m. elaine cress, phd professor department of kinesiology institute of gerontology
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M. Elaine Cress, PhD Professor Department of Kinesiology Institute of Gerontology The University of Georgia South Carolina Aging Research Conference. Objectives. Establish the theoretical basis for functional assessment - PowerPoint PPT PresentationTRANSCRIPT
M. Elaine Cress, PhDProfessor
Department of KinesiologyInstitute of Gerontology
The University of Georgia
South Carolina Aging Research Conference
Objectives• Establish the theoretical basis for functional
assessment• Describe the Continuous Scale Physical Functional
Performance (CS-PFP) Test and the psychometric properties CS-PFP
• Present CS-PFP Normative data • Provide data on interventions to increase functional
capacity • Posit some future directions function
FUNCTION
Psychosocial
Physical Environment
PhysicalHealth
Physical Function
Kaplan, G. In: Public Health and Aging Eds Hickey, T, Speers, MA, Prohaska, TR, 1997 p. 39
The Disablement Model
Nagi, 1976, 1991
Pathology ImpairmentFunctional Limitation Disability
The Disablement Model
Nagi, 1976, 1991
Pathology ImpairmentFunctional Limitation Disability
DEMANDDEMAND
CAPACITYCAPACITY
Phy
sica
l Fun
ctio
n
Low
High
Environmental PressLow High
More modificationstrategiesHigher risk of dependencyHigher risk of injury, malnutrition,social isolation
Risk of more sedentary behavior negative affect and maladaptive behavior
Max
imum
Com
fort
Max
imum
perfo
rman
ce
poten
tial
Zone of positiveaffect & adaptive behavior
Adapted from Lawton & Nahemow, 1973
M. Elaine Cress, PhD
VO2peak
mLkg-1min-1
(95% CI)
Strength
Nm/[kgm-1] (95% CI)
Threshold 20.13
(17.33, 22.92)
2.5 (1.91, 3.11)
CS-PFP Threshold
55.30 (47.8, 56.2)
58.05 (47.7, 58.6)
CS-PFP16 Threshold
The average CS-PFP Threshold = 57
Cress & Meyer, 2003
Pre-functional Limitation
•Task Modification
•Declines in Mobility
High Function
•No Difficulty
•High Mobility
Low Function
•Task Difficulty
•Low Mobility
0 = Retire Comm., SF36 < 651 = Comm. Dweller, SF36 65
Cress & Meyer, 2003Petrella & Cress, 2004
CAMRA, LLC 2006
4520
Cress & Meyer, 2003
Men: CS-PFP Normative dataN= 342 Min, Mean, Max
Women: CS-PFP Normative dataN= 559 Min, Mean, Max
CAMRA, LLC 2006
Congestive Heart Failure• Age – 62 11.4 year old men and women (n=61)• Comorbidity
– Class II CHF – 44%
– Class III CHF – 56%
• Beck Depression Inventory 21 8
6MWT CS-PFP10 Class II 401 92 44.3 14 Class III 276 116 31.2 15
Cress et al., MSSE, 2006
Public Housing Residents walking intervention
• Age – 71.5 8.1 n=26• Income – 80% < $20,000• African American 34%• CS-PFP10
– Total - 49.2 11.9– increase 9.8 CS-PFP units– Effect size .75
Moore et al., J. Geriatric PT, in press
CAMRA, LLC 2006
45
Cress & Meyer, 2003
52 64
Parkinson’s Disease
• 60 year old man with Parkinson’s Disease
• Hoehn & Yahr Scale = 2
• UPDRS – 41
• 4-month Endurance training
• 12 months home based exercise
Schenkman, et al., Physical Therapy, 2008
Parkinson’s Disease
Schenkman, et al., Physical Therapy, 2008
CS
-PF
P to
tal
Phy
sica
l Fun
ctio
n
Low
High
Environmental PressLow High
Zone of positiveaffect & adaptive behavior
Adapted from Lawton & Nahemow, 1973
49
7066
Summary
• Performance-based measures provide valuable information on the impact of aging or disease on physical function
• Functional performance provides information on physical reserve
• Future directions: Performance based linkages between function, environment and quality of life