Skip to main content
SpringerLink
Log in

Physical activity and performance in older persons with musculoskeletal impairment: results of a pilot study with 9-month follow-up

  • Original Articles
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: Physical activity in older adults improves fitness, but few studies have examined the short- and long-term effects on physical performance. This analysis is preliminary to a RCT investigating physical activity effects on performance over time in older persons with musculoskeletal impairment. Methods: Fifty sedentary participants, aged 65+, with musculoskeletal impairment and difficulties in complex mobility, but independent in basic activities of daily living (ADLs) were randomly assigned to 3- monthly, twice-a-week, supervised physical exercise (E) or unsupervised regular walking (W), and advised to keep active. Assessments: baseline (T0), discharge (T1), 6 (T2) and 9 (T3) months from baseline. Outcome: Summary of Performance Score (SPS), strength, flexibility; general mental health (GMH), vitality, and self-reported disability. Results: All participants completed follow-ups. At T3, only 12 E and 2 W participants reported exercising regularly. Each outcome, except for GMH, trunk flexibility and basic ADLs, changed over time significantly more in E than in W. After training, E increased SPS (1 point), along with muscle strength, flexibility, vitality, and reduced difficulties in complex mobility. At 9 months, all parameters, except passive hip flexion and shoulder abduction, had reverted to baseline levels. In the same time-frame, W progressively decreased SPS, knee flexion/extension strength and passive flexion, and increased difficulties in basic and complex mobility. Conclusions: In this physically impaired sample, a 3-month exercise program, compared with unsupervised regular walking, was associated with improved performance, fitness and vitality after discharge, and to delayed physical decline in the next 6-month follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ferrucci L, Guralnik JM, Cecchi F et al. Constant hierarchic patterns of physical functioning across seven populations in five countries. Gerontologist 1998; 38: 286–94.

    Article  PubMed  CAS  Google Scholar 

  2. Guralnik JM, Alecxih L, Branch LG, Wiener JM. Medical and long-term care costs when older persons become more dependent. Am J Public Health 2002; 92: 1244–5.

    Article  PubMed  Google Scholar 

  3. Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical per- formance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994; 49: M85–94.

    Article  PubMed  CAS  Google Scholar 

  4. Fried LP. Conference on the physiologic basis of frailty. April 28, 1992, Baltimore, Maryland, U.S.A. Introduction. Aging Clin Exp Res 1992; 4: 251–2.

    Article  CAS  Google Scholar 

  5. Brown M, Sinacore DR, Ehsani AA, Binder EF, Holloszy JO, Kohrt WM. Low-intensity exercise as a modifier of physical frailty in older adults. Arch Phys Med Rehabil 2000; 81: 960–5.

    Article  PubMed  CAS  Google Scholar 

  6. Shephard RJ. Aging, Physical Activity, and Health. New York: McGraw-Hill, 1997.

    Google Scholar 

  7. ACSM Position Stand on Exercise and Physical Activity for Older Adults. Med Sci Sports Med 1998; 30: 992–1008.

    Article  Google Scholar 

  8. Nelson ME, Layne JE, Bernstein MJ et al. The effects of multidimensional home-based exercise on functional performance in elderly people. J Gerontol A Biol Sci Med Sci 2004; 59A: 154–60.

    Article  Google Scholar 

  9. Faber MJ, Bosscher RJ, Chin A Paw MJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Arch Phys Med Rehabil 2006; 87: 885–96

    Article  PubMed  Google Scholar 

  10. LIFE Study Investigators, Pahor M, Blair SN, Espeland M et al. Effects of a physical activity intervention on measures of physical performance: results of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study. J Gerontol A Biol Sci Med Sci 2006; 61: 1157–65.

    Article  Google Scholar 

  11. Bandinelli S, Lauretani F, Boscherini V et al. A randomized, controlled trial of disability prevention in frail older patients screened in primary care: the FRASI study. Design and baseline evaluation. Aging Clin Exp Res 2006; 18: 359–66.

    Article  Google Scholar 

  12. Tuscany Region Resolution 595/30-05-05, COD2005DG 00000000661 www.regione.toscana.it http://www.regione.toscana.it

  13. Cecchi F, Ceppatelli S, Pini ME et al. Riabilitazione ed esercizio fisico nell’anziano affetto da patologia muscolo-scheletrica. Europa MediUphysica 2001; 37: 190–2.

    Google Scholar 

  14. Bellamy N. Muscoloskeletal clinical metrology. Dordrecht / Boston / London: Kluver Academic Publisher, 1993.

    Book  Google Scholar 

  15. Kendal FP, McCreary EK. Muscle testing and function. Baltimore: Williams & Wilkins, 1983.

    Google Scholar 

  16. Kellgreen JH, Lawrence JS. Radiological assessment of osteoarthritis. Ann Rheum Dis 1957; 16: 494–502.

    Article  Google Scholar 

  17. Guralnik JM, Ferrucci L, Pieper CF et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000; 55: M221–31.

    Article  PubMed  CAS  Google Scholar 

  18. Bandinelli S, Benvenuti E, Del Lungo I et al. Measuring muscular strength of the lower limbs by hand-held dynamometer: a standard protocol. Aging Clin Exp Res 1999; 11: 287–93.

    CAS  Google Scholar 

  19. Gajdosik RL, Bohannon RW. Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther 1987; 67: 1867–72.

    CAS  Google Scholar 

  20. Alaranta H, Hurri H, Heliovaara M, Soukka A, Harju R. Flexibility of the spine: normative values of goniometric and tape measurements. Scand J Rehab Med 1994; 26: 147–54.

    CAS  Google Scholar 

  21. Apolone G, Mosconi P. The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol 1998; 51: 1025–36.

    Article  PubMed  CAS  Google Scholar 

  22. Heikkinen E, Waters WE. The elderly in eleven countries — A socio-medical survey. Copenhagen: WHO, 1989.

    Google Scholar 

  23. Stata Statistical Software (7.1). Stata Corporation, College Station, TX.

  24. Leveille SG, Guralnik JM, Ferrucci L. Aging successfully until death in old age: opportunities for increasing active life-expectancy. Am J Epidemiol 1999; 149: 654–64.

    Article  PubMed  CAS  Google Scholar 

  25. Buchner DM, Larson EB, Wagner EH, Koepsell TD, deLauter BJ. Evidence for a nonlinear relationship between leg strength and gait speed. Age Ageing 1996; 25: 386–91.

    Article  PubMed  CAS  Google Scholar 

  26. Visser M, Simonsick EM, Colbert LH, Brach J et al; for the Health ABC Study. Type and intensity of activity and risk of mobility limitation: the mediating role of muscle parameters. J Am Geriatr Soc 2005; 53: 762–70.

    Article  PubMed  Google Scholar 

  27. King AC, Rejeski WJ, Buchner DM. Physical activity interventions targeting older adults. A critical review and recommendations. Am J Prev Med 1998; 15: 316–33.

    Article  CAS  Google Scholar 

  28. Perera S, Mody SH, Woodman RC, Studenski SA. Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 2006; 54: 743–9.

    Article  PubMed  Google Scholar 

  29. Evans WJ. Exercise training guidelines for the elderly. Med Sci Sports Exerc 1999; 31: 12–7.

    Article  PubMed  CAS  Google Scholar 

  30. Penninx BW, Guralnik JM, Bandeen-Roche K et al. The protective effect of emotional vitality on adverse health outcomes in disabled older women. J Am Geriatr Soc 2000; 48: 1525–6.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fondazione Don Carlo Gnocchi, IRCCS, Outpatient Rehabilitation Department, Istituto di Ricovero e Cura a Carattere Scientifico, V. Caccini 18, 50141, Florence, Italy

    Francesca Cecchi MD, Guido Pasquini, Massimiliano Chiti, Raffaello Molino Lova, Enrico Enock, Giacomo Nofri, Anita Paperini, Andrea A. Conti & Claudio Macchi

  2. Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy

    Andrea A. Conti & Claudio Macchi

  3. Rheumatology Unit and Quality Improvement Network, ASF, Florence, Italy

    Alessandro Mannoni

Authors
  1. Francesca Cecchi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guido Pasquini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Massimiliano Chiti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Raffaello Molino Lova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Enrico Enock
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giacomo Nofri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anita Paperini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Andrea A. Conti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alessandro Mannoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Claudio Macchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesca Cecchi MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cecchi, F., Pasquini, G., Chiti, M. et al. Physical activity and performance in older persons with musculoskeletal impairment: results of a pilot study with 9-month follow-up. Aging Clin Exp Res 21, 122–128 (2009). https://doi.org/10.1007/BF03325219

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03325219

Keywords

Search

Navigation