Community-Based Exercise Intervention for Gait and Functional Fitness Improvement in an Older Population: Study Protocol.

Functional fitness (FF) and gait ability in older populations have been associated with increased survival rates, fall prevention, and quality of life. One possible intervention for the improvement of FF is well-structured exercise programs. However, there are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. The aim of this protocol is to develop a community-based exercise intervention targeting an older population. The intervention aim is the improvement of gait parameters and FF. A control trial with follow-up will be performed. The primary outcome variables will be plantar pressure gait parameters. The secondary outcome variables will be aerobic endurance, lower limb strength, agility, and balance. These variables will be recorded at baseline and after 12, 24, and 36 weeks, in the intervention and control groups. If effective, this protocol can be used by exercise professionals in improving community exercise programs.

Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program.

INTRODUCTION: Mobility significantly depends on the ankle muscles' strength which is particularly relevant for the performance of daily activities. Few tools are available, to assess ankle strength with all of the measurement properties tested. The purpose of this study is to test the responsiveness of Calf-Raise Senior Test (CRS) in a sample of elderly participants undergoing a 24-week community exercise program. METHODS: 82 older adults participated in an exercise program and were assessed with CRS Test and 30-second chair stand test (CS) at baseline and at follow-up. Effect size (ES), standardized response mean (SRM) and minimal detectable change (MDC) measures were calculated for the CRS and CS tests scores. ROC curves analysis was used to define a cut-off representing the minimally important difference of Calf-Raise Senior test. RESULTS: Results revealed a small (ES = 0.42) to moderate (SRM = 0.51) responsiveness in plantar-flexion strength and power across time, which was lower than that of CS test (ES = 0.64, SRM = 0.67). The responsiveness of CRS test was more evident in groups of subjects with lower initial scores. A minimal important difference (MID) of 3.5 repetitions and a minimal detectable change (MDC) of 4.6 was found for the CRS. CONCLUSION: Calf-Raise Senior Test is a useful field test to assess elderly ankle function, with moderate responsiveness properties. The cutoff scores of MDC and MID presented in this study can be useful in determining the success of interventions aiming at improving mobility in senior participants.

Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study.

BACKGROUND: Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. OBJECTIVES: The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program. METHODS: A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15) and in a non-periodized exercise group (N=13). The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention. RESULTS: Both programs were tailored to older adults' functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. CONCLUSION: These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging.

Can the calf-raise senior test predict functional fitness in elderly people? A validation study using electromyography, kinematics and strength tests.

The assessment of the plantar-flexors muscle strength in older adults (OA) is of the utmost importance since they are strongly associated with the performance of fundamental tasks of daily life. The objective was to strengthen the validity of the Calf-Raise-Senior (CRS) test by assessing the biomechanical movement pattern of calf muscles in OA with different levels of functional fitness (FF) and physical activity (PA). Twenty-six OA were assessed with CRS, a FF battery, accelerometry, strength tests, kinematics and electromyography (EMG). OA with the best and worst CRS scores were compared. The association between the scores and EMG pattern of ankle muscles was determined. OA with the best CRS scores presented higher levels of FF, PA, strength, power, speed and range of movement, and a more efficient movement pattern during the test. Subjects who scored more at the CRS test demonstrated the possibility to use a stretch-shortening cycle type of action in the PF muscles to increase power during the movements. OA with different levels of FF can be stratified by the muscular activation pattern of the calf muscles and the scores in CRS test. This study reinforced the validity of CRS for evaluating ankle strength and power in OA.

Calf-raise senior: a new test for assessment of plantar flexor muscle strength in older adults: protocol, validity, and reliability.

PURPOSE: This study aimed to develop a new field test protocol with a standardized measurement of strength and power in plantar flexor muscles targeted to functionally independent older adults, the calf-raise senior (CRS) test, and also evaluate its reliability and validity. PATIENTS AND METHODS: Forty-one subjects aged 65 years and older of both sexes participated in five different cross-sectional studies: 1) pilot (n=12); 2) inter- and intrarater agreement (n=12); 3) construct (n=41); 4) criterion validity (n=33); and 5) test-retest reliability (n=41). Different motion parameters were compared in order to define a specifically designed protocol for seniors. Two raters evaluated each participant twice, and the results of the same individual were compared between raters and participants to assess the interrater and intrarater agreement. The validity and reliability studies involved three testing sessions that lasted 2 weeks, including a battery of functional fitness tests, CRS test in two occasions, accelerometry, and strength assessments in an isokinetic dynamometer. RESULTS: The CRS test presented an excellent test-retest reliability (intraclass correlation coefficient [ICC] =0.90, standard error of measurement =2.0) and interrater reliability (ICC =0.93-0.96), as well as a good intrarater agreement (ICC =0.79-0.84). Participants with better results in the CRS test were younger and presented higher levels of physical activity and functional fitness. A significant association between test results and all strength parameters (isometric, r=0.87, r2=0.75; isokinetic, r=0.86, r2=0.74; and rate of force development, r=0.77, r2=0.59) was shown. CONCLUSION: This study was successful in demonstrating that the CRS test can meet the scientific criteria of validity and reliability. The test can be a good indicator of ankle strength in older adults and proved to discriminate significantly between individuals with improved functionality and levels of physical activity.