Annals of Long Term Care

Improving Physical Function and Blood Pressure in Older Adults Through Cobblestone Mat Walking: A Randomized Trial
Fuzhong Li, PhD, K. John Fisher, PhD, and Peter Harmer, PhD

Objectives: To determine the relative effects of cobblestone mat walking, in comparison with regular walking, on physical function and blood pressure in older adults.

Design: Randomized trial with allocation to cobblestone mat walking or conventional walking.

Setting: General community in Eugene, Oregon.

Participants: One hundred eight physically inactive community-dwelling adults aged 60 to 92 (mean age±standard deviation=77.5±5.0) free of neurological and mobility-limiting orthopedic conditions.

Intervention: Participants were randomized to a cobblestone mat walking condition (n=54) or regular walking comparison condition (n=54) and participated in 60-minute group exercise sessions three times per week for 16 consecutive weeks.

Measurements: Primary endpoint measures were balance (functional reach, static standing), physical performance (chair stands, 50-foot walk, Up and Go), and blood pressure (systolic, diastolic). Secondary endpoint measures were Short Form-12 physical and mental health scores and perceptions of health-related benefits from exercise.

Results: At the 16-week posttest, differences between the two exercise groups were found for balance measures (P=.01), chair stands (P<.001), 50-foot walk (P= .01), and blood pressure (P=.01) but not for the Up and Go test (P=.14). Although significant within-group changes were observed in both groups for the secondary outcome measures, there were no differences between intervention groups.

Conclusion: Cobblestone mat walking improved physical function and reduced blood pressure to a greater extent than conventional walking in older adults. Additional benefits of this walking program included improved health-related quality of life. This new physical activity may provide a therapeutic and health-enhancing exercise alternative for older adults. J Am Geriatr Soc 2005;53(8): 1305-1312.

The Life Cycle of Bruises in Older Adults
Laura Mosqueda, MD, Kerry Burnight, PhD, and Solomon Liao, MD

Objectives: To summarize the occurrence, progression, and resolution of accidentally acquired bruises in a sample of adults aged 65 and older. The systematic documentation of accidentally occurring bruises in older adults could provide a foundation for comparison when considering suspicious bruising in older adults.

Design: Between April 2002 and August 2003, a convenience sample of 101 seniors was examined daily at home (up to 6 weeks) to document the occurrence, progression, and resolution of accidental bruises that occurred during the observation period.

Setting: Three community-based settings and two skilled nursing facilities in Orange County, California.

Participants: One hundred one adults aged 65 and older (mean age=83).

Measurements: Age, sex, ethnicity, functional status, handedness, medical conditions, medications, cognitive status, depression, history of falls, bruise size, bruise location, initial bruise color, color change over time.

Results: Nearly 90% of the bruises were on the extremities. There were no bruises on the neck, ears, genitalia, buttocks, or soles of the feet. Subjects were more likely to know the cause of the bruise if the bruise was on the trunk. Contrary to the common perception that yellow coloration indicates an older bruise, 16 bruises were predominately yellow within the first 24 hours after onset. People on medications known to affect coagulation pathways and those with compromised function were more likely to have multiple bruises.

Conclusion: Accidental bruises occur in a predictable location pattern in older adults. One cannot reliably predict the age of a bruise by its color. J Am Geriatr Soc 2005;53(8):1339-1343.

The Cost Effect of Newer Medication Adoption in an Older Medicaid Cohort
Theresa I.