Advertisement

Aging Clinical and Experimental Research

, Volume 12, Issue 4, pp 274–280 | Cite as

Assessment of physical function and exercise tolerance in older adults: Reproducibility and comparability of five measures

  • E. M. Simonsick
  • A. W. Gardner
  • E. T. Poehlman
Original Article

Abstract

This study examined the reproducibility and comparability of five measures of function and exercise tolerance. The test battery and questionnaire on function and physical activity were administered twice, 7–10 days apart to 38 men and 12 women aged 54–80 years at the Baltimore Veterans Affairs Medical Center. Tests included fast pace 4 and 20-meter walks, 6-minute and graded treadmill walks, and a seated step test. All tests demonstrated good reproducibility with Pearson and intraclass correlation coefficients ranging from 0.84 to 0.98, and percent differences on retest ranging from 4 to 11%. Although correlations between different tests were all significant (range 0.34–0.89), comparison of performance ranks and linear regression analyses indicated that the short fast walks and seated step test may not be suitable substitutes for treadmill or long self-paced corridor walks. Only 28% had the same quintile performance ranking on the step test as on the treadmill walk, and 36% had rankings 2 or more points apart. The fast 20m walk shows the most promise as a low-level alternative to the 6-minute walk; performances had a correlation of 0.73, 82% of ranks were within one point, and 20m speed explained 42% of the variance in distance covered. More development is needed for comprehensive assessment of exercise tolerance in older adults; the 6-minute walk did not adequately discriminate fitness level in persons who walk regularly, and the treadmill posed problems for those with walking difficulty.

Key words

Aging exercise tolerance fitness assessment physical function walking tests 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bruce R.A.: Functional aerobic capacity, exercise, and aging. In: Andres R., Bierman E.L., Hazzard W.R. (Eds.), Principles of Geriatric Medicine. McGraw-Hill Book Company, New York, 1985, pp. 87–103.Google Scholar
  2. 2.
    Blessey R.L.: Energy cost in the physically impaired geriatric population. Topics Geriatr. Rehab. 2: 33–43, 1986.CrossRefGoogle Scholar
  3. 3.
    Hollenberg M., Ngo L.H., Turner D., Tager I.B.: Treadmill exercise testing in an epidemiologic study of elderly subjects. J. Gerontol. 53: B259–B267, 1998.CrossRefGoogle Scholar
  4. 4.
    Wilson P.W.F., Paffenbarger Jr. R.S., Morris J.N., Havlik R.J.: Assessment methods for physical activity and physical fitness in population studies: Report of a NHLBI workshop. Am. Heart J. 111: 1177–1192, 1986.PubMedCrossRefGoogle Scholar
  5. 5.
    Peeters P., Mets T.: The 6-minute walk as an appropriate exercise test in elderly patients with chronic heart failure. J. Gerontol. 51A: M147–M151, 1996.CrossRefGoogle Scholar
  6. 6.
    Guyatt G.H., Sullivan M.J., Thompson P.J., Fallen E.L., Pugsley S.O., Taylor D.W., Berman L.B.: The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can. Med. Assoc. J. 132: 919–923, 1985.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Lipkin D.P., Scrivin A.J., Crake T., Poole-Wilson P.A.: Six minute walking test for assessing exercise capacity in chronic heart failure. BMJ 292: 653–655, 1986.PubMedCrossRefGoogle Scholar
  8. 8.
    Bittner V., Weiner D.H., Yusuf S., Rogers W.J., McIntyre K.M., Bangdiwala S.I., Kronenberg M.W., Kostis J.B., Kohn R.M., Guillotte M., Greenberg B., Woods P.A., Bourassa M.G.: Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. JAMA 270: 1702–1707, 1993.PubMedCrossRefGoogle Scholar
  9. 9.
    Butland R.J.A., Pang J., Gross E.R., Woodcock A.A., Geddes D.M.: Two-, six-, and 12-minute walking tests in respiratory disease. BMJ 284: 1607–1608, 1982.PubMedCrossRefGoogle Scholar
  10. 10.
    Swerts P.M.J., Mostert R., Wouters E.F.M.: Comparison of corridor and treadmill walking in patients with severe chronic obstructive pulmonary disease. Phys. Ther. 70: 439–442, 1990.PubMedGoogle Scholar
  11. 11.
    Swinburn C.R., Wakefield J.M., Jones P.W.: Performance, ventilation, and oxygen consumption in three different types of exercise test in patients with chronic obstructive lung disease. Thorax 40: 581–586, 1985.PubMedCrossRefGoogle Scholar
  12. 12.
    Knox A.J., Morrison J.F.J., Muers M.F.: Reproducibility of walking test results in chronic obstructive airways disease. Thorax 43: 388–392, 1988.PubMedCrossRefGoogle Scholar
  13. 13.
    Montgomery P.S., Gardner A.W.: The clinical utility of a six-minute walk test in peripheral arterial occlusive disease patients. J. Am. Geriatr. Soc. 46: 706–711, 1998.PubMedGoogle Scholar
  14. 14.
    Péloquin L., Gauthier P., Bravo G., Lacombe G., Billiard J.S.: Reliability and validity of the five-minute walking field test for estimating VO2 peak in elderly subjects with knee osteoarthritis. J. Aging Phys. Act. 6: 36–44, 1998.Google Scholar
  15. 15.
    Seeman T.E., Charpentier P.A., Berkman L.F., Tinetti M.E., Guralnik J.M., Albert M., Blazer D., Rowe J.W.: Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur Studies of Successful Aging. J. Gerontol. 49: M97–M108, 1994.PubMedCrossRefGoogle Scholar
  16. 16.
    Ferrucci L., Guralnik J.M., Bandeen-Roche K.J., Lafferty M.E., Pahor M., Fried L.P.: Physical performance measures. In: Guralnik J.M., Fried L.P., Simonsick E.M., Kasper J.D., Lafferty M.E. (Eds.), The Women’s Health and Aging Study: Health and social characteristics of older women with disability. National Institute on Aging, Bethesda, MD, 1995, pp. 35–49.Google Scholar
  17. 17.
    Cunningham D.A., Rechnitzer P.A., Pearce M.E., Donner A.P.: Determinants of self-selected walking pace across ages 19 to 66. J. Gerontol. 37: 560–564, 1982.PubMedCrossRefGoogle Scholar
  18. 18.
    Smith E.L., Gilligan C.: Physical activity prescription for the older adult. Physician Sports Med. 11: 91–101, 1983.Google Scholar
  19. 19.
    Simonsick E.M., Fried L.P.: Exercise tolerance and body composition. In: Guralnik J.M., Fried L.P., Simonsick E.M., Kasper J.D., Lafferty M.E. (Eds.), The Women’s Health and Aging Study: Health and social characteristics of older women with disability. National Institute on Aging, Bethesda, MD, 1995, pp. 106–117.Google Scholar
  20. 20.
    Simonsick E.M., Maffeo C.E., Rogers S.K., Skinner E.A., Davis D., Guralnik J.M., Fried L.P.: Methodology and feasibility of a home-based examination in disabled older women: The Women’s Health and Aging Study. J. Gerontol. 52A: M264–M274, 1997.CrossRefGoogle Scholar
  21. 21.
    Gardner A.W., Skinner J.S., Cantwell B.W., Smith L.K.: Progressive vs single-stage treadmill tests for evaluation of claudication. Med. Sci. Sports Exerc. 23: 402–408, 1991.PubMedCrossRefGoogle Scholar
  22. 22.
    Davies M.J., Dalsky G.P.: Economy of mobility in older adults. J. Orthop. Sports Phys. Ther. 26: 69–72, 1997.PubMedCrossRefGoogle Scholar
  23. 23.
    Jettè M., Sidney K., Blümchen G.: Metabolic Equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin. Cardiol. 13: 555–565, 1990.PubMedCrossRefGoogle Scholar
  24. 24.
    American College of Sports Medicine: Guidelines for Exercise Testing and Prescription, 4th Ed. Lea & Febiger, Philadelphia, 1991.Google Scholar
  25. 25.
    SAS Institute Inc.: SAS/STAT User’s Guide, release 6.03 ed. SAS Institute Inc., Cary, NC, 1988.Google Scholar
  26. 26.
    Oja P., Luakkanen R., Pasanen M., Tyry T., Vuori I.: A 2-km walking test for assessing the cardiorespiratory fitness of healthy adults. Int. J. Sports Med. 12: 356–362, 1991.PubMedCrossRefGoogle Scholar
  27. 27.
    Guyatt G.H., Pugsley S.O., Sullivan M.J., Thompson P.J., Berman L., Jones N.L., Fallen E.L., Taylor D.W.: Effect of encouragement on walking test performance. Thorax 39: 818–822, 1984.PubMedCrossRefGoogle Scholar
  28. 28.
    McGavin C.R., Gupta S.P., McHardy G.J.R.: Twelve-minute walking test for assessing disability in chronic bronchitis. BMJ 1: 822–823, 1976.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2000

Authors and Affiliations

  • E. M. Simonsick
    • 1
  • A. W. Gardner
    • 2
    • 3
  • E. T. Poehlman
    • 4
  1. 1.Epidemiology, Demography, and Biometry ProgramNational Institute on AgingBethesdaUSA
  2. 2.Department of Medicine, Division of GerontologyUniversity of MarylandBaltimoreUSA
  3. 3.Geriatric Research, Education and Clinical CenterBaltimore Veterans Affairs Medical CenterBaltimoreUSA
  4. 4.Department of MedicineUniversity of VermontBurlingtonUSA

Personalised recommendations