Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

Hardy, Susan; Kang, Yihuang; Studenski, Stephanie A.; Degenholtz, Howard B.

doi:10.1007/s11606-010-1543-2

Cited by 227 publications

(220 citation statements)

References 18 publications

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“…with nine response options: 1) Less than elementary school, 2) Elementary school, 3) Elementary school and at least one year of vocational education, 4) Middle school or folk high school, 5) Middle school or folk high school and at least one year of vocational education, 6) High school, 7) High school and at least one year of vocational education, 8) University degree and 9) Other education. For the analyses, the level of education was categorized into three groups: low (1-2), middle (3)(4)(5) and high (6)(7)(8) (Sainio et al 2007). All those who had answered "Other education" in the questionnaire had also provided another level of education, which was then used to define their level of education.…”

Section: Socioeconomic Statusmentioning

confidence: 99%

“…Mobility limitations, such as difficulties in walking, often result in decreased physical activity, and may thus lead to further functional decline (6). In older people with mobility limitations, even small amounts of physical activity, such as short walks have been shown to be beneficial in order to prevent further mobility loss (7).…”

Section: Introductionmentioning

confidence: 99%

“…Sedentary lifestyle is more common in people with low SES (8). Low SES is also associated with chronic musculoskeletal complaints (9), limited ability to walk a quarter of a mile (6), difficulties in climbing up stairs (10), lower likelihood of meeting the 4 physical activity recommendations (3) and an increased risk of mobility decline in chronically ill people (11). In addition to low SES and mobility limitations, lack of social support i.e.…”

Section: Introductionmentioning

confidence: 99%

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Barriers to outdoor physical activity and unmet physical activity need in older adults

Eronen

Bonsdorff

Törmäkangas

et al. 2014

Preventive Medicine

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Physical activity is a basic need, also in old age. However, many older people cannot fulfil this need, often due to walking limitations causing imbalance in person-environment fit. Decreased physical activity can lead to unmet physical activity need and restriction on life-space mobility. The opportunities to remain physically active depend on various factors, not all of which are equally achievable for all older adults. The aim was to investigate disparities in physical activity among older community-dwelling people, with a focus on functioning, environmental barriers and facilitators, and socioeconomic status (SES).The data were drawn from two studies conducted in Central Finland: Screening and Counseling for Physical Activity and Mobility (632 participants, 75% women, mean age 77.6) and Life-Space Mobility in Old Age (848 participants, 62% women, mean age 80.1). Walking limitations, SES, social support, environmental facilitators for outdoor walking and barriers to outdoor physical activity were self-reported. The outcome measures were unmet physical activity need, walking limitation and life-space mobility.Five outdoor physical activity barrier profiles were identified, in which people differed in health and functioning and vulnerability to the challenges of the environment. A higher number of environmental facilitators decreased the risk for walking limitation. The risk for unmet physical activity need increased along with the number of individual and environmental outdoor physical activity barriers, but was highest among people whose poor health and functioning hindered them from going outdoors. Low SES was associated with more restricted life-space mobility and unmet physical activity need, especially among persons with walking limitations.Disparities in physical activity can be traced back to various individual, social and environmental factors. The importance of the environment for physical activity is considerable especially among older people with walking limitations. Keywords ACKNOWLEDGEMENTSThis study was carried out at the Gerontology Research Center, Department of Health Sciences, University of Jyväskylä, Finland. My deepest gratitude goes to the supervisors of this thesis, Professor Taina Rantanen and Mikaela von Bonsdorff, PhD. Taina, I can't stop wondering how you always have solutions to the most complex problems and answers to even the trickiest questions. I highly value your knowledge and experience in the field of gerontology and feel proud that I have been able to conduct my PhD thesis under your supervision. Mikaela, thank you for always having time for me and my questions, especially during the first year of my PhD studies. I admire your enthusiasm towards research and appreciate the guidance and advice that you have given me. I feel that we have become friends during these years. I sincerely thank Professor Teppo Kröger for his interest and supportive comments on this work. I also want to thank Research Director Katja Kokko at the Gerontology Research Center, and Director of t...

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Section: Socioeconomic Statusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Barriers to outdoor physical activity and unmet physical activity need in older adults

Eronen

Bonsdorff

Törmäkangas

et al. 2014

Preventive Medicine

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“…More recently, [12] showed that six sessions of SIT improved insulin sensitivity by 37%, as well as a significant reduction in Non-Esterified Fatty Acids (NEFA). Unfortunately, many populations cannot physically utilize leg ergometry [15], and may be limited to upper extremity exercise.…”

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confidence: 99%

The Effects of Two Weeks of Arm Crank Sprint Interval Training in Men with Chronic Spinal Cord Injury

Harnish¹

2017

Int J Sports Exerc Med

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The purpose of this study was to examine the performance and metabolic effects of two weeks of Arm Crank Ergometry (ACE) Sprint Interval Training (SIT) in men with Spinal Cord Injury (SCI). Eight paraplegic males 50.5 ± 9.0 yo, 180.8 ± 6.7 cm tall, 85.1 ± 19.5 kg, and 35.1 ± 5.7% body fat completed three Oral Glucose Tolerance Tests (OGTTs) at baseline, 2 weeks later, prior to SIT, and 48 hrs Post SIT. Six SIT sessions were performed on a Monark 891E ACE. Subjects cranked against 3.5% body mass for 30 sec, completing 4 sprints in session 1, then 5, 5, 6, 6, and 7 sprints in the final session. All data are presented as means ± SD with absolute change responses from baseline ± 95% confidence intervals and changes that failed to cross 0 considered significant. Peak and average power output increased across all subjects; peak power increased 11.9%, while average power increased 9.9%. AUC for neither glucose nor insulin significantly changed and ISI-Cederholm insulin sensitivity also failed to improve; OGTT change was 3.93 31.3 95% CI). However, post-SIT plasma Non-Esterified Fatty Acids (NEFA) AUC dropped 0.34 mEq.L-1. In conclusion, two weeks of ACE SIT was effective at reducing NEFA in men with SCI, but did not improve insulin sensitivity or glucose levels. These data indicate that ACE SIT may be an effective adjunct training modality for those with SCI and other non-ambulatory populations.

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“…As of 2013, mobility disability makes up the largest category of functional disability among adults in the United States [2], as well as 46% of disabilities that result in serious limitations as of 2015 [3]. By 2040, impaired mobility is estimated to contribute $42 billion to annual national health care costs [4]. Rehabilitation is typically prescribed to restore a more functional gait pattern.…”

Section: Introductionmentioning

confidence: 99%

Internal representation of external patient dynamics in locomotor rehabilitation

Goodman¹

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ii ACKNOWLEDGEMENTSMy sincerest gratitude to my thesis advisor, Dr. Christopher J Hasson, for inviting me into his lab and being a significant contributor to the work presented. Dr. Hasson is genuinely enthusiastic about the work in his lab and is always available to patiently help. His expertise and creative approaches to tackling nuanced problems and concepts have created an exciting and rewarding intellectual experience. Manual gait rehabilitation is imperfect at complete restoration of locomotor function in patients with stroke. Physical therapy poses a unique learning challenge, as it involves simultaneous sensorimotor co-adaptation and co-learning between one or more therapists and a patient. While patient motor learning has been extensively investigated, how a therapist adapts and learns to manipulate the gait pattern of a patient has been largely unexplored. Multiple motor learning theories exist that explain various ways this may occur, but confounds resulting from therapistpatient co-adaptation make it difficult to probe therapist learning in a clinical setting. We used the ILS to control for these confounds and hypothesized that therapist learning follows the internal model hypothesis. The internal model hypothesis postulates that through interaction with novel physical dynamics a human develops the ability to predict the behavior of the system and extrapolate to subsequent interactions. In the ILS, a user interacted with a computerized virtual patient (VP) via a robotic manipulandum in order to modify the gait pattern. Manipulandum endpoint impedances transformed from joint-space rigid body dynamics and stiffness create a force field that makes the user feel as if they are holding onto the ankle of a real patient. The user must learn how to apply the correct forces to the leg of the VP to restore a healthy gait pattern.Examination of user responses to random catch trials, the presence of after effects, and the ability of users to generalize were analyzed to assess internal model formation. Results suggest that humans do create internal models of external locomotor dynamics. iv

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Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

Cited by 227 publications

References 18 publications

Barriers to outdoor physical activity and unmet physical activity need in older adults

Barriers to outdoor physical activity and unmet physical activity need in older adults

The Effects of Two Weeks of Arm Crank Sprint Interval Training in Men with Chronic Spinal Cord Injury

Internal representation of external patient dynamics in locomotor rehabilitation

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