title: Directly Measured Physical Function in Cardiac Rehabilitation.
abstract: OBJECTIVE
  The Short Physical Performance Battery (SPPB) is a strong predictor for risk of physical disability in older adults. Roughly half of individuals participating in phase II cardiac rehabilitation (CR) are 65 years or older, many presenting with low aerobic capacities and may be at increased risk for physical disability.
  
  
  METHODS
  The cohort consisted of 196 consecutive patients (136 men), aged 65 years or older, entering CR who were prospectively evaluated by the SPPB. Data were also obtained for age, self-reported physical function (Medical Outcomes Study Short Form-36 questionnaire), and peak aerobic capacity. Measures were repeated upon completion of CR for those individuals who completed the program.
  
  
  RESULTS
  The average age of patients was 74 ± 0.5 years. At baseline, total SPPB score was 9.7 ± 0.2 (out of 12). Followup data were obtained on 133 (68%) patients, with a mean improvement of 0.8 ± 0.1 (P < .0001), which was not clinically significant (≥1 point). Focusing on patients with a low baseline SPPB score, 72 subjects scored ≤9 (7.1 ± 0.2), with 45 completing exit measures. Improvements were found in gait speed (0.5 ± 0.1, P < .0001), chair-stand (1.0 ± 0.1, P < .0001), and total SPPB (1.6 ± 0.3, P < .0001) in this more disabled group. Measures of (Equation is included in full-text article.)O2peak were significantly reduced in the low SPPB group (13.5 ± 0.4 vs 17.5 ± 0.4 mL/kg/min, P < .0001). Measured (Equation is included in full-text article.)O2peak (R = 26%, P < .0001) and self-reported physical function score (R = 5%, P = .02) were the only multivariate predictors of baseline SPPB.
  
  
  CONCLUSIONS
  For patients who enter CR with low SPPB scores (37%), significant improvements in physical function were noted, largely explained by improved walking speed and leg strength (chair-stand).
authors.affiliation: Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, Burlington (Messrs Rengo and Savage, Ms Shaw, and Dr Ades); and University of Vermont College of Medicine, Burlington (Dr Ades).
authors.forename: Jason L
authors.initials: JL
authors.lastname: Rengo
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Savage
authors.forename: Joan C
authors.initials: JC
authors.lastname: Shaw
authors.forename: Philip A
authors.initials: PA
authors.lastname: Ades
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000072038:Cardiac Rehabilitation / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D011795:Surveys and Questionnaires