Task-specific resistance training to improve the ability of activities of daily living-impaired older adults to rise from a bed and from a chair

OBJECTIVES: To determine the effect of a 12-week intervention to improve th e ability of disabled older adults to rise from a bed and from a chair. DESIGN: Subjects were randomly allocated to either a 12-week task-specific resistance-training intervention (training in bed- and chair-rise subtasks, such as sliding forward to the edge of a chair with the addition of weight s) or a control flexibility intervention. SETTING: Seven congregate housing facilities. PARTICIPANTS: Congregate housing residents age 65 and older (n = 161, mean age 82) who reported requiring assistance (such as from a person, equipment , or device) in performing at least one of the following mobility-related a ctivities of daily living: transferring, walking, bathing, and toileting. MEASUREMENTS: At baseline, 6 weeks, and 12 weeks, subjects performed a seri es of bed- and chair-rise tasks where the rise task demand varied according to height of the head of the bed, chair seat height, and use of hands. Out comes were able or unable to rise and, if able, the time taken to rise. Log istic regression for repeated measures was used to test for differences bet ween tasks in the ability to rise. Following log transformation of rise tim e, a linear effects model was used to compare rise time between tasks. RESULTS. Regarding the maximum total number of bed-and chair-rise tasks tha t could be successfully completed, a significant training effect was seen a t 12 weeks (P = .03); the training effect decreased as the total number of tasks increased. No statistically significant training effects were noted f or rise ability according to individual tasks. Bed-and chair-rise time show ed a significant training effect for each rise task, with analytic models s uggesting a range of approximately 11 % to 20 % rise-time (up to 1.5 second s) improvement in the training group over controls. Training effects were a lso noted in musculoskeletal capacities, particularly in trunk range of mot ion, strength, and balance. CONCLUSIONS: Task-specific resistance training increased the overall abilit y and decreased the rise time required to perform a series of bed- and chai r-rise tasks. The actual rise-time improvement was clinically small but may be useful over the long term. Future studies might consider adapting this exercise program and the focus on trunk function to a frailer cohort, such as in rehabilitation settings, In these settings, the less challenging rise tasks (such as rising from an elevated chair) and the ability to perform i ntermediate tasks (such as hip bridging) may become important intermediate rehabilitation goals.