Aging, the Central Nervous System, and Mobility in Older Adults: Interventions

Varma, Vijay R.; Hausdorff, Jeffrey M.; Studenski, Stephanie A.; Rosano, Caterina; Camicioli, Richard; Alexander, Neil B.; Chen, Wen G.; Lipsitz, Lewis A.

doi:10.1093/gerona/glw080

Cited by 31 publications

(23 citation statements)

References 81 publications

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“…It is therefore not excluded that long-term WBV application would result in dynamic stability improvement in the elderly. The result that no increase in stance leg stiffness was observed in the WBV group post-treatment may possibly be ascribed to the progressive alteration with aging in the central structures (e.g., spinal motoneurons) (99,100), somatosensory receptors of the lower limbs (e.g., spindles and mechanoreceptors of the plantar foot sole) (101,102), and/or sensory-motor pathways involved in the TVR reflex (103). This alteration would make elderly's stance leg stiffness less sensitive to acute WBV application than young adults.…”

Section: Effects Of Acute Wbv On Postural Organization Of Gait Initiamentioning

confidence: 85%

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

et al. 2019

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Whole-body vibration (WBV) is a training method that exposes the entire body to mechanical oscillations while standing erect or seated on a vibrating platform. This method is nowadays commonly used by clinicians to improve specific motor outcomes in various sub-populations such as elderly and young healthy adults, either sedentary or well-trained. The present study investigated the effects of acute WBV application on the balance control mechanisms during gait initiation (GI) in young healthy adults and elderly. It was hypothesized that the balance control mechanisms at play during gait initiation may compensate each other in case one or several components are perturbed following acute WBV application, so that postural stability and/or motor performance can be maintained or even improved. It is further hypothesized that this capacity of adaptation is altered with aging. Main results showed that the effects of acute WBV application on the GI postural organization depended on the age of participants. Specifically, a positive effect was observed on dynamic stability in the young adults, while no effect was observed in the elderly. An increased stance leg stiffness was also observed in the young adults only. The positive effect of WBV on dynamic stability was ascribed to an increase in the mediolateral amplitude of “anticipatory postural adjustments” following WBV application, which did overcompensate the potentially destabilizing effect of the increased stance leg stiffness. In elderly, no such anticipatory (nor corrective) postural adaptation was required since acute WBV application did not elicit any change in the stance leg stiffness. These results suggest that WBV application may be effective in improving dynamic stability but at the condition that participants are able to develop adaptive changes in balance control mechanisms, as did the young adults. Globally, these findings are thus in agreement with the hypothesis that balance control mechanisms are interdependent within the postural system, i.e., they may compensate each other in case one component (here the leg stiffness) is perturbed.

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Section: Effects Of Acute Wbv On Postural Organization Of Gait Initiamentioning

confidence: 85%

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

et al. 2019

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“…For example, if screening identified reduced or rapidly declining gait speed, physical therapy could be used to reduce falls and maintain mobility and independence [26,27]. …”

Section: Discussionmentioning

confidence: 99%

Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease

Wolfgram

Garcia²,

Evans³

et al. 2017

Am J Nephrol

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Background: Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear. Methods: This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial. We evaluated estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) as predictors of 3 measures of functional status: EuroQol-5 Dimensional (EQ-5D) score, Falls Efficacy Scale (FES) score, and gait speed. Linear regression models were used to evaluate the associations between our independent variables and outcome measures. Results: Our analysis included 2,620 participants, mean age of 79.9 (4.0) years. Unadjusted models showed that lower eGFR level and higher UACR level were associated with lower EQ-5D (p < 0.001 for both) and slower gait speed (p < 0.001 for both) and worse scores on FES (p = 0.032 and p = 0.039). In the fully adjusted models, higher levels of UACR remained significantly associated with lower EQ-5D scores and slower gait speed (p = 0.011 and p = 0.002, respectively). In contrast, level of eGFR was not associated with any functional outcome measures when accounting for covariates. Conclusions: In individuals aged ≥75 years, albuminuria and eGFR were associated with impairments in physical performance and self-reported functional status; however, only the association with albuminuria remained after adjusting for relevant demographics and comorbidities. Evaluation of albuminuria may provide an additional tool for identifying older individuals at risk for functional impairment.

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“…Lack of effectiveness may be explained by the fact that effective mobility is the result of the integrated efficiency of different systems: the central and peripheral nervous system, the perceptual system, and the musculoskeletal and cardiorespiratory systems [14]. The optimal exercise regime for mobility, therefore, should include, as far as possible, activities stimulating all systems [45]. As previously reported, older individuals combining high lower limbs strength capacity with good proprioception perform better on mobility tasks [19].…”

Section: Discussionmentioning

confidence: 94%

Comparison of Neuromotor and Progressive Resistance Exercise Training to Improve Mobility and Fitness in Community-Dwelling Older Women

Forte

Vito

2019

J. of SCI. IN SPORT AND EXERCISE

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Purpose Neuromotor exercise, which stimulates motor fitness components (balance, agility, coordination), has been less investigated than other forms of exercise such as resistance or aerobic training to counteract the age-related impairment in mobility. The aim of the study was to verify whether neuromotor exercise was as effective as resistance training in improving mobility and related fitness components in healthy older women. Methods Thirty-five women (mean age 69.6 ± 3.2 years) were assigned to a neuromotor (NMT) or a progressive resistance training (PRT) group, both exercising 1 h, twice weekly for 12 weeks. The NMT group exercised static and dynamic balance, agility, speed, reaction time and coordination, while the PRT performed prevalently machine based, strengthening exercises. All participants were tested before and after the intervention for walking speed under different conditions, chair rise time, cardiorespiratory fitness, muscular strength and power. A 2 × 2 MANOVA and subsequent ANOVAs were performed to ascertain the effects of the two trainings. Results Similar improvements were observed for mobility (P = 0.000, 2 p = 0.73 ) and for fitness (P = 0.000, 2 p = 0.96 ) in both groups. Conclusions The present results suggest that in healthy older women improvements in mobility may be obtained through both strength and neuromotor exercise. The present results contribute to further our knowledge on the effects of neuromotor exercise for older people and add relevant information on exercise interventions targeting mobility in the elderly.

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Aging, the Central Nervous System, and Mobility in Older Adults: Interventions

Cited by 31 publications

References 81 publications

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease

Comparison of Neuromotor and Progressive Resistance Exercise Training to Improve Mobility and Fitness in Community-Dwelling Older Women

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