Article

Although clinicians have a number of measures to use to describe
walking performance, few, if any, of the measures capture a person's perceived
effort in walking. Perceived effort of walking may be a factor in what a person
does versus what he or she is able to do. OBJECTIVE: The objective of this study
was to examine the relationship of perceived effort of walking with gait,
function, activity, fear of falling, and confidence in walking in older adults
with mobility limitations. Design This investigation was a cross-sectional,
descriptive, relational study. METHODS: The study took place at a clinical
research training center. The participants were 50 older adults (mean age=76.8
years, SD=5.5) with mobility limitations. The measurements used were the Rating
of Perceived Exertion (RPE) for walking; gait speed; the Modified Gait
Abnormality Rating Scale; energy cost of walking; Late Life Function and
Disability Instrument (LLFDI) for total, basic, and advanced lower-extremity
function and for disability limitations; activity and restriction subscales of
the Survey of Activities and Fear of Falling in the Elderly (SAFFE); activity
counts; SAFFE fear subscale; and Gait Efficacy Scale (GES). The relationship of
the RPE of walking with gait, function, activity, fear, and confidence was
determined by using Spearman rank order coefficients and an analysis of variance
(adjusted for age and sex) for mean differences between groups defined by no
exertion during walking and some exertion during walking. RESULTS: The RPE was
related to confidence in walking (GES, R=-.326, P=.021) and activity (activity
counts, R=.295, P=.044). The RPE groups (no exertion versus some exertion)
differed in LLFDI scores for total (57.9 versus 53.2), basic (68.6 versus 61.4),
and advanced (49.1 versus 42.6) lower-extremity function; LLFDI scores for
disability limitations (74.9 versus 67.5); SAFFE fear subscale scores (0.346
versus 0.643); and GES scores (80.1 versus 67.8) (all P<.05). Limitations The
range of RPE scores for the participants studied was narrow. Thus, the real
correlations between RPE and gait, physical function, and psychological aspects
of walking may be greater than the relationships reported. CONCLUSIONS: The
perceived effort of walking was associated with physical activity and confidence
in walking. Reducing the perceived effort of walking may be an important target
of interventions to slow the decline in function of older adults with mobility
limitations.

Langue : ANGLAIS