M. Elaine Cress, PhD
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M. Elaine Cress, PhD Professor Department of Kinesiology Institute of Gerontology The University of Georgia South Carolina Aging Research Conference. Objectives. Establish the theoretical basis for functional assessment

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M. Elaine Cress, PhD Professor Department of Kinesiology Institute of Gerontology

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M. Elaine Cress, PhD

Professor

Department of Kinesiology

Institute of Gerontology

The University of Georgia

South Carolina Aging Research Conference


Objectives

  • Establish the theoretical basis for functional assessment

  • Describe the Continuous Scale Physical Functional Performance (CS-PFP) Test and the psychometric properties CS-PFP

  • Present CS-PFP Normative data

  • Provide data on interventions to increase functional capacity

  • Posit some future directions function


Physical Function

Physical

Health

Physical

Environment

Psychosocial


Kaplan, G. In: Public Health and Aging Eds Hickey, T, Speers, MA, Prohaska, TR, 1997 p. 39


The Disablement Model

Functional

Limitation

Disability

Pathology

Impairment

Nagi, 1976, 1991


The Disablement Model

DEMAND

Functional

Limitation

Disability

Pathology

Impairment

CAPACITY

Nagi, 1976, 1991


Zone of positive

affect & adaptive behavior

High

Risk of more sedentary behavior negative affect and maladaptive behavior

Maximum Comfort

More modification

strategies

Higher risk of dependency

Higher risk of injury, malnutrition,

social isolation

Maximum performance potential

Physical Function

Low

Low

High

Environmental Press

Adapted from Lawton & Nahemow, 1973


M. Elaine Cress, PhD


CS-PFP16 Threshold

The average CS-PFP Threshold = 57

Cress & Meyer, 2003


  • High Function

  • No Difficulty

  • High Mobility

  • Pre-functional Limitation

  • Task Modification

  • Declines in Mobility

  • Low Function

  • Task Difficulty

  • Low Mobility

0 = Retire Comm., SF36 < 65

1 = Comm. Dweller, SF36  65

Cress & Meyer, 2003

Petrella & Cress, 2004


45

20

CAMRA, LLC 2006

Cress & Meyer, 2003


Men: CS-PFP Normative dataN= 342 Min, Mean, Max


Women: CS-PFP Normative dataN= 559 Min, Mean, Max


Congestive Heart Failure

  • Age – 62  11.4 year old men and women (n=61)

  • Comorbidity

    • Class II CHF – 44%

    • Class III CHF – 56%

  • Beck Depression Inventory 21  8

CAMRA, LLC 2006

Cress et al., MSSE, 2006


Public Housing Residents walking intervention

  • Age – 71.5  8.1 n=26

  • Income – 80% < $20,000

  • African American 34%

  • CS-PFP10

    • Total - 49.2  11.9

    • increase 9.8 CS-PFP units

    • Effect size .75

Moore et al., J. Geriatric PT, in press


45

52

64

CAMRA, LLC 2006

Cress & Meyer, 2003


Parkinson’s Disease

Schenkman, et al., Physical Therapy, 2008

60 year old man with Parkinson’s Disease

Hoehn & Yahr Scale = 2

UPDRS – 41

4-month Endurance training

12 months home based exercise


Parkinson’s Disease

CS-PFP total

Schenkman, et al., Physical Therapy, 2008


Zone of positive

affect & adaptive behavior

High

Physical Function

Low

Low

High

Environmental Press

70

66

49

Adapted from Lawton & Nahemow, 1973


Summary

Performance-based measures provide valuable information on the impact of aging or disease on physical function

Functional performance provides information on physical reserve

Future directions: Performance based linkages between function, environment and quality of life


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