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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Old adults perform activities of daily living near their maximal capabilities
Tibor Hortobágyi1, Chris Mizelle, Stacey Beam
1Biomechanics Laboratory, 332A Ward Sports Medicine Building, East Carolina University, Greenville, NC 27858, USA. hortobagyit@mail.ecu.edu
Background:
Old adults' ability to execute activities of daily living (ADLs) declines with age. One possible reason for this decline is that the execution of customary motor tasks requires a substantially greater effort in old compared with young adults relative to their available maximal capacity.
Methods:
We tested the hypothesis that the relative effort (i.e., the percentage of joint moment relative to maximal joint moment) to execute ADLs is higher in old adults compared with young adults. Healthy young adults (n = 13; mean age, 22 years) and old adults (n = 14; mean age, 74 years) ascended and descended stairs and rose from a chair and performed maximal-effort isometric supine leg press. Using inverse dynamics analysis, we determined knee joint moments in ADLs and computed relative effort.
Results:
Compared with young adults, old adults had 60% lower maximal leg press moments, 53% slower knee angular velocity at peak torque, and 27% lower knee joint moments in the ADLs (all p <.05). Relative effort in ascent was 54% (SD +/- 16%) and 78% (+/-20%) in young and old adults, respectively; in descent, it was 42% (+/-20%) and 88% (+/-43%); and in chair rise, it was 42% (+/-19%) and 80% (+/-34%) (all p <.05). The relative electromyographic activity of the vastus lateralis and the coactivity of the biceps femoris associated with this relative effort were, respectively, 2- and 1.6-fold greater in old compared with young adults in the 3 ADLs (p <.05).
Conclusions:
For healthy old adults, the difficulty that arises while performing ADLs may be due more to working at a higher level of effort relative to their maximum capability than to the absolute functional demands imposed by the task.
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