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Gómez-Redondo P, Valenzuela PL, Morales JS, Ara I, Mañas A. Supervised Versus Unsupervised Exercise for the Improvement of Physical Function and Well-Being Outcomes in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med 2024; 54:1877-1906. [PMID: 38647999 PMCID: PMC11258164 DOI: 10.1007/s40279-024-02024-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Unsupervised exercise intervention (UNSUP) appears to be a practical and beneficial strategy for older adults, although its feasibility and effectiveness compared to supervised exercise intervention (SUP) remains unknown. We aimed to compare the safety, attendance/adherence rates, and effectiveness of SUP versus UNSUP on physical function and well-being outcomes in older adults. METHODS A systematic search was conducted in PubMed, Web of Science, CINAHL, SPORTDiscus, and APA PsycINFO up to September 2022 for randomized controlled trials comparing SUP versus UNSUP in older adults (≥ 60 years). Safety and attendance/adherence rates were registered as indicators of feasibility, and meta-analyses were performed for physical function and well-being outcomes. Sub-analyses were performed for those studies that applied a similar intervention in both groups and for those studies where participants performed ≥ 66% of the sessions in the assigned condition. RESULTS Thirty-four studies were included (n = 2830). No serious adverse events were reported, with similar attendance rates (81%) for both SUP and UNSUP. Compared with UNSUP, SUP induced significant higher benefits on knee extension strength (standardized mean difference (SMD) = 0.18, p = 0.002), sit-to-stand test (STS, SMD = 0.25, p = 0.050), timed-up-and-go test (TUG, SMD = 0.21, p = 0.035), usual gait speed (SMD = 0.29, p = 0.026), lean mass (mean difference = 1.05 kg, p < 0.001) and health-related quality of life (HRQoL, SMD = 0.21, p = 0.035), albeit only knee extension strength remained significant in sensitivity analyses. Sub-analyses revealed superior benefits of SUP on knee extension strength when only considering those studies that applied a similar intervention in both SUP and UNSUP groups. However, no significant benefits were found for the remaining outcomes. Beneficial effects of SUP over UNSUP were also observed for knee extension strength, STS, functional reach test, TUG, usual gait speed, lean mass, and HRQoL when separately analyzing those studies in which participants performed ≥ 66% of the sessions in the assigned condition. CONCLUSIONS Current evidence suggests that both SUP and UNSUP programs are safe and could exert benefits on physical function and HRQoL. However, despite being associated with similar attendance rates, SUP might offer some additional benefits, although further high-quality research (i.e., accounting for confounding factors such as presence of supervised sessions in UNSUP or vice versa, as well as equating the exercise dose) is necessary to confirm these findings. PROSPERO REGISTRATION NUMBER CRD42022326420.
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Affiliation(s)
- Paola Gómez-Redondo
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital, 12 de Octubre (imas12), Madrid, Spain
- Biology Systems Department, University of Alcalá, Madrid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerto Real University Hospital, University of Cadiz, Cadiz, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain.
- Center UCM-ISCIII for Human Evolution and Behavior, 28029, Madrid, Spain.
- Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain.
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Flores-Bello C, Correa-Muñoz E, Sánchez-Rodríguez MA, Mendoza-Núñez VM. Effect of Exercise Programs on Physical Performance in Community-Dwelling Older Adults with and without Frailty: Systematic Review and Meta-Analysis. Geriatrics (Basel) 2024; 9:8. [PMID: 38247983 PMCID: PMC10801556 DOI: 10.3390/geriatrics9010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. AIM To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. METHOD A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. RESULT We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. CONCLUSION Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.
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Affiliation(s)
- Cristina Flores-Bello
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (C.F.-B.); (E.C.-M.); (M.A.S.-R.)
- Postgraduate Master’s and Doctorate in Nursing, National Autonomous University of Mexico, Mexico City 09230, Mexico
| | - Elsa Correa-Muñoz
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (C.F.-B.); (E.C.-M.); (M.A.S.-R.)
- Postgraduate Master’s and Doctorate in Nursing, National Autonomous University of Mexico, Mexico City 09230, Mexico
| | - Martha A. Sánchez-Rodríguez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (C.F.-B.); (E.C.-M.); (M.A.S.-R.)
- Postgraduate Master’s and Doctorate in Nursing, National Autonomous University of Mexico, Mexico City 09230, Mexico
| | - Víctor Manuel Mendoza-Núñez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (C.F.-B.); (E.C.-M.); (M.A.S.-R.)
- Postgraduate Master’s and Doctorate in Nursing, National Autonomous University of Mexico, Mexico City 09230, Mexico
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Daniele de Araújo Silva J, Cândido Mendes Maranhão D, Machado Ferreira Tenório de Oliveira L, Luiz Torres Pirauá A. Comparison between the effects of virtual supervision and minimal supervision in a 12-week home-based physical exercise program on mental health and quality of life of older adults: Secondary analysis from a randomized clinical trial. Geriatr Gerontol Int 2023; 23:864-870. [PMID: 37743056 DOI: 10.1111/ggi.14673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023]
Abstract
AIM The objective of this study was to compare the effects of virtual supervision and minimal supervision in a 12-week home-based physical exercise program on the mental health and quality of life of community-dwelling older adults. METHODS This study presents a secondary analysis of a randomized clinical trial conducted during the COVID-19 pandemic. The sample comprised 38 elderly men and women (81.6% women, mean age 68 ± 6.4 years; mean weight 69.8 ± 12.1 km) without physical and/or cognitive impairments. The volunteers were divided into two groups: one group received virtual supervision (monitored via videoconference), while the other group received minimal supervision (monitored through weekly text messages). Both groups followed the same home-based physical exercise program, consisting of three sessions per week, differing only in the supervision strategy. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-21) in conjunction with the POMS questionnaire, which evaluates mood, and quality of life was assessed using the WHOQOL-OLD questionnaire. RESULTS Our findings demonstrated statistically significant superiority of virtual supervision compared with minimal supervision in relation to depression (-2.92, 95% confidence interval = -5.22 to -0.63). Conversely, minimal supervision exhibited superiority over virtual supervision regarding quality of life (-6.70, 95% confidence interval = -11.66 to -1.73). CONCLUSIONS Virtual supervision yielded better outcomes for the depression indicator, while minimal supervision favored the quality of life of older adults at the conclusion of the 12-week home-based physical exercise program. Geriatr Gerontol Int 2023; 23: 864-870.
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Wang L, Guo F, Zhao C, Zhao M, Zhao C, Guo J, Zhang L, Zhang L, Li Z, Zhu W. The effect of aerobic dancing on physical fitness and cognitive function in older adults during the COVID-19 pandemic-a natural experiment. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:196-204. [PMID: 37753419 PMCID: PMC10518797 DOI: 10.1016/j.smhs.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 09/28/2023] Open
Abstract
During the Coronavirus disease (COVID-19), the physical activity of older adults is at a lower level. The study aimed to examine the effectiveness of aerobic dancing on physical fitness and cognitive function in older adults. We conducted a randomized controlled trial with 34 older adults who were assigned into an aerobic dancing group and a control group. Three dance sessions weekly for 60 min were scheduled for the aerobic dancing group for a total of 12 weeks. Physical fitness, blood pressure, lipids, glucose, cognitive function were assessed before and after the intervention. Baseline adjusted Analysis of Covariance (ANCOVA) was used to determine whether outcome variables varied between groups at pre-test and post-test. Effect size (Cohen's d) was calculated to determine the differences between groups from baseline to post-test. After 12 weeks, we found that the aerobic dancing group showed significant improvement in memory (portrait memory: F = 10.45, p = 0.003, d = 1.18). The Limit of Stability (LOS) parameters in the aerobic dancing group displayed a significant increase after the intervention (right angle: F = 5.90, p = 0.022, d = 0.60; right-anterior angle: F = 4.23, p = 0.049, d = 0.12). Some beneficial effects were found on flexibility, grip strength, balance and subjective well-being (sit and reach: F = 0.25, p = 0.62, d = -0.40; grip strength: F = 3.38, p = 0.08, d = 0.89; one-legged standing with eyes closed: F = 1.26, p = 0.27, d = 0.50) in the aerobic dancing group. Aerobic dancing training was effective in improving memory and balance ability in older adults during the COVID-19 pandemic in China. In the future, aerobic dancing is a promising tool to encourage physical activity in older adults.
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Affiliation(s)
- Lin Wang
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Fei Guo
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Chenxi Zhao
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Minmin Zhao
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Chenglei Zhao
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Jiawei Guo
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Longhai Zhang
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Ling Zhang
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Zheng'ao Li
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
| | - Wenfei Zhu
- School of Physical Education, Shaanxi Normal University, 710100, Xi'an, Shaanxi Province, China
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Valeriani F, Protano C, De Giorgi A, Mazzeo E, Liguori G, Romano Spica V, Vitali M, Gallè F. Analysing features of home-based workout during COVID-19 pandemic: a systematic review. Public Health 2023; 222:100-114. [PMID: 37541063 DOI: 10.1016/j.puhe.2023.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/15/2023] [Accepted: 06/29/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE Since the beginning of the COVID-19 pandemic, a decrease in physical activity (PA) related to home confinement has been reported worldwide. However, some individuals were able to engage in physical activities at home. Thus, in a perspective of public health, it may be useful to analyse the available evidence regarding PA adopted during home restrictions, in order to identify possible strategies to help people stay active even during emergency situations. The aim of this review was to analyse how healthy individuals spontaneously exercised at home in the course of the pandemic, in order to detect possible factors associated with this behaviour. STUDY DESIGN A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS The protocol was registered in PROSPERO, an international prospective register of systematic reviews, with the registration number CRD42023394673. A literature search was conducted in PubMed, Scopus, and Web of Science. Cross-sectional studies published in English from the inception of each database to February 06th 2023 and focused on healthy individuals practicing spontaneous PA/exercise at home during the pandemic were considered eligible. The quality assessment was performed using the adapted Newcastle-Ottawa Quality Assessment Scale. Bibliographic information, sample size, study paricipant/population with age, gender, ethnicity, socioeconomic status, education, smart workers or not, anthropometric parameters, characteristics of at home exercises, athletic status and sedentariness, associated health-related effects, and main findings were synthetised. RESULTS From 504 articles, 19 were included. Notwithstanding the differences in the studies examined, the majority of them reported that previous PA level was associated with exercise in such challenging conditions. Furthermore, technologies aimed at supporting exercise were shown to be a useful resource. CONCLUSIONS Being habitually active and using digital supports may be associated with a positive attitude towards exercise at home during isolation. This suggests that in emergency situations, exercise should be promoted, also through digital media, especially among those groups who are usually less engaged in PA. Further analyses of longitudinal studies are needed to confirm these findings.
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Affiliation(s)
- F Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - C Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - A De Giorgi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - E Mazzeo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Liguori
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
| | - V Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - M Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - F Gallè
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
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Costa SN, Ferreira LHB, Bento PCB. Effects of Home-Based Exercise Programs on Mobility, Muscle Strength, Balance, and Gait in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2023; 31:693-704. [PMID: 36623512 DOI: 10.1123/japa.2022-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Individual unsupervised home-based exercise programs can enhance muscle strength, physical function, gait, and balance in older adults. However, the effectiveness of such programs may be limited by the lack of supervision. This study aims to verify the effectiveness of individual unsupervised home-based programs, compare the effects of individual unsupervised home-based to supervised programs, and verify the influence of supervision over individual unsupervised home-based programs on the physical function of older adults. METHODS A systematic literature search was performed in four electronic databases, and the trials involved randomized controlled comparing the home-based programs to supervised, control groups, or home-based + supervised evaluating the muscle strength, physical function, gait, and balance in older adults. RESULTS Eleven studies met the inclusion criteria. The meta-analysis revealed no differences between home-based program versus supervised program in gait, mobility, and balance, revealing a trend of significance to supervised program on strength (standardized mean difference [SMD] = 0.27, p = .05). The analysis revealed effects in mobility (SMD = 0.40, p = .003), balance (SMD = 0.58, p = .0002), and muscle strength (SMD = 0.36, p = .02) favoring home-based program versus control group. Significant effects between home-based program versus home-based + supervised program were observed in balance (SMD = 0.74, p = .002) and muscle strength (SMD = 0.58, p = .01) in favor of home-based + supervised program. CONCLUSION Home-based programs effectively improve older adults' physical function compared with control groups. However, supervised programs were more effective for muscle strength.
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Affiliation(s)
- Sabrine Nayara Costa
- Physical Education Department, Federal University of Paraná (UFPR), Curitiba,Brazil
| | | | - Paulo C B Bento
- Physical Education Department, Federal University of Paraná (UFPR), Curitiba,Brazil
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Nuzzo JL, Pinto MD, Nosaka K. Connective Adaptive Resistance Exercise (CARE) Machines for Accentuated Eccentric and Eccentric-Only Exercise: Introduction to an Emerging Concept. Sports Med 2023; 53:1287-1300. [PMID: 37097413 PMCID: PMC10127187 DOI: 10.1007/s40279-023-01842-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/26/2023]
Abstract
Eccentric resistance exercise emphasizes active muscle lengthening against resistance. In the past 15 years, researchers and practitioners have expressed considerable interest in accentuated eccentric (i.e., eccentric overload) and eccentric-only resistance exercise as strategies for enhancing performance and preventing and rehabilitating injuries. However, delivery of eccentric resistance exercise has been challenging because of equipment limitations. Previously, we briefly introduced the concept of connected adaptive resistance exercise (CARE)-the integration of software and hardware to provide a resistance that adjusts in real time and in response to the individual's volitional force within and between repetitions. The aim of the current paper is to expand this discussion and explain the potential for CARE technology to improve the delivery of eccentric resistance exercise in various settings. First, we overview existing resistance exercise equipment and highlight its limitations for delivering eccentric resistance exercise. Second, we describe CARE and explain how it can accomplish accentuated eccentric and eccentric-only resistance exercise in a new way. We supplement this discussion with preliminary data collected with CARE technology in laboratory and non-laboratory environments. Finally, we discuss the potential for CARE technology to deliver eccentric resistance exercise for various purposes, e.g., research studies, rehabilitation programs, and home-based or telehealth interventions. Overall, CARE technology appears to permit completion of eccentric resistance exercise feasibly in both laboratory and non-laboratory environments and thus has implications for researchers and practitioners in the fields of sports medicine, physiotherapy, exercise physiology, and strength and conditioning. Nevertheless, formal investigations into the impact of CARE technology on participation in eccentric resistance exercise and clinical outcomes are still required.
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Affiliation(s)
- James L Nuzzo
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Matheus D Pinto
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Kazunori Nosaka
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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Shafizadeh M, Parvinpour S, Ali K. Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review. SPORT SCIENCES FOR HEALTH 2022; 19:1-14. [PMID: 35967546 PMCID: PMC9360689 DOI: 10.1007/s11332-022-00993-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
Abstract
Aims The aim of this review study was to examine the effectiveness of home-based and community-based exercise programmes in the rate of falls and improving physical functioning in community-dwelling older adults. Methods All types of home-based and community-based exercise interventions were searched. From 1186 studies identified, 14 studies were selected for the umbrella review. Most studies had high methodological quality. The types of interventions were multi-functional programmes (n = 11 studies) and Otago Exercise Programme (OEP) (n = 3 studies). Results The results showed that home-based and community-based exercise interventions can reduce falls by 22-32%. Studies that included meta-analysis showed that the clinical significance of home-based interventions in fall prevention and improving physical function was moderate to high. Conclusions In conclusion, home-based and community-based exercise interventions are a safe, effective, and feasible method of fall prevention that could be implemented with minimum supervision by allied health professionals to maximise autonomy, self-efficacy, and adherence in community-dwelling older adults.
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Affiliation(s)
| | - Shahab Parvinpour
- Motor Behavior Department, Faculty of Physical Education and Sport Sciences, Kharazmi University, No.43.South Mofatteh Ave, Tehran, 15719-14911 Iran
| | - Khalid Ali
- Brighton and Sussex Medical School, Brighton, UK
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Resistance Circuit Training or Walking Training: Which Program Improves Muscle Strength and Functional Autonomy More in Older Women? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148828. [PMID: 35886680 PMCID: PMC9319797 DOI: 10.3390/ijerph19148828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
To evaluate the effects of two programs (resistance and walking training) on the functional autonomy and muscle strength (isometric and dynamic) of older women, 67 subjects were divided randomly into three groups: resistance training (RTG; Mean = 64.70 ± 6.74 years), walking (WG, Mean = 65.56 ± 7.82 years), and control (CG; Mean = 64.81 ± 4.34). The experimental groups underwent a 16-week intervention. Muscle strength (isometric and dynamic) and functional autonomy were assessed. The subjects participating in the RTG showed improvements in the comparison pre to post-test in the maximal forces of upper limb (MULS) (Δ% = 49.48%; p = 0.001) and lower limb (MLLS) (Δ% = 56.70%; p = 0.001), isometric biceps forces (BIS) (Δ% = 30.13%; p = 0.001) and quadriceps forces (QIS) (Δ% = 65.92%; p = 0.001), and in the general index (GI) of functional autonomy (Δ% = −18.32%; p = 0.002). The WG improved in all functional autonomy tests, except for the standing up from prone position test (SVDP). In strength tests, the WG obtained improvements only in the QIS (Δ% = 41.80%; p = 0.001) and MLLS (Δ% = 49.13%; p = 0.001) tests. The RTG obtained better results (p < 0.05) when compared to the WG and CG. The results allow us to infer that resistance exercise programs are more effective in increasing strength and functional autonomy, a fact that may mitigate the deleterious effects on health of aging.
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Sharma A, Vats S, Gupta R, Chahal A. Recent Advances in Chest Rehabilitation during COVID-19 Outbreak: A Systematic Review. J Lifestyle Med 2022; 12:72-82. [PMID: 36157887 PMCID: PMC9490015 DOI: 10.15280/jlm.2022.12.2.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/02/2022] [Indexed: 11/22/2022] Open
Abstract
Background The current COVID-19 pandemic has brought the entire world to a halt, resulting in illness, death, and changes in individual roles. Physical therapy and chest rehabilitation play a critical role following aftermath of pandemics. Methods PubMed, Google Scholar, PEDro, MEDLINE were searched for randomized controlled trials. Methodological quality was assessed independently by two authors using PEDro scale. Data for disability, chest physical functions and adverse effects were analyzed. Results A meta-analysis was not possible due to the heterogeneity of the studies included for review. After applying the studies’ inclusion and exclusion criteria, a total of eight articles with 420 patients were included in the study for their detailed analysis. Two independent authors verified and screened the data, with the third author double-checked and searched for additional articles. Conclusion Findings revealed that chest rehabilitation approaches influence the clinical condition of people during COVID-19 outbreak resulting in improved condition stabilization and recovery, the consequent reduction in hospitalization period and improved health-related quality of life.
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Affiliation(s)
- Abhishek Sharma
- Department of Paediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana. Haryana, India
| | - Sakshi Vats
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana. Haryana, India
| | - Riya Gupta
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana. Haryana, India
| | - Aksh Chahal
- Department of Musculoskeletal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana. Haryana, India
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Home-Based Frailty Prevention Program for Older Women Participants of Kayoi-No-Ba during the COVID-19 Pandemic: A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116609. [PMID: 35682192 PMCID: PMC9180024 DOI: 10.3390/ijerph19116609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 12/04/2022]
Abstract
This study presents a single-arm intervention that aimed to determine the feasibility of a three-month home-based exercise program to prevent the progression of frailty during COVID-19. We recruited four groups of Kayoi-no-ba, or community salons for frailty prevention, and a total of 69 community-dwelling older women who belonged to one of the Kayoi-no-ba in a preliminary study for a follow-up study. The intervention program was developed on the basis of the 5A approach, and the focus group by the volunteer leaders of Kayoi-no-ba. We adapted the National Center for Geriatrics and Gerontology Home Exercise Program for Older People for 10-min daily home-based exercise. For feasibility outcomes, 91.3% of the participants completed the intervention program, whereas the percentage of exercise performed was 86.5% during the intervention period. For health-related outcomes, the five times sit-to-stand test exhibited significant improvement after the intervention. The results of feasibility outcomes indicate that the program may be feasible due to the high rates of completion and exercise performed. Additionally, improvement was noted for the health indicators of the five times sit-to-stand test, which may help prevent frailty. The feasibility trial has provided the necessary data to design a future-cluster randomized controlled trial.
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12
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Home-Based Physical Activity as a Healthy Aging Booster before and during COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074317. [PMID: 35410000 PMCID: PMC8998434 DOI: 10.3390/ijerph19074317] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 12/11/2022]
Abstract
The role of physical activity in improving overall aspects of health regardless of age is well documented. Due to the coronavirus disease 2019 outbreak, preventive measures to limit airborne infection have been introduced, with people, especially older adults, advised to stay at home, thus increasing sedentary lifestyle and the risk of chronic diseases. As one of the few possible ways to stay active is home-based training, this review aims to provide evidence on alternative and feasible home-based activity programs as a tool to improve the fitness level in older adults, especially when preventive measures are needed to ensure isolation and limit interpersonal contacts. During quarantine, older adults, especially those with chronic diseases, are recommended to regularly exercise. Combined balance and muscle-strengthening training has proven to be particularly useful in limiting falls and mobility limitations. In addition, the use of virtual reality systems seems to be a potential strategy in remaining physically active, reducing physical inactivity time and significantly increasing the compliance of the older adults with physical activity programs. In conclusion, home-based programs induce improvements in physical functions in general and quality of life in older people with or without co-morbidities, and it can be considered in the future as one of the feasible and economic ways to increase physical well-being. This may be of unique importance in the setting of coronavirus disease 2019 enforced limitations in out-of-home activity.
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D’Oliveira A, De Souza LC, Langiano E, Falese L, Diotaiuti P, Vilarino GT, Andrade A. Home Physical Exercise Protocol for Older Adults, Applied Remotely During the COVID-19 Pandemic: Protocol for Randomized and Controlled Trial. Front Psychol 2022; 13:828495. [PMID: 35185739 PMCID: PMC8855123 DOI: 10.3389/fpsyg.2022.828495] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/12/2022] [Indexed: 12/15/2022] Open
Abstract
The emergence of the new coronavirus (COVID-19) at the beginning of 2020, considered a public health emergency due to its high transmission rate and lack of specific treatment, led many countries to adhere to social isolation. Although necessary, social isolation causes important psychological changes, negatively affecting the health of the population, including the older population. The aim of this study is to propose a 4-week, home-based physical exercise protocol for older people in social isolation and evaluate whether will promote positive changes in psychological variables such as anxiety, mood, depression, and stress, and in the variables sleep, quality of life, and physical capacities in the older adults. The sample will be selected in a probabilistic way from individuals aged 60 years or more from the city of Itajaí (Santa Catarina, Brazil). Of these, half will perform a home-based resistance training protocol, with 3 weekly sessions, for 4 consecutive weeks. For group allocation, patients will be randomized with a computer-generated 1:1 allocation to the physical exercise (PE) group or control group. Outcomes will be depressive symptoms, sleep quality, quality of life, stress, mood states, anxiety, and functional capacity, evaluated at baseline, after 4 weeks, and after 15 days of follow-up. This study will offer a home-based exercise protocol for older adults, with load progression and remote monitoring, thus filling a gap in the provision of PE in this population. The results will be able to identify possible improvements not only in physical health, but also in quality of life and mental health. Clinical Trial Registration: The trial registration was carried out in the Brazil Clinical Trials Registry (RBR-5qh6f3v). (https://ensaiosclinicos.gov.br/rg/RBR-5qh6f3v).
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Affiliation(s)
- Anderson D’Oliveira
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
| | - Loiane Cristina De Souza
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
| | - Elisa Langiano
- Department of Human Sciences, Society and Health/University of Cassino and Southern Lazio, Cassino, Italy
| | - Lavinia Falese
- Department of Human Sciences, Society and Health/University of Cassino and Southern Lazio, Cassino, Italy
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health/University of Cassino and Southern Lazio, Cassino, Italy
| | - Guilherme Torres Vilarino
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
| | - Alexandro Andrade
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
- *Correspondence: Alexandro Andrade,
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14
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Mahjur M, Norasteh AA. Effects of home-based specific and comprehensive balance-training programs on balance and functional status in healthy older adults. Exp Gerontol 2022; 159:111701. [PMID: 35033547 DOI: 10.1016/j.exger.2022.111701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The elderly population is increasing worldwide, and the decline in physical function resulting from this is a critical issue that, especially, leads to a disorder of balance. To investigate the effect of home-based specific and comprehensive balance training on balance and functional status in older adults. METHODS Forty elderly men were randomized to conditions specific (n = 13) and comprehensive (n = 14) balance training or control (n = 13). The exercises were performed individually at each subject's home three times a week for ten weeks. The BESTest total and subsection scores, Activities-specific Balance Confidence (ABC) score, gait speed, timed-up-and-go (TUG), and functional gait assessment were evaluated at baseline, immediately after training and at 4-week follow-up. RESULTS After the intervention, both intervention groups showed more significant improvements than the control group in all variables except section II of BESTest. At follow-up, significantly more gains than control were observed in all variables except section II of BESTest in the specific group and sections II and III in the comprehensive group. CONCLUSIONS Our findings provide evidence that these home-based balance training regimens can enhance balance and functional status in aged individuals. Therefore, at present, because of the coronavirus disease 19 stay-at-home restrictions, it seems that these interventions are applicable strategies for the elderly when access to facilities or opportunities for physical activity outside the home is restricted for all ages, especially the elderly.
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Affiliation(s)
- Mahdi Mahjur
- Department of Corrective Exercise and Sport Injury, Faculty of Sport Sciences, University of Guilan, Rasht, Iran.
| | - Ali Asghar Norasteh
- Department of Corrective Exercise and Sport Injury, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
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15
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Mañas A, Gómez-Redondo P, Valenzuela PL, Morales JS, Lucía A, Ara I. Unsupervised home-based resistance training for community-dwelling older adults: A systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev 2021; 69:101368. [PMID: 34022464 DOI: 10.1016/j.arr.2021.101368] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/07/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We aimed to summarize evidence on the safety, adherence and effectiveness of home-based resistance training (UHBRT) for improving health-related endpoints in community-dwelling older adults. METHODS Randomized controlled trials of UHBRT in older adults (≥60yrs) were included after a systematic search (PubMed, CINAHL, PsycInfo, SPORTDiscus, Web of Science, MEDLINE, Cochrane Central Register of Controlled Trials) until 02/19/2021. Adverse events and adherence rates were assessed as indicators of feasibility. Other endpoints included physical (muscle strength, muscle power, balance, physical performance) and mental-related measures (cognition, quality of life [QoL]) as well as other health-related variables (body composition, physical activity levels, falls). RESULTS 21 studies (N = 4,053) were included. No major adverse events were reported, with adherence averaging 67 % (range 47-97 %). UHBRT significantly improved lower-limb muscle strength (Hedges' g = 0.33; 95 % confidence interval [CI] = 0.11-0.57), muscle power measured through the sit-to-stand test (g = 0.44; 95 %CI = 0.06-0.84), and balance (assessed with the postural sway, g = 0.32; 95 %CI = 0.16-0.49). No benefits were found for other strength indices (handgrip strength), balance (single leg stance and functional reach test), physical performance (walking speed, TUG and SPPB), QoL, nor for the risk or rate of falls (all p > 0.05, g<0.61). No meta-analysis could be performed for the remaining endpoints. CONCLUSIONS Although efforts are needed to increase adherence, preliminary evidence suggests that UHBRT can be safe and modestly effective for improving some measures of lower-limb muscle strength, balance, and muscle power in community-dwelling older adults. However, no benefits were found for other physical fitness measures, QoL or falls. More evidence is therefore needed to draw definite conclusions.
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16
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Silva ÉQ, Santos DP, Beteli RI, Monteiro RL, Ferreira JSSP, Cruvinel-Junior RH, Donini A, Verissímo JL, Suda EY, Sacco ICN. Feasibility of a home-based foot-ankle exercise programme for musculoskeletal dysfunctions in people with diabetes: randomised controlled FOotCAre (FOCA) Trial II. Sci Rep 2021; 11:12404. [PMID: 34117342 PMCID: PMC8196027 DOI: 10.1038/s41598-021-91901-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/02/2021] [Indexed: 11/09/2022] Open
Abstract
This study sought to assess the feasibility of design, adherence, satisfaction, safety and changes in outcomes followed by a home-based foot–ankle exercise guided by a booklet in individuals with diabetic peripheral neuropathy (DPN). 20 participants were allocated usual care [control group (CG)] or usual care plus home-based foot–ankle exercises [intervention group (IG)] for 8 weeks. For feasibility, we assessed contact, preliminary screening and recruitment rates, adherence, and using a 5-point Likert scale to satisfaction and safety of the booklet. In the IG, we assessed preliminary changes in DPN symptoms, DPN severity (classified by a fuzzy model) and foot–ankle range of motion between baseline and Week 8. In the first 20 weeks, 1310 individuals were screened for eligibility by phone contact. Contact rate was 89% (contacted participants/20w), preliminary screening success 28% (participants underwent screening/20w), and recruitment rate 1.0 participants/week (eligible participants/20w). The recruitment rate was less than the ideal rate of 5 participants/week. The adherence to the exercises programme was 77%, and the dropout was 11% and 9% for the IG and CG, respectively. In the IG, participants’ median level of satisfaction was 4 (IQR: 4–5) and perceived safety was 3 (IQR: 3–5). IG significantly decreased the DPN severity (p = 0.020), increased hallux relative to forefoot (first metatarsal) range of motion (ROM) (p < 0.001) and decreased maximum forefoot relative to hindfoot (midfoot motion) dorsiflexion during gait (p = 0.029). The home-based programme was feasible, satisfactory, safe and showed preliminary positive changes in DPN severity and foot motion during gait. Trial Registration ClinicalTrials.gov, NCT04008745. Registered 02/07/2019. https://clinicaltrials.gov/ct2/show/NCT04008745.
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Affiliation(s)
- Érica Q Silva
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Danilo P Santos
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Raquel I Beteli
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Renan L Monteiro
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil.,Department of Physical Therapy, Universidade Federal do Amapá, Amapá, Brazil
| | - Jane S S P Ferreira
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Ronaldo H Cruvinel-Junior
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Asha Donini
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Jady L Verissímo
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil
| | - Eneida Y Suda
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil.,Department of Physical Therapy, Universidade Ibirapuera, São Paulo, SP, Brazil
| | - Isabel C N Sacco
- Department of Physical Therapy, Speech, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, SP, 05360-160, Brazil.
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Active Older Adults Keep Aerobic Capacity and Experience Small Reductions in Body Strength During Confinement Due to COVID-19 Outbreak. J Aging Phys Act 2021; 29:1034-1041. [PMID: 33893244 DOI: 10.1123/japa.2020-0395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/18/2020] [Accepted: 01/18/2021] [Indexed: 11/18/2022]
Abstract
The objective of this study was to observe the home-confinement effects on physical fitness, physical activity (PA), and body composition in active older adults, and to compare physical fitness and PA according to quality of life (QoL) during confinement. A total of 72 physically active older adults (61.1% females; 74.24 ± 5.57 years) were assessed pre- and postconfinement for aerobic capacity (6-min walk test), lower (30-s sit-to-stand), and upper (30-s arm-curl) body strength, PA (short-version of the International Physical Activity Questionnaire), and QoL (EQ-5D-visual analogue scale). The pre- and postconfinement comparisons show declines in upper (-2.24 ± 0.45 repetitions; p < .001; η2 = .276) and lower body strength (-2.65 ± 0.42 repetitions; p < .001; η2 = .378) in both genders, but not in aerobic capacity. Ninety percentage of older adults perceived a decline in PA. Older adults reporting high QoL increased 19.27 ± 97.04 m in the 6-min walk test, while the participants with low QoL reduced 28.32 ± 63.27 m (p = .018; η2 = .090). Previously active older adults did not have their aerobic capacity decrease significantly despite a decline in upper and lower body strength during an 11-week home confinement period.
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18
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Delivery Approaches Within Exercise Referral Schemes: A Survey of Current Practice in England. J Phys Act Health 2021; 18:357-373. [PMID: 33730692 DOI: 10.1123/jpah.2020-0388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/12/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Exercise referral schemes in England offer referred participants an opportunity to take part in an exercise prescription in a nonclinical environment. The aim of these schemes is to effect clinical health benefits, yet there is limited evidence of schemes' effectiveness, which could be due to the heterogeneity in design, implementation, and evaluation. Additionally, there has been no concerted effort to map program characteristics. OBJECTIVE To understand what key delivery approaches are currently used within exercise referral schemes in England. METHODS Across England, a total of 30 schemes with a combined total of 85,259 exercise referral scheme participants completed a Consensus on Exercise Reporting Template-guided questionnaire. The questionnaire explored program delivery, nonexercise components, and program management. RESULTS Results found that program delivery varied, though many schemes were typically 12 weeks in length, offering participants 2 exercise sessions in a fitness gym or studio per week, using a combination of exercises. Adherence was typically measured through attendance, with nonexercise components and program management varying by scheme. CONCLUSION This research provides a snapshot of current delivery approaches and supports the development of a large-scale mapping exercise to review further schemes across the whole of the United Kingdom in order to provide evidence of best practice and delivery approaches nationwide.
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19
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Vitale JA, Bonato M, Borghi S, Messina C, Albano D, Corbetta S, Sconfienza LM, Banfi G. Home-Based Resistance Training for Older Subjects during the COVID-19 Outbreak in Italy: Preliminary Results of a Six-Months RCT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9533. [PMID: 33352676 PMCID: PMC7767132 DOI: 10.3390/ijerph17249533] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of a six-month home-based resistance-training program on muscle health and physical performance in healthy older subjects during the unique condition of home confinement caused by the COVID-19 pandemic. METHODS This was a randomized-controlled study that enrolled older participants that were allocated to either an experimental group performing the six-months exercise prescription (EXE) or a control group (CON). At the beginning (PRE), and after 6 months (POST), participants were assessed for muscle strength, balance, gait assessment and body composition by dual energy X-ray absorptiometry and magnetic resonance imaging. Normality distribution of data was checked with the D'Agostino and Pearson test and changes between PRE and POST were assessed by paired Student's t-test while percentage and absolute changes between groups at POST were tested by unpaired t-test. RESULTS Nine participants were included for the final analysis: EXE, n = 5 (age: 66 ± 4; BMI: 27.5 ± 3.7) and CON, n = 4 (age: 71 ± 9; BMI: 24.2 ± 4.1). Significant PRE-to-POST changes were observed in the EXE group only in the chair-stand test (+19.8%, p = 0.048 and ES:1.0, moderate) and in total fat mass (+5.0%, p = 0.035 and ES:1.4, large) with no between-group differences. Moreover, EXE had significantly higher absolute thigh CSA values than CON at POST (14.138 ± 2977 vs. 9039 ± 1015, p = 0.0178, ES = 1.7). No other within- and between-group differences were detected. CONCLUSIONS The home-based resistance-training program during the lockdown period, caused by the COVID-19 outbreak, determined only within-group improvement in lower limb muscle strength but not in muscle mass and composition in older subjects. Home confinement may partially explain the increase in total body fat due to a reduced daily PA regime and altered diet pattern.
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Affiliation(s)
- Jacopo Antonino Vitale
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
| | - Matteo Bonato
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
| | - Stefano Borghi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20122 Milano, Italy;
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20122 Milano, Italy;
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy
| | - Sabrina Corbetta
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20122 Milano, Italy;
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy; (M.B.); (C.M.); (D.A.); (S.C.); (L.M.S.); (G.B.)
- Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
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Billany RE, Vadaszy N, Lightfoot CJ, Graham-Brown MP, Smith AC, Wilkinson TJ. Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials. J Sports Sci 2020; 39:1174-1185. [PMID: 33337982 DOI: 10.1080/02640414.2020.1861741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Skeletal muscle atrophy, dysfunction, and weakness are consequences of noncommunicable diseases which result in exercise and functional limitations which contribute to poor quality of life and increased mortality. Home-based resistance training may promote skeletal muscle health. Electronic-based systematic searches were performed identifying randomised controlled trials utilising home-based resistance training in patients with noncommunicable diseases defined as cancer, cardiovascular disease, diabetes mellitus (type 1 and 2), chronic kidney disease (including dialysis), and chronic respiratory disease (asthma, chronic obstructive pulmonary disease, pulmonary hypertension). A comparator group was defined as one containing "non-exercise" or "usual care". Of the 239 studies identified (published between 1996 and 2020), 22 met the inclusion criteria. Sixteen studies contained an adjunct aerobic training component. Study designs and outcome measures showed large variation. Reporting of the principles of training applied within interventions was poor. Heterogeneity in study characteristics, and poor reporting of training characteristics, prevents formal recommendations for optimising home-based resistance training. However, home-based interventions are less resource-intensive than supervised programmes and appear to have the ability to improve or preserve pertinent outcomes such as strength, functional ability, and quality of life; potentially reducing the risk of mortality in patients with chronic disease.
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Affiliation(s)
- Roseanne E Billany
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Noemi Vadaszy
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Courtney J Lightfoot
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | | | - Alice C Smith
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Thomas J Wilkinson
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
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Weiner-Light S, Wolf MS. Screen-Based Physical Activity Tools: Are the Current Recommendations Causing More Harm Than Good? J Am Geriatr Soc 2020; 69:322-324. [PMID: 33219989 DOI: 10.1111/jgs.16972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Sophia Weiner-Light
- Department of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael S Wolf
- Department of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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van den Helder J, Mehra S, van Dronkelaar C, Ter Riet G, Tieland M, Visser B, Kröse BJA, Engelbert RHH, Weijs PJM. Blended home-based exercise and dietary protein in community-dwelling older adults: a cluster randomized controlled trial. J Cachexia Sarcopenia Muscle 2020; 11:1590-1602. [PMID: 33103379 PMCID: PMC7749597 DOI: 10.1002/jcsm.12634] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/07/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Effective and sustainable interventions are needed to counteract the decline in physical function and sarcopenia in the growing aging population. The aim of this study was to determine the 6 and 12 month effectiveness of blended (e-health + coaching) home-based exercise and a dietary protein intervention on physical performance in community-dwelling older adults. METHODS This cluster randomized controlled trial allocated 45 clusters of older adults already engaged in a weekly community-based exercise programme. The clusters were randomized to three groups with ratio of 16:15:14; (i) no intervention, control (CON); (ii) blended home-based exercise intervention (HBex); and (iii) HBex with dietary protein counselling (HBex-Pro). Both interventions used a tablet PC with app and personalized coaching and were targeting on behaviour change. The study comprised coached 6 month interventions with a 6 month follow-up. The primary outcome physical performance was assessed by modified Physical Performance Test (m-PPT). Secondary outcomes were gait speed, physical activity level (PAL), handgrip muscle strength, protein intake, skeletal muscle mass, health status, and executive functioning. Linear mixed models of repeated measured were used to assess intervention effects at 6 and 12 months. RESULTS The population included 245 older adults (mean age 72 ± 6.5 (SD) years), 71% female, and 54% co-morbidities observed. Dropout of the intervention was 18% at 6 months and 26% at 12 months. Participants were well functioning, based on an m-PPT score of 33.9 (2.8) out of 36. For the primary outcome m-PPT, no significant intervention effects (HBex, +0.03, P = 0.933; HBex-Pro, -0.13, P = 0.730) were found. Gait speed (+0.20 m/s, P = 0.001), PAL (+0.06, P = 0.008), muscle strength (+2.32 kg, P = 0.001), protein intake (+0.32 g/kg/day, P < 0.001), and muscle mass (+0.33 kg, P = 0.017) improved significantly in the HBex-Pro group compared with control group after 6 month intervention. The protein intake, muscle mass, and strength remained significantly improved after 12 months as compared with those of control. Health change and executive functioning improved significantly in both intervention groups after 6 months. CONCLUSIONS This HBex and dietary protein interventions did not change the physical performance (m-PPT) in community-dwelling older adults. Changes were observed in gait speed, PAL, muscle mass, strength, and dietary protein intake, in response to this combined intervention.
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Affiliation(s)
- Jantine van den Helder
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition (room B1.28), Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Sumit Mehra
- CREATE-IT Applied Research, Faculty of Digital Media and Creative Industries, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Applied Psychology, Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Carliene van Dronkelaar
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition (room B1.28), Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Gerben Ter Riet
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition (room B1.28), Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Tieland
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition (room B1.28), Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Bart Visser
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Ben J A Kröse
- CREATE-IT Applied Research, Faculty of Digital Media and Creative Industries, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Raoul H H Engelbert
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands.,Department of Rehabilitation, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter J M Weijs
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition (room B1.28), Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands.,Department of Nutrition and Dietetics, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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23
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Machado CLF, Pinto RS, Brusco CM, Cadore EL, Radaelli R. COVID-19 pandemic is an urgent time for older people to practice resistance exercise at home. Exp Gerontol 2020; 141:111101. [PMID: 33049354 PMCID: PMC7547324 DOI: 10.1016/j.exger.2020.111101] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/24/2020] [Accepted: 09/26/2020] [Indexed: 12/16/2022]
Abstract
Social distancing measures have been used to contain the COVID-19 pandemic; nevertheless, it causes unintended greater time at home and consequently a reduction in general physical activity and an increase in sedentary time, which is harmful to older people. A decrease in daily physical activities and an increase in sedentary time culminates in an impactful skeletal muscle disuse period and reduction in neuromuscular abilities related to functional capacity. Home-based resistance training is a strategy to mitigate physical inactivity and improve or retain muscle function and functional performance. Therefore, it is an urgent time to encourage older people to perform resistance exercises at home to avoid a harmful functional decline and promote physical health.
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Affiliation(s)
- Carlos Leonardo Figueiredo Machado
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Ronei Silveira Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Clarissa Muller Brusco
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Régis Radaelli
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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24
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COVID-19 and Social Isolation: A Case for Why Home-Based Resistance Training Is Needed to Maintain Musculoskeletal and Psychosocial Health for Older Adults. J Aging Phys Act 2020; 29:353-359. [PMID: 32796139 DOI: 10.1123/japa.2020-0131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/26/2020] [Accepted: 06/17/2020] [Indexed: 11/18/2022]
Abstract
The coronavirus disease outbreak in China has become the world's leading health headline and is causing major panic and public concerns. Public health guidelines in many countries are suggesting that people stay at home to avoid human-to-human transmission of the virus, which may lead to reduced physical activity and greater feelings of isolation. Such effects may be particularly problematic in older adults due to their reduced physical capacities and their potential for increased mental health issues, such as anxiety and depression. A potential way to minimize many of these side effects of stay-at-home guidelines may be progressive home-based resistance training. A simple way to provide progressive overload in home-based resistance training may involve elastic resistance, which has been demonstrated to provide similar benefits to traditional resistance training equipment typically found in gymnasiums. Recommendations on how older adults can safely and effectively perform elastic resistance training at home are provided.
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25
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Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity Habits. Nutrients 2020; 12:nu12061549. [PMID: 32466598 PMCID: PMC7352228 DOI: 10.3390/nu12061549] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/04/2020] [Accepted: 05/20/2020] [Indexed: 12/11/2022] Open
Abstract
While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflammatory cytokines. All these factors have been strongly associated with the development of metabolic syndrome, which in turn increases the risk of multiple chronic diseases. A plausible mechanism involved in these impacts could be a positive energy balance promoted by maintaining usual dietary intake while reducing energy expenditure. This means that just as calorie intake restriction could help mitigate the deleterious impacts of a bout of physical inactivity, overeating under conditions of home confinement is very likely to exacerbate these consequences. Moreover, hypertension, diabetes, and cardiovascular disease have been identified as potential risk factors for more severely ill patients with COVID-19. Thus, adequate control of metabolic disorders could be important to reduce the risk of severe COVID-19.
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