Etiology and modification of gait instability in older adults: A randomized controlled trial of exercise

Journal of Applied Physiology

Volumn 90, Issue 6, 2001, Pages 2117-2129

  Hausdorff, Jeffrey M ^a,d   Nelson, Miriam E ^b   Kaliton, David ^a   Layne, Jennifer E ^b   Bernstein, Melissa J ^b   Nuernberger, Andrea ^b   Fiatarone Singh, Maria A ^b,c  

^a HARVARD MEDICAL SCHOOL   (United States)

^b TUFTS UNIVERSITY   (United States)

^c UNIVERSITY OF SYDNEY   (Australia)

^d BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

Author keywords

Aging; Dynamics variability; Exercise; Muscle function; Plasticity

Indexed keywords

AGED; AGING; ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DISEASE ASSOCIATION; DYNAMICS; EXERCISE; FEMALE; GAIT; HUMAN; MAJOR CLINICAL STUDY; MALE; MORBIDITY; MUSCLE FUNCTION; MUSCULOSKELETAL SYSTEM; NURSING HOME; PLASTICITY; PREDICTION; PRIORITY JOURNAL; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR;

EID: 0035007152     PISSN: 87507587     EISSN: None     Source Type: Journal    
DOI: 10.1152/jappl.2001.90.6.2117     Document Type: Article

References (93)

1. Alexander NB. Postural control in older adults. J Am Geriatr Soc 42: 93-108, 1994.
2. Alexander NB. Gait disorders in older adults. J Am Geriatr Soc 44: 434-451, 1996.
3. Bassey EJ, Fiatarone MA, O'Neill EF, Kelly M, Evans WJ, and Lipsitz LA. Leg extensor power and functional performance in very old men and women. Clin Sci (Colch) 82: 321-327, 1992.
4. Baylor A. Plasticity and exercise effects on aging motor function. In: Development of Posture and Gait Across the Lifetime, edited by Woollacott MH and Shumway-Cook A. Columbia, SC: University of South Carolina Press, 1989, p. 176-201.
5. Bickford P. Aging and motor learning: a possible role for norepinephrine in cerebellar plasticity. Rev Neurosci 6: 35-46, 1995.
6. Bittner V, Weiner DH, Yusuf S, Rogers WJ, McIntyre KM, Bangdiwala SI, Kronenberg MW, Kostis JB, Kohn RM, and Guillotte M. Prediction of mortality and morbidity with a 6-min walk test in patients with left ventricular dysfunction. SOLVD Investigators. JAMA 270: 1702-1707, 1993.
7. Blin O, Ferrandez AM, Pailhous J, and Serratrice G. Dopasensitive and dopa-resistant gait parameters in Parkinson's disease. J Neurol Sci 103: 51-54, 1991.
8. Blin O, Ferrandez AM, and Serratrice G. Quantitative analysis of gait in Parkinson patients: increased variability of stride length. J Neural Sci 98: 91-97, 1990.
9. Borg G and Linderholm H. Perceived exertion and pulse rate during graded exercise in various age groups. Acta Med Scand 1967: 194-206, 1967.
10. Brown M, Sinacore DR, and Host HH. The relationship of strength to function in the older adult. J Gerontol A Biol Sci Med Sci 50: 55-59, 1995.
11. Buchner DM, Cress ME, de Lateur BJ, Esselman PC, Margherita AJ, Price R, and Wagner EH. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. J Gerontol A Biol Sci Med Sci 52: M218-M224, 1997.
12. Buchner DM, Cress ME, Wagner EH, de Lateur BJ, Price R, and Abrass IB. The Seattle FICSIT/Movelt study: the effect of exercise on gait and balance in older adults. J Am Geriatr Soc 41: 321-325, 1993.
13. Buchner DM, Hornbrook MC, Kutner NG, Tinetti ME, Ory MG, Mulrow CD, Schechtman KB, Gerety MB, Fiatarone MA, and Wolf SL. Development of the common data base for the FICSIT trials. J Am Geriatr Soc 41: 297-308, 1993.
14. Buchner DM, Larson EB, Wagner EH, Koepsell TD, and de Lateur BJ. Evidence for a non-linear relationship between leg strength and gait speed. Age Ageing 25: 386-391, 1996.
15. Butefisch CM, Davis BC, Wise SP, Sawaki L, Kopylev L, Classen J, and Cohen LG. Mechanisms of use-dependent plasticity in the human motor cortex. Proc Natl Acad Sci USA 97: 3661-3665, 2000.
16. Cahalin LP, Mathier MA, Semigran MJ, Dec GW, and DiSalvo TG. The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure. Chest 110: 325-332, 1996.
17. Collins JJ and DeLuca CJ. Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res 95: 308-318, 1993.
18. Crosbie WJ, Nimmo MA, Banks MA, Brownlee MG, and Meldrum F. Standing balance responses in two populations of elderly women: a pilot study. Arch Phys Med Rehabil 70: 751-754, 1989.
19. Desrosiers J, Bravo G, Hebert R, and Dutil E. Normative data for grip strength of elderly men and women. Am J Occup Ther 49: 637-644, 1995.
20. Dorfman LJ and Bosley TM. Age-related changes in peripheral and central nerve conduction in man. Neurology 29: 38-44, 1979.
21. Duncan PW, Chandler J, Studenski S, Hughes M, and Prescott B. How do physiological components of balance affect mobility in elderly men? Arch Phys Med Rehabil 74: 1343-1349, 1993.
22. Duncan PW, Weiner DK, Chandler J, and Studenski S. Functional reach: a new clinical measure of balance. J Gerontol 45: M192-M197, 1990.
23. Enoka RM. Neural adaptations with chronic physical activity. J Biomech 30: 447-455, 1997.
24. Ferrucci L, Guralnik JM, Buchner D, Kasper J, Lamb SE, Simonsick EM, Corti MC, Bandeen-Roche K, and Fried LP. Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study. J Gerontol A Biol Sci Med Sci 52: M275-M285, 1997.
25. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, and Evans WJ. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA 263: 3029-3034, 1990.
26. Fiatarone MA, O'Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, Roberts SB, Kehayias JJ, Lipsitz LA, and Evans WJ. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330: 1769-1775, 1994.
27. Folstein MF, Folstein SE, and McHugh PR. "Mini-mental state." A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189-198, 1975.
28. Forette F, Seux ML, Thijs L, Le Divenah A, Perol MB, Rigaud AS, Latour F, Bouchacourt P, and Staessen JA. Detection of cerebral aging, an absolute need: predictive value of cognitive status. Eur Neurol 39: 2-6, 1998.
29. Gabell A and Nayak USL. The effect of age on variability in gait. J Gerontol 39: 662-666, 1984.
30. Giampaoli S, Ferrucci L, Cecchi F, Lo NC, Poce A, Dima F, Santaquilani A, Vescio MF, and Menotti A. Hand-grip strength predicts incident disability in non-disabled older men. Age Ageing 28: 283-288, 1999.
31. Grigsby J, Kaye K, Baxter J, Shetterly SM, and Hamman RF. Executive cognitive abilities and functional status among community-dwelling older persons in the San Luis Valley Health and Aging Study. J Am Geriatr Soc 46: 590-596, 1998.
32. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, and Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332: 556-561, 1995.
33. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, and Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49: M85-M94, 1994.
34. Guyatt G, Sullivan M, Thompson P, Fallen EL, Pugsley SO, Taylor DW, and Berman LB. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J 132: 919-923, 1985.
35. Hausdorff JM, Cudkowicz ME, Firtion R, Wei JY, and Goldberger AL. Gait variability and basal ganglia disorders: stride-to-stride variations in gait cycle timing in Parkinson's and Huntington's disease. Mov Disord 13: 428-437, 1998.
36. Hausdorff JM, Edelberg HE, Mitchell SL, Goldberger AL, and Wei JY. Increased gait unsteadiness in community dwelling elderly fallers. Arch Phys Med Rehabil 78: 278-283, 1997.
37. Hausdorff JM, Ladin Z, and Wei JY. Footswitch system for measurement of the temporal parameters of gait. J Biomech 28: 347-351, 1995.
38. Hausdorff JM, Lertratanakul A, Cudkowicz M, Peterson AL, and Goldberger AL. Dynamic markers of altered gait rhythm in amyotrophic lateral sclerosis. J Appl Physiol 88: 2045-2053, 2000.
39. Hausdorff JM, Mitchell SL, Firtion R, Peng C-K, Cudkowicz ME, Wei JY, and Goldberger AL. Altered fractal dynamics of gait: reduced stride interval correlations with aging and Huntington's disease. J Appl Physiol 82: 262-269, 1997.
40. Hausdorff JM, Rios D, and Edelberg HK. Gait variability and fall risk in community living older adults: a one-year prospective study. Arch Phys Med Rehabil. In press.
41. Hausdorff JM, Zemany L, Peng C-K, and Goldberger AL. Maturation of gait dynamics: stride-to-stride variability and its temporal organization in children. J Appl Physiol 86: 1040-1047, 1999.
42. Hu MH and Woollacott MH. Multisensory training of standing balance in older adults. I. Postural stability and one-leg stance balance. J Gerontol 49: M52-M61, 1994.
43. Jacqmin-Gadda H, Fabrigoule C, Commenges D, and Dartigues JF. A 5-year longitudinal study of the Mini-Mental State Examination in normal aging. Am J Epidemiol 145: 498-506, 1997.
44. Judge JO, King MB, Whipple R, Clive J, and Wolfson LI. Dynamic balance in older persons: effects of reduced visual and proprioceptive input. J Gerontol A Biol Sci Med Sci 50: M263-M270, 1995.
45. Judge JO, Schechtman K, and Cress E. The relationship between physical performance measures and independence in instrumental activities of daily living. The FICSIT Group Frailty and Injury: Cooperative Studies of Intervention Trials. J Am Geriatr Soc 44: 1332-1341, 1996.
46. Judge JO, Underwood M, and Gennosa T. Exercise to improve gait velocity in older persons. Arch Phvs Med Rehabil 74: 400-406, 1993.
47. Kamen G, Sison SV, Duke Du CC, and Patten C. Motor unit discharge behavior in older adults during maximal-effort contractions. J Appl Physiol 79: 1908-1913, 1995.
48. Kannus P, Parkkari J, Koskinen S, Niemi S, Palvanen M, Jarvinen M, and Vuori I. Fall-induced injuries and deaths among older adults. JAMA 281: 1895-1899, 1999.
49. Karni A, Meyer G, Jezzard P, Adams MM, Turner R, and Ungerleider LG. Functional MRI evidence for adult motor cortex plasticity during motor skill learning. Nature 377: 155-158, 1995.
50. Katz SE, Ford AB, Moskowitz RW, Jackson BA, and Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185: 914-919, 1963.
51. Krebs DE, Jette AM, and Assmann SF. Moderate exercise improves gait stability in disabled elders. Arch Phys Med Rehabil 79: 1489-1495, 1998.
52. Langenfeld H, Schneider B, Grimm W, Beer M, Knoche M, Riegger G, and Kochsiek K. The six-minute walk - an adequate exercise test for pacemaker patients? Pacing Clin Electrophysiol 13: 1761-1765, 1990.
53. Lawton MP and Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9: 179-186, 1969.
54. Lipkin D, Scriven A, Crake T, and Poole-Wilson P. Six minute walking test for assessing exercise capacity in chronic heart failure. Br Med J 292: 653-655, 1986.
55. Lord SR, Lloyd DG, Nirui M, Raymond J, Williams P, and Stewart RA. The effect of exercise on gait patterns in older women: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 51: M64-M70, 1996.
56. Lord SR, Ward JA, and Williams P. Exercise effect on dynamic stability in older women: a randomized controlled trial. Arch Phys Med Rehabil 77: 232-236, 1996.
57. Maki BE. Gait changes in older adults: predictors of falls or indicators of fear? J Am Geriatr Soc 45: 313-320, 1997.
58. Miller RA, Thaut MH, McIntosh GC, and Rice RR. Components of EMG symmetry and variability in Parkinsonian and healthy elderly gait. Electroencephalogr Clin Neurophysiol 101: 1-7, 1996.
59. Morganti CM, Nelson ME, Fiatarone MA, Dallai GE, Economos CD, Crawford BM, and Evans WJ. Strength improvements with 1 yr of progressive resistance training in older women. Med Sci Sports Exerc 27: 906-912, 1995.
60. Mulrow CD, Gerety MB, Kanten D, Cornell JE, DeNino LA, Chiodo L, Aguilar C, O'Neil MB, Rosenberg J, and Solis RM. A randomized trial of physical rehabilitation for very frail nursing home residents. JAMA 271: 519-524, 1994.
61. Nakamura T, Meguro K, Yamazaki H, Okuzumi H, Tanaka A, Horikawa A, Yamaguchi K, Katsuyama N, Nakano M, Arai H, and Sasaki H. Postural and gait disturbance correlated with decreased frontal cerebral blood flow in Alzheimer disease. Alzheimer Dis Assoc Disord 11: 132-139, 1997.
62. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, and Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial. JAMA 272: 1909-1914, 1994.
63. Nelson ME, Layne JE, Nuerenberger A, Bernstein MA, Kaliton D, Judge J, Buchner D, and Fiatarone Singh MA. The effects of a home-based exercise program on functional performance in the frail elderly: an update (Abstract). Med Sci Sports Exerc 31: 1929, 1999.
64. Newell KM and Corcos DM. Variability and Motor Control. Champaign, IL: Human Kinetics, 1993.
65. Ostchega Y, Harris TB, Hirsch R, Parsons VL, Kington R, and Katzoff M. Reliability and prevalence of physical performance examination assessing mobility and balance in older persons in the US: data from the Third National Health and Nutrition Examination Survey. J Am Geriatr Soc 48: 1136-1141, 2000.
66. Penninx BW, Guralnik JM, Ferrucci L, Simonsick EM, Deeg DJ, and Wallace RB. Depressive symptoms and physical decline in community-dwelling older persons. JAMA 279: 1720-1726, 1998.
67. Penninx BW, Leveille S, Ferrucci L, van Eijk JT, and Guralnik JM. Exploring the effect of depression on physical disability: longitudinal evidence from the established populations for epidemiologic studies of the elderly. Am J Public Health 89: 1346-1352, 1999.
68. Phillips P. Grip strength, mental performance and nutritional status as indicators of mortality risk among female geriatric patients. Age Ageing 15: 53-56, 1986.
69. Potter JM, Evans AL, and Duncan G. Gait speed and activities of daily living function in geriatric patients. Arch Phys Med Rehabil 76: 997-999, 1995.
70. Potvin AR, Syndulko K, Tourtellotte WW, Lemmon JA, and Potvin JH. Human neurologic function and the aging process. J Am Geriatr Soc 28: 1-9, 1980.
71. Rantanen T, Guralnik JM, Foley D, Masaki K, Leveille S, Curb JD, and White L. Midlife hand grip strength as a predictor of old age disability. JAMA 281: 558-560, 1999.
72. Reuben DB, Siu AL, and Kimpau S. The predictive validity of self-report and performance-based measures of function and health. J Gerontol Med Sci 47: M106-M110, 1999.
73. Reuben DB and Siu AL. An objective measure of physical function in elderly outpatients: the physical performance test. J Am Geriatr Soc 38: 1105-1112, 1990.
74. Rikli RE and Edwards DJ. Effects of a three-year exercise program on motor function and cognitive processing speed in older women. Res Q Exerc Sport 62: 61-67, 1991.
75. Rossiter-Fornoff JE, Wolf SL, Wolfson LI, and Buchner DM. A cross-sectional validation study of the FICSIT common data base static balance measures. Frailty and injuries: cooperative studies of intervention techniques. J Gerontol A Biol Sci Med Sci 50: M291-M297, 1995.
76. Sanes JN and Donoghue JP. Plasticity and primary motor cortex. Annu Rev Neurosci 23: 393-415, 2000.
77. Schultz AB. Mobility impairment in the elderly: challenges for biomechanics research. J Biomech 25: 519-528, 1992.
78. Seeman TE, Charpentier PA, Berkman LF, Tinetti ME, Guralnik JM, Albert M, Blazer D, and Rowe JW. Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. J Gerontol 49: M97-M108, 1994.
79. Stewart AL, Hays RD, and Ware JE Jr. The MOS short form general health survey. Reliability and validity in a patient population. Med Care 26: 724-735, 1988.
80. Tinetti ME, Mendes de Leon CF, Doucette JT, and Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol 49: M140-M147, 1994.
81. Tinetti ME and Powell L. Fear of falling and low self-efficacy: a case of dependence in elderly persons. J Gerontol 48: 35-38, 1993.
82. Tinetti ME, Williams TF, and Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 80: 429-434, 1986.
83. Topp R, Mikesky A, Wigglesworth J, Holt W Jr, and Edwards JE. The effect of a 12-week dynamic resistance strength training program on gait velocity and balance of older adults. Gerontologist 33: 501-506, 1993.
84. Topper AK, Maki BE, and Holliday PJ. Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall? J Am Geriatr Soc 41: 479-487, 1993.
85. Washburn RA, Smith KW, Jette AM, and Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46: 153-162, 1993.
86. Weiner DK, Duncan PW, Chandler J, and Studenski SA. Functional reach: a marker of physical frailty. J Am Geriatr Soc 40: 203-207, 1992.
87. West BJ and Griffin L. Allometric control of human gait. Fractals 6: 101-108, 1998.
88. Whipple RH, Wolfson LI, and Amerman PM. The relationship of knee and ankle weakness to falls in nursing home residents: an isokinetic study. J Am Geriatr Soc 35: 13-20, 1987.
89. Winter DA and Yack HJ. EMG profiles during normal human walking: stride-to-stride and intersubject variability. Electroencephalogr Clin Neurophysiol 67: 402-411, 1987.
90. Wolfson L, Judge J, Whipple R, and King M. Strength is a major factor in balance, gait, and the occurrence of falls. J Gerontol A Biol Sci Med Sci 50: 64-67, 1995.
91. Wolfson L, Whipple R, Derby C, Judge J, King M, Amerman P, Schmidt J, and Myers D. Balance and strength training in older adults: intervention gains and tai chi maintenance. J Am Geriatr Soc 44: 498-506, 1996.
92. Wolfson L, Whipple R, Judge J, Amerman P, Derby C, and King M. Training balance and strength in the elderly to improve function. J Am Geriatr Soc 41: 341-343, 1993.
93. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, and Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17: 37-49, 1982.