National physical activity recommendations for older Australians: Discussion Document

6. Measurement of physical activity in older people

The National Ageing Research Institute was commissioned by The Department of Health and Ageing to review the evidence and develop physical activity recommendations for older people.

Page last updated: 01 February 2011

To determine whether - and how - physical activity interventions are impacting on older people’s behaviour and ultimately their health, we need suitable measurement tools. The literature highlights the methodological weaknesses of existing research and discusses the challenges of ensuring the internal and external validity of measurement tools for older people. A methodological review is beyond the scope of this document. A summary of the key issues is given in Appendix 4.

Methodological challenges aside, there is level II evidence for the benefits of exercise across an array of biopsychosocial health outcomes in older people. The challenge for reviewers seeking to conduct meta-analyses is that studies have used a diverse collection of measurement tools for measuring the same outcome variable, making cross study comparison problematic. The outcome variability between and within individuals is further compounded by the variety of activity types researchers have evaluated.

Table 6.1 Common outcome measures and measurement tools used.

Outcome
      Variable
Examples of tools
Physiological
      Muscle strength
1RM, Dynamometer, Kincom, Cybex
      Endurance/Cardiovascular
Maximum oxygen consumption
      fitness
VO2max
6 minute walk test
10 m shuttle test
beep test
      Neuromuscular control
Reaction timer
      Body composition
Skinfold thickness/BMI
Function
      Flexibility
Range of motion
      Gait
Walking speed, stride length,
cadence, step width
      Balance
Clinical and laboratory tests of static
and dynamic balance, single and dual
task
      Activity level
Pedometers, Uptimer, activity monitors,
Human Activity Profile, PACE
      Activity of daily living
Barthel Index, Katz Index, Lawton and
Brody’s IADL scale
Health status
      Self reported health
SF-12, SF-36, SIP
      Mental health
CES-D, GDS, PGMS, POMS
      Quality of life
AQOL, EuroQoL
Key: CES-D Center for Epidemiological Studies- Depression Scale; GDS Geriatric Depression Scale; PGMS Philadelphia Geriatric Centre Morale Scale; POMS Profile of Moods Scale; SF-36 Short-Form-36 Health Survey; SIP Sickness Impact Profile;

Future research will need to systematically employ well validated, age appropriate measurement instruments. In order to contextualise observed changes in an individual’s behaviour, researchers and evaluators need to incorporate both individual level data collection and ecological level data to determine mediators and predictors operating across individual, societal and system levels of influence.
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