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Effect of Functional Exercise Training
walk distance in their subjects was virtually identical to that in
the current study (7% versus 7.4%, respectively). Contrary to the
current study, Whitehurst et al found significant improvements in
hamstring flexibility (14%). They used the standard sit-and-reach
test, whereas we used the chair sit-and-reach test. The increase in
hamstring flexibility in their study was 1.6 inches, and in our study
the increase was 1.2 inches. Thus, even though the improvement in
our group of subjects was not significant, the absolute improvement
was comparable to that reported by Whitehurst et al.
The goal of a functional fitness training program is to improve
the ability to perform ADLs. An improvement in the ability to
perform ADLs should make life easier for individuals and allow
them to maintain their independence. We did not directly assess
the psychological consequences of the increase in functional
fitness; however, comments made by the subjects suggested that
participants experienced carry-over benefit to common everyday
tasks. Several of the subjects commented that they found it easier
to “reach for things,” had “better balance,” and 1 subject found
it easier to “look over [her] shoulder while backing up [her] car.”
These comments are consistent with the findings of Whitehurst
et al, 12 whose subjects had increased physical functioning and
vitality scores, as assessed by the Medical Outcomes Study 36-Item
Short Form Health Survey (SF-36). Similar results were reported
in chronically ill patients who were living in an assisted living
facility. 20 Patients reported greater feelings of independence and a
greater quality of life that coincided with measured improvements
in flexibility, grip strength, and mobility.
A factor that makes the current findings even more meaningful
is that subjects in the current study were already regular exercisers.
All of the subjects were doing 30 to 45 minutes of aerobic exercise
3 days per week, as well as 10 to 15 minutes of resistance training.
Based on published age-specific and sex-specific norms for the FFT, 21
the subjects in the current study exceeded the 80th percentile for
each item. Comparisons between subjects in other studies, such as
those of Whitehurst et al, 12 provide further evidence of the fitness
of our subjects. Subjects in the 2 studies were of similar age, yet
subjects in the current study performed the pretesting 8-foot upand-go
test in 5.50 seconds, versus 7.92 seconds for their subjects.
Initial 6-minute walk distances were also very different, with our
subjects initially walking 618 yards, compared with 365 yards for
their subjects.
A possible limitation of any study investigating functional
exercises is that the training exercises closely resemble the testing
protocol. For example, the warm-up sequence included standing
hamstring stretches for flexibility. One of the tests on the FFT, the
chair sit-and-reach test, is designed to assess hamstring and low
back flexibility. Thus, it can be seen that the training and testing
movements were similar, but not identical. The key point is that
concerns about specificity of training/testing protocols in this type
of study should not be a major issue. If the testing battery is valid,
Table 2. Pretest and Posttest FFT Scores of Control and Experimental Groups
Variable
Group Pretesting Posttesting Change
Chair sit-to-stand, mean (SD), repetitions
Control
Experimental
Bicep curls, mean (SD), repetitions
Control
Experimental
6-minute walk, mean (SD), yds
Control
Experimental
15.0 (3.7)
13.8 (3.1)
15.1 (2.7)
13.8 (2.6)
641 (79.1)
618 (62.4)
14.9 (3.4)
-.1
15.6 (2.6) a +1.8
14.6 (3.4)
-.5
15.7 (3.1) a +1.9
+2
643 (83.9)
+43
661 (67.1) a
Chair sit-and-reach, mean (SD), in
Control
Experimental
-4.8 (3.5)
-5.3 (4.8)
-4.4 (3.9)
-4.1 (3.9)
-.04
-.8
Back scratch, mean (SD), in
Control
Experimental
8-foot up-and-go, mean (SD), sec
Control
Experimental
Abbreviations: FFT Functional Fitness Test; SD, standard deviation.
a
Significantly different from the control group (P < .05).
-2.6 (3.4)
-3.7 (5.8)
5.1 (.53)
5.5 (.77)
-2.7 (3.6)
-.1
-2.1 (4.9) a +1.6
5.1 (.75)
0
4.8 (.50) a -.7
Gundersen Lutheran Medical Journal • Volume 5, Number 1, July 2008 7