Balance. Single Leg Stance (Eyes Open, Eyes Closed, Foam) Gait Speed

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1 Balance Single Leg Stance (Eyes Open, Eyes Closed, Foam) Gait Speed

2 Single Leg Stance Eyes Open Eyes Closed 30 sec. max Arms crossed Legs not touching Foot planted Best of 3 Cutoff at 30 sec.

3 Single Leg Stance Single leg stance <30 seconds is associated with falls in community-dwelling seniors. 32 Recommended in the screening of high-functioning seniors with good reliability and response to function. 25

4 Single Leg Stance 35 Norms for Best of 3 (seconds) Age Eyes Open Eyes Closed Men Women Men Women

5 10 m with 5 m acceleration and deceleration zones Normal walking speed Measured in meters/second Gait Speed

6 Gait Speed Goal meters/second Normal Speed (m/s) Age Men Women

7 Balance

8 Community Athletes Fallers 10% 30% 0% 5% 10% 15% 20% 25% 30% 35% 40%

9 Balance

10 Balance

11 Balance

12 Balance

13 <15 sec. = Fall <12 sec. = Multi-Faller

14 Fall Predictors 6 <6 seconds = fall. <5 seconds = multiple falls

15 Odds of falling more than doubles!

16 Balance

17 Falls

18 Unexpected Predictor Chair Stand

19 Senior Athletes Community Dwelling Seniors Chair Stand 8 6 Falls increase above this line to to to to to 99

20 14 Senior Athletes Chair Stand The oldest senior athletes still outperform year old non-athletes Community Dwelling Seniors 8 6 Falls increase above this line to to to to to 99

21 Balance Lab SLS Eyes Open, Closed, Foam Gait Speed

22 Interpretation Results Provided Basic Education Report Card Referral to Find a PT as needed

23

24 Senior Athlete Fitness Exam (SAFE) CARDIOVASCU LAR Blood Pressure 119/70 mmhg Needs Improvem ent Normal x Goal <120/<80 mm Hg Oxygen Saturation 97% x 95 Heart Rate 70 beats/min x bpm Height 5 10 Weight 190 Lbs BMI 27.3 x

25 Your State Games Contact information, location, dates, events

26 What does being involved in the Senior Games mean to you? YoungFunCompete NewFriendsMakesMeFeelSpecialGivesMeHope Travel ParticipateFocusFitness Motivation PrideEnjoyvolleyballAge CompetitionFieldEvent

27 A chance to meet new friends and compete against myself and others. Gets me excited.

28 .Working out keeps me healthy and off of oxygen. I cannot run since I have emphysema but I participate in the shot putt, hammer and javelin. Limited running with rest in between each throw.

29 It shows me that we can feel and act as "kids" even as we get older. I feel more alive when I compete.

30 Being part of a greater organization Gave me incentive to train at a higher intensity. I enjoy winning. Got involved because my dad was involved.

31 Benefits Your State Games Community Service Education Opportunities Prevention New patients Service-learning for students

32 Equipment Needs One banquet table and several chairs BP cuff/stethoscope Pulse oximeter Scale* Portable treatment table Grip dynamometer Goniometer Airex Pad (2) Tape measure (2) Stop watch (2) Gait belt Hand Sanitizer Cleaning Wipes Trash Can *Not needed during state games

33 Adding to the Research July 3-16 National Senior Games in Twin Cities Human Subjects Protection CITI Training Becca Jordre, PT, DPT, GCS, CEEAA, Cert MDT The University of South Dakota School of Health Sciences Department of Physical Therapy 414 E. Clark St. Vermillion, SD 57069

34 References 1. National Senior Games Association. History of NSGA. Available at Accessed May 1, Section on Geriatrics. About the Section on Geriatrics. Available at Accessed Jan 20, Minor MAD, Minor SD. Patient Care Skills. 6 th ed. Upper Saddle River, NJ: Pearson Education, Inc.; ISBN American Heart Association. Available at High BloodPressure/Understanding-Blood-Pressure- Readings_UCM_301764_Article.jsp. Updated April 4, Mengelkoch LJ, Martin D, Lawler J. A review of the principles of pulse oximetry and accuracy of pulse oximeter estimates during exercise. Phys Ther. Jan 1994;74(1): Sines JE. Pulse oximetry: Prinicples and limitations. Am J Emerg Med 1999;17:59-67.

35 7.Pasco JA, Nicholson GC, Brennan SL, Kotowicz MA. Prevalence of obesity and the relationship between the body mass index and body fat: cross-sectional, population-based data. PloS one. 2012;7(1):e Bohannon RW, Brennan PJ, Pescatello LS, Marschke L, Hasson S, Murphy M. Adiposity of Elderly Women and Its Relationship with Self-reported and Observed Physical Performance. Journal of Geriatric Physical Therapy 2005;28(1): Siren R, Eriksson JG, Vanhanen H. Waist circumference a good indicator of future risk for type 2 diabetes and cardiovascular disease. BMC public health. 2012;12: Srikanthan P, Seeman TE, Karlamangla AS. Waist-hip-ratio as a predictor of all-cause mortality in high-functioning older adults. Annals of epidemiology.2009;19(10):

36 11. Price GM, Uauy R, Breeze E, Bulpitt CJ, Fletcher AE. Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death. Am J Clin Nutr. 2006;84(2): Norkin CC WD. Measurement of Joint Motion: A Guide to Goniometry. 4th ed. Philadelphia: F.A. Davis Company; Riddle DL, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting: shoulder measurements. Physical Therapy. 1987;67(5): Mecagni C. Balance and Ankle Range of Motion in Community-Dwelling Women Aged 64 to 87 Years: A Correlational Study. Physical Therapy. 2000;80(10): Clapis PA, Davis SM, Davis RO. Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test. Physiotherapy Theory & Practice. 2008;24(2):

37 16. Kendall FP, McCreary EK, Provance PG 2005 Muscles testing and function, 5th ed,.baltimore, MD, Williams & Wilkins. 17. Bohannon RW. Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders. Perceptual and motor skills.2006;103(1): Jordre B, Schweinle W, Beacom K, Ladwig A. The Five Times Sit to Stand Test in Senior Athletes. J Geriatr Phys Ther 2012;35: Bohannon RW. Alternatives for measuring knee extension strength of the elderly at home. Clin Rehabil.1998;12(5): Goldberg A. The five-times-sit-to-stand-test (FTSST), the short version of the activities-specific balance confidence (ABC) scale, and fear of falling predict step execution time (SET) in older adults. Arch Gerontol Geriatr. 2012(54):

38 21. Buatois S, Miljkovic D, Manckoundia P, et al. Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. J Am Geriatr Soc. 2008;56(8): Wang CY, Yeh CJ, Hu MH. Mobility-related performance tests to predict mobility disability at 2-year follow-up in community-dwelling older adults. Arch Gerontol Geriat. 2011;52(1): Tiedemann A, Shimada H, Sherrington C, Murray S, Lord S. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age and ageing.2008;37(4): Mong Y, Teo TW, Ng SS. 5-Repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Arch Phys Med Rehabil ; 91 : Curb JD, Ceria-Ulep CD, Rodriguez BL, et al. Performance-based measures of physical function for high-function populations. J Am Geriatr Soc. 2006;54(5):

39 26. Rantanen T, Guralnik JM, Foley D, et al. Midlife hand grip strength as a predictor of old age disability. Jama.1999;281(6): Angst F, Drerup S, Werle S, Herren DB, Simmen BR, Goldhahn J. Prediction of grip and key pinch strength in 978 healthy subjects. BMC Musculoskeltal Disorders. 2010;11: Sayer AA, Syddall HE, Martin HJ, Dennison EM, Roberts HC, Cooper C. Is grip strength associated with health-related quality of life? Findings from the Hertfordshire Cohort Study. Age Ageing. 2006;35(4): Gale CR, Martyn CN, Cooper C, Sayer AA. Grip strength, body composition, and mortality. Int J Epidemiol.2007;36(1): Horowitz BP, Tollin R, Cassidy G. Grip strength: collection of normative data with community dwelling elders. Physical & Occupational Therapy in Geriatrics. 1997;15(1): Bohannon RW. Single limb stance times: a descriptive meta-analysis of data from individuals at least 60 years of age. Top Geritr Rehabil. 2006;22(1):70-77.

40 32.Hurvitz EA, Richardson JK, Werner RA, Ruhl AM, Dixon MR. Unipedal Stance Testing as an Indicator of Fall Risk Among Older Outpatients. Arch Phys Med Rehabil (81): Ageberg E, Roberts D, Holmstrom E, Friden T. Balance in single-limb stance in healthy subjects--reliability of testing procedure and the effect of shortduration sub-maximal cycling. BMC Musculoskelet Disord. 2003;4: Bohannon RW, Larkin PA, Cook AC, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984;64(7): Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1): Daubney ME, Culham EG. Lower-extremity muscle force and balance performance in adults aged 65 years and older. Phys Ther. 1999;79(12): Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J of Gerentology. 1990;45:6.

41 38. Kage H, Okuda M, Nakamura I, Kunitsugu I, Sugiyama S, Hobara T. Measuring Methods for Functional Reach Test: Comparison of 1-Arm Reach and 2-Arm Reach. Arch Phys Med Rehab. 2009;90(12): Fritz S, Lusardi M. White paper: "walking speed: the sixth vital sign". J Geriatr Phys Ther. 2009;32(2): Bohannon RW, Williams AA. Normal walking speed: a descriptive metaanalysis. Physiotherapy. 2011;97(3): Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82(2): Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA. Jan ;305(1):50-58.

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