Volume 49, Issue 11 p. 1418-1427

Task-Specific Resistance Training to Improve the Ability of Activities of Daily Living–Impaired Older Adults to Rise from a Bed and from a Chair

Neil B. Alexander MD

Neil B. Alexander MD

Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center;

Division of Geriatric Medicine, Department of Internal Medicine, and

Institute of Gerontology, University of Michigan, Ann Arbor, Michigan; and

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Andrzej T. Galecki MD, PhD

Andrzej T. Galecki MD, PhD

Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center;

Institute of Gerontology, University of Michigan, Ann Arbor, Michigan; and

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Martina L. Grenier BA,

Martina L. Grenier BA,

Division of Geriatric Medicine, Department of Internal Medicine, and

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Linda V. Nyquist PhD

Linda V. Nyquist PhD

Institute of Gerontology, University of Michigan, Ann Arbor, Michigan; and

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Mark R. Hofmeyer BS

Mark R. Hofmeyer BS

Division of Geriatric Medicine, Department of Internal Medicine, and

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Julie C. Grunawalt MS RCNS

Julie C. Grunawalt MS RCNS

Division of Geriatric Medicine, Department of Internal Medicine, and

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Judi L. Medell BS, MPT

Judi L. Medell BS, MPT

Division of Geriatric Medicine, Department of Internal Medicine, and

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Donna Fry-Welch PT, PhD

Donna Fry-Welch PT, PhD

School of Health Professions and Studies, University of Michigan-Flint, Flint, Michigan.

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First published: 07 February 2002
Citations: 93
Address correspondence to Neil B. Alexander, MD, Division of Geriatric Medicine, Department of Internal Medicine, 1111 CCGCB, 1500 E Medical Center Drive, Ann Arbor, MI 48109.

Abstract

OBJECTIVES: To determine the effect of a 12-week intervention to improve the ability of disabled older adults to rise from a bed and from a chair.

DESIGN: Subjects were randomly allocated to either a 12-week task-specific resistance-training intervention (training in bed- and chair-rise subtasks, such as sliding forward to the edge of a chair with the addition of weights) or a control flexibility intervention.

SETTING: Seven congregate housing facilities.

PARTICIPANTS: Congregate housing residents age 65 and older (n = 161, mean age 82) who reported requiring assistance (such as from a person, equipment, or device) in performing at least one of the following mobility-related activities of daily living: transferring, walking, bathing, and toileting.

MEASUREMENTS: At baseline, 6 weeks, and 12 weeks, subjects performed a series of bed- and chair-rise tasks where the rise task demand varied according to height of the head of the bed, chair seat height, and use of hands. Outcomes were able or unable to rise and, if able, the time taken to rise. Logistic regression for repeated measures was used to test for differences between tasks in the ability to rise. Following log transformation of rise time, a linear effects model was used to compare rise time between tasks.

RESULTS: Regarding the maximum total number of bed- and chair-rise tasks that could be successfully completed, a significant training effect was seen at 12 weeks (P = .03); the training effect decreased as the total number of tasks increased. No statistically significant training effects were noted for rise ability according to individual tasks. Bed- and chair-rise time showed a significant training effect for each rise task, with analytic models suggesting a range of approximately 11% to 20% rise-time (up to 1.5 seconds) improvement in the training group over controls. Training effects were also noted in musculoskeletal capacities, particularly in trunk range of motion, strength, and balance.

CONCLUSIONS: Task-specific resistance training increased the overall ability and decreased the rise time required to perform a series of bed- and chair-rise tasks. The actual rise-time improvement was clinically small but may be useful over the long term. Future studies might consider adapting this exercise program and the focus on trunk function to a frailer cohort, such as in rehabilitation settings. In these settings, the less challenging rise tasks (such as rising from an elevated chair) and the ability to perform intermediate tasks (such as hip bridging) may become important intermediate rehabilitation goals.