Abstract
The elderly population is growing both in size and in proportion of the total population. The costs to the community of the elderly being in poor health are also growing proportionately. The beneficial effects of exercise on various physiological and psychological parameters in the elderly have been well established. The effects of exercise on the mobility and independence of the elderly are also of primary concern, their maintenance being an important exercise goal. Impaired balance and gait are the 2 most significant risk factors for limited mobility and falls in the elderly. It is important to understand the effects of aging and exercise on these risk factors.
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Schultz AB. Mobility impairment in the elderly: challenges for biomechanics research. J Biomech 1992; 25: 519–28
Martin PE, Grabiner MD. Aging, exercise, and the predisposition to falling. J Appl Biomech 1999; 15: 52–5
Australian Bureau of Statistics and Social Policy Directorate. Older people in New SouthWales: a profile. Sydney: Australian Government Publishing Service, 1995
Åstrand P-O. Why exercise? Med Sci Sports Exerc 1992: 24: 153–62
Rimmer JH. Fitness and rehabilitation programs for special populations. Madison (WI): Brown & Benchmark, 1994
Campanelli LC. Mobility changes in older adults: implications for practitioners. J Aging Phys Act 1996; 4: 105–18
Judge JO, Lindsey C, Underwood M, et al. Balance improvements in older women: effects of exercise training. Phys Ther 1993; 73: 254–62
Buchner DM. Preserving mobility in older adults. West J Med 1997; 167: 258–64
Hayes WC, Myers ER, Robinovitch SN, et al. Etiology and prevention of age-related hip fractures. Bone 1996; 18: 77–86S
Department of the Environment, Sport and Territories. Active and inactive Australians: assessing and understanding levels of physical activity. Canberra: Australian Government Publishing Service, 1995
Ostrow A, Dzewaltowski D. ‘Older adults’ perceptions of physical activity participation based on age-role and sex-role appropriateness. Res Q Exerc Sport 1986; 57: 67–169
Prohaska TR, Leventhal EA, Leventhal H, et al. Health practices and illness cognition in young, middle-aged and elderly adults. J Gerontol 1985; 40: 569–78
Barry HC, Rich BSE, Carlson RT. How exercise can benefit older patients: a practical approach. Physician Sports Med 1993; 21: 124–41
Ostrow A, Jones D, Spiker D. Age role expectations and sex role expectations for selected sport activities. Res Q Exerc Sport 1981; 52: 216–27
National Health and Medical Research Council. Exercise and the older person: series on clinical management problems in the elderly. No. 2. Canberra: Australian Government Publishing Service, 1994
Shephard RJ. The scientific basis of exercise prescribing for the very old. Physician Sports Med 1990; 11: 91–101
Seeman TE, Berkman LF, Charpentier PA, et al. Behavioural and psychosocial predictors of physical performance: Macarthur studies of successful aging. J Gerontol 1995; 50: M177–83
Strawbridge WJ, Cohen RD, Shema SJ, et al. Successful aging: predictors and associated activities. Am J Epidemiol 1996; 144: 135–41
Sandvik L, Erikssen J, Thaulow E, et al. Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N Engl J Med 1998; 338: 533–7
Vita AJ, Terry RB, Hubert HB, et al. Aging, health risks, and cumulative disability. N Engl J Med 1998; 338: 1035–41
Chodzko-Zajko WJ. Physical fitness, cognitive performance, and aging. Med Sci Sports Exerc 1991; 23: 868–72
Rogers RL, Meyer JS, Mortel KF. After reaching retirement age physical activity sustains cerebral perfusion and cognition. J Am Geriatr Soc 1991; 38: 123–8
La Croix AZ, Newton KM, Leveille SG, et al. Healthy aging: a women’s issue. West J Med 1997; 167; 220–32
Buckwalter JA. Decreased mobility in the elderly: the exercise antidote. Physician Sports Med 1997; 25: 126–8, 130–3
O’Brien SJ, Vertinsky PA. Elderly women, exercise and healthy aging. J Women Aging 1990; 2: 41–65
Leiper CI, Craik RL. Relationships between physical activity and temporal distance characteristics of walking in elderly women. Phys Ther 1991; 71: 791–803
Ho SC, Woo J, Yuen YK, et al. Predictors of mobility decline: the Hong Kong old-old study. J Gerontol 1997; 52: M356–62
Smith EL, Gilligan C. Physical activity prescription for the older adult. Physician Sports Med 1983; 11: 91–101
Van Camp SP, Boyer JL. Cardiovascular aspects of aging (1). Physician Sports Med 1989; 17: 120–30
Wilmore JH. The aging of bone and muscle. Clin Sports Med 1991; 10: 231–44
Booth FW, Gollnick PD. Effect of disuse on the structure and function of skeletal muscle. Med Sci Sports Exerc 1983; 15: 415–20
Voorrips LE, Lemmink KAPM, Van Heuvelen MJG, et al. The physical condition of elderly women differing in habitual physical activity. Med Sci Sports Exerc 1993; 25: 1152–7
Schoutens A, Laurent E, Poortmans JR. Effects of inactivity and exercise on bone. Sports Med 1989; 7: 71–81
Sauvage, LR, Myklebust BM, Crow-Pan J, et al. A clinical trial of strengthening and aerobic exercise to improve gait and balance in elderly male nursing home residents. Am J Phys Med Rehab 1992; 71: 333–42
Kelly PL, Kroemer KHE. Anthropometry of the elderly: status and recommendations. Hum Factors 1990; 32: 571–95
Stoudt H. The anthropometry of the elderly. Hum Factors 1981; 23: 29–37
Spidurso WW. Physical dimensions of aging. Champaign (IL): Human Kinetics, 1995
Kirkendall DT, Garrett WE. The effects of aging and training on skeletal muscle. Am J Sports Med 1998; 26: 598–602
Williams M. Human development and aging. In: Roitman JL, editor. ACSM resource manual for guidelines for exercise testing and prescription. 3rd ed. Baltimore (MD):Williams & Wilkins, 1998: 501–6
Marin J. Age-related changes in vascular responses: a review. Mech Ageing Dev 1995; 79: 71–114
Susic D. Hypertension, aging, and atherosclerosis: the endothelial interface. Med Clin North Am 1997; 81: 12–31
Bortz WM. Disuse and aging. JAMA 1982; 248: 1203–8
Blocker WP. Maintaining functional independence by mobilizing the aged. Geriatrics 1992; 47: 42–56
Martin PE, Morgan DW. Biomechanical considerations for economical walking and running. Med Sci Sports Exerc 1992; 24: 467–73
Åstrand P-O. Exercise physiology and its role in disease prevention and in rehabilitation. Arch Phys Med Rehabil 1987; 68: 305–9
Posner JD, McCully KK, Landsberg LA, et al. Physical determinants of independence in mature women. Arch Phys Med Rehabil 1995; 76: 373–80
Depres JP, Moorjani S, Lupien PJ, et al. Regional distribution of body fat, plasma lipoproteins and cardiovascular disease. Artherosclerosis 1990; 10: 497–511
Scott B, Going DP, Lohman TG, et al. Aging, body composition and physical activity: a review. J Aging Phys Act 1994; 2: 38–66
Frontera WR, Hughes VA, Lutz KJ, et al. A cross-sectional study of muscle strength and mass in 45 to 78-year-old men and women. J Appl Physiol 1991; 71: 644–50
Schoeller DA. Changes in total body water with age. Am J Clin Nutr 1989; 50: 1176–81
Enzu G, Gasparo M, Biondetti PR, et al. Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am J Clin Nutr 1986; 44: 739–46
Nieman DC, Henson DA, Gusewitch G, et al. Physical activity and immune function in elderly women. Med Sci Sports Exerc 1993; 25: 823–31
Berman R, Haxby JV, Pomerantz RS. Physiology of aging, part 1: normal changes. Patient Care 1988; 22: 20–36
Salthouse TA. Speed of behaviour and its implications for cognition. In: Birren JE, Schaie KW, editors. Handbook of the psychology of aging. New York (NY):Van Nostrand, 1985: 400–26
Vandervoort A, Hill K, Sandrin M, et al. Mobility impairment and falling in the elderly. Physiother Can 1990; 42: 99–107
Frischknecht R. Effect of training on muscle strength and motor function in the elderly. Rep Nutr Dev 1998; 38: 167–74
Aniansson A, Grimby G, Hedberg M. Compensatory muscle fiber hypertrophy in elderly men. J Appl Physiol 1992; 73: 812–6
Lexell J, Taylor CC, Sjostrom M. What is the cause of the ageing atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men. J Neurol Sci 1988; 84: 275–94
Lexell J, Downham D. What is the effect of ageing on type 2 muscle fibres? J Neurol Sci 1992; 107: 250–1
Lexell J, Downham D, Sjostram M. Distribution of different fibre types in human skeletal muscles: fibre type arrangement in m. vastus lateralis from three groups of healthy men between 15 and 83 years. J Neurol Sci 1998; 72: 211–22
Lexell J, Henriksson-Larsen K, Winblad B, et al. Distribution of different fibre types in human skeletal muscles: effects of aging studied in whole muscle cross sections. Muscle Nerve 1983; 6: 588–95
Vandervoort A, Kramer JF, Wharram ER. Eccentric knee strength of elderly females. J Gerontol 1990; 45: 125–8
Larsson L, Grimby G, Karlsson J. Muscle strength and speed of movement in relation to age and muscle morphology. J Appl Physiol 1979; 6: 451–6
Silver JJ, Einhorn TA. Osteoporosis and aging: current update. Clin Orthop Relat Res 1995; 316: 10–20
Riggs BL, Wahner HW, Melton LJ. Rates of bone loss in the axial and appendicular skeletons of women: evidence of substantial vertebral bone loss prior to menopause. J Clin Invest 1986; 77: 1487–91
Lewis CB. Musculoskeletal changes with age. Clin Manage Phys Ther 1984; 4: 12–5
Misner JE, Massey BH, Bemben M, et al. Long-term effects of exercise on the range of motion of aging women. J Orthop Sport Phys Ther 1992; 16: 37–42
Walker JM, Sue D, Miles-Elkousy N, et al. Active mobility of the extremities in older subjects. Phys Ther 1984; 64: 919–23
Einkauf D, Gohdes ML, Jensen GM, et al. Changes in spinal mobility with increasing age in women. Phys Ther 1987; 67: 370–5
Cononie CG, Graves JE, Pollock ML, et al. Effect of exercise training on blood pressure in 70-to-79-yr-old men and women. Med Sci Sports Exerc 1991; 23: 505–11
Schwender KI, Mikesky AE, Holt WS, et al. Differences in muscle endurance and recovery between fallers and nonfallers and between young and older women. J Gerontol 1997; 52: M155–60
Davies MJ, Dalsky GP. Economy of mobility in older adults. J Orthop Sports Phys Ther 1997; 26: 69–72
Schultz AB. Mobility impairment in the elderly: challenges for biomechanics research. J Biomech 1990; 25: 519–28
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–7
Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994; 49: M72–84
Era P, Heikkinen E. Postural sway during standing and unexpected disturbance of balance in random samples of men of different ages. J Gerontol 1985; 40: 287–95
Sheldon JH. The effect of age on the control of sway. Gerontol Clin 1963; 5: 129–38
Hasselkus BR, Shambes GM. Aging and postural sway in women. J Gerontol 1975; 30: 661–7
Bohannon RW, Larkin PA, Cook AC, et al. Decrease in timed balance test score with aging. Phys Ther 1984; 64: 1067–70
Woollacott MH. Gait and postural control in the aging adult. In: Bles W, Brandt TH, editors. Disorders of posture and gait. Amsterdam: Elsevier, 1986: 325–36
Birren JE. Vibratory sensitivity in the aged. J Gerontol 1974; 2: 267–8
Brocklehurst JC, Robertson D, James-Groom P. Clinical correlates of sway in old age-sensory modalities. Age Ageing 1982; 11: 1–10
Guimaraes RM, Isaacs B. Characteristics of the gait in old people who fall. Int Rehabil Med 1980; 2: 177–80
Murray MP, Kory RC, Clarkson BH. Walking patterns in healthy old men. J Gerontol 1969; 24: 169–78
Himann JE, Cunningham DA, Rechnitzer PA, et al. Age-related changes in speed of walking. Med Sci Sports Exerc 1988; 20: 161–6
Hageman PA, Blanke DJ. Comparison of gait of young women and elderly women. Phys Ther 1986; 66: 1382–7
Murray MP, Kory RC, Sepic SB. Walking patterns of normal women. Arch Phys Med Rehabil 1970; 50: 140–6
Heitmenn DK, Gossman MR, Shaddeau SA, et al. Balance performance and step width in noninstitutionalized, elderly, female fallers and nonfallers. Phys Ther 1989; 69: 923/43–931/51
Wolfson L, Whipple R, Amerman P, et al. Gait assessment in the elderly: a gait abnormality rating scale and its relation to falls. J Gerontol 1990; 45: M12–9
Visser H. Gait and balance in senile dementia of Alzheimer’s type. Age Ageing 1983; 12: 296–301
Ostrosky KM, VanSwearingen JM, Burdett RG, et al. A comparison of gait in young and old subjects. Phys Ther 1994; 74: 637–44
Winter DA, Patla AE, Frank JS, et al. Biomechanical walking pattern changes in the fit and healthy elderly. Phys Ther 1990; 70: 340–7
Baumann JU. Gait changes in elderly people [in German]. Orthopade 1994; 23: 6–9
Myklebust BM, Myklebust J, Prieto T, et al. Changes in kinematic gait parameters in healthy aging subjects. In: Woollacott MH, Horak F, editors. Posture and gait: control mechanisms. Proceedings of the XIth International Symposium of the Society for Postural and Gait Research; 1992 May 24–27; Portland (OR). Portland (OR): University of Oregon Books, 1992: 295–7
Hornbrook MC, Stevens VJ, Wingfield DJ, et al. Preventing falls among community dwelling older persons: results from a randomized trial. Gerontologist 1994; 34: 16–23
Quail GC. An approach to the assessment of falls in the elderly. Aust Fam Physician 1994; 23: 873, 876–82
Overstall PW, Exton-Smith AN, Imms FJ, et al. Falls in the elderly related to postural imbalance. BMJ 1977; 1: 261–4
Jensen RK, Fletcher P. Body segment moments of inertia of the elderly. J Appl Biomech 1993; 9: 287–305
Mills EM. The effect of low-intensity aerobic exercise on muscle strength, flexibility, and balance among sedentary elderly persons. Nurs Res 1994; 43: 207–11
Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994; 331: 821–7
Tinetti ME, Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol 1998; 53A: M112–9
Tinetti ME, Speechley M. Prevention of falls among the elderly. N Engl J Med 1989; 320: 1055–9
Tinetti ME. Performance-oriented assessment ofmobility problems in elderly patients. J Am Geriatr Soc 1986; 34: 119–26
Maki BE. Gait changes in older adults: predictors of falls or indicators of fear? J Am Gerontol Soc 1997; 45: 313–20
Snow CM. Exercise effects on falls in frail elderly: focus on strength. J Appl Biomech 1999; 15: 84–91
Holloszy JO. Exercise, health, and aging: a need for more information. Med Sci Sports Exerc 1983; 15: 1–5
Ettinger WH, Evans WJ, Weindruch R, et al. Exercise for the elderly. Patient Care 1989; 23: 165–91
Limacher MC. Aging and cardiac function: influence of exercise. South Med J 1994; 87: S13–6
Heyden S, Fodor GJ. Does regular exercise prolong life expectancy? Sports Med 1988; 6: 63–71
Fiatarone MA, Marks EC, Ryan ND, et al. High-intensity strength training in nonagenarians: effects on skeletal muscle. JAMA 1990; 263: 3029–34
Kohrt WM, Malley MT, Dalsky W, et al. Body composition of healthy sedentary and trained, young and older men and women. Med Sci Sports Exerc 1992; 24: 832–7
MacRae PG, Feltner ME, Reinsch S. A1-year exercise program for older women: effects on falls, injuries, and physical performance. J Aging Phys Act 1994; 2: 127–42
Chandler JM. Understanding the relationships between strength and mobility in frail older persons: a review of the literature. Top Geriatr Rehab 1996; 11: 20–37
Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330: 1769–75
Charette SL, McEvoy L, Pyka G, et al. Muscle hypertrophy response to resistance training in older women. J Appl Physiol 1991; 70: 1912–6
Frontera WR, Meredith CN, O’Reilly KP, et al. Strength conditioning in older men: skeletal muscle hypertrophy and improved function. J Appl Physiol 1988; 64: 1038–44
Schilke JM. Slowing the aging process with physical activity. J Gerontol Nurs 1991; 17: 4–8
Germain NW, Blair SN. Variability of shoulder flexion with age, activity and sex. Am Correct Ther J 1983; 37: 156–60
Frekany G, Leslie D. Effects of an exercise program on selected flexibility measurements of senior citizens. Gerontology 1975; 15: 182–3
Chandler JM, Duncan PW, Kochersberger G, et al. Is lower extremity strength gain associated with improvements in physical performance and disability in frail, community dwelling elders? Arch Phys Med Rehabil 1998; 79: 24–30
Lord SR, Caplan GA, Ward JA. Balance, reaction time, and muscle strength in exercising and nonexercising older women: a pilot study. Arch Phys Med Rehabil 1993; 74: 837–9
Rikli R, Busch S. Motor performance of women as a function of age and physical activity level. J Gerontol 1986; 41: 645–9
Wolf SL, Barnhart HX, Ellison GL, et al. The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Phys Ther 1997; 77: 371–81
Seidler RD, Martin PE. The effects of short term balance training on the postural control of older adults. Gait Post 1997; 6: 224–36
Verfaillie DF, Nichols JF, Turkel E, et al. Effects of resistance, balance, and gait training on reduction of risk factors leading to falls in elders. J Aging Phys Act 1997; 5: 213–28
Nichols JF, Hitzelberger LM, Sherman JG, et al. Effects of resistance training on muscular strength and functional abilities of community dwelling older adults. J Aging Phys Act 1995; 3: 238–50
Campbell AJ, Robertson MC, Gardner MM, et al. Randomized controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ 1997; 315: 1065–9
Buchner DM, Cress ME, de Lateur BJ, et al. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. J Gerontol 1997; 52: M218–24
Shupert CL, Horak FB. Adaptation of postural control in normal and pathologic aging: implications for fall prevention programs. J Appl Biomech 1999; 13: 64–74
Bendall MJ, Bassey EJ, Pearson MB. Factors affecting walking speed of elderly people. Age Ageing 1989; 18: 327–32
Godges JJ, MacRae PG, Engelke KA. Effects of exercise on hip range of motion, trunk muscle performance, and gait economy. Phys Ther 1993; 73: 57–66
Ronsky JL, Nigg BM, Fisher V. Correlation between physical activity and the gait characteristics and ankle joint flexibility of the elderly. Clin Biomech 1995; 10: 41–9
Berg WP, Lapp BA. The effect of a practical resistance training intervention on mobility in independent, community-dwelling older adults. J Aging Phys Act 1998; 6: 18–35
Owings TM, Pavol MJ, Foley KT, et al. Exercise: is it a solution to falls by older adults? J Appl Biomech 1999; 15: 56–63
Godges JJ, MacRae H, Longdon C, et al. The effects of two stretching procedures on hip range of motion and gait economy. J Orthop Sport Phys Ther 1989; 10: 350–7
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Daley, M.J., Spinks, W.L. Exercise, Mobility and Aging. Sports Med 29, 1–12 (2000). https://doi.org/10.2165/00007256-200029010-00001
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DOI: https://doi.org/10.2165/00007256-200029010-00001