Christopher R. Kovacs

Age-Related Changes in Gait and Obstacle Avoidance Capabilities in Older Adults: A Review

Walking is a fundamental motor skill that significantly affects the level of independence in older adults today. Changes in gait and obstacle avoidance strategies have been well documented in the literature, and falling has been shown to be one of the most significant health care concerns in the elderly population today. Falls are a major contributor to the increasing morbidity rates seen in the older population, and in many cases, alterations in gait or stepping ability have played a significant role. This reviewexamines the specific changes seen in gait and obstacle avoidance in the elderly population and some of the underlying changes seen in sensory capability that play a role in safe and efficient ambulation in older adults. Normal gait (unassisted ambulation) will be presented, followed by an examination of the literature that has examined changes in performance factors associated with gait and obstacle avoidance strategies.

Balance and Mobility Training for Older Adults: An Undergraduate Service-Learning Experience

all-related injuries result in billions of dollars in healthcare F costs each year. Ninety percent of the hip fractures and 50 percent of the vertebral fractures reported each year occur as a result of falls. Over the past decade, numerous balance-training intervention programs have been shown to decrease fall rates among older adults (e.g., Buchner et al., 1997; Close et al., 1999). Although it is unlikely that falls can be avoided altogether, decreasing the number of falls that occur is a sure means of decreasing the alarming cost of healthcare in this country. With this goal in mind, we began a service-learning program at the University of North Carolina at Greensboro (UNCG), in the spring of 1999, aimed at improving balance and mobility in a group of older adults while giving students an opportunity to interact with this segment of the population. Service-learning is a means of “combining authentic community service with integrated academic outcomes” (Erickson & Anderson, 1997, p. 1) and is used increasingly as a way to enhance the meaning of learning experiences for students at all levels of the educational process. Faculty in high schools, colleges, and universities infuse service-learning opportunities into their curricula as a way of connecting institutions to communities and adding “hands-on” experiences to traditional lectureand laboratorybased curricula (Floyd, 1998; Harris, 1996; Moore & Sandholtz, 1999). Sigmon (1994) described four general types of service-learning programs. In “service-LEARNING programs, learning is the primary goal, and service is of secondary importance. The typical internship and clinical programs found in most universities fall into this category. “SERVICElearning” programs, however, emphasize the service component, while “SERVICE-LEARNING programs view both aspects as equally important. Sigmon also described “service-learning” programs in which each component is independent, and there is no explicit intention that participation in one will inform the other. The goal of our UNCG program is SERVICE-LEARNING, where students use information from classroom lectures and laboratories to guide their hands-on community work. Over the past several years, UNCG faculty have offered students a range of servicelearning opportunities to enhance instruction and strengthen links between the university and the community. The university’s mission statement, which was revised in 1998, states that the university “will expand its outreach in the Piedmont Triad [the UNCG community], the State of North Carolina, and beyond” (UNCG, 1998). In the Department of Exercise and Sport Science, graduate and undergraduate students participate in a range of programs where they use Sports to teach elementary and middle jchool students about conflict-resolution strategies (Martinek, McLaughlin, & Schilling, 1999). Furthermore, high jchool students, with the guidance of university faculty and students, act as mentors for some of the elementary jchool children. In another program, undergraduate students work with underserved youths at boys’ and girls’ clubs (Harris, 1996). Our program is a service-learning opportunity for students enrolled in a required undergraduate motor-development course. Most of these students are exercise and sport science (ESS) majors who intend to pursue careers in physical education, fitness leadership, and the allied health professions. Nearly two-thirds of the ESS majors are planning to begin their careers in an allied health profession; since elderly Americans are the fastest growing portion of the U.S. population, many of these students will be working with the elderly after graduation. We started this program because we had been contacted by the director of an independent living center in Greensboro who did not have the resources to hire an on-site activities

Age and function differences in shared task performance: walking and talking.

Everyday activity often involves performing two or more simultaneous actions. Common examples are carrying groceries while walking, monitoring traffic while crossing the street, and walking while talking to another person. In older adults, simultaneous performance of two tasks has been shown to lead to performance declines in one or both tasks (Lundin-Olsson, Nyberg, & Gustafson, 1997; Woollacott & Shumway-Cook, 2002). Much of the previous research focused on shared and dual task performance in individuals with cognitive challenges or at risk for falls. Lundin-Olsson and colleagues (1997) found that older adults with a history of falls were unable to carry on a conversation while walking. These individuals tended to stop walking in order to talk with a companion. More recently, Sparrow, Bradshaw, Lamoureux, and Tirosh (2002) determined that increased attentional demands during gait, such as talking, increased reaction time. Increased reaction time during gait may predispose older adults to falls due to a decreased ability to avoid environmental changes, such as circumventing obstacles in their paths. ShumwayCook and colleagues (1997) found that individuals with a history of two or more recent falls swayed more during quiet stance than nonfallers as they completed a series of simultaneous cognitive tasks. Investigating the demands of simultaneous static balance and cognitive tasks has demonstrated the attention-demanding nature of even quiet stance. There have been fewer investigations of shared performance of dynamic tasks; it is equally important to determine the impact of the changing demands of these tasks on older adults. As noted previously, Lundin-Olsson and colleagues (1997) determined that older adults with a history of falls were unable to perform two tasks simultaneously. Many participants in their investigation were cognitively impaired, were depressed, or had had a stroke. Bowen and colleagues (2001) also reported gait changes among older adults recovering from stroke. Velocity decreased and double-support time increased, when these individuals attempted a simultaneous cognitive task. Other investigators have examined dual-task performance in healthy older adults. Chen and colleagues (1996) found that errors increased in both younger and older participants who responded to a visual reaction-time stimulus while walking and attempting to avoid a virtual object. The magnitude of increase was greater for the older adults. Other researchers suggested that a dual task situation requiring memorization also significantly impacts performing a secondary task, including walking over level surfaces. Additionally, there is evidence that cognitive tasks increase alterations in motor performance with increased age (Li, Lindenberger, Freund, & Baltes, 2001; Lindenberger, Marsiske, & Baltes, 2000). Less is known about the effects of normal aging on speech output than other motor actions, because studies of communication integrity have focused on voice production and linguistic parameters rather than speech production characteristics. Studies investigating Age and Function Differences in Shared Task Performance: Walking and Talking

Sensory Training Effects on Obstacle Avoidance in Healthy Older Adults

The purpose of this study was to examine the effectiveness of a five-day balance training program on obstacle avoidance measures in a group of healthy older adults. A 2 × 3 repeated measures MANOVA revealed no significant differences between three groups of older adult participants. A follow-up paired t-test revealed a significant difference between the control group and the experimental and walking control groups for pre- and post-tests. These results suggest that a five-day program is ineffective for improving measures of toe clearance, heel clearance, horizontal shear, and gait velocity, but may be beneficial in delaying a loss in obstacle crossing speed in healthy older adults.

Scuba Diving and Kinesiology: Development of an Academic Program

The use of scuba diving as a recreational activity within traditional university instructional programs has been well established. Departments focusing on kinesiology, physical education, or exercise science have often provided scuba diving lessons as part of their activity-based course offerings. However, few departments have developed an academic scuba diving minor designed to meet the professional needs of students interested in both a scuba-based career and a traditional kinesiology profession. The Department of Kinesiology at Western Illinois University has developed and implemented an academic minor in scuba diving designed to provide unique academic and professional preparation for students interested in diving as a professional career. Students from a variety of academic majors, including kinesiology, are benefitting from courses designed to prepare students scientifically, technically, and academically for future employment in recreational, law-enforcement, and scientific careers utilizing scuba diving skills and techniques. The purpose of this article is to highlight the development and usefulness of this unique program and discuss its significance to an academic department in kinesiology and to the overall professional field.

Self-reported exercise behaviour and perception of its importance to recreational divers

BACKGROUND This study examined self-reported physical activity and perceptions of exercise importance among certified divers in two distinct age groups. MATERIALS AND METHODS Questionnaires were distributed by hand at dive sites in three states of the United States, half to students from an academic programme in scuba diving at a regional university. The survey included questions about health status, dive history, certification levels, structured exercise activity levels and perceived importance of regular exercise to their health, diving ability, and safety. Also included was the Godin-Shephard Leisure-Time Physical Activity Questionnaire, a validated physical activity classification instrument for use among adults. RESULTS Non-students were older than the students and had greater diving experience. There was no detectable difference between groups in perceived exercise importance to health (p = 0.69), diving ability (p = 0.75), or diving safety (p = 0.25). Fitting age, sex, occupation and number of dives to a generalised linear model to predict Godin-Shephard scores, number of dives was removed first (p = 0.43), followed by student status (p = 0.33). Remaining predictors of Godin-Shephard exercise scores were age (-0.004 per year, p < 0.0001) and sex (males = + 0.11, 95% CI 0.04-0.17, p = 0.0012). Both groups reported similar structured exercise regularity, overall health and perceived importance of regular exercise for health, diving and safety. CONCLUSIONS Despite acknowledging the importance of exercise, Godin-Shephard scores for physical activity decrease with age.

Measuring Motor Skill Learning—A Practical Application

The assessment of fundamental motor skills in early learners is critical to the overall well-being and physical development of the students within the physical education setting. Olrich (2002) has suggested that any physical education program must be designed to assess both measures of physical fitness and fundamental motor skills in all students. By promoting and assessing the physical fitness of our youth in physical education programs, we may impact future behaviors that might influence lifelong patterns of physical activity (Whitall, 1992). The specific methods of physical fitness testing that are most appropriate in the classroom and how to perform those specific tests have been addressed in the literature (Wikgren, 1992).