Among mobility-limited older adults, both NIA and InVEST produce robust changes in observed physical performance and self-reported function. These improvements were not meaningfully different by statistical or clinical criteria. Compared with NIA, InVEST training produced greater improvements in limb power and equivalent improvements in strength. Observed differences between NIA and InVEST based upon baseline leg impairment status are informative for futures studies.
Performance-based and patient-reported measures of physical function appear to assess different aspects of an older person's functioning. The SPPB was associated with age and physiologic factors, whereas patient-reported function measured by the LLFDI was associated with these factors as well as with psychosocial and health factors.
Objectives-Mobility as measured by the Short Physical Performance Battery (SPPB) or habitual Gait Speed (GS) is predictive of mortality and disability among older adults. Clinically meaningful changes of these measures have been identified. Among physiologic attributes commonly targeted in rehabilitation, we sought to identify those attributes in which changes led to clinically meaningful differences (CMD) in the mobility outcomes.Participants-Community-dwelling, mobility-limited older adults (n=116) participating in a 16-week randomized controlled trial (RCT) of two modes of exercise
Setting-Outpatient rehabilitation centersDesign-Secondary analysis of data collected for a RCT of exercise using binary outcomes defined by recording a large CMD (SPPB=1 unit; GS=.1m/s). Iterative models were performed to evaluate possible confounding between physiologic variables and relevant covariates. Results-Participants were 68% female, had a mean age of 75.2 years, with a mean of 5.5 chronic conditions and a baseline mean SPPB score of 8.7. After controlling for age, site, group assignment, and baseline outcome values, leg power was the only attribute in which changes were significantly associated with a large CMD in SPPB (OR 1.48, 95% CI 1.09, 2.02) and GS (OR1.31, 95% CI 1.01, 1.70).
NIH Public AccessAuthor Manuscript J Am Geriatr Soc. Author manuscript; available in PMC 2011 December 1.Conclusion-Improvements in leg power, independent of strength, appear to make an important contribution towards clinically meaningful improvements in both SPPB and GS.
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