gms | German Medical Science

Physical activity and successful aging
10th International EGREPA Conference

European Group for Research into Elderly and Physical Activity

14.09. - 16.09.2006 in Köln

Use of impairment information to generate an exercise

Meeting Abstract

  • corresponding author M. Hirvensalo - University of Jyväskylä, Finland
  • J. Cohen-Mansfield - Research Institute on Aging, Finland
  • S. Rind - Adventist Rehabilitation Hospital, Finland
  • J.M. Guralnik - National Institute on Aging, Finland

Physical activity and successful aging. Xth International EGREPA Conference. Cologne, 14.-16.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06pasa059

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Veröffentlicht: 18. Dezember 2006

© 2006 Hirvensalo et al.
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Many healthcare professionals do not feel adequately prepared to design and prescribe exercise programs for their patients. The aim of this study is to present exercise recommendations that were made based on the use of a systematic impairment impact rating. The association between recommended exercise intensity level and impairment impact rating was analyzed.


The study uses data from the Hebrew Home Study of Impairment and Exercise, a community-based study of subjects aged 75 to 85 who were not currently disabled but were at risk of future disability and did little or no physical exercise. Nine specific impairments’ impact on walking, stationary bicycling, upper and lower extremity exercises, and balance exercises was estimated with an evaluation scale called the Global Impairment Impact Rating scale. The association between recommended exercise intensity level and impairments’ impact rating in exercise activities was analyzed by cross tabulation followed by chi square test.


Impaired balance, impaired physical endurance, and pain were estimated to have the largest impact on exercise activities, primarily walking, stair climbing, balance exercises, and stationary bicycling. Impaired physical endurance was estimated to limit 20 minutes of walking in 31% of the participants at a minimal reduction level and 51% of participants at a major reduction level. Impaired balance was rated as limiting balance exercises, with the corresponding percentages of 48% and 42%. Weakness was estimated to have an impact on ability to perform strength training with resistance: hip exercises with resistance in 79% of participants, knee exercises with resistance in 42% of participants, and shoulder exercises in 33% of participants at a minimal or major reduction level. Impairment impact rating on exercise activities was strongly associated with the exercise intensity recommendation. The intensity of the recommended exercise was very low or low for half of the participants for balance exercises, and for 86% of participants in walking. In those whose impairments were judged to have a major impact on ability to walk, a very low level walking intensity and duration were recommended, while those who were rated as having no limitation were recommended a moderate level of walking (p<.001).


A structured assessment, the Global Impairment Impact Rating scale, enabled to identify systematically the impact of a broad range of specific impairments and the global impact of all impairments on exercise activities in older adults. The impairment impact results facilitated the process of creating individualized exercise prescriptions for persons who have impairments and functional limitations.