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The Performance Enhancement Project: improving physical performance in older persons
Mary B King1, Robert H Whipple, Cynthia A Gruman
1Hartford Hospital Geriatric Program, CT 06106, USA. mking@harthosp.org
Archives of Physical Medicine and Rehabilitation
|August 6, 2002
Summary
Center-based exercise improved physical function in older adults for up to a year. However, these benefits diminished when participants transitioned to home-based routines, suggesting ongoing classes may be needed for sustained improvements in physical performance.
Area of Science:
- Gerontology and Exercise Science
- Geriatric Rehabilitation
- Physical Therapy Interventions
Background:
- Older adults are at risk for declining physical functioning, impacting independence.
- Community-dwelling seniors with mobility impairments require effective interventions.
- Understanding the long-term effects of different exercise settings is crucial.
Purpose of the Study:
- To evaluate the impact of center-based exercise on physical performance in older adults.
- To compare center-based exercise with home-based exercise in seniors at risk for functional decline.
- To determine the sustainability of exercise benefits after transitioning to home-based programs.
Main Methods:
- Randomized controlled trial involving 155 community-dwelling older adults (≥70 years) with mobility impairments.
- Intervention group: supervised center-based exercise (endurance, strength, balance, flexibility) for 12 months, followed by home exercise.
- Control group: home-based endurance exercise instruction.
- Outcome measures: MacArthur battery, Physical Performance Test (PPT-8), 6-Minute Walk Test (6MWT) assessed over 18 months.
Main Results:
- The center-based exercise group showed significant improvements in the MacArthur battery scores at 3, 6, and 12 months compared to the home control group.
- Improvements in the MacArthur battery were not sustained at 18 months after the intervention shifted to home-based exercise.
- No significant improvements were observed in the PPT-8 or 6MWT for either group.
- Predictors of sustained improvement included younger age, better baseline physical function, and self-perceived health.
Conclusions:
- Center-based exercise effectively enhanced gait, chair rise, and balance in older adults for the first year.
- The benefits of center-based exercise were not maintained when participants transitioned to home exercise programs.
- Ongoing supervised classes at senior centers may be essential for sustaining physical performance gains in older populations.