Background: Decreased physical activity levels are an increasing concern, specifically for the aging population. Older adults (>65 years) are able to achieve health benefits from participating in a regular exercise program based on studies done in younger community-dwelling older adults. However, there is less research investigating the efficacy of exercise for improving physical function among the older adult population in assisted living settings. Barriers among the research that has been done so far include generalizability, specificity and varying exercise prescription details. The present study investigated the novel idea of using a treadmill with a harness system, to engage older adults in aerobic exercise. It is unknown if it is feasible to recruit and retain older adults in assisted living settings for such a treadmill study and if older adults would be able to achieve intensities associated with health benefits. Objectives: To determine the feasibility of recruitment and retention of older adults in an assisted living facility for a pilot treadmill walking study. Secondary objectives include: to identify determinants of participation and compliance with the treadmill study and to determine if the older adult population in assisted living settings are able to achieve exercise intensities aligned with established guidelines that are associated with health benefits. Design and Setting: Pilot, multi-visit feasibility study in an Assisted Living Facility in the Kitchener-Waterloo Region with care needs ranging from Retirement Home to Palliative Care Population: Older adults (>65y) living in an assistive living facility who could follow two-step commands and were able to walk two metres independently (with or without the use of an aid). Methods: The feasibility of recruitment and retention was determined by recording: the number of older adults who consented to participate in treadmill walking for three weeks; the number of older adults (and/or their legal representatives) who declined treadmill participation and reasons as to why; and the number of participants who completed the six treadmill sessions. Healthrelated and demographic characteristics were collected to characterize the population while age, number of co-morbidities, number of medications, cognition, fear of falling and walking ability were evaluated as potential determinants of participation. A detailed attendance log was used to assess compliance with the study. To determine if participants could achieve the recommended exercise intensity associated with health benefits, exercise intensity (40 %HRR) and duration (twenty minutes) achieved after the final treadmill session were reported. Results: Thirty percent of the residents on the eligibility list were recruited and consented to participate in the treadmill study. Average compliance was 94.4%±10.8%; one treadmill participant dropped out due to declining health. There are no significant differences between treadmill participants and those who chose not to walk on the treadmill. Treadmill participants were able to achieve the recommended intensity (40%HRR) and achieved an average intensity of 50.3% ± 30.2% and a frequency of three sessions in one week. Average total duration was approximately five minutes shy (14:53min ± 6:43min) of the recommendation of twenty minutes. Conclusion: The current study provides preliminary evidence that it is feasible to recruit and retain older adults in assisted living facilities to participate in a three week treadmill walking study, however it may be difficult to recruit a large number of individuals for a larger study. Treadmill participants were able to achieve ACSM’s recommended intensity and frequency for aerobic or endurance exercise. Secondly, the older adult population living in assisted settings may be able to achieve the recommended exercise prescription targets for cardiovascular training, specifically intensity and frequency; however they may need more than three weeks of progression or multiple sessions per day to obtain the recommended duration.

Background: Decreased physical activity levels are an increasing concern, specifically for the aging population. Older adults (>65 years) are able to achieve health benefits from participating in a regular exercise program based on studies done in younger community-dwelling older adults. However, there is less research investigating the efficacy of exercise for improving physical function among the older adult population in assisted living settings. Barriers among the research that has been done so far include generalizability, specificity and varying exercise prescription details. The present study investigated the novel idea of using a treadmill with a harness system, to engage older adults in aerobic exercise. It is unknown if it is feasible to recruit and retain older adults in assisted living settings for such a treadmill study and if older adults would be able to achieve intensities associated with health benefits. Objectives: To determine the feasibility of recruitment and retention of older adults in an assisted living facility for a pilot treadmill walking study. Secondary objectives include: to identify determinants of participation and compliance with the treadmill study and to determine if the older adult population in assisted living settings are able to achieve exercise intensities aligned with established guidelines that are associated with health benefits. Design and Setting: Pilot, multi-visit feasibility study in an Assisted Living Facility in the Kitchener-Waterloo Region with care needs ranging from Retirement Home to Palliative Care Population: Older adults (>65y) living in an assistive living facility who could follow two-step commands and were able to walk two metres independently (with or without the use of an aid). Methods: The feasibility of recruitment and retention was determined by recording: the number of older adults who consented to participate in treadmill walking for three weeks; the number of older adults (and/or their legal representatives) who declined treadmill participation and reasons as to why; and the number of participants who completed the six treadmill sessions. Healthrelated and demographic characteristics were collected to characterize the population while age, number of co-morbidities, number of medications, cognition, fear of falling and walking ability were evaluated as potential determinants of participation. A detailed attendance log was used to assess compliance with the study. To determine if participants could achieve the recommended exercise intensity associated with health benefits, exercise intensity (40 %HRR) and duration (twenty minutes) achieved after the final treadmill session were reported. Results: Thirty percent of the residents on the eligibility list were recruited and consented to participate in the treadmill study. Average compliance was 94.4%±10.8%; one treadmill participant dropped out due to declining health. There are no significant differences between treadmill participants and those who chose not to walk on the treadmill. Treadmill participants were able to achieve the recommended intensity (40%HRR) and achieved an average intensity of 50.3% ± 30.2% and a frequency of three sessions in one week. Average total duration was approximately five minutes shy (14:53min ± 6:43min) of the recommendation of twenty minutes. Conclusion: The current study provides preliminary evidence that it is feasible to recruit and retain older adults in assisted living facilities to participate in a three week treadmill walking study, however it may be difficult to recruit a large number of individuals for a larger study. Treadmill participants were able to achieve ACSM’s recommended intensity and frequency for aerobic or endurance exercise. Secondly, the older adult population living in assisted settings may be able to achieve the recommended exercise prescription targets for cardiovascular training, specifically intensity and frequency; however they may need more than three weeks of progression or multiple sessions per day to obtain the recommended duration.

Background: Decreased physical activity levels are an increasing concern, specifically for the aging population. Older adults (>65 years) are able to achieve health benefits from participating in a regular exercise program based on studies done in younger community-dwelling older adults. However, there is less research investigating the efficacy of exercise for improving physical function among the older adult population in assisted living settings. Barriers among the research that has been done so far include generalizability, specificity and varying exercise prescription details. The present study investigated the novel idea of using a treadmill with a harness system, to engage older adults in aerobic exercise. It is unknown if it is feasible to recruit and retain older adults in assisted living settings for such a treadmill study and if older adults would be able to achieve intensities associated with health benefits. Objectives: To determine the feasibility of recruitment and retention of older adults in an assisted living facility for a pilot treadmill walking study. Secondary objectives include: to identify determinants of participation and compliance with the treadmill study and to determine if the older adult population in assisted living settings are able to achieve exercise intensities aligned with established guidelines that are associated with health benefits. Design and Setting: Pilot, multi-visit feasibility study in an Assisted Living Facility in the Kitchener-Waterloo Region with care needs ranging from Retirement Home to Palliative Care Population: Older adults (>65y) living in an assistive living facility who could follow two-step commands and were able to walk two metres independently (with or without the use of an aid). Methods: The feasibility of recruitment and retention was determined by recording: the number of older adults who consented to participate in treadmill walking for three weeks; the number of older adults (and/or their legal representatives) who declined treadmill participation and reasons as to why; and the number of participants who completed the six treadmill sessions. Healthrelated and demographic characteristics were collected to characterize the population while age, number of co-morbidities, number of medications, cognition, fear of falling and walking ability were evaluated as potential determinants of participation. A detailed attendance log was used to assess compliance with the study. To determine if participants could achieve the recommended exercise intensity associated with health benefits, exercise intensity (40 %HRR) and duration (twenty minutes) achieved after the final treadmill session were reported. Results: Thirty percent of the residents on the eligibility list were recruited and consented to participate in the treadmill study. Average compliance was 94.4%±10.8%; one treadmill participant dropped out due to declining health. There are no significant differences between treadmill participants and those who chose not to walk on the treadmill. Treadmill participants were able to achieve the recommended intensity (40%HRR) and achieved an average intensity of 50.3% ± 30.2% and a frequency of three sessions in one week. Average total duration was approximately five minutes shy (14:53min ± 6:43min) of the recommendation of twenty minutes. Conclusion: The current study provides preliminary evidence that it is feasible to recruit and retain older adults in assisted living facilities to participate in a three week treadmill walking study, however it may be difficult to recruit a large number of individuals for a larger study. Treadmill participants were able to achieve ACSM’s recommended intensity and frequency for aerobic or endurance exercise. Secondly, the older adult population living in assisted settings may be able to achieve the recommended exercise prescription targets for cardiovascular training, specifically intensity and frequency; however they may need more than three weeks of progression or multiple sessions per day to obtain the recommended duration.

Background: Decreased physical activity levels are an increasing concern, specifically for the aging population. Older adults (>65 years) are able to achieve health benefits from participating in a regular exercise program based on studies done in younger community-dwelling older adults. However, there is less research investigating the efficacy of exercise for improving physical function among the older adult population in assisted living settings. Barriers among the research that has been done so far include generalizability, specificity and varying exercise prescription details. The present study investigated the novel idea of using a treadmill with a harness system, to engage older adults in aerobic exercise. It is unknown if it is feasible to recruit and retain older adults in assisted living settings for such a treadmill study and if older adults would be able to achieve intensities associated with health benefits. Objectives: To determine the feasibility of recruitment and retention of older adults in an assisted living facility for a pilot treadmill walking study. Secondary objectives include: to identify determinants of participation and compliance with the treadmill study and to determine if the older adult population in assisted living settings are able to achieve exercise intensities aligned with established guidelines that are associated with health benefits. Design and Setting: Pilot, multi-visit feasibility study in an Assisted Living Facility in the Kitchener-Waterloo Region with care needs ranging from Retirement Home to Palliative Care Population: Older adults (>65y) living in an assistive living facility who could follow two-step commands and were able to walk two metres independently (with or without the use of an aid). Methods: The feasibility of recruitment and retention was determined by recording: the number of older adults who consented to participate in treadmill walking for three weeks; the number of older adults (and/or their legal representatives) who declined treadmill participation and reasons as to why; and the number of participants who completed the six treadmill sessions. Healthrelated and demographic characteristics were collected to characterize the population while age, number of co-morbidities, number of medications, cognition, fear of falling and walking ability were evaluated as potential determinants of participation. A detailed attendance log was used to assess compliance with the study. To determine if participants could achieve the recommended exercise intensity associated with health benefits, exercise intensity (40 %HRR) and duration (twenty minutes) achieved after the final treadmill session were reported. Results: Thirty percent of the residents on the eligibility list were recruited and consented to participate in the treadmill study. Average compliance was 94.4%±10.8%; one treadmill participant dropped out due to declining health. There are no significant differences between treadmill participants and those who chose not to walk on the treadmill. Treadmill participants were able to achieve the recommended intensity (40%HRR) and achieved an average intensity of 50.3% ± 30.2% and a frequency of three sessions in one week. Average total duration was approximately five minutes shy (14:53min ± 6:43min) of the recommendation of twenty minutes. Conclusion: The current study provides preliminary evidence that it is feasible to recruit and retain older adults in assisted living facilities to participate in a three week treadmill walking study, however it may be difficult to recruit a large number of individuals for a larger study. Treadmill participants were able to achieve ACSM’s recommended intensity and frequency for aerobic or endurance exercise. Secondly, the older adult population living in assisted settings may be able to achieve the recommended exercise prescription targets for cardiovascular training, specifically intensity and frequency; however they may need more than three weeks of progression or multiple sessions per day to obtain the recommended duration.

The present study validates the Treadmill Rehabilitation Platform (TRP) protocol that assessed standing balance performance; spatial and temporal gait variability; stability measures and visual spatial cognitive task performances. Healthy individuals (mean age = 61.4± 4.4 years; n = 30) performed tasks from the TRP protocol while standing and while walking on treadmill. Moderate to High test retest reliability was observed for the TRP tool measures with a few exceptions. Standing balance decreased significantly as visual task load increased. Spatial and temporal gait variability increased whereas walking stability decreased significantly as visual task load increased. Visual task performance decreased significantly as physical load increased. In conclusion, the TRP protocol allows us to assess the ability to prioritize the division of attention when visual spatial cognitive tasks are performed while standing and during walking. Also, it allows reliable assessment of the effects of compromised attention during the tasks performances.

The present study validates the Treadmill Rehabilitation Platform (TRP) protocol that assessed standing balance performance; spatial and temporal gait variability; stability measures and visual spatial cognitive task performances. Healthy individuals (mean age = 61.4± 4.4 years; n = 30) performed tasks from the TRP protocol while standing and while walking on treadmill. Moderate to High test retest reliability was observed for the TRP tool measures with a few exceptions. Standing balance decreased significantly as visual task load increased. Spatial and temporal gait variability increased whereas walking stability decreased significantly as visual task load increased. Visual task performance decreased significantly as physical load increased. In conclusion, the TRP protocol allows us to assess the ability to prioritize the division of attention when visual spatial cognitive tasks are performed while standing and during walking. Also, it allows reliable assessment of the effects of compromised attention during the tasks performances.

Purpose: To determine the step count accuracy of three pedometers and one accelerometer in pregnant women during treadmill walking. Methods: Subjects were 30 women in the second or third trimester (20-36 weeks) who were screened for pregnancy-related risk factors. Each subject was fitted with a belt containing three physical activity monitors: Yamax Digiwalker SW-200 (DW), New Lifestyles NL 2000 (NL), and GT3X Actigraph accelerometer (ACT). The Omron HJ-720 (HJ) was placed in the pants pocket. Subjects walked at 54, 67, 80, and 94 m•min-1 for two minutes each. Actual steps were determined by an investigator using a hand-tally counter. Percentage of actual steps was calculated for each device at each speed and compared. Results: There was a significant interaction between speed and device (F9,20=7.574,P<0.001). At all speeds, the NL and HJ were most accurate. At 54 m•min-1, the DW was significantly less accurate (P<0.001) than all other devices and the ACT was significantly less accurate (P<0.001) than the NL and HJ. At 67 m•min-1, the ACT and DW were significantly less accurate (P<0.001) than the NL and HJ. At 80 m•min-1, the DW was significantly less accurate (P=0.024) than the NL and HJ. At 94 m•min-1, the ACT was significantly less accurate (P=0.001) than the NL and HJ. No significant differences were found at any speed for the NL (P=0.996) and HJ (P=0.298). Trimester did not significantly affect device accuracy. Conclusion: In pregnant women, the ACT and DW are less accurate than the NL and HJ. The HJ appeared to be the most accurate. These results can be useful in developing further research studies and physical activity programs that focus on walking during pregnancy.

Purpose: To determine the step count accuracy of three pedometers and one accelerometer in pregnant women during treadmill walking. Methods: Subjects were 30 women in the second or third trimester (20-36 weeks) who were screened for pregnancy-related risk factors. Each subject was fitted with a belt containing three physical activity monitors: Yamax Digiwalker SW-200 (DW), New Lifestyles NL 2000 (NL), and GT3X Actigraph accelerometer (ACT). The Omron HJ-720 (HJ) was placed in the pants pocket. Subjects walked at 54, 67, 80, and 94 m•min-1 for two minutes each. Actual steps were determined by an investigator using a hand-tally counter. Percentage of actual steps was calculated for each device at each speed and compared. Results: There was a significant interaction between speed and device (F9,20=7.574,P<0.001). At all speeds, the NL and HJ were most accurate. At 54 m•min-1, the DW was significantly less accurate (P<0.001) than all other devices and the ACT was significantly less accurate (P<0.001) than the NL and HJ. At 67 m•min-1, the ACT and DW were significantly less accurate (P<0.001) than the NL and HJ. At 80 m•min-1, the DW was significantly less accurate (P=0.024) than the NL and HJ. At 94 m•min-1, the ACT was significantly less accurate (P=0.001) than the NL and HJ. No significant differences were found at any speed for the NL (P=0.996) and HJ (P=0.298). Trimester did not significantly affect device accuracy. Conclusion: In pregnant women, the ACT and DW are less accurate than the NL and HJ. The HJ appeared to be the most accurate. These results can be useful in developing further research studies and physical activity programs that focus on walking during pregnancy.

<p>The general aim of this work was to evaluate the outcome of specialised stroke rehabilitation and to examine the relation between both subjectively perceived and objectively assessed balance and impairments and some activity limitations. A further, integrated aim was to establish some psychometric properties and the usability of a newly developed Falls-Efficacy Scale, Swedish version (FES(S)) in stroke rehabilitation.</p><p>Seventy-three patients younger than 70 years of age with a first stroke and reduced walking ability were randomised into an intervention group (walking on a treadmill with body weight support) and a control group (walking on the ground). Time points of assessment were: on admission for rehabilitation, at discharge and 10 months after stroke. Walking training on a treadmill with body weight support and walking training on the ground were found to be equally effective in the early rehabilitation. The patients in both groups improved their walking velocity, motor function, balance, self-efficacy and ADL performance.</p><p>In a geriatric sample of 37 stroke patients examined at similar time points, significant improvements in self-efficacy, motor function, balance, ambulation and ADL occurred from admission to discharge independently of age. In comparison with observer-based balance measures, FES(S) at discharge was the most powerful predictor of ADL performance 10 months after onset of stroke.</p><p>In 30 patients with stable stroke, the overall test-retest reliability of FES(S) was found to be adequate. The internal consistency confirmed that FES(S) has an adequate homogeneity.</p><p>In a subsample of 62 patients from the original sample and in the geriatric sample, FES(S) correlated significantly with Berg’s balance scale, the Fugl-Meyer balance scale, with motor function and with gait performance. In the relatively younger group ADL (measured by the Functional Independence Measurement) correlated significantly with FES(S) on admission and at 10 months follow-up, while at discharge none of the FES(S) measures correlated significantly with ADL. In this subsample effect size statistics for detecting changes in FES(S) demonstrated very acceptable responsiveness of this scale during the early treatment period and during the total observation period</p><p>In the light of these findings assessment and treatment of self-efficacy seems relevant in stroke rehabilitation. </p>

The general aim of this work was to evaluate the outcome of specialised stroke rehabilitation and to examine the relation between both subjectively perceived and objectively assessed balance and impairments and some activity limitations. A further, integrated aim was to establish some psychometric properties and the usability of a newly developed Falls-Efficacy Scale, Swedish version (FES(S)) in stroke rehabilitation. Seventy-three patients younger than 70 years of age with a first stroke and reduced walking ability were randomised into an intervention group (walking on a treadmill with body weight support) and a control group (walking on the ground). Time points of assessment were: on admission for rehabilitation, at discharge and 10 months after stroke. Walking training on a treadmill with body weight support and walking training on the ground were found to be equally effective in the early rehabilitation. The patients in both groups improved their walking velocity, motor function, balance, self-efficacy and ADL performance. In a geriatric sample of 37 stroke patients examined at similar time points, significant improvements in self-efficacy, motor function, balance, ambulation and ADL occurred from admission to discharge independently of age. In comparison with observer-based balance measures, FES(S) at discharge was the most powerful predictor of ADL performance 10 months after onset of stroke. In 30 patients with stable stroke, the overall test-retest reliability of FES(S) was found to be adequate. The internal consistency confirmed that FES(S) has an adequate homogeneity. In a subsample of 62 patients from the original sample and in the geriatric sample, FES(S) correlated significantly with Berg’s balance scale, the Fugl-Meyer balance scale, with motor function and with gait performance. In the relatively younger group ADL (measured by the Functional Independence Measurement) correlated significantly with FES(S) on admission and at 10 months follow-up, while at discharge none of the FES(S) measures correlated significantly with ADL. In this subsample effect size statistics for detecting changes in FES(S) demonstrated very acceptable responsiveness of this scale during the early treatment period and during the total observation period In the light of these findings assessment and treatment of self-efficacy seems relevant in stroke rehabilitation.