Aging-related decline in functional mobility is associated with loss of independence. This decline may be mitigated through programs of physical activity. Despite reports of aging-related mobility impairment in middle-aged adults, this age group has been largely overlooked in terms of exercise programs that target functional mobility and the preservation of independence in older age. A method to quantitatively assess changes in functional mobility could direct rehabilitation in a proactive rather than reactive manner. Thirty-three healthy but sedentary middle-aged adults participated in a four week low-volume, vigorous intensity stepping exercise program. Two baseline testing sessions and one post-training testing session were conducted. Functional mobility was assessed using the timed up and go (TUG) test, with its constituent sit-to-walk and walk-to-sit phases examined using a novel inertial sensor-based method. Additionally, semi-tandem balance and knee extensor muscle isometric torque were assessed. Trunk acceleration during walk-to-sit reduced significantly post-training, suggesting altered movement control due to the exercise program. No significant training-induced changes in sit-to-walk acceleration, TUG time, balance or torque were observed. The novel method of functional mobility assessment presented provides a reliable means to quantify subtle changes in mobility during postural transitions. Over time, this exercise program may improve functional mobility.
Bibliographical noteReference text: 1Aagaard, P., E. B. Simonsen, J. L. Andersen, P. Magnusson, and P. Dyhre-Poulsen. Increased rate of force development and neural drive of human skeletal muscle following resistance training. J. Appl. Physiol. 93(4):1318– 1326, 2002.
2Bautista, L., B. Reininger, J. L. Gay, C. S. Barroso, and J. B. McCormick. Perceived barriers to exercise in Hispanic adults by level of activity. J. Phys. Act. Health. 8(7):916– 925, 2011. DOHENY et al.
3Burns, A., B. R. Greene, M. J. McGrath, et al. SHIMMER TM—a wireless sensor platform for non-invasive biomedical research. IEEE Sensors J. 10:1527–1534, 2010.
4Burton, E., G. Lewin, and D. Boldy. Physical activity levels of older people receiving a home care service. J. Aging Phys. Act. 21(2):140–154, 2012.
5Chen, H.-B., T.-S. Wei, and L.-W. Chang. Postural influence on stand-to-sit leg load sharing strategies and sitting impact forces in stroke patients. Gait Posture 32(4):576– 580, 2010.
6Clark, D. O., T. E. Stump, and F. D. Wollnsky. Predictors of onset of and recovery from mobility difficulty among adults aged 51–61 years. Am. J. Epidemiol. 148(1):63–71, 1998.
7Connelly, D. M., H. Carnahan, and A. A. Vandervoort. Motor skill learning of concentric and eccentric isokinetic movements in older adults. Exp. Aging Res. 26(3):209–228, 2000.
8Covinsky, K. E., K. Lindquist, D. D. Dunlop, and E. Yelin. Pain, functional limitations, and aging. J. Am. Geriatr. Soc. 57(9):1556–1561, 2009.
9de Vries, N. M., C. D. van Ravensberg, J. S. M. Hobbelen, M. G. M. Olde Rikkert, and M. W. G. Nijhuis-van der Sanden. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility,
physical disability and/or multi-morbidity: a meta-analysis. Ageing Res. Rev. 11(1):136–149, 2012.
10DeBusk, R. F., U. Stenestrand, M. Sheehan, and W. L. Haskell. Training effects of long versus short bouts of exercise in healthy subjects. Am. J. Cardiol. 65(15):1010– 1013, 1990.
11Ferraris, F., U. Grimaldi, and M. Parvis. Procedure for effortless in-field calibration of three-axis rate gyros and accelerometers. Sensors Mater. 7(5):311–330, 1995.
12Frykberg, G. E., T. Thierfelder, A. C. Aberg, K. Halvorsen, J. Borg, and H. Hirschfeld. Impact of stroke on anterior-posterior force generation prior to seat-off during sit-to-walk. Gait Posture 35(1):56–60, 2012.
13Gabriel, D. A., G. Kamen, and G. Frost. Neural adaptations to resistive exercise: mechanisms and recommendations for training practices. Sports Med. 36(2):133–149, 2006.
14Ganea, R., A. Paraschiv-Ionescu, C. Bula, S. Rochat, and K. Aminian. Multi-parametric evaluation of sit-to-stand and stand-to-sit transitions in elderly people. Med. Eng. Phys. 33(9):1086–1093, 2011.
15Gault, M. L., R. E. Clements, and M. E. Willems. Functional mobility of older adults after concentric and eccentric endurance exercise. Eur. J. Appl. Physiol. 112(11):3699–
16Greene, B. R., D. McGrath, R. O’Neill, K. J. O’Donovan, A. Burns, and B. Caulfield. An adaptive gyroscope-based algorithm for temporal gait analysis. Med. Biol. Eng. Comput. 48(12):1251–1260, 2010.
17Gur, H., N. Cakin, B. Akova, E. Okay, and S. Kucukoglu. Concentric versus combined concentric-eccentric isokinetic training: effects on functional capacity and symptoms in patients with osteoarthrosis of the knee. Arch. Phys. Med. Rehabil. 83(3):308–316, 2002.
18Hirvensalo, M., T. Rantanen, and E. Heikkinen. Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population. J. Am. Geriatr. Soc. 48:493–498, 2000.
19Hogue, C. C. Falls and mobility in late life: an ecological model. J. Am. Geriatr. Soc. 32(11):858–861, 1984.
20Janssen, W. G., J. B. Bussmann, H. L. Horemans, and H. J. Stam. Validity of accelerometry in assessing the duration of the sit-to-stand movement. Med Biol Eng Comput. 46(9):879–887, 2008.
21Kalapotharakos, V. I., S. P. Tokmakidis, I. Smilios, M. Michalopoulos, J. Gliatis, and G. Godolias. Resistance training in older women: effect on vertical jump and functional performance. J. Sports Med. Phys. Fitness
45(4):570–575, 2005. 22Karvonen, M. J., E. Kentala, and O. Mustala. The effects of training on heart rate: a longitudinal study. Ann. Med. Exp. Biol. Fenn. 35(3):307–315, 1957.
23Keen, D. A., G. H. Yue, and R. M. Enoka. Training-related enhancement in the control of motor output in elderly humans. J. Appl. Physiol. 77(6):2648–2658, 1994.
24Kerr, A., D. Rafferty, K. M. Kerr, and B. Durward. Timing phases of the sit-to-walk movement: validity of a clinical test. Gait Posture 26(1):11–16, 2007.
25Knaggs, J. D., K. A. Larkin, and T. M. Manini. Metabolic cost of daily activities and effect of mobility impairment in older adults. J. Am. Geriatr. Soc. 59(11):2118–2123, 2011.
26Krebs, D. E., D. M. Scarborough, and C. A. McGibbon. Functional versus strength training in disabled elderly outpatients. Am. J. Phys. Med. Rehabil. 86(2):93–103, 2007.
27McGibbon, C. A., and D. E. Krebs. Age-related changes in lower trunk coordination and energy transfer during gait. J. Neurophysiol. 85(5):1923–1931, 2001.
28McGibbon, C. A., M. S. Puniello, and D. E. Krebs. Mechanical energy transfer during gait in relation to strength impairment and pathology in elderly women. Clin. Biomech. 16(4):324–333, 2001.
29Melzer, D., E. Gardener, and J. M. Guralnik. Mobility disability in the middle-aged: cross-sectional associations in the English longitudinal study of Ageing. Age Ageing.
34(6):594–602, 2005. 30Moe-Nilssen, R., and J. L. Helbostad. Trunk accelerometry as a measure of balance control during quiet standing. Gait Posture 16(1):60–68, 2002.
31Morie, M., K. F. Reid, R. Miciek, et al. Habitual physical activity levels are associated with performance in measures of physical function and mobility in older men. J. Am. Geriatr. Soc. 5 (9):1727–1733, 2010.
32Mosher, P. E., M. A. Ferguson, and R. O. Arnold. Lipid and lipoprotein changes in premenstrual women following step aerobic dance training. Int. J. SportsMed. 26(8):669–674, 2005.
33Nusselder, W. J., C. W. N. Looman, O. H. Franco, A. Peeters, A. S. Slingerland, and J. P. Mackenbach. The relation between non-occupational physical activity and years lived with and without disability. J. Epidemiol. Community Health 62(9):823–828, 2008.
34Olivares, P. R., N. Gusi, J. Prieto, and M. A. Hernandez- Mocholi. Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults. Health Qual. Life Outcomes 9:117, 2011.
35Peron, E. P., S. L. Gray, and J. T. Hanlon. Medication use and functional status decline in older adults: a narrative review. Am. J. Geriatr. Pharmacother. 9(6):378–391, 2011.
36Prieto, T. E., J. B. Myklebust, R. G. Hoffmann, E. G. Lovett, and B. M. Myklebust. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Trans. Bio-med. Eng. 43(9):956–966, 1996.
37Quinn, T. J., J. R. Klooster, and R. W. Kenefick. Two short, daily activity bouts versus one long bout: are health and fitness improvements similar over twelve and twentyfour weeks? J. Strength Cond. Res. 20(1):130–135, 2006. Exercise and Mobility in Middle-Aged Adult
38Sakari, R., P. Era, T. Rantanen, E. Leskinen, P. Laukkanen, and E. Heikkinen. Mobility performance and its sensory, psychomotor and musculoskeletal determinants from age 75 to age 80. Aging Clin. Exp. Res. 22(1):47–53, 2010.
39Shrout, P. E., and L. E. Fleiss. Intraclass correlation: uses in assessing rater reliability. Psychol. Bull. 86(2):420–428, 1979.
40Steeves, J. A., D. R. Bassett, E. C. Fitzhugh, H. A. Raynor, and D. L. Thompson. Can sedentary behavior be made more active? A randomized pilot study of TV commercial
stepping versus walking. Int. J. Behav. Nutr. Phys. Act. 9:95, 2012.
41Weiss, C. O., L. P. Fried, and K. Bandeen-Roche. Exploring the hierarchy of mobility performance in highfunctioning older women. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 62(2):167–173, 2007.
42Weiss, A., T. Herman, M. Plotnik, et al. Can an accelerometer enhance the utility of the timed up & go test when evaluating patients with Parkinson’s disease? Med. Eng. Phys. 32(2):119–125, 2010.
43World Health Organization. ICF: International Classification of Functioning. Disability and Health. Geneva: World Health Organization, 2001.