Walking With a Rollator and the Level of Physical Intensity in Adults 75 Years of Age or Older

Abstract

ABSTRACT. Eggermont LH, van Heuvelen MJ, van Keeken BL, Hollander AP, Scherder EJ. Walking with a rollator and the level of physical intensity in adults 75 years of age or older. Arch Phys Med Rehabil 2006;87:733-6.Objective: To determine whether walking with a rollator by persons 75 years of age or older is of sufficient intensity to improve aerobic fitness.Design: A cross-sectional cohort study. Setting: University movement laboratory. Participants: Fifteen subjects 75 years of age or older (mean age, 83.7y) who could only walk by using a rollator.Interventions: Not applicable. Main Outcome Measures: During 6 minutes of self-paced treadmill walking using a rollator at a mean walking speed of 0.6m/s, oxygen uptake (V O 2 ), carbon dioxide production, and heart rate were determined. Respiratory exchange ratio (RER) and energy expenditure were calculated. The energy expenditure was expressed as the number of metabolic equivalents (METS), the percentage of estimated maximal V O 2 (V O 2 max), the percentage of estimated V O 2 max reserve, and the percentage of estimated maximal heart rate.Results T HERE IS INCREASING EVIDENCE of a positive relation between physical activity, physiologic parameters such as blood pressure, functional abilities, balance, flexibility, muscle strength, and cognitive functioning in older adults. [1][2][3][4][5][6] Cognitive functions are particularly vulnerable to aging 7 and are crucial for independent living. 8 Older adults with a decrease in physical activity caused by poor cardiorespiratory condition have experienced greater cognitive decline over a period of 6 years compared with older adults showing high cardiorespiratory fitness. 9 In healthy, sedentary older subjects, aerobic activities resulted in a significant improvement in the maximal oxygen uptake (V O 2 max) and to benefit executive functions such as inhibition and planning. 10 These studies, however, involved high-intensity physical activity such as running. 10 This type of physical activity is usually not appropriate for people of advanced age. 11 It is known that physical fitness (eg, muscle strength, balance) decreases with age. 12 Consequently, many of the oldest old (age Ͼ75y) can only stay mobile by the use of a walking aid 13 and are unable to run. In 1 study, 14 more than half of the 599 subjects aged 75 or over who were surveyed owned 1 or more walking devices. In sum, for frail older people, walking with a device like a rollator is a much more appropriate activity than activities such as running.In view of the effects of aerobic activity on for instance executive functions, it is important to know the exact amount of energy expended when walking with a rollator and does this constitute adequate aerobic activity. This has not been examined before. According to the guidelines of the American College of Sports Medicine (ACSM), 15 activities with an intensity of 55% to 65% of maximal heart rate or 40% to 50% of V O 2 max reserve (V O 2 max minus resting V O 2 ) are appropriate to increase or maintain cardiorespirato...

Why is walker-assisted gait metabolically expensive?

“…Many elderly people report that walkers are difficult to use [3,4]. A major difficulty is that the metabolic cost of ambulation with a walker is greatly elevated [5][6][7][8][9] combined with the diminished aerobic capacity associated with aging [10][11][12][13][14]. In this study, we quantified the major reasons why walker-assisted gait is so expensive.…”

The Intensity of Chair-Assisted Exercises in Cognitively Healthy Older Adults

“…The chair-assisted exercises of this study meet the intensity criterion for healthy aging (Chodzko-Zajko et al, 2009). The intensity of chair-assisted exercises is comparable to the intensity of walking in older people (Eggermont et al, 2006). It is known that walking may increase cognition, in particular executive functions (Kramer, Erickson, & Colcombe, 2006).…”

“…Participants were excluded from the study if they were younger than 70 years, not able to walk short distances with or without a walking aid, or suffering from a cognitive impairment (MMSE < 23). Participants' medical history showed comorbidities that were representative of the general population of this age (Eggermont, van Heuvelen, van Keeken, Hollander, & Scherder, 2006). Fifteen participants used β-blockers during their participation in this study, and 3 participants used other heart-rate-reducing medication (amiodaron, flecainide).…”

“…The mean intensity of the 30-min session of chair-assisted exercises was calculated and expressed as mean VO 2 (L/min) and mean VO 2 per kilogram of body weight (ml · min -1 · kg -1 ). To estimate whether VO 2 was of at least moderate intensity, it was recalculated as a percentage of participants' estimated VO 2max by the same method as a comparable study for people age 55-86 years (Eggermont et al, 2006 of participants' estimated HR max , which was estimated by 220 -age. The mean percentage of HR max was determined for the whole group (n = 44, because HR measure failed in 3 participants) and for the group of non-b-blocker users (n = 26), because β-blockers (n = 15) reduce HR (Parakh & Bhargava, 2011).…”

Lichamelijke activiteit, cognitie en dementie

“…Een activiteit die veel wordt uitgevoerd door verzorgingshuisbewoners en daardoor mogelijk een geschikte interventie zou kunnen zijn is lopen, eventueel met een rollator. Onderzocht is wat het energieverbruik is van het uitvoeren van deze activiteit door ouderen (Eggermont et al, 2006a). Vijftien ouderen (gemiddelde leeftijd 84 jaar) liepen met hun rollator in hun eigen tempo op een loopband terwijl het zuurstofverbruik en de hartslag werden gemeten.…”