Step Training Improves the Speed of Voluntary Step Initiation in Aging

Rogers, Mathew W.; Johnson, Matthew L.; Martinez, Katherine M.; Mille, Marie-Laure; Hedman, Lois Deming

doi:10.1093/gerona/58.1.m46

Cited by 97 publications

(71 citation statements)

References 23 publications

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“…This underscores the contribution of other changes occurring in response to training beyond leg strength improvement, which could include psychological changes such as self-efficacy and -confidence [23] , reaction time [24] , or an interaction of factors related to movement and mobility.…”

Section: Discussionmentioning

confidence: 96%

Impact of Training Modality on Strength and Physical Function in Older Adults

et al. 2009

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Background: The importance of maintaining strength in older adults is well documented and various training modalities have been recommended; however, the effectiveness of various interventions with high translation to public health practice has not been completely characterized. Additionally, the interrelations among mode, strength, and lower extremity physical function (LEPF) changes in older adults warrant further investigation. Purpose: The primary aims were to examine the effectiveness of cardiovascular endurance training (CVE) compared with balance and flexibility training (FLEX) and to explore the relationship of muscle strength to LEPF. Methods: Fifty-five adults (69.1 ± 5.6 years, 35 female) were randomly assigned to 10 months of CVE or FLEX. Knee extension and flexion at 60 and 120°·s^–1 were measured using an isokinetic dynamometer. LEPF was measured using a battery of tasks. The CVE group exercised using treadmills, cycles, and elliptical trainers. The FLEX group participated in a group exercise class that incorporated flexibility and balance activities. Results: The CVE training group significantly improved peak oxygen consumption by 6% (p = 0.03), while the FLEX training group showed no change (p = 0.47). Participants significantly improved peak torque at both speeds and muscle actions by 21–65% (p ≤ 0.05), with no group effect (p > 0.05). Both groups also significantly improved performance on all LEPF tasks included in this study (4–7%, p ≤ 0.05). Significant correlations (all p = 0.00) were found between improvements in strength and improvements in LEPF including timed walk and peak torque extension and flexion at 60°·s^–1 (r = 0.40 and 0.27, respectively), obstacle walk and peak torque extension and flexion at 60 and 120°·s^–1 (r range 0.27–0.40), and stair ascent and peak torque extension at 120°·s^–1 (r = 0.37). Conclusions: Sedentary older adults achieve similar improvements in strength and LEPF with either CVE or FLEX training with the latter being related to improvements in leg strength.

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Section: Discussionmentioning

confidence: 96%

Impact of Training Modality on Strength and Physical Function in Older Adults

et al. 2009

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“…0.03). Rogers et al [21] found that a 3-week period of either voluntary or waist-pull-induced step training reduced step initiation time in older and younger adults. However, the findings of previous studies regarding the effects of exercise on step/gait initiation reaction times are inconsistent.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only a few studies have examined the effects of exercising on step reaction times under single-task conditions [21] , and others have suggested including step training during dual-task conditions [22,23] in the elderly. An additional aim was to investigate the association between step execution behavior and self-reported physical function and balance performance in older persons.…”

mentioning

confidence: 99%

Regular Exercise in the Elderly Is Effective to Preserve the Speed of Voluntary Stepping under Single-Task Condition but Not under Dual-Task Condition

Melzer

Marx²,

Kurz³

2008

Gerontology

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Background: Stepping response may be considered the most important postural reaction to prevent a fall because it is the inability to respond effectively to a loss of balance that ultimately determines whether a fall occurs. However, very little has been studied on the effect of exercising on step execution behavior in the elderly. Objectives: To explore whether older persons who exercise regularly have faster voluntary stepping times than sedentary elderly persons. Additionally, we investigated the association between step execution behavior, self-reported physical function, and balance performance. Methods: Case-control study of 48 elderly adults aged 65–91 years who live independently in retirement homes. Participants were classified as 24 exercisers (reporting >2 exercise training activities/week) and 24 age- and gender-matched inactive elderly individuals (who do not exercise regularly). The Voluntary Step Execution Test was performed as a reaction time task while standing on a force platform under single-task and dual-task conditions. Step initiation phase, foot off time, foot contact time, preparatory, and swing phases were extracted from center of pressure and ground reaction force data. Self-reported function was examined using Late-Life Function and Disability Instrument; Berg Balance Test was also performed. Results: Exercisers had significantly faster voluntary step times in single-task condition (959 vs. 1,158 ms) but not during dual-task condition (1,170 vs. 1,303 ms). Exercisers had a significantly higher Berg Balance Test (53.7 ±3.6 vs. 49.8 ±5.3), consumed less medication (3.3 ±2.3 vs. 5.6 ±2.9), and their lower extremity function scores were higher (88.61 ±2.3 vs. 73.1 ±2.7) than those of inactive subjects. Conclusion: Exercising regularly protects from physical functioning loss in older persons and against a decrease in voluntary step execution times during single-task but not during dual-task conditions. Lack of specificity (dual-task exercises) during the training may be the cause of insignificant differences in dual-task stepping performance. Thus, adding dual-task training may improve dual-task performance in the elderly.

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“…However, the task is difficult, and some elderly people cannot carry out this task. Rogers et al [26] reported their attempt to characterize the agility of elderly people by measuring the time before stepping begins in response to sensory stimulation. This method, however, requires a device for measurement and is hence somewhat complicated.…”

Section: Discussionmentioning

confidence: 99%

A New Simple Performance Test Focused on Agility in Elderly People: The Ten Step Test

et al. 2008

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Background: Not only the reduction of muscle strength or balance, but also the reduction of the agility are regarded as important factors of falls in elderly people. If an agility test for elderly people is established, the precision of the fall prediction rises and can be used for individual training. Objectives: To develop a new performance test focused on agility for elderly people and to evaluate the usefulness of this test. Design: Cross-sectional study. Setting: The Welfare Center of Kagami Town, Kagami Town Office, etc., Kochi, Japan. Participants: 828 community-dwelling, independent adults aged 20–99 years with no obvious cognitive or functional disability, were randomly recruited from Kagami town and the surrounding areas. Measurements: The Ten Step Test (TST, a new performance test), motor reaction time (MRT), knee extensor isometric strength, single leg standing time (SLST), and some other tests were used to evaluate the criterion-related validity and the content validity. TST was developed as a modified version of other step tests which require the subjects to place the whole foot on a block, then return it to the floor. In addition, female participants over 70 were asked whether or not they had fallen in the past year. Results: Excellent reliability for TST was found for interrelation (intra-class correlation coefficients, ICC = 0.96), and re-test reliability was sufficient (ICC = 0.86). Evidence for criterion-related validity was found through high single correlation with the timed supine-to-stand (r = 0.68) and high single correlation with MRT (r = 0.59). In addition, content validity was found through low correlation with knee extensor strength (–0.35) and SLST (–0.36) in 112 women over 70 years of age. The error rate by TST to predict falls (35.2%) was lower than the error rate by muscle strength (44.4%) and the balance (38.7%). TST confirmed decline after 50 years of age, and it conformed to a cubic curve. Conclusion: The findings indicate that TST is a reliable measure of agility, and it can help to predict the risk of falls. The decline of agility accelerates after 50 years of age. It shows that the decline of agility differs from the decline of leg muscle strength and balance.

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Step Training Improves the Speed of Voluntary Step Initiation in Aging

Cited by 97 publications

References 23 publications

Impact of Training Modality on Strength and Physical Function in Older Adults

Impact of Training Modality on Strength and Physical Function in Older Adults

Regular Exercise in the Elderly Is Effective to Preserve the Speed of Voluntary Stepping under Single-Task Condition but Not under Dual-Task Condition

A New Simple Performance Test Focused on Agility in Elderly People: The Ten Step Test

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