Neuromuscular Attributes Associated With Lower Extremity Mobility Among Community-Dwelling Older Adults.

Author: Jacob ME1,2,3,4, Travison TG5,6, Ward RE2,3, Latham NK7, Leveille SG8, Jette AM9, Bean JF1,2,3
1Spaulding Rehabilitation Hospital, Boston, Massachusetts.
2Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
3New England GRECC, VA Boston Healthcare System, Massachusetts.
4Health and Disability Research Institute, Boston University School of Public Health, Massachusetts.
5Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts.
6Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
7Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
8College of Nursing and Health Sciences, University of Massachusetts, Boston.
9Department of Physical Therapy, MGH Institute of Health Professions, Boston, Massachusetts.
Conference/Journal: J Gerontol A Biol Sci Med Sci.
Date published: 2019 Mar 14
Other: Volume ID: 74 , Issue ID: 4 , Pages: 544-549 , Special Notes: doi: 10.1093/gerona/gly102. , Word Count: 291

BACKGROUND: The Short Physical Performance Battery (SPPB) is advocated as a screening tool in geriatric care for predicting future disability. We aimed to identify the leg neuromuscular attributes to be targeted in rehabilitative care among older adults with poor SPPB scores.

METHODS: Boston Rehabilitative Impairment Study of the Elderly (Boston RISE) participants (n = 430) underwent assessment of neuromuscular attributes (leg strength, leg velocity, trunk extensor endurance, knee flexion range of motion [ROM], ankle ROM, and foot sensation). Linear regression models examined association between each neuromuscular attribute and SPPB, adjusting for age, race, gender, comorbidity, body mass index, depression, cognition, and other neuromuscular attributes.

RESULTS: Participants with 1 SD unit higher leg strength, leg velocity, and trunk extensor endurance had 0.52, 0.30, and 0.52 points higher SPPB total score. Participants with ankle ROM impairment and foot sensory loss had 0.43 and 0.57 lower SPPB total score compared with those without these. Leg strength and trunk extensor endurance were associated with balance; leg velocity, trunk extensor endurance, and ankle ROM were associated with gait speed; and strength, trunk extensor endurance, knee ROM, and feet sensation were associated with chair stand score. Neuromuscular attributes, along with covariates, explained 40.4% of the variance in the total SPPB score, a substantial increase over the 22.7% variance explained by covariates alone.

CONCLUSIONS: Neuromuscular attributes affect mobility performance in older patients as measured by the SPPB. Specific impairments are associated with poor performance in specific component scores. Assessment of the SPPB components and rehabilitation of associated impairments may help improve the functional performance among older adults.

© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

KEYWORDS: Balance; Disablement process; Functional performance; Gait; Rehabilitation

PMID: 30285233 PMCID: PMC6417482 DOI: 10.1093/gerona/gly102