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de Medeiros CSP, Farias LBA, Santana MCDL, Pacheco TBF, Dantas RR, Cavalcanti FADC. A systematic review of exergame usability as home-based balance training tool for older adults usability of exergames as home-based balance training. PLoS One 2024; 19:e0306816. [PMID: 39172915 PMCID: PMC11340971 DOI: 10.1371/journal.pone.0306816] [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] [Received: 09/19/2023] [Accepted: 06/24/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Exergames are a fun, viable, attractive, and safe way to engage in physical exercise for most patient populations, including older adults. Their use in the home environment enables an expanded understanding about its applicability and its impact on clinical outcomes that can contribute to improved functionality and quality of life in this population. This systematic review aimed to synthesize the evidence on the usability of exergames as a tool for home-based balance training in older adults. METHODS The search was realized in 6 electronic databases and were included 1) randomized controlled trials with exergames home-based training as intervention, 2) studies involving older adults (aged 60 years or older) described as having impaired static or dynamic balance, 3) that compared the effects of exergames to usual care, health education or no intervention, and 4) reported usability and balance outcomes. The Cochrane Risk of Bias tool for randomized trials version 2 and the Grading of Recommendations Assessment, Development, and Evaluation were used to evaluate the methodological quality of studies and levels of evidence for outcomes. RESULTS After screening 1107 records, we identified 4 trials were included. The usability score of exergames was classified as an acceptable, good, and feasible tool. The pooled effect indicated improvements in favor of the exergame group for functional balance by TUG test (MD = -5.90; 95%CI = -10.29 to -1.51) with low-certainty evidence and Tinetti scale (MD = 4.80; 95%CI = 3.36 to 6.24) with very low-certainty evidence. Analyzing the different immersion level, it was observed a significant difference in the experimental group for the immersive exergames (MD = -9.14; 95%CI = -15.51 to -2.77) with very low-certainty evidence. CONCLUSION Exergames applied at home showed good usability and had significant effects on functional balance compared to usual care or no intervention, especially in the immersive modality. TRIAL REGISTRATION PROSPERO registration number: CRD42022343290.
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Affiliation(s)
| | | | | | | | - Rummenigge Rudson Dantas
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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dos Santos IK, Cobucci RN, de Medeiros JA, de Assis GG, de Medeiros RCDSC, Knackfuss MI, Cabral BGDAT, dos Santos RVT, Dantas PMS. Home-Based Indoor Physical Activity Programs for Community-Dwelling Older Adults: A Systematic Review. Sports Health 2024; 16:377-382. [PMID: 37329120 PMCID: PMC11025514 DOI: 10.1177/19417381231175665] [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] [Indexed: 06/18/2023] Open
Abstract
CONTEXT Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside. OBJECTIVE To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults. DATA SOURCES A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases. STUDY SELECTION A total of 11 studies (13 publications) were included involving a total of 1004 older adults. STUDY DESIGN A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. LEVEL OF EVIDENCE Level 2. DATA EXTRACTION Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome. RESULTS There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home. CONCLUSION The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling. PROTOCOL REGISTER NUMBER CRD42020182008.
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Affiliation(s)
- Isis Kelly dos Santos
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ricardo Ney Cobucci
- Graduate Program of Biotechnology and Medical School, Universidade Potiguar (UnP), Natal, Rio Grande do Norte, Brazil
| | | | - Gilmara Gomes de Assis
- Department of Molecular Biology, Gdansk University of Physical Education and Sports, Gdansk, Poland, and Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Science, Poland
| | | | - Maria Irany Knackfuss
- Department of Physical Activity, State University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Paulo Moreira Silva Dantas
- Graduate Program in Health Sciences and Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
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Dawson R, Oliveira JS, Kwok WS, Bratland M, Rajendran IM, Srinivasan A, Chu CY, Pinheiro MB, Hassett L, Sherrington C. Exercise Interventions Delivered Through Telehealth to Improve Physical Functioning for Older Adults with Frailty, Cognitive, or Mobility Disability: A Systematic Review and Meta-Analysis. Telemed J E Health 2024; 30:940-950. [PMID: 37975811 PMCID: PMC11035924 DOI: 10.1089/tmj.2023.0177] [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: 04/06/2023] [Revised: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 11/19/2023] Open
Abstract
Introductions: This study assessed the effects of telehealth-delivered exercise interventions on physical functioning for older adults and explored implementation measures related to program delivery. Methods: We conducted a systematic review of studies investigating effects of exercise interventions delivered through telehealth in adults 60+ years of age with frailty, mobility, or cognitive disability on mobility, strength, balance, falls, and quality of life (QoL). Electronic databases (MEDLINE, CINAHL, SPORTSDiscus, and Physiotherapy Evidence Database) were searched from inception until May 2022. Evidence certainty was assessed with Grading of Recommendations, Assessment, Development, and Evaluation and meta-analysis summarized study effects. Results: A total of 11 studies were included, 5 randomized controlled trials, 2 pilot studies, and 4 feasibility studies. The overall certainty of evidence was rated as "low" or "very low." Pooled between-group differences were not statistically significant, but effect sizes suggested that telehealth produced a moderate improvement on mobility (n = 5 studies; standardized mean difference [SMD] = 0.63; 95% confidence interval [CI] = -0.25 to 1.51; p = 0.000, I2 = 86%) and strength (n = 4; SMD = 0.73; 95% CI = -0.10 to 1.56; p = 0.000, I2 = 84%), a small improvement on balance (n = 3; SMD = 0.40; 95% CI = -035 to 1.15; p = 0.012, I2 = 78%), and no effect on QoL. Analysis of implementation measures suggested telehealth to be feasible in this population, given high rates of acceptability and adherence with minimal safety concerns. Discussion: Telehealth may provide small to moderate benefits on a range of physical outcomes and appears to be well received in aged care populations.
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Affiliation(s)
- Rik Dawson
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Juliana S. Oliveira
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Wing S. Kwok
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Marte Bratland
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Ian Matthew Rajendran
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Ajith Srinivasan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Chun Yin Chu
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, Australia
| | - Marina B. Pinheiro
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Leanne Hassett
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Insititue for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Gadigal Country, Sydney, Australia
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Buckinx F, Rezoulat M, Lefranc C, Reginster JY, Bruyere O. Comparing remote and face-to-face assessments of physical performance in older adults: A reliability study. Geriatr Nurs 2024; 55:71-78. [PMID: 37976558 DOI: 10.1016/j.gerinurse.2023.11.004] [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: 10/09/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Older people often experience a decline in their physical performance. Tests have been approved to evaluate this performance in person. Yet, the constraints associated with in-person assessments (e.g. lack of medical facilities, pandemic lockdown, and contagion risk) are making us contemplate setting up assessments remotely. OBJECTIVES To determine whether remote physical performance measurements of older adults are reliable and valid compared to face-to-face measurements. METHODS Forty-five subjects aged 65 and over completed the normal/fast speed test (NWT/FWT), the unipodal balance test (UBT), the normal/fast timed up and go test (NTUG/FTUG), the 5 and 10 rep sit to stand test (5STS and 10STS), the 30 sec chair stand (30CS), the 2 minute step test (2MST) and the flexibility before standing (SAD) once face-to-face and twice remotely, by two different observers. The intraclass correlation coefficients (ICC), the standard errors of measurement (SEM%) and minimum detectable changes (MDC%) were calculated for both intra- and inter-observer conditions, to assess the relative and the absolute reliability. An ICC value exceeding 0.90 indicates a very high reliability, while an ICC between 0.70 and 0.89 signifies a high reliability. In clinical practice, a SEM % of less than 10% is considered acceptable. A smaller MDC % indicates a measurement that is more sensitive to detecting changes. RESULTS Intra-observer relative reliability was very high (ICC>0.9) for the UBT, NWT, NTUG, FTUG, 5STS, 10STS, 30CS and the SAD; and high (ICC>0.7) for the 2MST and FWS. SEM% values ranged from 0% to 24.03% and MDC from 0% to 9.93%. Inter-observer relative reliability was considered very high (ICC>0.9) for all tests. SEM% values ranged from 0% to 17.68% and MDC from 0% to 7.32%. CONCLUSION Our findings demonstrate that remote assessments exhibited consistently high to very high levels of intra- and inter-observer relative reliability when compared to face-to-face assessments. Additionally, certain remote evaluations showed acceptable absolute reliability, making them viable alternatives for healthcare professionals when in-person assessments are not feasible in clinical practice.
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Affiliation(s)
- Fanny Buckinx
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.
| | - Marvin Rezoulat
- Department of physical activity and rehabilitation sciences, University of Liège, Belgium
| | - César Lefranc
- Department of physical activity and rehabilitation sciences, University of Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Olivier Bruyere
- WHO Collaborating Center for Epidemiologic aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium; Department of physical activity and rehabilitation sciences, University of Liège, Belgium
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Villar R, Beltrame T, Ferreira dos Santos G, Zago AS, Bocalini DS, Pontes Júnior FL. Test-retest reliability and agreement of remote home-based functional capacity self-administered assessments in community-dwelling, socially isolated older adults. Digit Health 2024; 10:20552076241254904. [PMID: 38778868 PMCID: PMC11110522 DOI: 10.1177/20552076241254904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Objectives To determine the test-retest reliability and agreement of home-based functional capacity self-administered assessments in socially isolated older adults. Methods Fourteen community-dwelling older adults (eight females, 67.9 ± 7.7 years) volunteered for this study. Before testing, participants were screened online for eligibility and received instructional videos explaining test set-up and execution. Participants underwent the 30-second sit-to-standing test, gait speed tests at the usual pace, and timed-up-and-go tests administered 4 weeks apart. For the 30-second sit-to-standing protocol, participants were instructed to repeatedly sit and stand from a chair (with a height of ∼ 43 cm and without armrests) for 30 s, with the number of repetitions recorded. In the gait speed test protocol, participants were instructed to walk at their usual and comfortable pace, with the time taken recorded (seconds). In the timed-up-and-go, participants stood up from a chair, walked as fast as possible for 3 m, circled a marked point, and returned to the chair to sit down, completing the test, with the score recorded (seconds). A trained researcher conducted the scoring virtually via synchronous video. Results 30-second sit-to-standing, gait speed test, and timed-up-and-go showed excellent mean coefficient of variation values (2.0-4.9), small standard error of measurement (0.08-1.27), excellent intraclass coefficient (0.97-0.99), very strong correlations (0.97-0.99) and good agreement between the two days of testing. Conclusion Self-administered functional capacity tests performed by older adults at home were reliable with good agreement. Healthcare professionals and older adults should take advantage of simple remote self-administered assessments performed at home to evaluate older adults' health status.
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Affiliation(s)
- Rodrigo Villar
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Thomas Beltrame
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
- Department of Physiotherapy, Universidade Ibirapuera, São Paulo, São Paulo, Brazil
- Institute of Computing, University of Campinas, Campinas, São Paulo, Brazil
| | - Gabriela Ferreira dos Santos
- Physiology of Exercise & Aging Laboratory, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Anderson Saranz Zago
- Department of Physical Education, Graduate Program in Movement Sciences, São Paulo State University-UNESP, SP, Brazil
| | - Danilo Sales Bocalini
- Biochemistry and Physiology Laboratory. Physical Education and Sport Center of Federal University of Espirito Santo, Vitoria, Brazil
| | - Francisco Luciano Pontes Júnior
- Physiology of Exercise & Aging Laboratory, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
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Vasodi E, Saatchian V, Dehghan Ghahfarokhi A. Virtual reality-based exercise interventions on quality of life, some balance factors and depression in older adults: A systematic review and meta-analysis of randomized controlled trials. Geriatr Nurs 2023; 53:227-239. [PMID: 37598426 DOI: 10.1016/j.gerinurse.2023.07.019] [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: 05/27/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the impact of virtual reality-based exercise on the quality of life, some balance variables, and depression among older adults aged 60 years or older. METHOD We systematically searched five electronic databases. RESULTS Twenty-seven articles met our inclusion criteria. Meta-analysis revealed that exercise using virtual reality had a significant positive effect on overall quality of life (p = 0.05), mental (p = 0.001) and physical component scores (p = 0.01), social relation (p = 0.0002), psychological health(p = 0.01), physical health(p = 0.04), and environmental health (p = 0.04). Additionally, depression significantly improved following virtual reality-based exercise (p = 0.01). However, there were significant improvements in the balance berg scale (p<0.00001) and ABC scale (p<0.00001) but not in timed-up-and-go(TUG) or 8-foot-up-and-go(8-FUG). DISCUSSION Virtual reality-based exercise has a positive impact on various aspects of quality of life, BBS and ABC scores, and depression. More studies with larger sample sizes and less heterogeneity in design and assessments are required.
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Affiliation(s)
- Elham Vasodi
- Department of Physical Education and Sport Sciences, Shahrood University of Technology, Shahrood, Iran
| | - Vahid Saatchian
- Department of Physical Education and Sport Sciences, Imam Reza international University, Mashhad, Iran.
| | - Amin Dehghan Ghahfarokhi
- Sport Management Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Webster KE, Seng JS, Gallagher NA, Gothe NP, Colabianchi N, Lavoie Smith EM, Ploutz-Snyder R, Larson JL. Physical Activity Programming for Older Adults in Assisted Living: Residents' Perspectives. West J Nurs Res 2023; 45:105-116. [PMID: 35775102 PMCID: PMC11348889 DOI: 10.1177/01939459221107579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Decreasing sedentary behavior and increasing light physical activity could promote the maintenance of functional abilities for older adults in assisted living (AL). The purpose of this qualitative study was to gather residents' recommendations about a proposed self-efficacy enhancing intervention to replace sedentary behavior with light physical activity. We interviewed 20 residents (mean age 83.1; 60% women). Topics included their current activities and thoughts about physical activity. We presented the intervention and asked questions to inform its modification. Data were analyzed with content and thematic analysis. Specific recommendations included shorter one-hour sessions and framing the intervention as increasing light physical activity rather than decreasing sedentary behavior. The thematic analysis identified multiple factors that could influence intervention implementation, including motivation to be active, safety concerns, ageist attitudes about physical activity, varying abilities of residents, social influences, and limited opportunities for physical activity. These results will inform physical activity intervention implementation for AL residents.
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Affiliation(s)
| | | | | | - Neha P. Gothe
- University of Illinois at Urbana-Champaign College of Applied Health Sciences
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Ugartemendia-Yerobi M, Kortajarena M, Elordi U, Zinkunegi-Zubizarreta N, Zarrazquin I, Calvo-Aguirre JJ, Irazusta A. Effects of a multicomponent physical exercise programme on perceived health-related quality of life and on depressive symptoms in older adults living in long-term nursing homes. Int J Nurs Sci 2022; 10:16-22. [PMID: 36860716 PMCID: PMC9969169 DOI: 10.1016/j.ijnss.2022.12.015] [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: 08/14/2022] [Revised: 11/25/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives This study aimed to investigate the impact of a multicomponent exercise programme on perceived health-related quality of life (HRQoL) and depressive symptomatology in older people living in a long-term nursing home (LTNH). Methods A quasi-experimental study was conducted. Forty-one older people were conveniently selected from the largest LTNH in the Basque Country. The participants were assigned to either an intervention group (n = 21) or a control group (n = 20). The intervention group participated in 50-min moderate intensity multicomponent physical exercise sessions (strength and balance, three sessions a week for 3 months). The control group participants continued their usual activities in the LTNH. Assessments were completed at baseline and reassessed after the 12-week intervention by the same nurse researchers who filled out the questionnaires: the 36-item Short Form Survey (SF-36) and the Geriatric Depression Scale (GDS). Results Thirty-eight participants completed the study (19 participants in each group). In the SF-36 parameters, physical functioning increase in the intervention group tends with a mean increase of 11.06 units (a 17.2% increase over the pre). In the role-emotional, the increase in the intervention group is with a mean increase of 5.27 units (a 29.1% increase over the pre) (P < 0.05). In social functioning, the increase in the control group is significant with a mean increase of 13.16 units (a 15.4% increase over the pre) (P < 0.05). There are no significant changes in the rest of the parameters, there are no differences between groups in the evolutionary pattern either. Conclusions As for the effects of the multicomponent exercise programme on HRQoL and depressive symptomatology, no statistically significant effects were obtained in the outcome data among older adults living in LTNHs. An increase in the sample size could confirm the trends obtained. The results may help inform the design of future studies.
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Affiliation(s)
- Maider Ugartemendia-Yerobi
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Guipuzkoa, Spain,Corresponding author.
| | - Maider Kortajarena
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Guipuzkoa, Spain
| | - Udane Elordi
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Guipuzkoa, Spain
| | - Nagore Zinkunegi-Zubizarreta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Guipuzkoa, Spain
| | - Idoia Zarrazquin
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Guipuzkoa, Spain
| | | | - Amaia Irazusta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Guipuzkoa, Spain
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Miranda FB, de Castro JBP, dos Santos AOB, da Silva GCPSM, Nogueira CJ, Guimarães AC, Lima VP, Vale RGDS, Dantas EHM. Effects of resistance training on the functional autonomy of middle-aged and older women: a systematic review and meta-analysis of randomized controlled trials. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Pinheiro ÉP, Cavalheiro do Espírito Santo R, Peterson Dos Santos L, Gonçalves WV, Forgiarini Junior LA, Xavier RM, Filippin LI. Multicomponent or Resistance Training for Nursing Home Residents: A Systematic Review With Meta-Analysis. J Am Med Dir Assoc 2022; 23:1926.e1-1926.e10. [PMID: 35841975 DOI: 10.1016/j.jamda.2022.06.009] [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: 03/08/2022] [Revised: 06/01/2022] [Accepted: 06/12/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To perform a systematic review with meta-analysis to verify the effects of multicomponent and resistance training on the physical performance in older adult residents in long-term care, as well as to compare these modalities. DESIGN Systematic review with meta-analysis of randomized controlled trials. SETTING AND PARTICIPANTS Older adults age over 60 years who are nursing home residents in long-term care. METHODS Seven electronic databases (PubMed, Embase, Central, Web of Science, SportDiscus, LILACS, and SCIELO) were searched from their inception until May 1, 2022. The methodological quality was assessed using PEDro scale. Mean difference and 95% confidence interval were pooled using a random-effects model. The significance level established was P value of ≤.05 for all analyses. RESULTS A total of 30 studies were included in the qualitative review (n = 1887, mean age 82.68 years and 70% female). Multicomponent training appeared in 19 studies and resistance training in 12 studies. Out of these, 17 studies were incorporated into the meta-analysis. Multicomponent training and resistance training showed statistically significant difference (P ≤ .05) in the physical performance of institutionalized older adults compared with the control groups (usual care); this was evaluated with the Short Physical Performance Battery (+1.2 points; +2 points), 30-second chair-stand (approximately +3 repetitions; both), and Timed Up and Go (-4 seconds on mean; both) tests. Comparisons between multicomponent and resistance training did not show statistically significant differences in any of the physical outcomes evaluated. CONCLUSIONS AND IMPLICATIONS The studies provide evidence that both multicomponent training and resistance training may be effective in improving the physical performance of institutionalized older adults. Further studies with more representative sample numbers, an improvement in methodological quality, and a more specified prescription of the training used are necessary.
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Affiliation(s)
| | - Rafaela Cavalheiro do Espírito Santo
- Autoimmune Diseases Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Leonardo Peterson Dos Santos
- Autoimmune Diseases Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Ricardo Machado Xavier
- Autoimmune Diseases Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Lidiane Isabel Filippin
- Autoimmune Diseases Laboratory, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Postgraduate Program in Health and Human Development, La Salle University, Canoas, Rio Grande do Sul, Brazil
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Narsakka N, Suhonen R, Kielo-Viljamaa E, Stolt M. Physical, social, and symbolic environment related to physical activity of older individuals in long-term care: A mixed-method systematic review. Int J Nurs Stud 2022; 135:104350. [DOI: 10.1016/j.ijnurstu.2022.104350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 10/31/2022]
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Wootten S, Wiseman N, Harris N. Measuring the outcomes for aged care residents' participation in physical activity interventions: A systematic review of randomised controlled trials. Australas J Ageing 2022; 41:165-187. [PMID: 34921588 DOI: 10.1111/ajag.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 10/13/2021] [Accepted: 10/31/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Lack of physical activity presents substantial health risks to older adults living in residential aged care facilities. The objective of this review was to examine the suitability of physical activity outcome measurement instruments among cognitively sound residents. METHODS Search terms were used to explore health, nursing and social science databases to identify applicable English-language research from January 2000 to July 2020. RESULTS Sixteen papers met the inclusion criteria. The findings show that a diverse range of outcome measurement instruments have been used to evaluate physical activity intervention effectiveness. Most were found not to be validated for use specifically with residential aged care populations. CONCLUSIONS A range of Outcome Measurement Instruments (OMI) appear to effectively measure physical activity intervention outcomes among residential aged care older adults. Results highlighted the need for greater rigour in study design and selection of valid and population-appropriate instruments for use with this population.
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Affiliation(s)
- Steven Wootten
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Nicola Wiseman
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Neil Harris
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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Peyrusqué E, Granet J, Pageaux B, Buckinx F, Aubertin-Leheudre M. Assessing Physical Performance in Older Adults during Isolation or Lockdown Periods: Web-Based Video Conferencing as a Solution. J Nutr Health Aging 2022; 26:52-56. [PMID: 35067703 PMCID: PMC8590923 DOI: 10.1007/s12603-021-1699-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/23/2021] [Indexed: 01/06/2023]
Abstract
During the COVID-19 pandemic, face-to-face assessments were limited. Fortunately, older adults have access to web-technology (60%). Thus, we aimed to explore if assessing physical performance remotely is as reliable and valid as in person. At the end of the first lockdown, 15 older adults agreed to perform two similar evaluations in remote and face-to-face conditions. Functional capacities [5-repetitions Sit-to-Stand (STS); unipodal balance, 4-m walking speed (normal (NWS); fast (FWS)), 3-m Timed-Up and Go (normal (nTUG); fast (fTUG))] and muscle power and endurance were assessed. Fast walking speed was moderately reliable. Unipodal balance, NWS and nTUG were highly reliable (ICC>0.7). fTUG, STS, muscle endurance and power were extremely reliable (ICC>0.9). For absolute reliability, SEM varied from 15.54 to 5.14%. Finally, the MDC varied from 43.07 to 14.21%. Assessing functional capacities and muscle function remotely is as reliable and valid as a face-to-face assessment and should be considered as a clinical practice.
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Affiliation(s)
- E Peyrusqué
- Mylène Aubertin-Leheudre, PhD, Département des sciences de l'activité physique, Université du Québec à Montréal, Pavillon des sciences biologiques, 141 avenue Président-Kennedy, SB-4615, Montréal, Québec, Canada H3C 3P8.
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Narsakka N, Suhonen R, Stolt M. Environment in institutional care settings as a promoting factor for older individuals' mobility: A systematic review. Scand J Caring Sci 2021; 36:382-392. [PMID: 34893995 PMCID: PMC9300114 DOI: 10.1111/scs.13053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
Background Mobility is important for health and well‐being; however, older individuals in institutional care settings are relatively sedentary. The environment has an increased influence on mobility in older age due to changes in individual functioning; thus, environmental mobility support solutions for this population are needed. Objectives The aim of this systematic review was to identify elements of the environment that have been used in the content and delivery of interventions to promote mobility and to assess the effects of these interventions on mobility outcomes. Design A systematic literature search was conducted using CINAHL and MEDLINE from the earliest date through 30 September 2020 for randomised controlled trials, quasi‐experimental and pre‐post design studies. Inclusion and critical appraisal of articles were conducted by two independent researchers. Data were extracted and synthesised. Setting and participants Studies were included if they had employed some element of the environment in the content and/or delivery of the intervention and had assessed mobility‐related outcomes of older individuals in institutional long‐term care settings providing full‐time care. Measures Studies were included if they reported data on mobility‐related outcomes including aspects of physical activity, physical function, life space and functional autonomy. Results Eight studies were included. Physical, social and symbolic elements of the environment were utilised in the interventions. Positive effects on mobility outcomes were reported in exercise interventions utilising environmental elements mostly as supportive components. Conclusions and implications Empirical evidence about effective mobility interventions employing elements of the environment as main intervention components is lacking. A serious dilemma exists about the need for older individuals’ independence and mobile/active late life and the lack of support for such initiatives in long‐term care. Given the emphasised relationship of the environment and mobility with age due to changes in functioning, environmental solutions require further examination.
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Affiliation(s)
- Noora Narsakka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital and City of Turku Welfare Division, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
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Lewis LK, Henwood T, Boylan J, Hunter S, Lange B, Lawless M, Milte R, Petersen J. Re-thinking reablement strategies for older adults in residential aged care: a scoping review. BMC Geriatr 2021; 21:667. [PMID: 34847860 PMCID: PMC8638477 DOI: 10.1186/s12877-021-02627-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The number of older adults in residential aged care is increasing. Aged care residents have been shown to spend most of the day sedentary and have many co-morbidities. This review aimed to systematically explore the effectiveness of reablement strategies in residential aged care for older adults' physical function, quality of life and mental health, the features of effective interventions and feasibility (compliance, acceptability, adverse events and cost effectiveness). METHOD This scoping review was undertaken according to PRISMA guidelines (extension for scoping reviews). Five e-databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL) were searched from 2010 onwards. Randomised controlled trials investigating reablement strategies addressing physical deconditioning for older adults (mean age ≥ 65 yrs) in residential aged care on physical function, quality of life or mental health were included. Feasibility of the interventions (compliance, acceptability, satisfaction, adverse events and cost effectiveness) was explored. RESULTS Five thousand six hundred thirty-one citations were retrieved, and 63 studies included. Sample sizes ranged from 15 to 322 and intervention duration from one to 12 months. Exercise sessions were most often conducted two to three times per week (44 studies) and physiotherapist-led (27 studies). Interventions were predominately multi-component (28 studies, combinations of strength, balance, aerobic, functional exercises). Five interventions used technology. 60% of studies measuring physical function reported significant improvement in the intervention versus control, 40% of studies measuring quality of life reported significant improvements in favour of the intervention, and 26% of studies measuring mental health reported significant intervention benefits. Over half of the studies measured compliance and adverse events, four measured acceptability and none reported cost effectiveness. CONCLUSIONS There has been a research surge investigating reablement strategies in residential aged care with wide variability in the types and features of strategies and outcome measures. Few studies have measured acceptability, or cost effectiveness. Exploration of core outcomes, mapping stakeholders and co-designing a scalable intervention is warranted. TRIAL REGISTRATION Prospectively registered review protocol (Open Science Framework: DOI https://doi.org/10.17605/OSF.IO/7NX9M ).
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Affiliation(s)
- Lucy K Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Tim Henwood
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Jo Boylan
- Southern Cross Care (SA, NT & Vic) Inc., PO Box 155, Glen Osmond, SA, 5064, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Michael Lawless
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jasmine Petersen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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Janhunen M, Karner V, Katajapuu N, Niiranen O, Immonen J, Karvanen J, Heinonen A, Aartolahti E. Effectiveness of Exergame Intervention on Walking in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther 2021; 101:pzab152. [PMID: 34160022 PMCID: PMC8459884 DOI: 10.1093/ptj/pzab152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/19/2021] [Accepted: 05/05/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used, and the risk of bias. METHODS A literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo, and PEDro up to January 10, 2020. Studies with a randomized controlled trial design, people ≥60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking-related outcomes were included. Cochrane RoB2, meta-analysis, meta-regression, and Grading of Recommendations, Assessment, Development and Evaluation were used to estimate quality, treatment effect, covariates' effect, and the certainty of evidence, respectively. RESULTS In the studies included (n = 66), the overall risk of bias was low (n = 2), unclear (n = 48), or high (n = 16). Compared with comparison groups, exergaming interventions were more effective for walking improvements (standardized mean difference = -0.21; 95% CI = -0.36 to -0.06; 3102 participants, 58 studies; moderate-quality evidence) and more or equally effective (standardized mean difference = -0.32; 95% CI = -0.64 to 0.00; 1028 participants, 13 studies; low-quality evidence) after nonexergaming follow-up. The strongest effect for covariates was observed with the type of comparison group, explaining 18.6% of the variance. CONCLUSION For older adults without neurological disorders, exergame-based training improved walking, and improvements were maintained at follow-up. Greater benefits were observed when exergaming groups were compared with inactive comparison groups. To strengthen the evidence, further randomized controlled trials on the effectiveness of gamified exercise intervention are needed. IMPACT Exergaming has an effect equivalent to other types of exercising on improving walking in older adults. Physical therapists and other rehabilitation professionals may consider exergaming as a promising form of exercise in this age group.
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Affiliation(s)
- Maarit Janhunen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Vera Karner
- Physiotherapy, University of Applied Sciences for Health Professions Upper Austria, Linz, Austria
| | - Niina Katajapuu
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | - Oona Niiranen
- Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | - Jaakko Immonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha Karvanen
- Faculty of Mathematics and Science, University of Jyväskylä, Jyväskylä, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eeva Aartolahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Schröder D. [Exergames to promote physical activity and mobility in inpatient long-term nursing-An overview]. Z Gerontol Geriatr 2021; 55:502-506. [PMID: 34351484 DOI: 10.1007/s00391-021-01951-2] [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: 02/17/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
Maintaining and promoting mobility is a key objective and central goal of nursing care. Active video games or so-called exergames can also be used for this purpose. In the group of older people some studies showed indications of positive effects with respect to mobility. In this article the focus is on studies that examined the use of exergames for the purpose of maintaining or promoting physical activity and mobility in the setting of long-term inpatient nursing. In summary, a literature search in databases indicated that individual studies on this topic found indications of positive effects: however, the informative value of the results is limited due to their heterogeneity and small samples.
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Affiliation(s)
- Dorit Schröder
- Institut für Pflegewissenschaft, Universität Bielefeld, Universitätsstr. 25, 33615, Bielefeld, Deutschland.
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Salisbury JP. Using Medical Device Standards for Design and Risk Management of Immersive Virtual Reality for At-Home Therapy and Remote Patient Monitoring. JMIR BIOMEDICAL ENGINEERING 2021; 6:e26942. [PMID: 38907371 PMCID: PMC11041430 DOI: 10.2196/26942] [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: 01/04/2021] [Revised: 02/22/2021] [Accepted: 04/17/2021] [Indexed: 01/25/2023] Open
Abstract
Numerous virtual reality (VR) systems have received regulatory clearance as therapeutic medical devices for in-clinic and at-home use. These systems enable remote patient monitoring of clinician-prescribed rehabilitation exercises, although most of these systems are nonimmersive. With the expanding availability of affordable and easy-to-use head-mounted display (HMD)-based VR, there is growing interest in immersive VR therapies. However, HMD-based VR presents unique risks. Following standards for medical device development, the objective of this paper is to demonstrate a risk management process for a generic immersive VR system for remote patient monitoring of at-home therapy. Regulations, standards, and guidance documents applicable to therapeutic VR design are reviewed to provide necessary background. Generic requirements for an immersive VR system for home use and remote patient monitoring are identified using predicate analysis and specified for both patients and clinicians using user stories. To analyze risk, failure modes and effects analysis, adapted for medical device risk management, is performed on the generic user stories and a set of risk control measures is proposed. Many therapeutic applications of VR would be regulated as a medical device if they were to be commercially marketed. Understanding relevant standards for design and risk management early in the development process can help expedite the availability of innovative VR therapies that are safe and effective.
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Aubertin-Leheudre M, Rolland Y. The Importance of Physical Activity to Care for Frail Older Adults During the COVID-19 Pandemic. J Am Med Dir Assoc 2020; 21:973-976. [PMID: 32513558 PMCID: PMC7190526 DOI: 10.1016/j.jamda.2020.04.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/17/2020] [Accepted: 04/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Mylene Aubertin-Leheudre
- Centre de recherche, Institut universitaire de gériatrie de Montréal (IUGM), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada; Département des Sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montreal, Canada.
| | - Yves Rolland
- Gerontopole of Toulouse, University Hospital of Toulouse (CHU-Toulouse), Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France
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20
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Senior physical activity contests in nursing homes: a feasibility study. Aging Clin Exp Res 2020; 32:869-876. [PMID: 32189244 DOI: 10.1007/s40520-020-01529-9] [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: 01/10/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Competition has been shown to improve motivation and physical performance in young people. This method has been rarely studied in older people. AIMS To evaluate the feasibility of senior physical activity (PA) contests between two nursing homes and to assess changes in the motivational level and physical performance of the residents over time. METHODS Residents from two Belgian nursing homes were invited to participate in PA contests. A pretest and three contest sessions were organized over a period of 3 months. The activities proposed were body balance, gait speed, sit-to-stand performance, arm curl and address tests. Feasibility was measured by contest session adherence (expected score > 80%), difficulty scores (expected score < 40%) and appreciation scores (expected score > 80%). Motivational questionnaires were administered: the BREQ-2 (assessing amotivation, introjected regulation, identified regulation, intrinsic motivation and external motivation) and the A-PMCEQ (assessing ego- and task-involving climates). Friedman's analysis of variance was performed to evaluate the changes in physical performance and motivational levels. RESULTS Of the 24 participants, seven did not complete all sessions because of medical or personal reasons not related to the study. During the three sessions, the adherence was 86%, the mean difficulty score was 30.8% and the satisfaction score was 87%. After three sessions, residents experienced a significant decrease ranged from 3 to 0 point for amotivation (p = 0.03), 1 to 0 point for external motivation (p = 0.03) and 2.5 to 2 points for ego-involving climate (p = 0.02) and a significant improvement ranged from 0.7 to 0.9 m/s for gait speed (p < 0.001), 18.5 to 15.6 s for sit-to-stand performance (p < 0.001) and 11.5 to 15 curls for arm curl scores (p < 0.001). CONCLUSIONS In nursing home settings, senior PA contests are feasible and may improve the motivational climate and physical performance.
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21
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A Systematic Approach for Prescribing Posthospitalization Home-Based Physical Activity for Mobility in Older Adults: The PATH Study. J Am Med Dir Assoc 2019; 20:1287-1293. [DOI: 10.1016/j.jamda.2019.01.143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 11/17/2022]
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Buckinx F, Aubertin-Leheudre M. Relevance to assess and preserve muscle strength in aging field. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109663. [PMID: 31176745 DOI: 10.1016/j.pnpbp.2019.109663] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/05/2019] [Accepted: 05/30/2019] [Indexed: 01/06/2023]
Abstract
According to the revised European consensus on sarcopenia, muscle strength is the primary parameter of sarcopenia and is associated with adverse outcomes or physical limitation. This literature review aims to clarify how and why to measure and preserve muscle strength in older population. Overall, the relationship between muscle strength and physical function is impacted by level of muscle mass, the degree of obesity (BMI), age and physical activity. Therefore, these factors are to be considered in the evaluation of muscle strength. It is necessary to have objective, reliable and sensitive tools to assess muscle strength, in different populations to detect and quantify weakness, to adapt physical exercises to patients' capacity and to evaluate the effects of treatment. Handgrip strength measurement might be reasonable for clinical practice while the measurement of knee flexors/extensors strength with both 1RM and dynamometers is increasingly important yet restricted by the requirement of special equipment. Physical activity and nutrition are two important behavioral factors to maintain muscle strength. Combined exercise and nutrition interventions improved muscle strength to a more prominent degree than exercise or nutrition alone.
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Affiliation(s)
- F Buckinx
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - M Aubertin-Leheudre
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada.
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Carvalho LP, Pion CH, El Hajj Boutros G, Gaudreau P, Chevalier S, Bélanger M, Morais JA, Aubertin-Leheudre M. Effect of a 12-week mixed power training on physical function in dynapenic-obese older men: does severity of dynapenia matter? Aging Clin Exp Res 2019; 31:977-984. [PMID: 30293107 DOI: 10.1007/s40520-018-1048-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/24/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Mobility disability affects nearly 15% of people aged 65 or over worldwide. Excess weight or obesity (OB), along with an accentuated loss of muscle strength (dynapenia), is recognized to be one of the most common risk factors for mobility impairment among the elderly. OBJECTIVE To investigate the effect of a 12-week mixed power training (MPT high-velocity resistance training mixed with functional exercises) on physical function in obese older men exhibiting different severities of dynapenia. METHODS Community-dwelling older men (69 ± 6 years) were assigned to the study if they were considered obese (OB, fat mass ≥ 25% body weight, BW) and to one of the two groups according to severity of dynapenia [(handgrip strength-HS)/BW]: type 1(OB-DY1) or type 2(OB-DY2), < 1 or 2SD from a young reference group. Participants followed a 12-week MPT, three times/week, 75 min/session. Main outcomes included the performance on the 4-m and 6-min walking tests, Timed Up and Go, stair and balance tests. RESULTS AND DISCUSSION At baseline, OB-DY1 performed better than OB-DY2 in all functional tests (p < 0.05). Following the intervention, medium-to-large training effect size (ES) were observed for fat (ES = 0.21) and lean (ES = 0.32, p < 0.001) masses, functional performance (ES 0.11-0.54, p < 0.05), HS (ES = 0.10, p < 0.05) and lower limb muscle strength (ES = 0.67, p < 0.001) and power (ES = 0.60, p < 0.05). Training-by-group interaction showed that OB-DY1 lost more FM (ES = 0.11, p = 0.03) and OB-DY2 improved more HS (ES = 0.19, p = 0.006) than their counterparts. CONCLUSIONS Seniors with obesity and severe dynapenia have poorer physical function than those in the early stage of dynapenia. Both seem to benefit from a high-velocity resistance training mixed with functional exercises, although by slightly different pathways.
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Affiliation(s)
- Livia P Carvalho
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada.
| | - Charlotte H Pion
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
- Département de Biologie, Université du Québec à Montréal, Montreal, Canada
| | - Guy El Hajj Boutros
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
| | - Pierrette Gaudreau
- Centre Hospitalier de l'Université de Montréal, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Stéphanie Chevalier
- McGill University Health Centre, Research Institute and Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Marc Bélanger
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada
| | - José A Morais
- McGill University Health Centre, Research Institute and Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Mylène Aubertin-Leheudre
- Département des Sciences de l'Activité Physique, Université du Québec à Montréal, (UQAM) Pavillon des sciences biologiques (SB), 4th Floor, 141 Avenue Président-Kennedy, SB-4615, Montreal, QC, H3C 3P8, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
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Masciocchi E, Maltais M, Rolland Y, Vellas B, de Souto Barreto P. Time Effects on Physical Performance in Older Adults in Nursing Home: A Narrative Review. J Nutr Health Aging 2019; 23:586-594. [PMID: 31233082 DOI: 10.1007/s12603-019-1199-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To gather available evidence about overtime changes on physical performance in institutionalized elderly. DESIGN, SETTING AND PARTICIPANTS An electronic search was performed on PubMed database on May 2018. We selected articles reporting the evolution of physical performance in older adults living in care institutions. We looked for data from observational longitudinal studies; data from clinical trials were extracted only for subjects who did not receive exercise intervention. All types of performance-based tests, for upper- and/or lower-body, were scrutinized. RESULTS Seventeen studies were reviewed; mean age varied from 78.3 to 88 years old. Fourteen studies were randomized controlled trials (RCTs), other three studies were non-randomized trials and a longitudinal observational study. Different tests assessing physical performance were examined: upper limb strength and lower limb strength, static balance, dynamic balance and mobility showed a tendency to decline over time. On average hand grip strength decreased by 2.2% per month, chair stand test by 3.5%, Berg balance scale by 2%, timed up-and-go test by 2.8%, gait speed by 2.1% and short physical performance battery by 2.8%. A minority of studies have shown an improvement in lower limb muscle strength, endurance and gait speed: in these studies, participants did not attend any kind of physical training but took part to social activities or cognitive interventions. CONCLUSION This review shows how physical performance decreases over time in nursing home residents and quantifies their decline. However, in active controls, there was an improvement in some physical performance measures, which indicates that intervention other than exercise might prevent some loss in physical performance.
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Affiliation(s)
- E Masciocchi
- Mathieu Maltais, PhD, Gérontopôle de Toulouse, Institut du Vieillissement, Bâtiment B, 37 Allée Jules Guesde, 31000, Toulouse France, +33 6 74 70 63 71, E-mail :
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Buckinx F, Gouspillou G, Carvalho LP, Marcangeli V, El Hajj Boutros G, Dulac M, Noirez P, Morais JA, Gaudreau P, Aubertin-Leheudre M. Effect of High-Intensity Interval Training Combined with L-Citrulline Supplementation on Functional Capacities and Muscle Function in Dynapenic-Obese Older Adults. J Clin Med 2018; 7:jcm7120561. [PMID: 30562948 PMCID: PMC6306942 DOI: 10.3390/jcm7120561] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/16/2022] Open
Abstract
Background: To compare the effects of high-intensity interval training (HIIT) alone vs. HIIT combined with L-citrulline (CIT) supplementation on functional capacity and muscle function in dynapenic-obese elderly. Methods: A total of 56 obese (fat mass: men > 25%, women > 35%) and dynapenic (grip strength/body weight: women < 0.44, men < 0.61) subjects were recruited and divided in two groups: HIIT+CIT (n = 26; age: 6 5 ± four years) vs. HIIT+Placebo (PLA, n = 30; age: 68 ± four years). Participants followed a 12-week HIIT using an elliptical trainer. Participants took a single and isocaloric 10 g-dose of CIT or PLA every day. Body composition; functional and aerobic capacities; absolute or relative upper and lower limbs muscle strength, muscle power; and energy balance were measured pre and post intervention. Results: Both groups significantly improved functional capacity and muscle function. However, HIIT+CIT demonstrated greater improvements in fast-paced Timed Up & Go (p = 0.04) and upper limbs muscle strength (absolute and relative) (p = 0.05) than HIIT+Placebo. Conclusion: CIT supplementation when combined with HIIT seems to induce greater improvements in upper limbs muscle strength and walking speed in dynapenic-obese elderly. Further studies are needed to confirm our results, to elucidate the mechanisms underlying the beneficial effects of CIT and to define the long-term impact of CIT/HIIT.
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Affiliation(s)
- Fanny Buckinx
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Gilles Gouspillou
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Livia P Carvalho
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Vincent Marcangeli
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Guy El Hajj Boutros
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Maude Dulac
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Philippe Noirez
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Institut de Recherche bioMédicale et d'Épidémiologie du Sport (IRMES), Université Paris Descartes, Sorbonne Paris Cité, 75012 Paris, France.
| | - José A Morais
- Division of Geriatric Medicine, McGill University Health Centre (MUHC), McGill University, Montréal, QC H3A 1A1, Canada.
| | - Pierette Gaudreau
- Département de Médecine de l'Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Université de Montréal, Montréal, QC H2X 3E4, Canada.
| | - Mylène Aubertin-Leheudre
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
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