The effects of aging on motoneuron firing rates and muscle contractile properties were studied in tibialis anterior muscle by comparing results from six young (20.8 ± 0.8 yr) and six old men (82.0 ± 1.7 yr). For each subject, data were collected from repeated tests over a 2-wk period. Contractile tests included maximal voluntary contraction (MVC) with twitch interpolation and stimulated twitch contractions. The old men had 26% lower MVC torque (P < 0.01) than did the young men, but percent activation was not different (99.1 and 99.3%, respectively). Twitch contraction durations were 23% longer (P < 0.01) in the old compared with the young men. During a series of repeated brief steady-state contractions at 10, 25, 50, 75, and 100% MVC, motor unit firing rates were recorded. Results from ∼950 motor unit trains in each subject group indicated that at all relative torque levels mean firing rates were 30–35% lower (P < 0.01) in the old subjects. Comparisons between young and old subjects’ mean firing rates at each of 10%, 50%, and MVC torques and their corresponding mean twitch contraction duration yielded a range of moderate-to-high correlations (r = −0.67 to −0.84). That lower firing rates were matched to longer twitch contraction durations in the muscle of old men, and relatively higher firing rates were matched with shorter contraction times from the young men, indirectly supports the neuromuscular age-related remodeling principle.

Objectives: To examine the process of community reintegration over the first year following stroke, from the patient’s perspective. Design: Qualitative, longitudinal, grounded theory study involving ten participants. During the first year post discharge from inpatient rehabilitation, 46 one-on-one semi-structured interviews were conducted with ten participants. Interviews were completed with participants before discharge from inpatient stroke rehabilitation and in their homes at two weeks, three months, six months and one year post discharge. Analysis was guided by grounded theory methods described by Corbin and Strauss. Subjects: Four women and six men (mean age 59.6 ± 18.0, all with left hemiparesis and without aphasia) who had sustained their first hemispheric stroke and were returning to the community following inpatient rehabilitation. Results: The process of community reintegration after stroke involved transitioning through a series of goals: gaining physical function, establishing independence, adjusting expectations and getting back to real living. The ultimate challenge for stroke survivors during this process of community reintegration was to create a balance between their expectations of themselves and their physical capacity to engage in meaningful roles. Conclusions: Over the first year after stroke, participants reported that the process of community reintegration was marked by ongoing changes in their goals. Formal and informal caregivers need to work with stroke survivors living in the community to facilitate realistic and achievable goal setting. Tools which identify meaningful activities should also be incorporated to provide stroke survivors with the opportunity to contribute and engage with others in the community.

Purpose: This study's purposes were to examine the measurement properties of the 2-minute walk test (2MWT), to illustrate the use of reliability coefficients in clinical practice, and to estimate sample size for a subsequent validity study. Method: Sixteen residents of long-term care (LTC; mean age = 87 years) completed two 2MWTs with Rater A and two 2MWTs with Rater B on test days 1 and 2, approximately 1 week apart. On a third test day, subjects completed one trial of the Berg Balance Scale (BBS), timed up-and-go (TUG) test, and 6-minute walk test (6MWT) with Rater A. On 2 other test days, approximately 1 week apart, Rater A administered the 2MWT to five older adults living in a retirement facility. Absolute and relative reliability and concurrent and known-groups validity coefficients were calculated. Results: No main effect for rater, trial, or occasion was found. Test–retest reliability estimates of 0.94 and 0.95 were obtained. The 2MWT demonstrated concurrent validity (r ≥ 0.84) with the BBS, TUG, and 6MWT. Comparison of distance walked by LTC and retirement residents showed a difference of 72.9 m (95% CI: 44.2, 101.6). The results suggest that 90% of truly stable older adults will display random fluctuations in 2MWT performance within a boundary of 15 m. Conclusion: The 2MWT had sound measurement properties in this sample of LTC residents. Based on our results, 24 subjects would be required for a subsequent hypothesis-testing validity study.

Most of the data that describe maximal oxygen uptake (VO_2max) and the requirements for its attainment have been developed using young adults as subjects. Many older adults are unable to satisfactorily complete a maximal exercise effort in a standard exercise stress test. This review describes exercise tests currently available to measure VO_2max in older adults. PubMed and CINAHL databases were searched for studies including healthy individuals older than 65 years with reproducible descriptions of the testing protocol. The research on VO_2max testing in healthy individuals older than 65 years is limited, does not describe the protocols in detail, and/or lacks information on the psychometric properties of the exercise tests. There is a need for refinement of the few existing protocols for testing aerobic capacity in older adults, as well as the development of new protocols specifically applicable to older adults. Consensus on the criteria defining VO_2max attainment during exercise in older adults is required, as well as agreement on the most appropriate exercise protocols and equipment, specific to older adults, to successfully fulfil these criteria.