Balance and muscle strength as predictors of frailty among older adults.

The term frailty is increasingly used in gerontological literature and in practice. However, indicators differentiating frail from nonfrail are not well delineated. Identifying factors discriminating between frail and nonfrail older community-residing adults may lead to more comprehensive clinical assessments and targeted interventions to minimize or prevent frailty. Eighty-four adults, ages 60 to 88 (mean = 74) living independently in the community completed a functional performance questionnaire and a perceived health questionnaire that were combined as measures of frailty. Predictor variables of frailty included four measures of balance and three measures of lower leg strength. Discriminant analysis revealed that one balance score and dorsiflexion correctly classified 65% of group membership, with better prediction of the nonfrail than frail group. This study clarifies that the predictors of frailty include the combination of dorsiflexion strength and balance, specifically the contribution of vision to balance when the support surface is compliant. Recommendations are proposed for conceptualizing and operationalizing frailty and adding variables to enhance discrimination between frailty and nonfrailty. Nursing implications include adding clinical assessments of specific components of balance and ankle strength to develop a more comprehensive evaluation of frailty.

Effect of resistance training on strength, postural control, and gait velocity among older adults.

The purpose of this study was to examine the effects of a 14-week resistance training program on the ankle strength, training intensity, postural control, and gait velocity of older adults. Forty-two older adults (mean age = 72), 21 in the resistance and control groups, completed the 14-week project. The resistance training group participated in 14 weeks of resistance training three times per week using elastic bands (Theraband) for resistance. Isokinetic ankle strength, training intensity, postural stability, and gait velocity were measured prior to and following the 14-week intervention. Following the training, the resistance group exhibited improved ankle dorsiflexion, training resistances, and gait velocity, but showed no change in plantar flexion or postural control. The control group also exhibited improvements in dorsiflexion, but these gains were approximately one-half of the gains observed in the resistance training group. Finally, when adjusted for baseline differences, subjects in the resistance training group demonstrated no changes in the dependent measures over the control group.

The initial RNF research survey: rehabilitation nursing research interests of ARN members.

The data from this survey provide baseline information for comparison with subsequent surveys. Respondents to this initial survey demonstrate involvement in research activities, primarily for the direct improvement of care. Findings from the data suggest that the research climate is right for collaborative efforts between rehabilitation nurses caring directly for clients and nurses with research degrees to conduct multisite research projects and to encourage enhanced research preparation, including computer literacy, for nurses at the graduate level.

A hard hand-positioning device to decrease wrist and finger hypertonicity: a sensorimotor approach for the patient with nonprogressive brain damage.

To investigate whether a hand-positioning device placed in the palm of a patient with nonprogressive brain damage will decrease hypertonicity of the flexor muscles of the hand through proprioreceptive sensory input to the alpha-gamma coactivation loop, a hard cone was placed in the affected hand of 11 subjects who had sustained cerebrovascular accidents and had flexor hypertonicity of the upper extremity. Measurements of hypertonicity and functionality were made weekly for four weeks. All subjects experienced a significant decrease in flexor hypertonicity. Only slight changes were observed in functionality.