Priscilla G. MacRae

Functional Incidental Training, Mobility Performance, and Incontinence Care with Nursing Home Residents

OBJECTIVE: To determine if an exercise intervention, Functional Incidental Training (FIT), results in improvements in mobility endurance and physical activity when compared with prompted voiding (PV) among cognitively and mobility impaired nursing home residents.

A Walking Program for Nursing Home Residents: Effects on Walk Endurance, Physical Activity, Mobility, and Quality of Life

OBJECTIVES: To determine the effects of a 12‐week walking program on walk endurance capacity, physical activity level, mobility, and quality of life in ambulatory nursing home residents who had been identified as having low physical activity levels and low walk endurance capacities. To determine the effects of 12 versus 22 weeks of walk training on walk endurance capacity, physical activity level, mobility, and quality of life in ambulatory nursing home residents.

Does Physical Activity Improve Sleep in Impaired Nursing Home Residents

OBJECTIVES: To determine if two physical activity programs of varying intensity would result in improved sleep among incontinent and physically restrained nursing home residents.

Exercise with Physically Restrained Nursing Home Residents: Maximizing Benefits of Restraint Reduction

OBJECTIVE: To evaluate an exercise protocol designed to improve strength and mobility, and to decrease injury risk factors in physically restrained nursing home residents.

Reaction time and nigrostriatal dopamine function: the effects of age and practice

Normal aged and Parkinsonian individuals lose the ability to initiate movements rapidly (increased reaction time) in parallel with changes in the nigrostriatal dopamine (DA) system. However, the ability of these individuals to improve their reaction time with practice has not been adequately assessed. We have developed a rodent model of human reaction time in which reaction time performance correlates highly with neurochemical measures of nigrostriatal DA integrity. In the present report, 15 young and 10 old male Sprague-Dawley rats were conditioned in a reaction time task to release a lever quickly in response to external stimuli in order to avoid a mild footshock. In order to examine the effects of practice on this reaction time task, the young animals were tested for 5 days at 3, 6 and 9 months of age and the old animals were tested for 5 days at 18, 21, and 24 months of age. From this well-practiced task, reaction time response latencies were measured and compared to measures of nigrostriatal DA function (steady-state levels of DA and its metabolites, D2DA receptor affinity and density). The old animals were slower in response latencies than the young animals. These age differences in response latencies, however, disappeared after several days of testing at each of the 3 test sessions, so that the old animals were not significantly slower than the young animals on days 4 and 5 of each session. As expected, the old animals showed reduced striatal D2DA receptor density with no age differences in DA receptor affinity.(ABSTRACT TRUNCATED AT 250 WORDS)

Wheelchairs as Mobility Restraints: Predictors of Wheelchair Activity in Nonambulatory Nursing Home Residents

OBJECTIVE: The purpose of this paper is to describe factors affecting wheelchair mobility in nonambulatory nursing home (NH) residents.

Quantitative gait assessment as a predictor of prospective and retrospective falls in community-dwelling older women

The purpose of this investigation was to identify gait-related risk factors associated with both retrospective and prospective falls in 17 community-dwelling older women (mean age 73.4 years). The subjects were videotaped walking at their freely-chosen speed and 21 quantitative kinematic biomechanical variables describing the gait of each individual were computed. Faller status in the preceding year was determined by retrospective self reports and was monitored by an investigator for 10 months after the subjects were videotaped. None of the variables distinguished the retrospective fallers from nonfallers or were a significant predictor of prospective falls. The findings suggest that quantitative kinematic gait variables alone may not identify risk factors associated with falling in community-dwelling older women.

Strength training effects on rearfoot motion in running.

The investigation examined isokinetic (IK) and nonisokinetic (NIK) strength training programs for the inversion (INV) and eversion (EV) muscles on pronation during running. Seventy-seven volunteers were videotaped running on a treadmill at 3.8 m.s-1 and total pronation (delta beta PRO) was computed. Eighteen heel-strike runners with the largest values of delta beta PRO (X = 16.7 degrees) were selected as subjects. During the pre- and posttests, isokinetic muscle strength at 20 and 180 degrees.s-1 was determined for the concentric (CON) and eccentric (ECC) actions of the INV and EV muscle groups. The subjects also were videotaped running on a treadmill (3.8 m.s-1). The IK training group performed three sets of eight CON and ECC repetitions at 20, 90, and 180 degrees.s-1 for both muscle groups; and the NIK subjects did exercises commonly used in ankle rehabilitation. Each group trained three times weekly for 8 wk. The IK group showed significantly (P < or = 0.05) CON and ECC strength increases for all INV test conditions and three of the four EV conditions (20 degrees.s-1 CON and ECC, and 180 degrees.s-1 CON). They also demonstrated significant decreases in the rearfoot (2.2 degrees) and pronation/supination (2.9 degrees) angles at heel strike and in delta beta PRO (-2.2 degrees).l The NIK group exhibited no change in rearfoot motion and only increased INV strength at the 180 degrees.s-1 ECC test condition. The findings suggest that pronation can be decreased by an isokinetic strength training program for the INV and EV muscles.

Why Do Healthy Older Adults Fall

Falls among elders at senior centers may be due more to behavioral and environmental risks than to impaired health, strength, and balance. We monitored 222 older adults at senior centers weekly for two years and documented 242 falls; their location (outdoors: inside the home, or in transition areas, such as garage or patio), activities associated with the fall, and consequences of the fall, such as parts of the body that received the impact of the fall and the associated level of injury. As hypothesized, healthy elderly fell more often outdoors and in transition areas than inside their home. They fell most often due to inattention and in association with hazardous activities.

Age and practice effects on inter-manual performance asymmetry

Manual dexterity declines with increasing age, however, the way in which inter-manual asymmetry responds to aging is unclear. Our purpose was to determine the effect of age and practice on inter-manual performance asymmetry in an isometric force pinch line tracing task that varied in difficulty within segments. Thirty right-handed participants, five males and five females in each of three age groups, young (Y20), young–old (O70), and old–old (O80), practiced an isometric force pinch task for 10 trials with each hand on each of five consecutive days. Inter-manual performance asymmetry of the right and left hands was analyzed with a repeated measures analysis of variance (ANOVA) of asymmetry with age groups, practice, task difficulty, and hand as factors. The within-individual magnitude of asymmetry was also analyzed with a repeated measures ANOVA of manual asymmetry calculated as an asymmetry index (AI). Post hoc pair-wise comparisons were performed when significance was found. We observed no inter-manual performance asymmetry on this isometric tracing task among any of the age groups, either in the hand performance differences or in the magnitude of the AI. Age and practice interacted in terms of manual performance: the Y20 and O70 group improved accuracy and task time across the 5 days of practice but the O80 group did not. However, practice did not differentially affect the AI for accuracy or task time for any group. Accuracy of performance of the two hands was differentially affected by practice. All age groups exhibited poorer performance and larger AIs on the most difficult segments of the task (3 and 6) and this did not change with practice.