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Service providers are becoming sensitized to unique aspects of aging and its impact on health, and the healthcare delivery system for all, including those with preexisting disabilities. However, many have little or no experience navigating the complexity of conditions that are often superimposed on preexisting disabilities. The inadequate number of service providers with the expertise in health conditions related to the older adult will significantly impact adults with developmental disabilities, one of the most vulnerable and fragile segments of American society. This article reviews the health considerations of the aging individual with developmental disabilities and emphasizes prevention of further disabling conditions. Since the aging process often affects the disabled earlier than the nondisabled population, a preventive approach that preserves functional mobility, strength, and range of motion is of critical importance. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether a 6-week Divided-Attention Stepping Accuracy Task (DATSAT) intervention improved the primary outcome measure, maximal step length; other balance measures (Berg Balance scale and Timed Up and Go test); leg strength; endurance (6-min walk test); and functional tasks in 15 community-dwelling healthy older adults ( x ¯ age: 71.5 years, female: 46.7%) compared with 15 community-dwelling healthy older adults in a Bike and Strength (B&S) program ( x ¯ age: 73.8 years, female: 33.3%). Participants trained 3× per week, 30-60 min per session. Stepping-group differences were significant for all measures. B&S group improved in maximal step length (anterior and lateral), strength, and one functional task. Stepping group outperformed B&S group in Timed Up and Go and maximal step length posterior. B&S group outperformed stepping group in two strength measures. Exertion scores were lower for the stepping group. Overall, Divided-Attention Timed Stepping Accuracy Task training resulted in more within-group improvements and two between-group measures with less perceived effort and shorter intervention times.

Background: Persons with multiple sclerosis (MS) commonly have difficulty walking. The 6-Minute Walk Test (6MWT) assesses functional capacity but may be considered burdensome for persons with MS, especially those with higher disability levels. The 2-Minute Walk Test (2MWT) may be an alternative measure to the 6MWT. The purpose of this study was to investigate the validity of the 2MWT in persons with MS., Methods: Twenty-eight ambulatory persons with MS aged 18 to 64 years participated in this cross-sectional study. Participants completed five measures of walking performance (2MWT, 6MWT, usual and fast gait speed, and Timed Up and Go test) and two functional measures (Berg Balance Scale and five-times sit-to-stand test) during a testing session. Participants were classified into two subgroups based on Disease Steps scale classification., Results: The 2MWT was significantly correlated with the 6MWT (r = 0.947), usual gait speed (r = 0.920), fast gait speed (r = 0.942), the Timed Up and Go test (r = -0.911), and other functional measures. The 2MWT explained 89% of the variance seen during the 6MWT. The distances completed on the 2MWT and 6MWT accurately distinguished the subgroups., Conclusions: This study demonstrated good construct and discriminant validity of the 2MWT in persons with MS, providing an efficient and practical alternative to the 6MWT. Validation of the 2MWT with other functional measures further supports these findings., Competing Interests: The authors declare no conflicts of interest.

A spinal cord injury (SCI) frequently results in impaired balance, endurance, and strength with subsequent limitations in functional mobility and community participation. The purpose of this case report was to implement a training program for an individual with a chronic incomplete SCI using a novel divided-attention stepping accuracy task (DASAT) to determine if improvements could be made in impairments, activities, and participation. The client was a 51-year-old male with a motor incomplete C4 SCI sustained 4 years prior. He presented with decreased quality of life (QOL) and functional independence, and deficits in balance, endurance, and strength consistent with central cord syndrome. The client completed the DASAT intervention 3 times per week for 6 weeks. Each session incorporated 96 multi-directional steps to randomly-assigned targets in response to 3-step verbal commands. QOL, measured using the SF-36, was generally enhanced but fluctuated. Community mobility progressed from close supervision to independence. Significant improvement was achieved in all balance scores: Berg Balance Scale by 9 points [Minimal Detectable Change (MDC) = 4.9 in elderly]; Functional Reach Test by 7.62 cm (MDC = 5.16 in C5/C6 SCI); and Timed Up-and-Go by 0.53 s (MDC not established). Endurance increased on the 6-Minute Walk Test, with the client achieving an additional 47 m (MDC = 45.8 m). Lower extremity isokinetic peak torque strength measures were mostly unchanged. Six minutes of DASAT training per session provided an efficient, low-cost intervention utilizing multiple trials of variable practice, and resulted in better performance in activities, balance, and endurance in this client.

Unlike the aging population without intellectual and developmental disabilities (IDD), few standardized performance measures exist to assess physical function and risk for adverse outcomes such as nonfatal, unintentional injuries. We modified 3 selected standardized performance tools in the areas of general fitness (2-Minute Walk Test), balance and gait (Performance-Oriented Mobility Assessment I), and functional independence (Modified Barthel Index) for administration with people with IDD. The modified tools were piloted with 30 participants. Results indicated the measures are strongly associated and successfully distinguished between participants with an adverse health event in the previous year. The modified tools have potential to provide clinicians with quantitative measures that track physical performance changes associated with aging in people with IDD.

Friedreich ataxia, although rare, is the most prevalent inherited ataxia. Recent insight into the disease pathogenesis is creating new hope for effective therapies. The purposes of this update are: (1) to review the etiology, presentation, and progression of Friedreich ataxia and (2) to describe a comprehensive physical therapist examination emphasizing valid and reliable performance measurements associated with disease progression. Early identification of individuals with Friedreich ataxia and precise characterization of impairments and functional limitations gain importance as new drug therapies are considered.

The purpose of this study was to investigate the effectiveness of mental practice in increasing the rate of skill acquisition during a novel motor task. Twenty-six subjects were randomly assigned to two groups. The Control Group (n = 13) performed only physical practice; the Experimental Group (n = 13) performed both mental and physical practice. The task was to toss, by flexing the elbow, a Ping-Pong ball held in a cup on a forearm splint to a target. The biceps brachii muscle and the long and lateral heads of the triceps brachii muscle were monitored electromyographically to determine any changes occurring during skill acquisition. The Experimental Group's accuracy improved at a significantly greater rate than that of the Control Group. In addition, the Experimental Group demonstrated changes in timing variables that led to a more efficient movement. These changes included a decrease in time from the onset of muscle activity to peak activity and an increase in the time elapsed from the onset of agonist contraction to the onset of antagonist contraction. These results suggest that mental practice may be an important tool in facilitating the acquisition of a new motor skill.