Article

OBJECTIVE: To identify neuromuscular impairments most predictive of unfavorable
mobility outcomes in late life. DESIGN: Longitudinal cohort study. SETTING:
Research clinic. PARTICIPANTS: Community-dwelling primary care patients aged
>/=65 years (N=391) with self-reported mobility modifications, randomly selected
from a research registry. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Categories of decline in and persistently poor mobility across baseline, 1 and 2
years of follow-up in the Lower-Extremity Function scales of the Late-Life
Function and Disability Instrument. The following categories of impairment were
assessed as potential predictors of mobility change: strength (leg strength),
speed of movement (leg velocity, reaction time, rapid leg coordination), range of
motion (ROM) (knee flexion/knee extension/ankle ROM), asymmetry (asymmetry of leg
strength and knee flexion/extension ROM measures), and trunk stability (trunk
extensor endurance, kyphosis). RESULTS: The largest effect sizes were found for
baseline weaker leg strength (odds ratio [95% confidence interval]: 3.45
[1.72-6.95]), trunk extensor endurance (2.98 [1.56-5.70]), and slower leg
velocity (2.35 [1.21-4.58]) predicting a greater likelihood of persistently poor
function over 2 years. Baseline weaker leg strength, trunk extensor endurance,
and restricted knee flexion motion also predicted a greater likelihood of decline
in function (1.72 [1.10-2.70], 1.83 [1.13-2.95], and 2.03 [1.24-3.35],
respectively). CONCLUSIONS: Older adults exhibiting poor mobility may be prime
candidates for rehabilitation focused on improving these impairments. These
findings lay the groundwork for developing interventions aimed at optimizing
rehabilitative care and disability prevention, and highlight the importance of
both well-recognized (leg strength) and novel impairments (leg velocity, trunk
extensor muscle endurance).
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS