Gine two example
how the physical
proirment effect our daily activities and
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The crops that were grown for market use to earn more profit are called ___________ crops. *
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Background and Purpose. The decline of physical function of older adults, associated with loss of independent living status, is a major public health concern. The purpose of this study was to examine the relationship of physical impairment and disability to performance of activities of daily living (ADL) among community-dwelling older adults. Subjects and Methods. Eighty-three community-dwelling older men who were referred to a comprehensive outpatient geriatric evaluation program (mean age=75.5 years, SD=7.0, range=64–97) were examined. Measurements of physical impairment (muscle force production, flexibility, and fitness) and physical disability (gait speed, stride length, risk for recurrent falls, and physical function) were recorded. Results. A stepwise linear regression was used to determine the relationship of physical impairments and disability measures with ADL. The results indicated that walking speed, fall risk, and muscle force contributed independently to the characterization of the activities of daily living of the community-dwelling older men studied (adjusted R2=.68; F=56.81; df=3,80; P<.001). Using a principal components factor analysis, 4 domains were identified that explained 68.2% of the variance in performance of ADL: (1) mobility/fall risk=26.5%, (2) coordination=15%, (3) fitness=14.7%, and (4) flexibility=12.0%. Discussion and Conclusion. The identification of domains of physical function may be useful to physical therapists in the development of interventions targeted for physical impairments and disabilities that contribute to deficits in performance of ADL. Targeting interventions for physical impairments and disabilities related to function may improve the effectiveness of physical therapist interventions and reduce the loss of independence among community-dwelling older people.
Function and disability are essential parts of the examination of older people.1 Unrecognized physical impairments and disabilities can often lead to a loss of independence in community dwelling,2 an increased use of support services,3 institutionalization,4 and mortality.5,6 The process of increasing impairment and disability may be altered by interventions7; thus, the potential exists to delay dependency and increase active life expectancy among older people.8
Based on the definitions in the World Health Organization's (WHO's) International Classification of Impairments, Disabilities, and Handicaps (ICIDH),9,10 a number of impairments (eg, limited range of motion, reduced muscle force) and disabilities (eg, falling, difficulty walking) in older people have been described. Either individually or in combination, the impairments and disabilities have been assumed to be contributing factors to a decline in health (even death) and function and to the loss of independence. For some impairments and disabilities, a relationship has been demonstrated.*,12–15
Function has been the focus of investigators1,16,17 who have attempted to identify community-dwelling older people who are at risk for losing independence. Establishing guidelines and identifying interventions to alter the risk or to provide public health services to manage increasing dependence has also been a focus of researchers.16,17Physical function relates to the ability to perform activities of daily living (ADL), instrumental activities of daily living, and mobility tasks important for independent living without substantial risk of injury.18
Understanding the relationship of physical impairments and disabilities to physical function of community-dwelling older adults may increase the ability to identify older adults who are at risk for loss of independence and may help streamline the process of functional assessment. Identifying physical impairments and disability associated with physical capabilities may be useful in developing interventions that can be tailored to specific impairments and disabilities. The purpose of our study was to examine the relationship of physical impairment and disability to physical function in community-dwelling older adults (≥60 years of age). We expected 4 domains (eg, a practical or meaningful set of related physiological functions, actions, or tasks11) in physical impairment and disability to contribute to function in a manner consistent with independent community-dwelling living status: (1) mobility/fall risk, (2) muscle force, (3) coordination, and (4) general fitness.
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