Gait Reeducation Program in Older Adults

Several tools have been proposed to evaluate mobility and to assess it. In this study, physical performance was measured using the Short Physical Performance Battery (SPPB), which has been validated for use in older populations. This test includes three components: balance (foot together, semi-tandem, tandem), 4-meter gait speed, and chair stand test (standing and sitting five times). The SPPB scores each timed task based on predefined thresholds, resulting in a total score ranging from 0 (worst performance) to 12 (best performance).

The SPPB was designed to quickly identify the physical status of older adults by assessing lower limb functionality. Performance in these tests is strongly associated with mobility-related disability and serves as an independent predictor of short-term mortality and institutionalization. The medical community uses SPPB, among other tools, as a primary approach to detect and identifying frailty.

Gait speed was assessed using the Timed Up and Go Test (Up&Go), a fundamental mobility indicator. This test measures the time taken for a person to rise from a chair with armrests, walk 3 meters, return, and sit back down.

This standardized approach ensured reliability and accuracy in the calf circumference data, strengthening its role as a valid anthropometric marker for evaluating nutritional and functional health status in older adults.

Abdominal circumference (AC), also referred to as waist circumference, is an important anthropometric parameter commonly used to assess nutritional status and central adiposity. It is a well-established indicator of cardiometabolic risk, strongly associated with conditions such as cardiovascular and cerebrovascular disease.

In this study, AC was measured following standard anthropometric procedures, specifically 2.5 cm above the navel, using a non-elastic, flexible measuring tape. Participants were instructed to stand upright with feet shoulder-width apart, arms relaxed at their sides, and abdomen relaxed but not contracted. The measurement was taken at the end of a normal expiration to avoid variability caused by breathing.

All measurements were conducted by trained health professionals experienced in anthropometric assessment. Each measurement was taken twice; if the two values differed by more than 1.0 cm, a third measurement was performed.

SARC-F (Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling) is a self-reported screening tool used in the sarcopenia diagnosis process that has been proposed and validated for various English-speaking and Latin populations. The test is based on the following questions: Ability to carry 4.5 kg; Need for assistance to cross a room; Ability to stand up from a chair; Ability to climb 10 steps; Number of falls in the past year. For the first four questions, the responses are scored as follows: None = 0, Some = 1, Much or Cannot = 2. For the fifth question, responses are scored as follows: None = 0, 1-3 falls = 1, 4 or more falls = 2. A SARC-F (Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling) score > 4 indicates a positive risk for diagnosing sarcopenia.

Dynamometry, or handgrip strength measurement, is used to assess the function and strength of the upper extremities. Handgrip strength was assessed using a Jamar hydraulic handheld dynamometer (Jamar, Sammons Preston, Bolingbrook, IL), a standard and validated tool for measuring isometric grip force. Each participant performed three trials with their dominant hand, with a 60-second rest between trials to prevent fatigue. Verbal encouragement was provided during each trial to ensure maximal effort. The highest value obtained from the three attempts was used for analysis. This method is widely recommended for evaluating overall muscle strength and functional capacity in older adults.

The Barthel Index (BI) is considered one of the most suitable tools for identifying functional limitations that impact older adults' quality of life in home and community settings.