title: Which impairments are most associated with high mobility performance in older adults? Implications for a rehabilitation prescription.
abstract: OBJECTIVE
  To test which rehabilitative impairments are associated with higher mobility performance among community-dwelling, mobility-limited older adults.
  
  
  METHODS
  Cross-sectional analysis of baseline data from participants within a randomized controlled trial.
  
  
  METHODS
  Outpatient rehabilitation research center.
  
  
  METHODS
  Community-dwelling older adults (N=138; mean age, 75.4 y) with mobility limitations as defined by the Short Physical Performance Battery (SPPB).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Balance measured via the Berg Balance Scale, leg strength, leg velocity, submaximal aerobic capacity, body mass index (BMI), and mobility performance as measured by the SPPB.
  
  
  RESULTS
  Each of the 5 physiologic attributes (unipedal balance, leg strength, leg velocity, submaximal aerobic capacity, BMI) was categorized into tertiles by using lower values as reference for impairment status. Within an adjusted model, measures associated with higher SPPB performance (>9) included a BBS score greater than or equal to 54 (odds ratio [OR]=4.54; 95% confidence interval [CI], 1.11-18.60), leg strength greater than or equal to 21.5 N/kg (OR=30.35; 95% CI, 5.48-168.09), leg velocity .0101 to .0129 m.s(-1).kg(-1) (OR=5.31; 95% CI, 1.25-22.57), and leg velocity greater than or equal to .0130 m.s(-1).kg(-1) (OR=22.86; 95% CI, 3.88-134.75).
  
  
  CONCLUSIONS
  Our investigation highlights the importance of rehabilitative impairments in leg strength, leg velocity, and balance as being associated with mobility status as measured by the SPPB. In our sample of participants within an exercise trial, submaximal aerobic capacity and BMI status were not associated with mobility performance. These findings suggest that the augmentation of not only leg strength and balance but also leg velocity may be important in the rehabilitative care of mobility-limited older adults.
authors.affiliation: Department of Physical Medicine, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA. jfbean@partners.org
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kiely
authors.forename: Sharon
authors.initials: S
authors.lastname: LaRose
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005080:Exercise Test; D005260:Female; D006801:Humans; D007866:Leg; D016015:Logistic Models; D008297:Male; D051346:Mobility Limitation; D015999:Multivariate Analysis; D053580:Muscle Strength; D004856:Postural Balance; D012046:Rehabilitation; D013647:Task Performance and Analysis