C. Jessie Jones

A 30-s Chair-Stand Test as a Measure of Lower Body Strength in Community-Residing Older Adults

Measuring lower body strength is critical in evaluating the functional performance of older adults. The purpose of this study was to assess the test-retest reliability and the criterion-related and construct validity of a 30-s chair stand as a measure of lower body strength in adults over the age of 60 years. Seventy-six community-dwelling older adults (M age = 70.5 years) volunteered to participate in the study, which involved performing two 30-s chair-stand tests and two maximum leg-press tests, each conducted on separate days 2-5 days apart. Test-retest intraclass correlations of .84 for men and .92 for women, utilizing one-way analysis of variance procedures appropriate for a single trial, together with a nonsignificant change in scores from Day 1 testing to Day 2, indicate that the 30-s chair stand has good stability reliability. A moderately high correlation between chair-stand performance and maximum weight-adjusted leg-press performance for both men and women (r = .78 and .71, respectively) supports the criterion-related validity of the chair stand as a measure of lower body strength. Construct (or discriminant) validity of the chair stand was demonstrated by the tests ability to detect differences between various age and physical activity level groups. As expected, chair-stand performance decreased significantly across age groups in decades--from the 60s to the 70s to the 80s (p < .01) and was significantly lower for low-active participants than for high-active participants (p < .0001). It was concluded that the 30-s chair stand provides a reasonably reliable and valid indicator of lower body strength in generally active, community-dwelling older adults.

The Reliability and Validity of a Chair Sit-and-Reach Test as a Measure of Hamstring Flexibility in Older Adults

The purpose of this study was to examine the test-retest reliability and the criterion validity of a newly developed chair sit-and-reach (CSR) test as a measure of hamstring flexibility in older adults CSR performance was also compared to sit-and-reach (SR) and back-saver sit-and-reach (BSR) measures of hamstring flexibility. To estimate reliability, 76 men and women (M age = 70.5 years) performed the CSR on 2 different days, 2-5 days apart. In the validity phase of the study, scores of 80 men and women (M age = 74.2 years) were obtained on three field test measures of hamstring flexibility (CSR, SR, and BSR) and on a criterion test (goniometer measurement of a passive straight-leg raise). Results indicate that the CSR has good intraclass test-retest reliability (R = .92 for men; r = .96 for women), and has a moderate-to-good relationship with the criterion measure (r = .76 for men; r = .81 for women). The criterion validity of the CSR for the male and female participants is comparable to that of the SR (r = .74 and r = .71, respectively) and BSR (r = .70 and r = .71, respectively). Results indicate that the CSR test produces reasonably accurate and stable measures of hamstring flexibility. In addition, it appears that the CSR is a safe and socially acceptable alternative to traditional floor sit-and-reach tests as a measure of hamstring flexibility in older adults.

Age and Physical Activity Effects on Reaction Time and Digit Symbol Substitution Performance in Cognitively Active Adults

University professors (N = 56), divided into two age groups (< 50 years and > 50 years) and two physical activity level groups (high and low), were tested on three tasks requiring increasingly complex cognitive processing--simple reaction time (SRT), choice reaction time (CRT), and on a digit symbol substitution test (DSST). A significant main effect for exercise, with high active subjects performing better than low active subjects, was found for SRT (p < .001) and CRT (p < .01) but not for DSST (p < .09). Significant main effects for age, with younger subjects performing better than older subjects, were found on DSST (p < .01) and CRT (p < .05) but not for SRT (p < .09). The observation that the effect of age was more pronounced with increasing task complexity is consistent with previous research. However, the tendency for exercise effects to decrease with increasing task complexity is not consistent with former findings, suggesting that perhaps the controlled high level of cognitive activity of subjects in this study may have offset the usual effects of exercise on information processing speed. No significant Age x Activity Level interactions were found on any of the dependent raw score data. However, compared to normative scores of the population at large, there was a slight increase in DSST percentile ranks with age for the older aerobically active professors, whereas a decrease occurred for the inactive subjects.

Positive associations between physical and cognitive performance measures in fibromyalgia.

OBJECTIVE To investigate the associations between perceived physical function (self-report) and physical and cognitive performance (objective assessments) in persons with fibromyalgia (FM). DESIGN Correlational study. SETTING Exercise testing laboratory in Southern California. PARTICIPANTS Community-residing ambulatory adults meeting the American College of Rheumatology 1990 criteria for FM (N=68; mean age, 59.5y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Composite Physical Function scale, Senior Fitness Test (3 items), Fullerton Advanced Balance scale, 30-foot walk, Trail Making Test parts A and B, Digit Symbol Substitution Test, a composite score of these 3 cognitive measures, attention/executive function composite, processing speed composite, problem solving, inhibition, and episodic memory composite. RESULTS Hierarchical regression analyses showed that after controlling for age and FM symptoms, better physical performance (based on assessments, not self-report) was associated with higher cognitive function in attention/executive function, processing speed, problem solving, and inhibition. CONCLUSIONS Researchers should continue to investigate the relationship between physical and cognitive function in both clinical and nonclinical populations, as well as explore changes across time. Because physical activity has been associated with neural improvements, further research may identify whether particular mechanisms, such as neurogenesis, synaptogenesis, or changes in inflammatory marker levels, are involved.

Do fall predictors in middle aged and older adults predict fall status in persons 50+ with fibromyalgia? An exploratory study.

We explored potential predictors of fall status in 70 community-dwelling persons > or =50 years of age with fibromyalgia (FM). Over 40% of the sample reported one or more falls in the year prior to the study. A logistic regression model using 10 variables known to predict falls in middle aged and older persons predicted 45% of the variance in fall status. Three variables offered significant independent contributions to the overall model predicting fall status: perception of postural instability, balance performance, and executive function processing speed. The results support prior work in both nonclinical and clinical populations of middle aged and older adults indicating that falls are associated with multiple risk factors. Prospective designs with larger samples are needed to (a) validate and extend these findings, and (b) identify risk factors related to fall status that are unique to persons with FM.

Physical Performance as a Predictor of Attention and Processing Speed in Fibromyalgia

UNLABELLED Cherry BJ, Weiss J, Barakat BK, Rutledge DN, Jones CJ. Physical performance as a predictor of attention and processing speed in fibromyalgia. OBJECTIVE To explore the associations between physical (both self-report and objective measures) and cognitive function for persons with fibromyalgia (FM). DESIGN Correlational study. SETTING An exercise testing laboratory in southern California. PARTICIPANTS Community-residing and functionally independent (not wheelchair-bound) adults meeting the American College of Rheumatology 1990 criteria for FM (N=51) with a mean age of 54 years and no history of stroke. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Composite Physical Function Scale, Fibromyalgia Impact Questionnaire, adapted Trail Making Test parts A (TMT-A) and B (TMT-B), Digit Symbol Substitution Test, a composite index of TMT-A, TMT-B, and Digit Symbol Substitution Test combined, and physical performance assessments. RESULTS Hierarchical regression analyses indicated that better objective physical performance predicted increased cognitive function for TMT-A and the composite cognitive score after controlling for age and symptom burden. That is, as the physical performance level decreased, cognitive performance levels decreased. CONCLUSIONS Findings suggest that research is needed to determine whether patterns of physical activity participation, through their effects on physical fitness and performance, can enhance cognitive performance in persons with FM. Physiologic changes in specific brain regions in FM (eg, hippocampus, neural pain regions) suggest that further research is also warranted in determining specific relationships between biomarkers and cognitive performance in persons with FM.

Effects of Topical Essential Oil on Exercise Volume After a 12-Week Exercise Program for Women with Fibromyalgia: A Pilot Study

OBJECTIVES We determined--in women with fibromyalgia (FM)--effects of essential oils used with a 12-week exercise program on exercise volume, pain, physical performance, and physical function. DESIGN This was a randomized clinical trial comparing 024 essential oil with sham oil combined with exercise. SETTINGS SETTINGS included community sites in southern California. SUBJECTS The study included 20 women randomized to 024 oil, 23 to sham oil. INTERVENTIONS Women were trained in oil application before exercise, at bedtime on exercise days; the 12-week program included weekly group sessions with trained leaders guided by a prerecorded regimen (allowing choice of program level) plus 2 days of home exercise with the recorded regimen. OUTCOME MEASURES Primary: Exercise volume (number of days exercised multiplied by exercise level--intensity and duration). Secondary: Pain (Brief Pain Inventory), measures of physical performance (30-second chair stands, 6-minute walk, multidimensional balance), and self-reported physical function (Composite Physical Function scale). RESULTS The average participant was 54 years old, had some college education, was married, Caucasian, and minimally/mildly depressed. There was no significant difference in exercise volume between women using 024 as compared with those using sham oil after 12 weeks (depression as covariate). There were no significant group nor pre- to postexercise changes in pain intensity or interference. There were greater positive changes in 30-second chair stands, 6-minute walk distance, and multidimensional balance scores in the 024 group than in the sham group, but these were not significant. The counterirritant 024 oil was not different from the sham oil in its effect on exercise volume (frequency, exercise level--intensity and duration) for women with FM. It is unknown whether 024 actually decreases local pain when used with exercise. CONCLUSIONS Increases in physical function found, while not significant, may be attributable to the exercise regimen or to the interaction of the oils and exercise regimen.

A Comparison of Women With Fibromyalgia Syndrome to Criterion Fitness Standards: A Pilot Study

PURPOSE To compare fitness of women with fibromyalgia syndrome (FMS) aged 50+ with performance standards associated with functional independence in late life. METHODS Data came from a longitudinal study tracking physical and cognitive function of 93 women with FMS and included the most recent symptoms, activity levels, and fitness assessments. RESULTS Most women performed below criterion-referenced fitness standards for all measures. Nearly 90% percent of those < 70 years scored below the standard for lower body strength. Only ~20% of respondents < 70 years old met the criteria for aerobic endurance. A third of those aged over 70 met the standard in agility and dynamic balance. Physical activity was positively associated with fitness performance, while pain and depression symptoms were negatively associated. DISCUSSION High proportions of women with FMS do not meet fitness standards recommended for maintaining physical independence in late life, indicating a risk for disability. Regular fitness assessments and targeted exercise interventions are warranted.

Impact of Employment and Caregiving Roles on the Well-Being of People with Fibromyalgia Syndrome

Objective This study examined the associations between social roles [namely, employment and caregiving] and health status, quality of life, physical functioning, and depression in individuals 50+ years of age with and without fibromyalgia syndrome [FMS]. Methods Seventy people with FMS [93 percent female, mean age 60 years] and 76 people without FMS [67 percent female, mean age 68 years] completed questionnaires and assessments, including the Composite Physical Function scale and Beck Depression Inventory-II. Results Although the FMS group had significantly poorer outcomes overall, roles predicted better outcomes among the FMS group when compared with the non-FMS group. Specifically, linear regressions revealed that, for the FMS group, increased roles were positively associated with better health status, quality of life, and physical functioning, as well as fewer depression symptoms. For the non-FMS group, number of roles was positively linked with depression and not significantly associated with any of the other outcomes. Conclusion Results suggest that fulfilling multiple roles may enhance the overall well-being of individuals with FMS.

Typology of Chronic Pain Among Overweight Mexican Americans

Having a better understanding of the intersection between chronic pain and obesity in the Mexican American community can be valuable for pain management specialists in determining treatment, service, and prevention strategies. The objectives of this study were (1) to describe the type and severity of chronic pain among overweight/obese Hispanic adults aged 40 years and older, and (2) to determine the association between chronic pain indices and key demographic variables, including excessive weight. Hispanic adults (N=101) were interviewed using validated questionnaires and measured for BMI and waist circumference. Data analyses revealed that most participants had widespread pain; 60% were suffering severe pain (including back, knee, and shoulder pain); the most common pain location was head (headache, 80%), followed by knee and upper back (75-76%), shoulder (73%) and lower back (73%). Greater obesity was associated with some negative pain outcomes. Results are relevant for pain management with this at-risk population.