Objectives: To evaluate a dynamic form of weighted vest exercise suitable for home use and designed to enhance muscle power, balance, and mobility. Design: A single‐blind, randomized, controlled trial. Setting: Outpatient exercise research facility situated within an academic long‐term care center. Participants: Twenty‐one community‐dwelling women aged 70 and older with a Short Physical Performance Battery (SPPB) score between 4 and 10 (out of 12). Interventions: Subjects were randomized into a progressive resistance‐training program using weighted vests for resistance with exercises designed to be specific to mobility tasks and have a component performed at the fastest possible velocity (Increased Velocity Exercise Specific to Task (InVEST), n=11) or a control exercise group (control, n=10), which performed slow‐velocity, low‐resistance exercise. Both groups exercised three times a week for 12 weeks. Measurements: Changes in muscle power, balance, and physical performance were compared. Results: In comparison to control group, InVEST group manifested significant improvements (P<.05) in leg power across measurements obtained at 75% to 90% of the one‐repetition maximum. Both groups demonstrated significant improvements in chair stand and SPPB score from baseline, and the InVEST group showed significant improvements in gait speed and chair stand from baseline (P<.05). InVEST produced significantly greater changes in chair stand time than control (P<.05). Conclusion: InVEST training appears be an effective means of enhancing leg power and chair rise in this population and is worthy of further investigation as a means of enhancing balance and mobility.

OBJECTIVES:The purpose of this study was to assess the influence of leg power and leg strength on the physical performance of community-dwelling mobility-limited older people. DESIGN: Cross-sectional analysis of baseline data from a 12-week randomized controlled exercise-intervention study. SETTING: Exercise laboratory within the Department of Health Science of an urban university. PARTICIPANTS: Forty-five community-dwelling mobility-limited people (34 women, 11 men), aged 65 to 83. MEASUREMENTS: Health status, depression, cognition, physical activity, and falls efficacy; physiological measures of lower extremity strength and power; and measures of physical performance. RESULTS: Through bivariate analyses, leg power was significantly associated with physical performance as measured by stair-climb time, chair-stand time, tandem gait, habitual gait, maximal gait, and the short physical performance battery describing between 12% and 45% of the variance ( R 2 ). Although leg power and leg strength were greatly correlated ( r ϭ .89) in a comparison of bivariate analyses of strength or power with physical performance, leg power modeled up to 8% more of the variance for five of six physical performance measures. Despite limitations in sample size, it appeared that, through quadratic modeling, the influence of leg power on physical performance was curvilinear. Using separate multivariate analyses, partial R 2 values for leg power and leg strength were compared, demonstrating that leg power accounted for 2% to 8% more of the variance with all measures of physical performance. CONCLUSION:Leg power is an important factor influencing the physical performance of mobility-limited older people. Although related to strength, it is a separate attribute that may exert a greater influence on physical performance. These findings have important implications for clinicians practicing geriatric rehabilitation. J Am Geriatr Soc 50:461-467, 2002.

These findings emphasize the 6mw as a measure of functional limitation among mobility-limited elders without cardiorespiratory or peripheral vascular disease.

Muscle power appears to be a more generalized attribute between the upper and lower limbs than is muscle strength, suggesting that mechanisms underlying velocity of movement, as opposed to force production, may be important factors underlying muscle power in elderly persons. Additionally, upper limb muscle power measures may serve as a useful surrogate measure of limb power having implications for clinicians and researchers.

OBJECTIVES-To evaluate associations of baseline lower extremity strength with decline in functional performance at up to six-year follow-up among men and women with lower extremity peripheral arterial disease (PAD). DESIGN-Prospective observational study.SETTING-Three Chicago-area hospitals. PARTICIPANTS-374 men and women with PAD.MEASUREMENTS-Baseline isometric hip extension, hip flexion, knee flexion, and knee extension strength were measured with a Musculoskeletal Fitness Evaluation chair. The following outcomes were assessed at baseline and annually thereafter: usual and fastest-paced four meter walking velocity, the six-minute walk, and the Short Physical Performance Battery (SPPB). Analyses adjust for age, sex, race, the ankle brachial index (ABI), co-morbidities, and other confounders. RESULTS-In women with PAD, lower baseline hip and knee flexion strength were associated with faster average annual decline in usual-paced four meter walking velocity (p trend <0.001 and p trend = 0.02 respectively) and the SPPB (p trend =0.019 and p trend = 0.01 respectively). Among women, poorer hip extension strength was associated with faster decline in the usual-paced four meter walking velocity and SPPB (p trend =0.01 and p trend <0.01, respectively). There were no significant associations of baseline strength with decline in six minute walk among women. There were no significant associations of any baseline strength measure with functional decline among men. NIH Public AccessAuthor Manuscript J Am Geriatr Soc. Author manuscript; available in PMC 2010 December 1.CONCLUSION-Poorer baseline leg strength is associated with faster functional decline in nonendurance measures of functional performance among women with PAD but not among men with PAD.

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Objectives/Hypothesis Few studies have specifically addressed auditory complaints in patients with nonblast mild traumatic brain injury (mTBI). Herein, we aimed to investigate auditory symptoms in patients following mTBI using patient‐reported outcome measures. Study Design Retrospective analysis of prospectively collected data in a tertiary‐care hospital. Methods The patients included those with mTBI (cases) and those without mTBI (controls). Individuals (≥18 years old) with and without mTBI were screened. Exclusion criteria included history of otologic disorders, blast injury, or occupational noise exposure. Primary outcomes included the Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and Hyperacusis Questionnaire (HQ). Secondary outcomes included subjective auditory complaints. Results From September 2017 to September 2018, 52 patients with mTBI and 55 controls met inclusion and exclusion criteria. The mean time between mTBI and survey intake was 70.6 months. The mean age and gender were 51.5 years old and 73% female in the mTBI group, and 46.1 years old and 56.3% female in the control group (P = .112 and P = .105, respectively). Patients with mTBI reported hyperacusis (67.3% of all mTBI patients), hearing loss (61.5%), and tinnitus (61.5%), compared to 8.3%, 12.7%, and 16.4%, respectively, for control subjects (P < .0001). The mean HHIA score in the mTBI group was 38.3 versus 8.5 in controls (P = .002). The mean THI score was 27.4 in the mTBI group and 3.1 in controls (P < .0001). The mean HQ score was 26.5 in mTBI group and 7.3 in controls (P = .001). Conclusions Auditory symptoms and associated handicap were common in patients with nonblast mTBI compared to age‐matched controls. Findings have implications for the pathophysiology and management of symptoms in this patient population. Level of Evidence 3 Laryngoscope, 130:761–767, 2020

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