Effect of a functional-based training program on the performance of instrumental activities of daily living among older adults residing in retirement communitites Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/sj139452j

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  • Sustaining an older adult's ability to live independently is a very important goal of geriatrics and gerontology. The extent to which an individual can live independently depends on his or her ability to perform Instrumental Activities of Daily Living. Impairments in the physical domains of muscle strength, flexibility, endurance, and neuromuscular control are often responsible for the inability to carry out these Instrumental Activities of Daily Living. Therefore, research has typically focused on administering interventions to older adults to mitigate or delay impairments in the physical domains in hopes that the older adults would subsequently improve functional ability and maintain independence. The effect these types of exercise interventions have on improving function is not clear. Because living independently requires an individual to carry out daily functional tasks without assistance, given the Principal of Specificity, an exercise program composed of these functional tasks would be the most specific and efficient way to improve the functional abilities of older adults. The aim of this study was to determine the effect a A total of 14 individuals (mean age 82 ± 4 yrs) participated in this study. All participants took part in a 10 wk control period followed by a 10 wk functional based training program. The LIFE (Living Independently through Functional Exercise) training program consisted of a multi-station circuit with nine different activity stations mimicking functional tasks. The stations included, sit-to-stand, stair climbing, laundry, grocery shopping, vacuuming, sweeping, putting on and removing a jacket, pulling a suitcase, and getting down and up from the floor. Participants were tested before and after the control period and after the training program. The tests included the Physical Performance Test and the Physical Functional Performance 10 to measure the ability to perform Instrumental Activities of Daily Living and the Senior Fitness Test to evaluate the physical domains of strength, flexibility, endurance and dynamic balance. A repeated-measures ANOVA revealed that there were no significant differences on any test scores during the control period except for lower extremity flexibility of the Senior Fitness Test After the training period, improvements ranging from 10-40% (p < 0.05) were seen on all tests of the Physical Performance Test, the Physical Functional Performance 10, and on the chair stands, endurance walk, and arm curl of the Senior Fitness Test After conversion to standard scores, paired t-tests revealed that the magnitude of change in the Physical Performance Test (0.58 ± 0.15) and the Physical Functional Performance-lO (0.69 ± 0.11) was significantly greater (p <0.05) than the magnitude of change in the Senior Fitness Test (0.10 ± .08). The regression analysis revealed a positive relationship between improvements in the Physical Functional Performance- 10 and the Senior Fitness Test scores following the training program (p = 0.002, R² = 0.605). For every unit of change in the Physical Functional Performance- 10 standard score there was only half as much of an increase in the Senior Fitness Test standard score. There was not a significant relationship between the Physical Performance Test and the Senior Fitness Test. Our results support the hypothesis that this novel functional-based training program was able to facilitate improvements in a broad spectrum of functional measures among frail older adults. Furthermore, consistent with the Principle of Specificity, improvements in function were significantly greater than improvements in fitness. This program offers an alternative to traditional exercise programs for this population.
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