How Exercise Translates to Function

If you are thinking about seeing a physical therapist for the first time or interested in learning more about the profession, you may wonder how exercises translates to improved function? This is a great question that any physical therapist would love to answer and depends on your individual problem or limitation. However, the simplest answer involves how physical therapists write goals and develop our treatment plan. For example, a client may see a physical therapist to be able to go up and down the stairs or to be able walk safely in the community or even to be able to stand and cook entire meal from start to finish. All these goals and many more would be perfect reasons to go see a physical therapist. At our initial assessment we will talk with you to determine why these functional mobility skills and activities of daily living (ADLs) are difficult to do and administer outcome measures to assess your current level of function based on your goals. Many of the outcome measures a physical therapist may conduct is validated by research for many populations including older adults. Moreover, certain scores on these outcome measures can predict your risk of falling in the future and establish what your functional impairments are. The following are five outcome measures your physical therapist may perform at an initial evaluation:

1. 5 Time Sit to Stand: The 5 Time Sit to Stand is a measure of functional strength and power, ability to transfer from sitting to standing, and determines your risk of falling. This measures how fast you can stand up and down from a standard height chair five times. In older adults, > or equal to 12 seconds indicates a need of further assessment into your fall risk and a score of > 15 seconds indicates a need to assess for recurrent fall risk.¹ A common exercise a physical therapist may prescribe is sit to stands to build up glute, hamstring, and quadricep strength to improve your functional strength over time.
2. Timed Up and Go (TUG): The timed up and go measures how quickly you can stand up from a chair walk around a cone placed 3 meters in front of you and sit back down. A score of > or = 12 seconds indicates a person is at risk of falling.² Depending on your performance, a physical therapist may prescribe lower extremity and core strengthening or standing balance and coordination exercises.
3. 10 Meter Walk Test: The 10-meter walk test measures how long it takes you to walk 10 meters to determine your comfortable walking speed. A walking speed of less than 0.7 m/s is indicative of an increased risk of adverse event such as a fall, hospitalization, need for caregiver, fracture, etc. in healthy older adults.³ To improve your walking speed your physical therapist may prescribe balance, coordination, and glute and calf strengthening exercises to improve your walking efficiency.
4. Berg Balance Assessment: The Berg balance assessment objectifies an individual’s standing balance during 14 items such as reaching outside your base of support, standing with your feet together, or standing with your eyes closed. A score of < 45/56 indicates an older adult may be at greater risk of falling.⁴ A physical therapist may prescribe standing balance or core exercises based on your individual needs.
5. Functional Gait Assessment: The functional gait assessment assesses your balance during 12 walking tasks (i.e., walking with eyes closed, tandem walking, backwards walking, or stepping over an obstacle). A score of 22/30 or less indicates a community dwelling older adult is at risk of falling.⁵ Your physical therapist may prescribe lower body strengthening, coordination, or dynamic balance and vestibular exercises.

These are just a few examples of how a physical therapist’s assessment and exercise prescription will translate to improved function and quality of life especially for older adults. At Live Your Life our physical therapy services come to you! Contact us today for a free consultation on how our services can address a wide range of health needs. 

References

¹Shirley Ryan AbilityLab. Five Times Sit to Stand Test. Shirley Ryan AbilityLab – Formerly RIC. Published June 20, 2013. https://www.sralab.org/rehabilitation-measures/five-times-sit-stand-test

²CDC. Centers for Disease Control and Prevention National Center for Injury Prevention and Control.; 2017. https://www.cdc.gov/steadi/pdf/TUG_test-print.pdf

³10 Meter Walk Test. neuropt.org. Accessed March 30, 2024. 1.0 METER WALK TEST (10MWT). https://neuropt.org/docs/default-source/cpgs/core-outcome-measures/10mwt-pocket-guide-proof8-(2)28db36a5390366a68a96ff00001fc240.pdf?sfvrsn=e4d85043_0_10

⁴Shirley Ryan Ability Lab. Berg Balance Scale. Shirley Ryan AbilityLab – Formerly RIC. Published June 19, 2013. https://www.sralab.org/rehabilitation-measures/berg-balance-scale

⁵Functional Gait Assessment. Shirley Ryan AbilityLab – Formerly RIC. Published November 9, 2016. https://www.sralab.org/rehabilitation-measures/functional-gait-assessment ‌