title: Efficacy and Feasibility of Functional Upper Extremity Task-Specific Training for Older Adults With and Without Cognitive Impairment.
abstract: BACKGROUND
  Although functional task-specific training is a viable approach for upper extremity neurorehabilitation, its appropriateness for older populations is unclear. If task-specific training is to be prescribed to older adults, it must be efficacious and feasible, even in patients with cognitive decline due to advancing age.
  
  
  OBJECTIVE
  This cross-sectional study tested the efficacy and feasibility of upper extremity task-specific training in older adults, including those with lower cognitive scores.
  
  
  METHODS
  Fifty older adults (age 65-89 years) without any confounding neuromuscular impairment were randomly assigned to a training group or no-training group. The training group completed 3 days (dosage = 2250 repetitions) of a functional upper extremity motor task (simulated feeding) with their nondominant hand; the no-training group completed no form of training at all. Both groups' task performance (measured as trial time) was tested at pre- and posttest, and the training group was retested 1 month later. Efficacy was determined by rate, amount, and retention of training-related improvement, and compared across levels of cognitive status. Feasibility was determined by participants' tolerance of the prescribed training dose.
  
  
  RESULTS
  The training group was able to complete the training dose without adverse responses and showed a significant rate, amount, and retention of improvement compared with the no-training group. Cognitive status did not alter results, although participants with lower scores on the Montreal Cognitive Assessment were slower overall.
  
  
  CONCLUSIONS
  Task-specific training may be appropriate for improving upper extremity function in older adults, yet future work in older patients with specific neurological conditions is needed.
authors.affiliation: Utah State University, Logan, UT, USA University of Utah, Salt Lake City, UT, USA sydney.schaefer@usu.edu.
authors.forename: Sydney Y
authors.initials: SY
authors.lastname: Schaefer
authors.affiliation: University of Utah, Salt Lake City, UT, USA.
authors.forename: Leland E
authors.initials: LE
authors.lastname: Dibble
authors.affiliation: University of Utah, Salt Lake City, UT, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Duff
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003072:Cognition Disorders / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D026741:Physical Therapy Modalities; D018709:Statistics, Nonparametric; D034941:Upper Extremity / Q000503:physiopathology*
keywords: aging; cognition; motor learning; task-specific training; upper extremity