老年学と老年医学の研究

概要

Comparison of Functional Walking Training Using Concentric-Eccentric Resistance on Hip Muscle Strength, Balance, and Functional Mobility in Working and Retired Older Adults

Carol A. Maritz, Shaylea McCray and Jennifer Bell

Background: Age-related lower extremity weakness leads to difficulty with stair negotiation, gait, and balance. The purpose of this study was to evaluate and compare the impact of functional walking training on hip strength, balance, and functional mobility among community-dwelling working and retired older adults.

Methods: 12 healthy working adults (10 females and 2 males; mean age 66 years) were recruited from the campus community and 15 retired community-dwelling adults (13 females and 2 males; mean age 75 years) were recruited from a church. Subjects completed pre-post-test measurements: hip strength (flexion, abduction, and extension) were tested using hand held dynamometer; Timed Up and Go test, 30-Second Chair Rise test, and static and dynamic balance tested using the Zeno Walkway System. Subjects completed 8 sessions of functional walking using the BTE TM Primus RS. Subjects were connected to the Primus using cable attachment and waist belt. Primus was set in concentric-eccentric mode and resistance was applied. Subjects walked seven feet in four directions: forward; backward; sideways both directions a total of five times each. Resistance was increased each session.

Results: The working group had significant improvements (p= 0.02-0.0003) in Timed Up and Go, 30-Second Chair Rise test, and hip strength following the intervention. The retired group had significant (p=0.01-0.0002) improvements in Timed Up and Go, 30-Second Chair Rise, hip strength, and dynamic balance. Neither group showed statistically significant changes in static balance. Only the Timed Up and Go was significantly different in the amount of change between groups.

Conclusion: A resisted functional walking program resulted in significant improvements in function and strength in both working and retired older adults. Functional walking with resistance allows older adults to benefit without having them assume difficult exercise positions. This exercise protocol can be easily modified for the clinical setting and be used in falls prevention programs.