99% for the aerobic and resistance training, respectively. Conclusions Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach. Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify. Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population.

PROFILE PD

Individuals with Parkinson disease (PD) experience a range of deficits of body systems and activities. A clinical test is needed that is reliable, valid, applicable to physical therapist practice, and appropriate for use in early and mid-stages of the disease. PROFILE PD is one such scale, consisting of 24 items that would typically be assessed during the physical therapist's examination and evaluation of individuals with PD. The purpose of this article is to report on clinimetric properties of the PROFILE PD and to make the test available for use. Interrater reliability was determined using the intraclass correlation coefficient. Construct validity was determined by comparing scores on the PROFILE PD with the gold standard (Unified Parkinson's Disease Rating Scale [UPDRS]) as well as scales of physical activity and participation. Construct validity and structure of the PROFILE PD were further examined using exploratory factor analysis using principal component analysis with Promax rotation that allows a correlated factor structure. Interrater reliability of the PROFILE PD was high (ICC = 0.97). Construct validity was demonstrated with the UPDRS (r = 0.86, P < 0.0001), Schwab & England Activities of Daily Living Scale (S&E) (r = -0.83, P < 0.0001), and Continuous Scale Physical Functional Performance test (r = -0.62, P < 0.0001). Principal component analysis demonstrated that the test comprises a single scale. The PROFILE PD is a reliable and valid scale that can be used to quantify alterations in body systems and activity of individuals in early and mid-stages of PD. Use of the scale can provide an overall summary of the impact of PD on body systems and activities.

Response Of Perceived And Performance Based Function In Older Adults With Exercise Intervention

Exercise interventions have been used to increase physical function in older adults. However, with some older adults, measures of perceived and performance-based physical function are not aligned. Individuals who express little or no perceived functional limitation may have low performance based function putting them at risk of future dependency (Cress & Meyer, 2003). PURPOSE: This study evaluates the influence of exercise on both perceived and performance-based physical function with the hypothesis that after the exercise intervention, more individuals would have alignment between perceived and performance-based function. METHODS: Using a cross-sectional and longitudinal designs, older adults, 74.5 years ± 6.21(n=73), from the community at large or retirement dwellings responded to the SF36 physical function (SF36PF) questionnaire and performed the Continuous Scale Physical Functional Performance (CS-PFP) test. SF36PF ≤ <65 (0-100) and CS-PFP <57 (0-100) are associated with increased dependence, "at risk" (Cress & Meyers, 2003). Participants were randomly assigned to either a control or an aerobic/strength combined or walking exercise group. The predictive value of the SF36 PF using a cutoff of ≤ 65 was determined based on the CS-PFP (gold standard) using a cutoff of <57. For analysis, participant's baseline results were stratified into four groups (CS-PFP <57and SF36 scores ≤65, CS-PFP ≥57and SF36 ≤65, CS-PFP<57 and SF36 ≥65, and CS-PFP ≥57 and SF36 >65 scores). RESULTS: The predictive value of the SF36PF, using a cutoff of ≤ 65, was determined based on the CS-PFP (gold standard) using a cutoff of < 57. The SF36PF specificity was 100% and the sensitivity was 23.9%. At baseline testing, the prevalence of those "at risk" was approximately equal in the exercise (48.6%) and control (47.3%) groups. Following the intervention, the control group showed a slight decrease (7.89%) in the prevalence of "at risk" participants, however, the decrease in the (25.72%) exercise (25.7%) was dramatic. The bulk of the responders were those with high perceived and low performance based function. CONCLUSION: The non-alignment of perceived and performance-based function can be an effective tool for targeting individuals at greatest risk of dependency, while exercise interventions can reduce the prevalence of that risk.

Effects of Resistance Training and Chiropractic Treatment in Women with Fibromyalgia

The objective of this study was to evaluate resistance training (RES) and RES combined with chiropractic treatment (RES-C) on fibromyalgia (FM) impact and functionality in women with FM. The design of the study was a randomized control trial. Testing and training were completed at the university and chiropractic treatment was completed at chiropractic clinics. Participants (48 +/- 9 years; mean +/- standard deviation) were randomly assigned to RES (n = 10) or RES-C (n = 11). Both groups completed 16 weeks of RES consisting of 10 exercises performed two times per week. RES-C received RES plus chiropractic treatment two times per week. Strength was assessed using one repetition maximum for the chest press and leg extension. FM impact was measured using the FM impact questionnaire, myalgic score, and the number of active tender points. Functionality was assessed using the 10-item Continuous Scale Physical Functional Performance test. Analyses of variance with repeated measures compared groups before and after the intervention. Six (6) participants discontinued the study: 5 from RES and 1 from RES-C. Adherence to training was significantly higher in RES-C (92.0 +/- 7.5%) than in RES (82.8 +/- 7.5%). Both groups increased (p < or = 0.05) upper and lower body strength. There were similar improvements in FM impact in both groups. There were no group interactions for the functionality measures. Both groups improved in the strength domains; however, only RES-C significantly improved in the pre- to postfunctional domains of flexibility, balance and coordination, and endurance. In women with FM, resistance training improves strength, FM impact, and strength domains of functionality. The addition of chiropractic treatment improved adherence and dropout rates to the resistance training and facilitated greater improvements in the domains of functionality.

Use of the Continuous Scale Physical Functional Performance Test in Stroke Survivors

Manns PJ, Tomczak CR, Jelani A, Cress ME, Haennel R. Use of the continuous scale physical functional performance test in stroke survivors. Objective To (1) determine the feasibility of the continuous scale physical functional performance 10-item test (CS-PFP10) for the measurement of physical function in stroke survivors, (2) characterize physical functional performance of stroke survivors and their matched controls, and (3) explore the associations among physical functional performance, ambulatory activity, and peak oxygen uptake (V o 2peak). Design Case control. Setting University research setting. Participants Ten participants with stroke and 10 healthy controls matched for age, sex, and physical activity. Interventions Not applicable. Main Outcome Measures The CS-PFP10 test was used to measure functional ability. The test requires performance of 10 serial tasks that range from low to high difficulty. The step activity monitor was used to measure absolute ambulatory activity and was reported as the average number of steps a day over a 4-day period. V o 2peak was determined using a metabolic cart and a recumbent cycle ergometer. Results Stroke survivors scored lower than healthy controls on all individual tasks, domains, and the total score on the CS-PFP10. Higher V o 2peak was associated with higher total scores on the CS-PFP10 in both stroke survivors and controls. In stroke survivors, lower levels of impairment (as indicated by the Chedoke-McMaster stroke assessment) were associated with higher total CS-PFP10 scores. Conclusions The CS-PFP10 is a measure of physical performance that is feasible to use with ambulatory participants with stroke. Future investigations with people with stroke should explore the ability of the CS-PFP10 to provide meaningful information about change in CS-PFP10 subscales with interventions that target items on the subscales, such as balance or upper extremity strength.

Functional Movement Training for Recurrent Low Back Pain: Lessons From a Pilot Randomized Controlled Trial

Despite considerable effort to reduce low back pain (LBP), approximately 60% of patients have recurrence after their first episode. The high rate of recurrence suggests that more effective intervention approaches are needed. This randomized, controlled feasibility trial was designed to compare disability, physical functional capacity, and pain outcomes at 2, 6, and 12 months for 2 conventional and 1 novel physical therapy (functional movement training) intervention for recurrent LBP. Randomized, controlled feasibility trial. University hospital outpatient physical therapy clinic. Sixty-one participants (60% female) with recurrent LBP. Subjects were randomized to 1 of 3 intervention groups: group 1 had a single session consisting of standard back pain education; group 2 had 6 sessions in 8 weeks of conventional physical therapy; and group 3 had 6 sessions in 8 weeks of a novel method of functional movement training. Change from baseline was used to determine within-group changes and between-group differences for participants who finished each time point (2, 6, and 12 months). Changes were evaluated using analysis of variance and Newman-Keuls post hoc analysis. The primary outcome measure was the novel Continuous Scale Physical Functional Performance test (CS-PFP), a measure of actual physical functional capacity. Secondary measures included the revised Oswestry Disability Index, a measure of pain-related disability, the Roland Morris Disability Questionnaire, and a standard visual analogue pain scale. Of the participants, 67% provided data at 2 months and 44% provided information at 12 months. Raw change scores were evaluated at 2, 6, and 12 months. While no statistical significance was reached with any outcome measure, the trends suggested little change for group 1 (education) and suggested that greatest improvement in function may occur in group 3 (functional movement training). In particular, at 2 months, the CS-PFP change scores revealed a trend (P=.072) toward greater improvement in groups 2 (conventional physical therapy) and 3 (functional movement training) compared with group 1. At 12 months, Oswestry Disability Index and CS-PFP scores also trended toward significance for groups 2 and 3 (P=.7 and .9, respectively). Mean change scores were also calculated and revealed groups 2 and 3 had improved by 2 months and this improvement remained stable at the 1-year mark. Trends in the direction of best improvement occurred for those in the functional movement training group. A large-scale randomized, controlled trial is warranted to determine whether an intervention based on functional movement training is superior to conventional, impairment-based intervention for individuals with recurrent LBP.

Physical Activity Level and Physical Functionality in Nonagenarians Compared to Individuals Aged 60-74 Years

Functional dependence and the risks of disability increase with age. The loss of independence is thought to be partially due to a decrease in physical activity. However, in populations, accurate measurement of physical activity is challenging and may not provide information on functional impairment. This study therefore assessed physical functionality and physical activity level in a group of nonagenarians (11 men/11 women; 93+/-1 years, 66.6+/-2.4 kg, body mass index [BMI]=24+/-1 kg/m2) and a group of participants aged 60-74 years (17 men/15 women; 70+/-1 years, 83.3+/-3.0 kg, BMI=29+/-1 kg/m2) from the Louisiana Healthy Aging Study. Physical activity level was calculated from total energy expenditure (TEE) and resting metabolic rate (RMR). Physical functionality was assessed using the Reduced Continuous Scale Physical Functional Performance Test (CS-PFP10). Nonagenarians had lower absolute (p<.001) and adjusted (p<.007) TEE compared to participants aged 60-74 years which was attributed to a reduction in both RMR and physical activity level. Nonagenarians also had reduced functional performance (p<.001) which was correlated with activity level (r=0.68, p<.001). When compared to individuals aged 60-74 years, 73% of the reduction in TEE in nonagenarians can be attributed to a reduction in physical activity level, the remaining being accounted for by a reduction in RMR. The reduced physical activity in nonagenarians is associated with less physical functionality. This study provides the first objective comparison of physical functionality and actual levels of physical activity in older individuals.

Continuous Scale Physical Functional Performance Test: Appropriateness for Middle-Aged Adults With and Without Parkinson’s Disease

Functional measures are needed that are applicable to middle-aged adults with neurological disorders who are on the threshold of disability. One potential measure is the Continuous Scale Physical Functional Performance Test (CS-PFP), which has been normalized and validated to older adults but performance is unknown for adults younger than the age of 65 years with and without neurological disorders. The purposes of this investigation were (1) to compare scores on the CS-PFP of nondisabled adults in three age groups from 35 to 64 years with two groups of individuals older than the age of 65; (2) to determine whether there is a ceiling effect for nondisabled middle-aged adults; and (3) to determine whether performance of individuals in early stages of Parkinson's disease (PD) age 45 to 64 years differ significantly from performance of similarly aged nondisabled adults. Data were obtained from three samples: (1) 37 adults with PD (45-54 and 55-64 years; 57% female), (2) 70 nondisabled adults (35-44, 45-54, and 55-64 years; 69% female); (3) 72 nondisabled older adults (65-74 and 75-85 years; 79% female). The CS-PFP was administered in a single test session for each subject. Analysis of variance was performed for group differences with adjustment of sex as a covariate followed by a Student-Newman-Keuls post hoc analysis. For nondisabled individuals, the CS-PFP total and domain scores were significantly lower in the oldest group (75-85 years) compared to all other age groups and significantly higher in the younger two groups (35-44 and 45-54 years) compared to the older groups. There was no ceiling effect for any domain score or total score for the adults younger than 65 years. For individuals with PD, both age groups had significantly lower scores on the CS-PFP than did the nondisabled counterparts. Results from the nondisabled middle-aged individuals provide comparison data to be used clinically or in investigations of middle-aged adults with neurological dysfunction. Comparison of middle-aged individuals with PD to middle-aged nondisabled adults illustrates the true extent of functional difficulty experienced by individuals with PD and demonstrates the importance of using age appropriate comparison data. The CS-PFP is particularly applicable to middle-aged adults with compromised functional performance for their age but is too high to be effectively quantified with other assessment measures.

A Comparison of Physical Functional Performance and Strength in Women With Fibromyalgia, Age- and Weight-Matched Controls, and Older Women Who Are Healthy

The purpose of this study was to compare functionality and strength among women with fibromyalgia (FM), women without FM, and older women. Twenty-nine women with FM (age [X+/-SD]=46+/-7 years), 12 age- and weight-matched women without FM (age=44+/-8 years), and 38 older women who were healthy (age=71+/-7 years) participated. The Continuous Scale-Physical Functional Performance Test (CS-PFP) was used to assess functionality. Isokinetic leg strength was measured at 60 degrees/s, and handgrip strength was measured using a handgrip dynamometer. The women without FM had significantly higher functionality scores compared with women with FM and older women. There were no differences in functionality between women with FM and older women. Strength measures for the leg were higher in women without FM compared with women with FM and older women, and both women with and without FM had higher grip strengths compared with older women. This study demonstrated that women with FM and older women who are healthy have similar lower-body strength and functionality, potentially enhancing the risk for premature age-associated disability.

Efficacy of Commonly Used Screening Parameters in Predicting Physical Function in Community Dwelling Older Adults.

2201 PURPOSE: By the year 2030, persons 85 years or older will be the fastest growing segment of the population, and the number who are 65 years or older will reach 70 million in the United States (ACSM, 1998). Because of this, it is important to identify effective screening methods for predicting functional independence among older adults. Parameters that are often used in primary care screening include Body Mass Index (BMI) and self-report measures such as the Medical Outcomes Survey (S hort Form – 36). This study investigated the efficacy of screening parameters that are commonly used in primary care to predict performance-based measures of physical function among independent older adults. METHODS: A cross sectional design was used. The sample included 34 male and 51 female subjects 58–84 years of age. All subjects were independent community dwellers that reported a high level of function in activities of daily living. Each subject completed: (1) the Continuous Scale Physical Functional Performance Test – a performance-based measure of physical function and (2) the MOS SF-36. In addition, Body Mass Index was calculated for all subjects. Multiple regression was used to identify predictors of overall performance-based physical function (CSP-total), upper body strength (CSP-UBS), and lower body strength (CSP-LBS) from a set of commonly used screening variables including age, BMI, SF-36 Physical Function score (SF-PF), and SF-36 General Health score (SFGH). RESULTS: Multiple regression indicated that age (p = .000, partial r2 adj. = .417) and SF-PF (p = .000, partial r2 adj. = .099) were significant predictors of CSP-total; age (p = .000, partial r2 adj. = .302) and SF-PF (p = .003, partial r2 adj. = .064) were significant predictors of CSP-UBS; and age (p = .000, partial r2 adj. = .412) and SF-PF (p = .000, partial r2 adj. = .086) were significant predictors of CSP-LBS. SF-GH and BMI were ineffective predictors of all performance measures. CONCLUSIONS: This study indicates that age is the only substantive predictor of performance-based physical function in this sample of high functioning older adults. Even though SF-PF was a significant predictor, it added little to the overall variance accounted for in the model used. These results suggest the need for more discriminating field screening tools for predicting physical function among healthy, independent community dwelling older adults such as this sample when resources, time, and money are not readily available for performance-based testing. Results also suggest that performance-based measures should be used whenever possible since SF-PF accounted for only 6.4 to 9.9% of the variance in CSP measures.

Efficacy of Commonly Used Screening Parameters in Predicting Physical Function in Community Dwelling Older Adults.

2201 PURPOSE: By the year 2030, persons 85 years or older will be the fastest growing segment of the population, and the number who are 65 years or older will reach 70 million in the United States (ACSM, 1998). Because of this, it is important to identify effective screening methods for predicting functional independence among older adults. Parameters that are often used in primary care screening include Body Mass Index (BMI) and self-report measures such as the Medical Outcomes Survey (S hort Form – 36). This study investigated the efficacy of screening parameters that are commonly used in primary care to predict performance-based measures of physical function among independent older adults. METHODS: A cross sectional design was used. The sample included 34 male and 51 female subjects 58–84 years of age. All subjects were independent community dwellers that reported a high level of function in activities of daily living. Each subject completed: (1) the Continuous Scale Physical Functional Performance Test – a performance-based measure of physical function and (2) the MOS SF-36. In addition, Body Mass Index was calculated for all subjects. Multiple regression was used to identify predictors of overall performance-based physical function (CSP-total), upper body strength (CSP-UBS), and lower body strength (CSP-LBS) from a set of commonly used screening variables including age, BMI, SF-36 Physical Function score (SF-PF), and SF-36 General Health score (SFGH). RESULTS: Multiple regression indicated that age (p = .000, partial r2 adj. = .417) and SF-PF (p = .000, partial r2 adj. = .099) were significant predictors of CSP-total; age (p = .000, partial r2 adj. = .302) and SF-PF (p = .003, partial r2 adj. = .064) were significant predictors of CSP-UBS; and age (p = .000, partial r2 adj. = .412) and SF-PF (p = .000, partial r2 adj. = .086) were significant predictors of CSP-LBS. SF-GH and BMI were ineffective predictors of all performance measures. CONCLUSIONS: This study indicates that age is the only substantive predictor of performance-based physical function in this sample of high functioning older adults. Even though SF-PF was a significant predictor, it added little to the overall variance accounted for in the model used. These results suggest the need for more discriminating field screening tools for predicting physical function among healthy, independent community dwelling older adults such as this sample when resources, time, and money are not readily available for performance-based testing. Results also suggest that performance-based measures should be used whenever possible since SF-PF accounted for only 6.4 to 9.9% of the variance in CSP measures.

THE EFFECT OF STRENGTH AND POWER TRAINING ON PHYSICAL FUNCTION IN INDEPENDENT COMMUNITY-DWELLING OLDER ADULTS

The ability of an older adult to perform daily tasks is influenced by the age-associated reductions in the neuromuscular system. Strength training has demonstrated improvements in physical function; however, the effects of power training have rarely been studied in older adults. PURPOSE: To compare the effect of a strength and power-training program on physical function and anaerobic power in older adults. Primary outcome measures include: the Continuous Scale Physical Functional Performance (CS-PFP) test, 1RM strenght, and Wingate anaerobic power (AP). The CS-PFP test includes tasks such as vacuuming, making a bed, six-minute walk, and stair climbing. METHODS: Thirty-nine men and women (mean age = 72.56 ± 6.3) with below average lower extremity power were randomly assigned to an attention control (C; n = 15), strength (ST; n = 13), or power (PT; n = 11) training group. The intervention groups met 3d/wk for 16 weeks while the control group maintained usual activity and attended 3 lectures. RESULTS: After training, a significant improvement in 1RM (24% & 16%) and CS-PFP total score (4% & 15%) were observed in the ST & PT groups, respectively, while peak AP relative to lean thigh volume improved in the ST group (19%). After controlling for baseline, the effect size for comparisons between groups is shown below, *p < 0.05. CONCLUSION: Power training is safe and more effective than strenght training for improving physical function in older adults. Supported by the University of Georgia Gerontology Consortium Seed GrantTable: No Caption Available

Anaerobic power and physical function in strength-trained and non-strength-trained older adults.

Challenging daily tasks, such as transferring heavy items or rising from the floor, may be dependent on the ability to generate short bursts of energy anaerobically. The purposes of this study were to determine if strength-trained (ST) older adults have higher anaerobic power output compared with non-strength-trained (NST) older adults and to determine the relationship between anaerobic power and performance-based physical function. Thirty-five men and women (age 71.5 +/- 6.4 years, mean +/- SD; NST: n = 18, ST: n = 17) were grouped by training status. Outcome variables included relative anaerobic power (Wingate test), physical function measured with the Continuous Scale Physical Functional Performance Test (CS-PFP, scaled 0 to 100), and anthropometric lean thigh volume (LTV). Analysis of covariance (with age and sex as covariates) was used to determine group differences in the dependent variables listed above. Pearson's r was used to determine the relationship between anaerobic power, CS-PFP total score (TOT), and CS-PFP lower body strength domain score (LBS). The ST group had significantly higher mean anaerobic power (NST 58.9 +/- 16 W/l, ST 96.3 +/- 23 W/l), CS-PFP total (NST 61.2 +/- 13, ST 73.7 +/- 8), and LBS (NST 54.1 +/- 17, ST 70.9 +/- 8) compared with the NST group (p <.05). However, LTV was similar for both groups (NST 3.323 +/- 0.75; ST 3.179 +/- 0.79), which suggests that the ST group had higher muscle quality compared with the NST group. Anaerobic power was significantly related to TOT (r =.611, p =.001) and LBS (r =.650, p =.001). High levels of physical function in ST older adults may in part be explained by higher levels of anaerobic power associated with strength training.

Application of the Continuous Scale Physical Functional Performance Test to People with Parkinson Disease

Parkinson disease (PD) is a chronic progressive neurological disorder, often resulting in substantial limitation of function. A number of self-report and performance-based measures have been used to quantify change of disease state or function in people who have PD. These measures have limitations when used to quantify function in individuals in the early or mid-stages of PD, especially in people with preclinical levels of functional difficulty. The purpose of this paper is to (1) review tests and measures currently available to quantify functional limitations of those with PD; (2) determine reliability and concurrent validity of a new measure, the Continuous Scale Physical Functional Performance (CSPFP) test applied to those with PD. Participants were 42 independent, community-dwelling adults with idiopathic PD. Mean (SD) age was 63.7 (11.5); 31.7% were women. Participants completed self-report measures of function, the CS-PFP, and 3 other performance-based tests (Functional Reach, Timed Up & Go, 360° turn). Ten participants were tested twice on the CS-PFP, one week apart. The CS-PFP was found to be a reliable measure of physical function in the early and mid-stages of PD (k = 0.95). The CS-PFP correlated moderately strongly with other self-report measures (eg, United Parkinson Disease Rating Scale (UPDRS) r = -.62, p=.0001; Northwestern University Disability Scale, r = .43, p = .006) and with performance based measures (eg, Functional Reach, r = .70, p = .0001;Timed Up & Go, r = -.69, p = .0001). Multivariate analysis showed the UPDRS to be a predictor of CS-PFP score. The regression model (including control variables of age, sex, depression, and pain) explained over 50% of the variance in CS-PFP; age and UPDRS scores were the significant predictors. The CS-PFP is a reliable and valid measure for determining physical function in individuals who are in the early and mid-stages of PD. This scale identified substantial functional decline to a greater extent than other scales specific to PD.

ANAEROBIC POWER AND PHYSICAL FUNCTION IN STRENGTH TRAINED AND UNTRAINED OLDER ADULTS

Many challenging daily tasks such as transferring heavy items, climbing stairs, or rising from the floor may be dependent on the ability to generate short bursts of energy anaerobically. The purposes of this study were to determine if older adults who strength train (ST) have higher anaerobic power output compared to those that do not strength train (UT) and to determine the relationship between anaerobic power and performance-based physical function. Thirty-five men and women (mean age = 71.5 ± 6.4 yr., UT: n = 18, ST: n = 17) were grouped by training status. A one way ANCOVA, with age as the covariate, was used to determine group differences in the dependent variables. These include relative anaerobic power (AP) measured using a Wingate test, physical function measured with the Continuous Scale Physical Functional Performance Test (CS-PFP, scaled 0–100), and anthropometric lean thigh volume (LTV). Pearson's r was used to determine the relation of AP and CS-PFP (total and lower body). Results indicated that the ST group had significantly higher AP (UT = 58.9 ± 16 W/L, ST = 96.3 ± 23 W/L), CS-PFP total score (UT = 61.2 ± 13, ST = 73.7 ± 8) and CS-PFP lower body strength (UT = 54.1 ± 17, ST = 70.9 ± 8) when compared to the UT group (p < 0.05). However, there was no significant difference between groups in LTV suggesting a difference in muscle quality between the groups. Anaerobic power was significantly related to CS-PFP total score (Adj. R2 = 0.354, p < 0.0000) and CS-PFP lower body strength (Adj. R2 = 0.405, p < 0.0001). We conclude that older adults who strength train have higher anaerobic power compared to untrained, which in turn contributes to higher physical function. Supported by the Georgia Gerontology Consortium