title: Rhythmic Interlimb Coordination Impairments and the Risk for Developing Mobility Limitations.
abstract: BACKGROUND
  The identification of novel rehabilitative impairments that are risk factors for mobility limitations may improve their prevention and treatment among older adults. We tested the hypothesis that impaired rhythmic interlimb ankle and shoulder coordination are risk factors for subsequent mobility limitations among older adults.
  
  
  METHODS
  We conducted a 1-year prospective cohort study of community-dwelling older adults (N = 99) aged 67 years and older who did not have mobility limitations (Short Physical Performance Battery score > 9) at baseline. Participants performed antiphase coordination of the right and left ankles or shoulders while paced by an auditory metronome. Using multivariable logistic regression, we determined odds ratios (ORs) for mobility limitations at 1-year follow-up as a function of coordination variability and asymmetry.
  
  
  RESULTS
  After adjusting for age, sex, body mass index, Mini-Mental State Examination score, number of chronic conditions, and baseline Short Physical Performance Battery score, ORs were significant for developing mobility limitations based on a 1 SD difference in the variability of ankle (OR = 1.88; 95% confidence interval [CI]: 1.16-3.05) and shoulder (OR = 1.96; 95% CI: 1.17-3.29) coordination. ORs were significant for asymmetry of shoulder (OR = 2.11; 95% CI: 1.25-3.57), but not ankle (OR = 0.95; 95% CI: 0.59-1.55) coordination. Similar results were found in unadjusted analyses.
  
  
  CONCLUSIONS
  The results support our hypothesis that impaired interlimb ankle and shoulder coordination are risk factors for the development of mobility limitations. Future work is needed to further examine the peripheral and central mechanisms underlying this relationship and to test whether enhancing coordination alters mobility limitations.
authors.affiliation: Department of Physical Therapy, University of Massachusetts, Lowell.
authors.forename: Eric G
authors.initials: EG
authors.lastname: James
authors.affiliation: College of Nursing and Health Sciences, University of Massachusetts, Boston.
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
authors.affiliation: Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.|Sagol School of Neuroscience, Tel Aviv University, Israel.|Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Hausdorff
authors.affiliation: Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts.
authors.forename: Thomas
authors.initials: T
authors.lastname: Travison
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester.
authors.forename: David N
authors.initials: DN
authors.lastname: Kennedy
authors.affiliation: Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts, Lowell.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston.
authors.forename: Soham
authors.initials: S
authors.lastname: Al Snih
authors.affiliation: Sealy Center on Aging, University of Texas Medical Branch, Galveston.
authors.forename: Kyriakos S
authors.initials: KS
authors.lastname: Markides
authors.affiliation: New England GRECC, VA Boston Healthcare System, Massachusetts.|Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D001259:Ataxia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D015992:Body Mass Index; D015331:Cohort Studies; D018450:Disease Progression; D005121:Extremities / Q000503:physiopathology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D051346:Mobility Limitation; D004856:Postural Balance / Q000502:physiology; D011314:Preventive Health Services; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013223:Statistics as Topic; D014481:United States
keywords: Aging; Coordination; Interlimb; Mobility; Risk