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Jamrasi P, Li X, Sung Y, Kim DH, Ahn SH, Kang YS, Song W. Enhancing physical and cognitive function in older adults through walking & resistance exercise: Korean national aging project randomized controlled study. J Exerc Sci Fit 2024; 22:383-389. [PMID: 39211295 PMCID: PMC11359743 DOI: 10.1016/j.jesf.2024.07.002] [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: 02/18/2024] [Revised: 07/05/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
Background The rapid aging of Korea's population underscores the urgent need for effective programs to enhance the well-being and longevity of the elderly. This study presents preliminary results from the Korean project, examining the impact of cost-effective and accessible exercise programs on functional performance of older people and to determine the long-term maintenance of intervention. Methods We randomized 90 older adults aged ≥65 years to the walking group (WG), resistance + walking (RWG), or active control (CG) group. We designed a 12-week main intervention (supervised resistance training 2 d/week and individual walking exercise) and a 12-week follow-up through self-directed exercise (same protocol but unsupervised). The participants' mini mental state examination, color-word Stroop test and 5-time sit to stand, timed up & go, handgrip strength, and knee extensor strength tests were assessed at pre, post, as well as follow-up. Results For the RWG group, significant improvements were found in timed up & go (P < 0.001), and 5-time sit to stand (P < 0.001) compared to CG, with benefits maintained at follow-up. Both RWG and WG showed significant enhancements in knee extensor power (RWG: P < 0.0001; WG: P < 0.001) and flexor power (RWG: P < 0.01; WG: P = 0.018) compared to CG. Although cognitive performance did not show significant group-by-time interactions, RWG exhibited improvements in the Stroop Color and Color-Word tests at follow-up compared to baseline. Conclusion A resistance training program combined with walking effectively enhanced functional performance in older adults, providing lasting benefits over 12 weeks on physical functions, such as strength and endurance. However, it showed limited benefits on cognitive performance.
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Affiliation(s)
- Parivash Jamrasi
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Xinxing Li
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Yunho Sung
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Dong Hyun Kim
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Seo Hyun Ahn
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Yu Seon Kang
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Wook Song
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
- Institute of Sport Science, Seoul National University, Seoul, Republic of Korea
- Institute on Aging, Seoul National University, Seoul, Republic of Korea
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Boithias M, Le TTT, Guillet-Descas E, Belli A, Julin M, Duncan MJ. Physiological and Psychological Effects of Short-Term Recreational Football in Adults 60. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1194. [PMID: 39338077 PMCID: PMC11430819 DOI: 10.3390/ijerph21091194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/26/2024] [Accepted: 09/03/2024] [Indexed: 09/30/2024]
Abstract
Recreational football has shown growing evidence that it could be played safely in adults aged 60+ and that it is physically beneficial. Less is known about the psychological aspects, except for the lived experiences of players. The aim of the present study was to analyze both physiological and psychological effects of short-term recreational football. Fifteen participants took part in a six-week training program of recreational football played at a walking pace with two sessions of 1 h and 30 m per week. Physical fitness was assessed before and after the training period and psychological questionnaires were given at the same time. Body mass and body mass index were significantly decreased, but no other significant effects were found on physical fitness. Participants experienced less frustration related to psychological needs (autonomy and competence). Six weeks were too short to observe significant physical improvements while psychological benefits were already experienced. In this short period, psychological aspects seem predominant. These effects may encourage to long-term adhesion. The activity has the potential to keep adults 60+ exercising, which is important for maintaining good global health and seeing physical changes later.
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Affiliation(s)
- Mélanie Boithias
- Inter-University Laboratory of Human Movement Biology, Campus Sante, University Jean Monnet Saint-Etienne, 42023 Saint-Etienne, France
| | - Thi Thao Truc Le
- Laboratory of Vulnerabilities and Innovation in Sport, UFR STAPS, University Claude Bernard LYON 1, 69100 Villeurbanne, France
| | - Emma Guillet-Descas
- Laboratory of Vulnerabilities and Innovation in Sport, UFR STAPS, University Claude Bernard LYON 1, 69100 Villeurbanne, France
| | - Alain Belli
- Inter-University Laboratory of Human Movement Biology, Campus Sante, University Jean Monnet Saint-Etienne, 42023 Saint-Etienne, France
| | - Mikko Julin
- Research, Development and Innovation Unit, Laurea University of Applied Sciences, 02650 Espoo, Finland
| | - Michael J Duncan
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry CV1 5FB, UK
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Sansano-Nadal O, Roman-Viñas B, Socorro-Cumplido JL, Nieto-Guisado A, Dallmeier D, Coll-Planas L, Fuente-Vidal A, Giné-Garriga M. [What needs do experts and future Physical Activity and Sport professionals perceive to promote healthy aging? Professionals and students' views]. Rev Esp Geriatr Gerontol 2024; 59:101495. [PMID: 38691897 DOI: 10.1016/j.regg.2024.101495] [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: 09/21/2023] [Revised: 02/27/2024] [Accepted: 03/22/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Physical activity acts as an adjuvant in the treatment of numerous diseases and in the promotion of healthy aging. Increasing longevity entails an increase in the demand for professionals who prescribe physical activity, specifically physiotherapists and physical-activity educators. OBJECTIVES The main objective of this study was to explore the perceptions of a group of third- and fourth-year Physiotherapy students (n=9) and Sport Sciences students (n=5), and experts who work with older adults (n=3) about their knowledge of the older adult population and healthy aging. The secondary objectives were to: (a) explore what knowledge future professionals need about physical activity programming and about physical activity programs aimed at maintaining and improving health among older adults; (b) explore what would be the best methodology to acquire such knowledge; and (c) explore whether a relationship is perceived between knowledge about the older adult population and motivation to work with this population group. METHODS Two discussion groups with students and three interviews with experts were conducted. Discussion groups and interviews were transcribed verbatim and analyzed through a reflexive thematic analysis, following the steps described by Braun and Clarke (2021). RESULTS Three themes were identified from the discussion groups: (1) conception and ideas about older adults, (2) skills and knowledge perceived as important, and (3) proposals for motivational intervention addressed to the older population. Four themes were identified from the interviews with experts: (1) characteristics of the future professional, (2) physical activity programs for older people: the recipe for success, (3) the role of enjoyment as key to success, and (4) barriers/obstacles along the path. CONCLUSION Students of both degrees and experts believe that more practical training opportunities are needed, to enable students to interact with the older population and get to know their needs, motivations, and barriers, to increase physical activity levels in this population group.
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Affiliation(s)
- Oriol Sansano-Nadal
- Facultad de Psicología, Ciencias de la Educación y del Deporte Blanquerna, Universitat Ramon Llull, Grupo de Investigación en Salud, Actividad Física y Deporte (SAFE), Barcelona, España; Escola Universitària de la Salut i l'Esport (EUSES) Terres de l'Ebre, Universitat Rovira i Virgili, Amposta, España
| | - Blanca Roman-Viñas
- Facultad de Psicología, Ciencias de la Educación y del Deporte Blanquerna, Universitat Ramon Llull, Grupo de Investigación en Salud, Actividad Física y Deporte (SAFE), Barcelona, España; Facultad de Ciencias de la Salud Blanquerna, Universitat Ramon Llull, Barcelona, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn). Instituto de Salud Carlos III (ISCIII), Madrid, España.
| | - Jose Luis Socorro-Cumplido
- Facultad de Psicología, Ciencias de la Educación y del Deporte Blanquerna, Universitat Ramon Llull, Grupo de Investigación en Salud, Actividad Física y Deporte (SAFE), Barcelona, España
| | - Ainhoa Nieto-Guisado
- Facultad de Psicología, Ciencias de la Educación y del Deporte Blanquerna, Universitat Ramon Llull, Grupo de Investigación en Salud, Actividad Física y Deporte (SAFE), Barcelona, España
| | - Dhayana Dallmeier
- Departamento de Investigación, Clínica Agaplesion Bethesda de Geriatría, Ulm, Alemania; Departamento de Epidemiología, Escuela de Salud Pública de la Universidad de Boston, Boston, Estados Unidos
| | - Laura Coll-Planas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O). Facultad de Ciencias de la Salud y Bienestar Social, Centro de Investigación en Salud y Asistencia Social (CESS), Universidad de Vic-Universidad Central de Cataluña (UVic-UCC), Vic, España; Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, España
| | - Andrea Fuente-Vidal
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O). Facultad de Ciencias de la Salud y Bienestar Social, Centro de Investigación en Salud y Asistencia Social (CESS), Universidad de Vic-Universidad Central de Cataluña (UVic-UCC), Vic, España; Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, España
| | - Maria Giné-Garriga
- Facultad de Psicología, Ciencias de la Educación y del Deporte Blanquerna, Universitat Ramon Llull, Grupo de Investigación en Salud, Actividad Física y Deporte (SAFE), Barcelona, España; Facultad de Ciencias de la Salud Blanquerna, Universitat Ramon Llull, Barcelona, España
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Wu S, Guo Y, Cao Z, Nan J, Zhang Q, Hu M, Ning H, Huang W, Xiao LD, Feng H. Effects of Otago exercise program on physical function in older adults: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr 2024; 124:105470. [PMID: 38718487 DOI: 10.1016/j.archger.2024.105470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/21/2024] [Accepted: 05/01/2024] [Indexed: 06/17/2024]
Abstract
BACKGROUND Maintaining physical function is critical for older adults to achieve healthy aging. The Otago exercise program (OEP) has been widely used to prevent falls for older adults. However, the effects of OEP on physical function remain controversial and the possible effects modifiers have not been assessed. OBJECTIVE To evaluate the effects of OEP on physical function in older adults and to explore potential moderators underlying the effects of OEP. METHODS We searched five electronic databases and relevant systematic reviews to identify studies. We included randomized controlled trials (RCTs) evaluating the effects of OEP as a single intervention on physical function among older adults aged 65 and over. Meta-analysis was performed using the random-effects model. Standardized mean differences (SMD) for physical function changes, pertinent to balance, strength, and mobility, were outcome measures. Subgroup analyses on exercise protocol and participants' characteristics were performed. RESULTS Thirteen RCTs consisting of 2402 participants were included in this systematic review and meta-analysis. Results indicated a significant effect of OEP on balance (SMD = 0.59, 95 % CI: 0.22∼0.96), lower body strength (SMD = 0.93, 95 % CI: 0.31∼1.55), and mobility (SMD = -0.59, 95 % CI: -0.95∼-0.22) against control groups. No significant OEP effects were found on upper body strength (MD = 1.48, 95 % CI: -0.58∼3.55). Subgroup analysis revealed that the video-supported delivery mode was more effective for improving balance (P = 0.04) and mobility (P = 0.02) than the face-to-face mode. Session durations over 30 min was more effective on lower body strength (P < 0.001) and mobility (P < 0.001) than those 1-30 min. Program period of 13-26 weeks was more effective on mobility (P = 0.02) than those of 4-12 weeks. However, the effects of OEP on physical function were not associated with age groups, and baseline falling risks. CONCLUSION The OEP could improve physical function including balance, lower body strength, and mobility in older adults. Implementing the OEP in video-supported, more than 30 min per session and 4-12 weeks may be the most appropriate and effective exercise protocol for improving physical function among older adults. More RCTs with rigorous design and larger scale are needed to further assess the effectiveness of diverse OEP protocols and quantify the dose-effect relationship.
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Affiliation(s)
- Shuang Wu
- Xiangya School of Nursing, Central South University, China; College of Nursing and Health Sciences, Flinders University, Australia
| | - Yongzhen Guo
- Xiangya School of Nursing, Central South University, China
| | - Zeng Cao
- Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital, Central South University, China
| | - Jiahui Nan
- The first affiliated hospital of Zhengzhou University, Zhengzhou University, China
| | - Qiuxiang Zhang
- The Third Xiangya Hospital, Central South University, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, China
| | - Weiping Huang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
| | - Hui Feng
- Xiangya School of Nursing, Central South University, China; Xiangya-Oceanwide Health Management Research Institute, Central South University, China; Xiangya Research Center of Evidence-Based Healthcare, Central South University, China.
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Stephan AT, McVey A, Steele T, Cooper K, Phillips CB, Ross LA. Older Adults' Perceptions of Cognitive, Physical, and Exergame Training: A Mixed Methods Investigation of a Four-Armed Randomized Controlled Pilot Trial. Games Health J 2024. [PMID: 39069966 DOI: 10.1089/g4h.2023.0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
Purpose: Although the health benefits of behavioral interventions for older adults are well studied, research focused on intervention acceptability in older adult populations is less established and is needed. This mixed methods study investigated older adults' perceptions of training interventions. Methods: Community-dwelling older adults (N = 41) were randomized into three groups (cognitive, physical, and exergame) and completed 20 in-lab training sessions over 10 weeks. At every fifth session, participants provided feedback on their perceived gains across functional domains, enjoyment of and motivation to complete training, and aspects they most and least enjoyed regarding study participation. Results: Based on the multivariate analysis of variance, perceived cognitive and everyday function gains did not vary by training group. However, physical and exergame groups perceived greater improvement in physical function than the cognitive training group (P < 0.001). Enjoyment of and motivation to complete training did not vary by training group. Exploratory qualitative coding results suggest that participants across groups most enjoyed social interaction and feelings of improvement. Participants least enjoyed traveling to the study site and engaging in aspects of training (e.g., specific games, structure or duration of training). Conclusion: These findings highlight the importance of incorporating meaningful social engagement and balancing the challenge of training components with goal attainment when working with older adults, regardless of the intervention type. Future research and practice should consider salient aspects of the participant experience (e.g., social connection, accessible locations or remote options) when designing interventions for older adults.
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Affiliation(s)
- Abigail T Stephan
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, South Carolina, USA
| | - Ava McVey
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, South Carolina, USA
| | - Tate Steele
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, South Carolina, USA
| | - Kalvry Cooper
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, South Carolina, USA
| | - Christine B Phillips
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, South Carolina, USA
| | - Lesley A Ross
- Department of Psychology and Institute for Engaged Aging, Clemson University, Clemson, South Carolina, USA
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Li X, Ye Q, Liu Q, Peng J, Li N, Deng Q, Hu J, Yong C, Li S, Wang Y, Zhu J, Zhao X, Zhou J. Longer-term Effect of Physical Activity Intervention on Sleep Quality: A Secondary Analysis of Cluster Randomized Controlled Trial. Sleep 2024:zsae165. [PMID: 39041369 DOI: 10.1093/sleep/zsae165] [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: 04/25/2024] [Indexed: 07/24/2024] Open
Abstract
STUDY OBJECTIVES To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers. METHODS This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months. RESULTS The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point. CONCLUSION The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.
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Affiliation(s)
- Xianlan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qin Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jie Peng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Nanyan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qian Deng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Julinling Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chan Yong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyi Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yufei Wang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Jingjie Zhu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Siqueira VAAA, Shigematsu R, Sebastião E. Stepping towards health: a scoping review of square-stepping exercise protocols and outcomes in older adults. BMC Geriatr 2024; 24:590. [PMID: 38987666 PMCID: PMC11238358 DOI: 10.1186/s12877-024-05187-8] [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: 04/10/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Square-Stepping Exercise (SSE) is a type of physical-cognitive exercise. Such exercise has been used as an exercise approach in different studies with older adults. This scoping review provides an overview of the protocols and outcomes of studies employing the SSE in older adults. METHODS We searched in the PubMed, CINAHL, Scopus, CABI Global Health, and Web of Science databases for articles published between 2006 (first research article published on SSE) to December 2023 that met a robust inclusion criterion. The search yielded 424 articles, and after inclusion criteria being applied, 37 articles were included in the final analysis. RESULTS A total of 37 studies were included in the final analysis. Thirty-three out of the 37 studies focused on apparently healthy older adults, while four were conducted with older adults with neurological disease (i.e., multiple sclerosis, Parkinson's disease, and stroke). Most studies (n = 25) adopted an experiment (i.e., randomized controlled trial) or quasi-experimental approach, while 12 were classified as non-randomized (i.e., cross-sectional, mixed methods). The studies were conducted in different parts of the globe and adopted three major formats of intervention delivery, namely in-person, online, and home-based. Frequency, SSE session duration and intervention length significantly varied among studies, and reported outcomes were in the domains of physical and cognitive function. CONCLUSION This review comprehensively described the characteristics of 37 studies employing SSE in apparently healthy older adults and older adults with neurological diseases. The findings demonstrated that SSE has been used by researchers across the globe, adopting a variety of forms of delivery, and to particularly improve physical and cognitive function of different segments of the older adult population. The review further identified important gaps in research, including the restricted outcomes, and the lack of studies combining SSE with more traditional exercise modalities to address potential combinatory effects.
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Affiliation(s)
- Vitor A A A Siqueira
- Department of Health and Kinesiology, University of Illinois at Urbana- Champaign, Urbana, IL, USA
| | - Ryosuke Shigematsu
- Department of Health and Sports Sciences, Chukyo University, Toyota, Japan
| | - Emerson Sebastião
- Department of Health and Kinesiology, University of Illinois at Urbana- Champaign, Urbana, IL, USA.
- Department Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
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Li X, Bae JH, Lim B, Seo JW, Sung Y, Jiang S, Jamrasi P, Ahn S, Shin C, Pan M, Song W. Impact of Taekwondo training on cognitive and physical function in elderly individuals: A comprehensive review of randomized controlled trials. Complement Ther Clin Pract 2024; 57:101878. [PMID: 38959563 DOI: 10.1016/j.ctcp.2024.101878] [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: 03/07/2024] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Researchers have investigated the physical and psychosocial advantages of Taekwondo for older adults. However, prior studies of Taekwondo's impact on physical function and psychological well-being in this demographic have produced inconsistent findings. Thus, this systematic review aimed to assess how Taekwondo practice affects the physical function and psychological well-being of older adults. METHODS We systematically searched PubMed, EMBASE, CINAHL, SPORTDiscus, Scopus, Korea Education and Research Information Service, Korean Studies Information Service System, Korean National Assembly Library, Research Information Sharing Service, National Digital Science Library, and China National Knowledge Infrastructure from their inception to December 2023. Two reviewers independently selected and extracted data from each study. We calculated effect sizes using a random-effects model with a 95 % confidence interval (CI) and evaluated study quality using the Physiotherapy Evidence Database scale. RESULTS This review included ten studies with 227 participants aged 66.1-73.6 years. The meta-analysis revealed significant enhancements in cognitive function [Korean Version of Mini-Mental State Examination, standard mean difference (SMD) = 0.700, 95 % CI (0.364-1.037), I2 = 0 %, p < .001], blood indicators [β-amyloid, SMD = 0.613, 95 % CI (0.103-1.123), I2 = 34.920 %, p < .05; brain-derived neurotrophic factor, SMD = 0.566, 95 % CI (0.166-0.966), I2 = 0 %, p < .01; high-density lipoprotein cholesterol, SMD = 0.677, 95 % CI (0.357-0.966), I2 = 0 %, p < .001; low-density lipoprotein cholesterol, SMD = 0.809, 95 % CI (0.376-1.242), I2 = 42.621 %, p < .001; and total cholesterol, SMD = 0.979, 95 % CI (0.603-1.356), I2 = 22.221 %, p < .001], and physical function [lean body mass, SMD = 0.465, 95 % CI (0.109-0.821), I2 = 0 %, p < .05, and handgrip strength, SMD = 0.929, 95 % CI (0.194-1.663), I2 = 48.217 %, p < .05]. CONCLUSIONS This meta-analysis indicates that Taekwondo training is a beneficial therapy with protective effects on cognitive function, physical function, and body composition in older adults. These findings highlight its potential significance in cognitive rehabilitation and physiological health promotion among this demographic population.
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Affiliation(s)
- Xinxing Li
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea; Institute on Aging, Seoul National University, 03087, Seoul, Republic of Korea
| | - Jun-Hyun Bae
- Institute of Sport Science, Seoul National University, 08826, Seoul, Republic of Korea; Institute on Aging, Seoul National University, 03087, Seoul, Republic of Korea
| | - Byunggul Lim
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea; Institute on Aging, Seoul National University, 03087, Seoul, Republic of Korea
| | - Ji-Won Seo
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea
| | - Yunho Sung
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea
| | - Shu Jiang
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea
| | - Parivash Jamrasi
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea
| | - SoYoung Ahn
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea
| | - Chaeyoung Shin
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea
| | - Mingzhu Pan
- School of Physical Education, Shangrao Normal University, 334001, Shangrao, Jiangxi, China
| | - Wook Song
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, 08826, Seoul, Republic of Korea; Institute of Sport Science, Seoul National University, 08826, Seoul, Republic of Korea; Institute on Aging, Seoul National University, 03087, Seoul, Republic of Korea.
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Lieber SB, Moxley J, Mandl LA, Reid MC, Czaja SJ. Social support and physical activity: does general health matter? Eur Rev Aging Phys Act 2024; 21:16. [PMID: 38902616 PMCID: PMC11188280 DOI: 10.1186/s11556-024-00347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/26/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Physical activity levels remain suboptimal in older adults. Exploration of potentially modifiable factors such as social support is needed to inform the development and implementation of patient-oriented physical activity interventions for older adults. The impact of general health on the relationship between social support and physical activity is not well understood. We aimed to determine the association between social support and self-reported physical activity in a study of community-dwelling older adults. In addition, we examined whether self-reported general health mediates the relationship between social support and self-reported physical activity. METHOD This cross-sectional study analyzed baseline data collected as part of a randomized controlled trial comparing a digital physical activity intervention, which included social support features, with a tablet-based educational control. Adults ≥ 60 years of age were enrolled at 2 sites. Self-reported general health, social support, physical activity, and sociodemographic characteristics and comorbid conditions were assessed. Pearson and point-biserial correlations were computed to evaluate the relationship between physical activity and general health, social support, and sociodemographic features. Social support (exposure), general health (mediator), and physical activity (outcome) were incorporated into a mediation model. RESULTS Among 181 participants (mean age of 70.1 years), significant correlations were found between physical activity and both general health and social support (r = -0.19 and r = 0.21, respectively; both p < 0.01). General health significantly mediated the relationship between social support and physical activity (unstandardized ß coefficient 416.9; 95% confidence interval 96.4, 842.0). CONCLUSIONS Augmentation of social support, particularly when coupled with other modes of health promotion to improve personal wellbeing, may be a valuable component of physical activity promotion programs. Further longitudinal research is needed to clarify the potential mechanistic pathways linking social support, general health, and physical activity to inform development of evidence-based physical activity interventions for older adults and improve downstream health-related outcomes. TRIAL REGISTRATION ClinicalTrials.gov, ClinicalTrials.gov identifier NCT03538158 . Registered May 25, 2018.
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Affiliation(s)
- Sarah B Lieber
- Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA.
| | - Jerad Moxley
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
| | - Lisa A Mandl
- Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
| | - M Carrington Reid
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
| | - Sara J Czaja
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
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10
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Baptista FM, Andias R, Rocha NP, Silva AG. A Practice Guide for Physical Therapists Prescribing Physical Exercise for Older Adults. J Aging Phys Act 2024:1-13. [PMID: 38862112 DOI: 10.1123/japa.2023-0283] [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: 08/12/2023] [Revised: 03/24/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual. OBJECTIVES This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population. METHODS Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults. RESULTS Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities. CONCLUSIONS An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality. SIGNIFICANCE Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population.
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Affiliation(s)
- Frederico M Baptista
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- CINTESIS.UA@RISE, University of Aveiro, Aveiro, Portugal
| | - Rosa Andias
- CINTESIS.UA@RISE, University of Aveiro, Aveiro, Portugal
| | - Nelson P Rocha
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Aveiro, Portugal
| | - Anabela G Silva
- CINTESIS.UA@RISE, University of Aveiro, Aveiro, Portugal
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
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11
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Ali SI, Elballah K, Begum N, Pathath AW, Sayed A, Mohammed HH, Shaban M. Evaluating the Effectiveness of Geriatric-Specific Cancer Rehabilitation Programs on Patient Health Outcomes. Asian Pac J Cancer Prev 2024; 25:2033-2042. [PMID: 38918665 PMCID: PMC11382855 DOI: 10.31557/apjcp.2024.25.6.2033] [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: 12/21/2023] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE This study evaluated a specialized rehabilitation program's impact on senior cancer patients' quality of life. METHODS one hundred and thirty patients aged ≥65 years with various cancer types undergoing/recovering from treatment were enrolled in oncology clinics in Al-Ahsa, Saudi Arabia. The intervention arm (n=65) participated in a tailored geriatric cancer rehabilitation program. The control group (n=65) received standard oncology care. The Functional Assessment of Cancer Therapy-General (FACT-G) tool assessed the quality of life across physical, social, emotional, and functional domains. T-tests and multivariate regression analyses compared outcomes. RESULT Total FACT-G scores showed a significantly higher quality of life for the geriatric cancer rehabilitation group versus standard care. Rehabilitation patients also demonstrated meaningful improvements across physical, social, and functional subscales. Rehabilitation involvement was the most predictive factor for optimized outcomes. CONCLUSION Specialized geriatric cancer rehabilitation meaningfully improved several quality of life domains in older patients over standard care. Despite persistent barriers, rehabilitation programming optimized older cancer patients' physical and psychosocial health. Oncology and geriatrics must collaborate to ensure evidence-based rehabilitation access meets older cohorts' unique needs.
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Affiliation(s)
- Sayed Ibrahim Ali
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf, Saudi Arabia
| | - Khaled Elballah
- College of Education, Department of Special Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nurjahan Begum
- Department of Clinical Neuroscience, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Abdul Wahab Pathath
- Department of Clinical Neuroscience, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Alaa Sayed
- Faculty of Nursing, Helwan University, Egypt
| | | | - Mostafa Shaban
- Geriatric Nursing Department, Faculty of Nursing, Cairo University, Egypt
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12
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Xu X, Zheng Y, Fang J, Huang J, Yang X, Zhu X, Liu Y, Chen L, Wu S. Associations between regular physical exercise and physical, emotional, and cognitive health of older adults in China: an 8-year longitudinal study with propensity score matching. Front Public Health 2024; 12:1301067. [PMID: 38655510 PMCID: PMC11037100 DOI: 10.3389/fpubh.2024.1301067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/04/2024] [Indexed: 04/26/2024] Open
Abstract
Background The importance of healthy aging is growing in China as it has the largest number of older adults in the world and is one of the fastest-aging countries. This study aimed to examine the predictive value of regular physical exercise in relation to the physical, emotional, and cognitive health among samples of adults aged ≥60 years in China during an 8-year period. Methods A total of 10,691 older adults were extracted from two waves of national data from the China Family Panel Studies in 2010 and 2018. To minimize the impact of selection bias on the findings, a longitudinal propensity score matching (LPSM) method was used to examine the relationships between regular physical exercise and emotional health (depression), between regular physical exercise and physical health (instrumental activities of daily living), and between regular physical exercise and cognitive health (cognitive ability) of older adults. After LPSM, 856 older adults were included in the study. In the regular physical exercise group, the average age of participants at baseline year was 65.67 years, with an average age of 65.90 years for 238 men and 65.45 years for 190 women, and in the non-physical exercise group, their average age at baseline year was 65.70 years, with an average age of 65.45 years for 253 men and 65.98 years for 175 women. Results LPSM indicated that regular physical exercise has been found to be effective in improving physical function and reducing depressive symptoms in old adults, even after controlling for background differences. However, the sensitivity analysis suggests that the positive association between regular physical exercise and cognitive function may not be sufficiently valid. Conclusion The findings of this study indicate that engaging in long-term structured and repetitive physical exercise can have a significant positive effect on reducing depressive symptoms and improving the physical function of older adults. As a result, incorporating regular physical exercise into the lifestyle of older adults is recognized as an effective strategy for promoting healthy aging and reducing the strain on public health resources.
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Affiliation(s)
- Xiaoyan Xu
- Department of Psychiatry, The Third People’s Hospital of Huzhou Municipal, The Affiliated Hospital of Huzhou University, Zhejiang, China
| | - Yawen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China
| | - Juan Fang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiahui Huang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xudong Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xianghe Zhu
- Department of Psychology, School of Mental Health, Key Laboratory of Alzheimer’s Disease of Zhejiang Province, Institute of Aging, and Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, China
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shaochang Wu
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China
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13
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Swales B, Ryde GC, Whittaker AC. A Mixed Methods Feasibility Study of Machine-Based Resistance Training With Prefrail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial II. J Aging Phys Act 2024; 32:244-263. [PMID: 38262397 DOI: 10.1123/japa.2022-0170] [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: 05/11/2022] [Revised: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 01/25/2024]
Abstract
Physical activity is an effective, proactive intervention to reduce or reverse frailty and functional decline. However, uncertainty exists about the feasibility and impact of resistance training on multidimensional health in prefrail older adults in residential care. This mixed methods feasibility study assessed practicability with limited efficacy testing on health and functional outcomes. Eleven prefrail older adults participated in a 6-week progressive resistance training protocol three times per week. The intervention and measures were found to be appropriate and acceptable by those who completed the trial, with participants self-reporting improved well-being, mood, and function. Analysis identified several barriers to recruitment, including prior commitments, seasonal impact, and session timing, and offered potential solutions with further recommendations for program refinement prior to a definitive randomized controlled trial. These findings add to our understanding of prefrail older adults' preferences regarding participation in physical activity research and the perceived benefits of resistance training. This trial was registered with ClinicalTrials.gov: NCT03141879.
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Affiliation(s)
- Bridgitte Swales
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Gemma C Ryde
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Anna C Whittaker
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
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14
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Lyu L, Li Y, Fan X, Seo J, Eunna O. The effect of Tai Chi exercise intervention on sleep quality in community residing older adults: a systematic review and meta-analysis. Eur Geriatr Med 2024; 15:381-396. [PMID: 38227110 DOI: 10.1007/s41999-023-00923-6] [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: 08/24/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE While clinical research has shown that Tai Chi exercise may improve the sleep quality of older adults, there is a lack of robust evidence-based verification. Therefore, this study conducted a systematic review of published research on the effect of Tai Chi exercise on the sleep quality of community-dwelling older adults, aiming to provide solid evidence-based medicine to enhance their sleep quality. METHODS A systematic search was conducted on PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and SinoMed databases from their inception to December 9, 2022. The Cochrane risk of bias assessment tool 2.0 was used to assess the risk of bias in the included studies. RESULTS This systematic review included 12 original articles, involving a total of 1,058 community-dwelling older adults, with 553 in the Tai Chi group and 505 in the control group. The meta-analysis results revealed a significant improvement in the sleep quality of community-dwelling older adults who practiced Tai Chi compared to the control group [WMD = - 1.96 (95% CI: - 3.02 to - 0.90, z = 3.62, P < 0.001)]. Subgroup analysis showed that Tai Chi had significantly beneficial effects regardless of age, country/region, intervention time, and Tai Chi type. CONCLUSIONS Tai Chi exercise can serve as an effective non-medication approach for addressing sleep problems in this demographic. Among the various types of Tai Chi exercises, the 24-form Tai Chi exercise emerges as a preferred option. Moreover, Tai Chi exercise proves to be an excellent choice for older people in their later years, promoting their overall well-being and health.
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Affiliation(s)
- Linyu Lyu
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea.
| | - Yuelin Li
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Xing Fan
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Jisu Seo
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Oh Eunna
- College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
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15
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Savvakis I, Adamakidou T, Kleisiaris C. Physical-activity interventions to reduce fear of falling in frail and pre-frail older adults: a systematic review of randomized controlled trials. Eur Geriatr Med 2024; 15:333-344. [PMID: 38411771 PMCID: PMC10997712 DOI: 10.1007/s41999-024-00944-9] [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: 08/18/2023] [Accepted: 01/15/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Frailty in older adults leads to progressive deterioration of their physical condition and makes them prone to develop Fear of Falling (FoF). Physical-activity interventions appear to be effective in managing the components of frailty but there is no clear evidence to determine whether physical-activity may affect FoF in frail and pre-frail older adults. OBJECTIVE Τhis systematic literature review aims to synthesize evidence on the relationship between the physical interventions to ameliorate balance, strength, and mobility and FoF reduction in frail and pre-frail older adults. METHODS Studies assessing physical-activity interventions for frail and pre-frail older adults aged 60 years and older were identified in English through searches in PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials databases till February 2023. Study quality was assessed, and a qualitative synthesis of results was performed. RESULTS A total of 13 studies published were included. All of them were Randomized Control Trials and the most frequent assessment tool used to assess FoF (10 of 13 studies) was the Fall Efficacy Scale-International (FES-I). Six studies were assessed as having a low risk of bias. Cumulatively, the findings of this review indicate that physical-activity interventions are effective in reducing the FoF of frail and pre-frail older adults. CONCLUSION The results are encouraging and recapitulate the positive role of physical interventions in FoF reduction. However, future research would benefit from longer follow-up periods, longer intervention duration, and participation of interdisciplinary teams.
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Affiliation(s)
- Ioannis Savvakis
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece.
| | - Theodoula Adamakidou
- Department of Nursing, Faculty of Health Sciences, University of West Attica, Athens, Greece
| | - Christos Kleisiaris
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
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16
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Gately ME, Waller DE, Metcalf EE, Moo LR. Caregivers' Role in In-Home Video Telehealth: National Survey of Occupational Therapy Practitioners. JMIR Rehabil Assist Technol 2024; 11:e52049. [PMID: 38483462 PMCID: PMC10979337 DOI: 10.2196/52049] [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: 08/21/2023] [Revised: 12/20/2023] [Accepted: 01/12/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Older adults face barriers to specialty care, such as occupational therapy (OT), and these challenges are worse for rural older adults. While in-home video telehealth may increase access to OT, older adults' health- and technology-related challenges may necessitate caregiver assistance. OBJECTIVE This study examines caregiver assistance with in-home OT video telehealth visits from the perspectives of OT practitioners at Veterans Health Administration (VHA). METHODS A web-based national survey of VHA OT practitioners about caregivers' role in video telehealth was conducted between January and February 2022. Survey items were developed with input from subject matter experts in geriatrics and OT and identified patient factors that necessitate caregiver participation; the extent to which caregivers assist with different types of tasks (technological and clinical tasks); and the perceived facilitators of, benefits of, and barriers to caregiver involvement. RESULTS Of approximately 1787 eligible VHA OT practitioners, 286 (16% response rate) participated. Not all survey items required completion, resulting in different denominators. Most respondents were female (183/226, 81%), White (163/225, 72.4%), and occupational therapists (275/286, 96.2%). Respondents were from 87 VHA medical centers, the catchment areas of which served a patient population that was 34% rural, on average (SD 0.22). Most participants (162/232, 69.8%) had >10 years of OT experience serving a patient cohort mostly aged ≥65 years (189/232, 81.5%) in primarily outpatient rehabilitation (132/232, 56.9%). The top patient factors necessitating caregiver involvement were lack of technical skills, cognitive impairment, and advanced patient age, with health-related impairments (eg, hearing or vision loss) less frequent. Technological tasks that caregivers most frequently assisted with were holding, angling, moving, repositioning, or operating the camera (136/250, 54.4%) and enabling and operating the microphone and setting the volume (126/248, 50.8%). Clinical tasks that caregivers most frequently assisted with were providing patient history (143/239, 59.8%) and assisting with patient communication (124/240, 51.7%). The top facilitator of caregiver participation was clinician-delivered caregiver education about what to expect from video telehealth (152/275, 55.3%), whereas the top barrier was poor connectivity (80/235, 34%). Increased access to video telehealth (212/235, 90.2%) was the top-rated benefit of caregiver participation. Most respondents (164/232, 70.7%) indicated that caregivers were at least sometimes unavailable or unable to assist with video telehealth, in which case the appointment often shifted to phone. CONCLUSIONS Caregivers routinely assist VHA patients with in-home OT video visits, which is invaluable to patients who are older and have complex medical needs. Barriers to caregiver involvement include caregivers' challenges with video telehealth or inability to assist, or lack of available caregivers. By elucidating the caregiver support role in video visits, this study provides clinicians with strategies to effectively partner with caregivers to enhance older patients' access to video visits.
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Affiliation(s)
- Megan Elizabeth Gately
- VA Bedford Health Care System, Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, United States
- Boston University School of Medicine, Division of Geriatrics, Boston, MA, United States
| | - Dylan E Waller
- VA Portland Health Care System, Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, United States
| | - Emily E Metcalf
- VA Portland Health Care System, Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, United States
- Oregon Medical Research Center, Portland, OR, United States
| | - Lauren R Moo
- VA Bedford Health Care System, Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, United States
- Massachusetts General Hospital, Cognitive Behavioral Neurology Unit, Boston, MA, United States
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17
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Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil 2024; 38:361-374. [PMID: 37715644 PMCID: PMC10829420 DOI: 10.1177/02692155231201048] [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: 08/12/2021] [Accepted: 08/27/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To analyse the components used in exercise interventions for people with symptoms of neurogenic claudication due to lumbar spinal stenosis and identify components associated with successful interventions. DATA SOURCES Eligible papers published up to April 2023 from MEDLINE, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and trial registry websites. REVIEW METHODS Literature searches were performed by an Information Specialist. We searched for randomised trials evaluating exercise interventions for people with neurogenic claudication symptoms (the primary symptom of lumbar spinal stenosis). Two authors independently performed study selection, data extraction, and quality assessments using the Cochrane Risk of Bias tool Version 2 and the TIDieR checklist for intervention reporting. Details of intervention components were extracted, tabulated, and synthesised using an intervention component analysis approach. RESULTS We found thirteen trials reporting 23 exercise interventions delivered to 1440 participants. These featured 60 different components. Most exercise interventions included supervision and flexion-based exercises. Balance exercises were rarely included. Exercise components featured more frequently in successful interventions included stretches, strength or trunk muscle exercises, fitness exercises, especially cycling, and psychologically informed approaches. Interpretation is limited by low study numbers and heterogeneity. No conclusions could be drawn about exercise supervision or dose. DISCUSSION Exercise interventions for people with neurogenic claudication typically feature multiple components. Common features such as supervision, lumbar flexion, and aerobic fitness exercises and also less common features such as stretches, strengthening exercises, and psychologically informed approaches warrant consideration for inclusion when designing and optimising exercise interventions for people with lumbar spinal stenosis.
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Affiliation(s)
- Christine Comer
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Faculty of Medicine, University of Leeds, UK
- Leeds Community Healthcare Musculoskeletal and Rehabilitation Services, Leeds Community Healthcare NHS Trust, UK
| | - Esther Williamson
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Suzanne McIlroy
- Physiotherapy Department, King's College Hospital NHS Foundation Trust, UK
- Health Psychology Section, The Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Cynthia Srikesavan
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | | | - Sarah E Lamb
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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18
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Liu J, Yang Y, Shi H, Sun M, Feng R. Developing and evaluating a mindfulness-based finger/hand exercise intervention for ethnically diverse older adults with and without disabilities: A feasibility study. Geriatr Nurs 2024; 56:148-158. [PMID: 38350340 DOI: 10.1016/j.gerinurse.2024.02.008] [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: 12/21/2023] [Revised: 01/18/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
Few exercise interventions target ethnic minority older adults, especially those with disability. We evaluated feasibility of newly-developed finger/hand exercises to promote health in ethnically diverse older adults with/without disability. We conducted 10-minute video exercises daily, supervised by research assistants. The feasibility, evaluated via three studies, focused on recruitment, intervention fidelity, safety, outcome assessment, and acceptability. Studies varied in design and delivery methods, being conducted across settings (senior centers, apartments). We enrolled 101 Chinese older adults (mean age = 72) without disability in Study 1, and 15 older Africans/Hispanics with disability (mean age = 70) in Studies 2 and 3. Intervention, either in-person or online, was implementable and acceptable with high fidelity. Attendance was satisfactory (79.6%, 74.2%, 76.7%) and attrition was low (12%, 0%, 0%). Outcome measures data was ascertained. No adverse events were observed. Preliminary findings indicate feasibility, acceptability, and safety of the simple finger/hand exercise for diverse older adults.
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Affiliation(s)
| | - Yi Yang
- University of Pennsylvania, United States
| | - Haoer Shi
- University of Pennsylvania, United States
| | | | - Rui Feng
- University of Pennsylvania, United States
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Wollesen B, Herden M, Lamberti N, Giannaki CD. Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process. Eur Rev Aging Phys Act 2024; 21:3. [PMID: 38302886 PMCID: PMC10835929 DOI: 10.1186/s11556-024-00337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/14/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology. METHODS Two hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1-10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%). RESULTS In round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate. DISCUSSION AND IMPLICATIONS The results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article.
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Affiliation(s)
- Bettina Wollesen
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany.
| | - Mona Herden
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Christoforos D Giannaki
- Department of Life Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
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20
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Zwingmann K, Schlesinger T, Müller K. The Impact of an Outdoor Motor-Cognitive Exercise Programme on the Health Outcomes of Older Adults in Community Settings: A Pilot and Feasibility Study. Sports (Basel) 2024; 12:49. [PMID: 38393269 PMCID: PMC10892309 DOI: 10.3390/sports12020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/12/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor-cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor-cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, ηp2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults.
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Affiliation(s)
- Katharina Zwingmann
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany; (T.S.); (K.M.)
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21
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Sánchez González ML, Cruz-Gonzalez M, Falgas-Bague I, Markle SL, Alegría M. Resilience of racial and ethnic minority older adults during the COVID-19 pandemic: The role of a prior disability prevention intervention. AMERICAN PSYCHOLOGIST 2024; 79:241-253. [PMID: 37471006 PMCID: PMC10799164 DOI: 10.1037/amp0001177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Older adults from racially and ethnically diverse backgrounds and with preexisting mental illness have been disproportionately vulnerable to severe illness, disability, and death due to the adverse impacts of the COVID-19 pandemic. This study used a sample of older adults (60 +; N = 307) from a randomized clinical trial (Positive Minds-Strong Bodies [PMSB]) conducted between May 25, 2015, and March 5, 2019. Participants were recontacted to assess symptoms of anxiety, depression, general distress, and physical functioning during the COVID-19 pandemic between March 2, 2021, and July 18, 2022 (62.7% recontacting rate excluding ineligible participants; N = 165). We estimated an analysis of covariance model to evaluate whether or not prior differences between the PMSB intervention and enhanced usual care (EUC) groups continued to be observed at the COVID-19 follow-up. Results showed that, compared to EUC, participants who received the PMSB intervention reported fewer depression symptoms (Geriatric Depression Scale-15 scores) and greater physical functioning (Late-Life Functioning and Disability Instrument scores) at the COVID-19 follow-up. No significant differences were observed between the PMSB intervention and EUC groups on anxiety symptoms (Generalized Anxiety Disorder-7 scores) during the pandemic. Last, findings suggested that the lower depression symptoms and greater physical functioning observed after treatment completion were sustained, though not further improved, over time. These findings provide evidence that the PMSB intervention is a powerful intervention to promote resilience and prevent disability associated with major life stressors, such as the COVID-19 pandemic. Future research is needed to examine the underlying mechanisms of psychosocial and exercise training interventions that lead to lasting resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Irene Falgas-Bague
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Sheri L Markle
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
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22
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van Gameren M, Voorn PB, Bosmans JE, Visser B, Frazer SWT, Pijnappels M, Bossen D. Optimizing and Implementing a Community-Based Group Fall Prevention Program: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:162. [PMID: 38397653 PMCID: PMC10887802 DOI: 10.3390/ijerph21020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Falls and fall-related injuries among older adults are associated with decreased health. Therefore, fall prevention programs (FPPs) are increasingly important. However, the translation of such complex programs into clinical practice lacks insight into factors that influence implementation. Therefore, the aim of this study was to identify how to optimize and further implement a widely used group-based FPP in the Netherlands among participants, therapists and stakeholders using a mixed methods study. FPP participants and therapists filled out a questionnaire about their experiences with the FPP. Moreover, three focus groups were conducted with FPP participants, one with therapists and one with other stakeholders. Data were analysed according to the thematic analysis approach of Braun and Clarke. Overall, 93% of the 104 FPP participants were satisfied with the FPP and 86% (n = 12) of the therapists would recommend the FPP to older adults with balance or mobility difficulties. Moreover, six themes were identified regarding further implementation: (1) recruiting and motivating older adults to participate; (2) structure and content of the program; (3) awareness, confidence and physical effects; (4) training with peers; (5) funding and costs; and (6) long-term continuation. This study resulted in practical recommendations for optimizing and further implementing FPPs in practice.
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Affiliation(s)
- Maaike van Gameren
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (M.v.G.); (P.B.V.); (M.P.)
| | - Paul B. Voorn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (M.v.G.); (P.B.V.); (M.P.)
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
| | - Judith E. Bosmans
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
| | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
| | - Sanne W. T. Frazer
- Consumer Safety Institute (VeiligheidNL), 1062 XD Amsterdam, The Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (M.v.G.); (P.B.V.); (M.P.)
| | - Daniël Bossen
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
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23
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Choi Y, Kim D, Kim SK. Effects of Physical Activity on Body Composition, Muscle Strength, and Physical Function in Old Age: Bibliometric and Meta-Analyses. Healthcare (Basel) 2024; 12:197. [PMID: 38255085 PMCID: PMC10815094 DOI: 10.3390/healthcare12020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVES Accumulating evidence suggests that physical activity (PA) is an efficient intervention to maintain functional capabilities and mitigate physiological changes in the older population. However, an attempt has yet to be made to comprehensively investigate the published landscape on the subject. METHODS This study had two aims. The first aim was to perform a bibliometric analysis for two keywords, "aging" and "PA", to analyze the research trend. Since "frailty" was the most noticeable co-occurring keyword with the two keywords, the second aim was to investigate the effects of PA, particularly, resistance training (RT), on frailty using a meta-analysis to provide a summary of the current evidence base. RESULTS The bibliometric analysis revealed that the number of publications on this research topic has gradually increased, highlighting the importance of understanding the role of PA in aging. The meta-analysis found that RT had significant beneficial effects on physical frailty factors, including handgrip strength, lower limb strength, balance, gait speed, and stair-climbing ability. CONCLUSION These findings demonstrate that RT is an effective intervention for improving physical function in frail populations; thus, it has important implications for the development of PA programs for older adults with frailty. Future research is warranted to explore the optimal dose, frequency, and duration of RT programs for older adults, as well as the potential benefits of combining RT with other forms of PA, such as aerobic or balance exercises.
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Affiliation(s)
- Yerim Choi
- Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea;
| | - Daekyoo Kim
- Department of Physical Education, Korea University, Seoul 02841, Republic of Korea;
| | - Seung Kyum Kim
- Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea;
- Department of Sports Science, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
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24
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Zhang M, Jia J, Yang Y, Zhang L, Wang X. Effects of exercise interventions on cognitive functions in healthy populations: A systematic review and meta-analysis. Ageing Res Rev 2023; 92:102116. [PMID: 37924980 DOI: 10.1016/j.arr.2023.102116] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Chronic exercise intervention is a non-pharmacological therapy suggested to improve cognitive function in various populations. However, few meta-analyses have assessed the cognitive benefits associated with all FITT-VP variables (exercise frequency, intensity, bout duration time, type, volume or total intervention length, and progression) in healthy populations by age. Thus, this meta-analysis assessed the effects of each FITT-VP variable on cognitive function in healthy children, adults, and older adults. This study followed PRISMA guidelines. After searching PubMed and the Web of Science, we included 54 randomized controlled trials to examined the effects of FITT-VP variables on five cognitive domains: global cognition, executive function, memory, attention, and information processing. Moderation analyses assessed the effects by age and by each exercise variables. Exercise benefitted overall cognition and all subcognitive domains. Aerobic and resistance exercise showed the greatest benefits on global cognition and executive function respectively, whereas mind-body exercise benefitted memory. Among all populations, older adults showed the greatest benefits of exercise on global cognition, executive function, and memory compared with controls. Additional studies are needed to assess the effects of exercise on attention and information processing. This meta-analysis offers new insights on the relationships between cognition and FITT-VP exercise variables in healthy populations.
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Affiliation(s)
- Minggang Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Jiafeng Jia
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Yang Yang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Lepu Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiaochun Wang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China.
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25
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Curtin D, Cadwallader CJ, Taylor EM, Andrews SC, Stout JC, Hendrikse JJ, Chong TTJ, Coxon JP. Ageing attenuates exercise-enhanced motor cortical plasticity. J Physiol 2023; 601:5733-5750. [PMID: 37917116 DOI: 10.1113/jp285243] [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: 07/04/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023] Open
Abstract
Cardiorespiratory exercise is known to modulate motor cortical plasticity in young adults, but the influence of ageing on this relationship is unknown. Here, we compared the effects of a single session of cardiorespiratory exercise on motor cortical plasticity in young and older adults. We acquired measures of cortical excitatory and inhibitory activity of the primary motor cortex using transcranial magnetic stimulation (TMS) from 20 young (mean ± SD = 25.30 ± 4.00 years, 14 females) and 20 older (mean ± SD = 64.10 ± 6.50 years, 11 females) healthy adults. Single- and paired-pulse TMS measurements were collected before and after a 20 min bout of high-intensity interval cycling exercise or an equivalent period of rest, and again after intermittent theta burst stimulation (iTBS). In both young (P = 0.027, Cohen's d = 0.87) and older adults (P = 0.006, Cohen's d = 0.85), there was an increase in glutamatergic excitation and a reduction in GABAergic inhibition from pre- to postexercise. However, in contrast to younger adults, older adults showed an attenuated plasticity response to iTBS following exercise (P = 0.011, Cohen's d = 0.85). These results demonstrate an age-dependent decline in cortical plasticity and indicate that a preceding bout of high-intensity interval exercise might be less effective for enhancing primary motor cortex plasticity in older adults. Our findings align with the hypothesis that the capacity for cortical plasticity is altered in older age. KEY POINTS: Exercise enhances motor cortical plasticity in young adults, but how ageing influences this effect is unknown. Here, we compared primary motor cortical plasticity responses in young and older adults before and after a bout of high-intensity interval exercise and again after a plasticity-inducing protocol, intermittent theta burst stimulation. In both young and older adults, exercise led to an increase in glutamatergic excitation and a reduction in GABAergic inhibition. Our key result was that older adults showed an attenuated plasticity response to theta burst stimulation following exercise, relative to younger adults. Our findings demonstrate an age-dependent decline in exercise-enhanced cortical plasticity and indicate that a preceding bout of high-intensity interval exercise might be less effective for enhancing primary motor cortex plasticity in older adults.
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Affiliation(s)
- Dylan Curtin
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Claire J Cadwallader
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Eleanor M Taylor
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sophie C Andrews
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Julie C Stout
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Joshua J Hendrikse
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Trevor T-J Chong
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - James P Coxon
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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26
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Santos A, Braaten K, MacPherson M, Vasconcellos D, Vis-Dunbar M, Lonsdale C, Lubans D, Jung ME. Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses. Int J Behav Nutr Phys Act 2023; 20:134. [PMID: 37990239 PMCID: PMC10664287 DOI: 10.1186/s12966-023-01535-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To determine rates of compliance (i.e., supervised intervention attendance) and adherence (i.e., unsupervised physical activity completion) to high-intensity interval training (HIIT) among insufficiently active adults and adults with a medical condition, and determine whether compliance and adherence rates were different between HIIT and moderate-intensity continuous training (MICT). METHODS Articles on adults in a HIIT intervention and who were either insufficiently active or had a medical condition were included. MEDLINE, EMBASE, PsychINFO, SPORTDiscus, CINAHL, and Web of Science were searched. Article screening and data extraction were completed by two independent reviewers. Risk of bias was assessed using RoB 2.0 or ROBINS-I. Meta-analyses were conducted to discern differences in compliance and adherence between HIIT vs. MICT. Sensitivity analyses, publication bias, sub-group analyses, and quality appraisal were conducted for each meta-analysis. RESULTS One hundred eighty-eight unique studies were included (n = 8928 participants). Compliance to HIIT interventions averaged 89.4% (SD:11.8%), while adherence to HIIT averaged 63% (SD: 21.1%). Compliance and adherence to MICT averaged 92.5% (SD:10.6%) and 68.2% (SD:16.2%), respectively. Based on 65 studies included in the meta-analysis, compliance rates were not different between supervised HIIT and MICT interventions [Hedge's g = 0.015 (95%CI: - 0.088-0.118), p = .78]. Results were robust and low risk of publication bias was detected. No differences were detected based on sub-group analyses comparing medical conditions or risk of bias of studies. Quality of the evidence was rated as moderate over concerns in the directness of the evidence. Based on 10 studies, adherence rates were not different between unsupervised HIIT and MICT interventions [Hedge's g = - 0.313 (95%CI: - 0.681-0.056), p = .096]. Sub-group analysis points to differences in adherence rates dependent on the method of outcome measurement. Adherence results should be interpreted with caution due to very low quality of evidence. CONCLUSIONS Compliance to HIIT and MICT was high among insufficiently active adults and adults with a medical condition. Adherence to HIIT and MICT was relatively moderate, although there was high heterogeneity and very low quality of evidence. Further research should take into consideration exercise protocols employed, methods of outcome measurement, and measurement timepoints. REGISTRATION This review was registered in the PROSPERO database and given the identifier CRD42019103313.
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Affiliation(s)
- Alexandre Santos
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kyra Braaten
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Megan MacPherson
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Diego Vasconcellos
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mathew Vis-Dunbar
- Library, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Chris Lonsdale
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Lubans
- School of Education, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mary E Jung
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada.
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27
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Karmakar P, Wong MY(C, AlMarzooqi MA, Alghamdi N, Ou K, Duan Y, Rhodes RE, Zhang CQ. Enhancing Physical and Psychosocial Health of Older Adults in Saudi Arabia through Walking: Comparison between Supervised Group-Based and Non-Supervised Individual-Based Walking. Eur J Investig Health Psychol Educ 2023; 13:2342-2357. [PMID: 37998055 PMCID: PMC10670657 DOI: 10.3390/ejihpe13110165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
Walking is widely recognized as one of the most common and effective forms of physical activity, particularly for older adults. This study examined the comparative effects of two types of walking interventions, including supervised group-based intervention (SGBI) and non-supervised individual-based intervention (NSIBI), on frailty syndrome, cognitive functions or skills, and health-related quality of life among sedentary older Saudi individuals. A 15-week double-blinded, randomized controlled trial (RCT) including three groups (two were intervention groups while the other was the control group) was conducted among older adults who were inactive to examine the effect of different forms of walking interventions on frailty syndrome, cognitive functions, and health-related quality of life. A total of 107 participants, including 65 males and 42 females, were divided into three groups, which include SGBI, NSIBI, and the control group. Frailty syndrome was measured using the physical performance test (PPT), while cognitive function and health-related quality of life were assessed using the Mini-mental State Examination (MMSE) and the Short Form 36 (SF 36) health survey questionnaire. One-way repeated measures analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA) with the pre- and post-tests were performed for within- and between-group differences. while post-test data for the control group participants were absent due to the change in elderly center regulation, and they were excluded from the analysis. Hence, the comparison was stated only between the intervention groups. Both of the intervention groups (SGBI and NSIBI) showed significant within-subject differences in the Physical Function subscale of the health-related quality of life scale only, with F(1,20) = 23.03, p < 0.001, and F(1,18) = 27.22, p < 0.001, respectively. On the other hand, the Physical Performance Test revealed significant [F(2,51) = 9.21, p < 0.001] between-group differences in the post-test based on the baseline values. In addition, the average step count of older adults was increased from 4000 steps per session to around 7000 steps per session in the intervention group. The average heart rate of the NSIBI group did not show a visible change, and the resting heart rate of both groups showed a slightly declining trend throughout the intervention period. The walking intervention significantly increased participants' physical function, which is a component of health-related quality of life and physical performance (frailty level), along with average daily step counts for older adults in Saudi Arabia. Regular engagement in the recommended level of walking is strongly advisable for Saudi Arabian older adults to maintain their overall quality of life at this stage.
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Affiliation(s)
- Palash Karmakar
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China; (P.K.); (K.O.); (Y.D.)
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Ming-Yu (Claudia) Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Mezna A. AlMarzooqi
- Department of Community Health Sciences, College of Applied Medical Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.A.); (N.A.)
- Leaders Development Institute, Ministry of Sport, Riyadh 12641, Saudi Arabia
| | - Nouf Alghamdi
- Department of Community Health Sciences, College of Applied Medical Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.A.); (N.A.)
| | - Kailing Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China; (P.K.); (K.O.); (Y.D.)
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China; (P.K.); (K.O.); (Y.D.)
| | - Ryan E. Rhodes
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou 510275, China;
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28
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Lee C, Ahn J, Lee BC. A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs. Bioengineering (Basel) 2023; 10:1142. [PMID: 37892872 PMCID: PMC10604191 DOI: 10.3390/bioengineering10101142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs.
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Affiliation(s)
- Chihyeong Lee
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea;
| | - Jooeun Ahn
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea;
- Institute of Sport Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Beom-Chan Lee
- Institute of Sport Science, Seoul National University, Seoul 08826, Republic of Korea
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA
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29
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Wong MYC, Karmakar P, Almarzooqi MA, Rhodes RE, Zhang CQ, Ou KL, Yanping D, Chung PK, Alghamdi NA. The effects of walking on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia: a study protocol of randomized control trial by comparing supervised group-based intervention and non-supervised individual-based intervention. BMC Geriatr 2023; 23:602. [PMID: 37759212 PMCID: PMC10523652 DOI: 10.1186/s12877-023-04200-w] [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: 08/10/2022] [Accepted: 07/27/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Kingdom of Saudi Arabia (KSA) demographics are also changing with the increase in life expectancy in the country and the rise in the number of older Saudi Arabians. Saudi Arabia has a higher rate of physically inactive people, and most of them are between the ages of 55-64. Walking is one of the most prevalent forms of physical activity in Saudi Arabia and the study showed that most people prefer walking for recreational and health benefits. Therefore, the purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia. METHOD This study will apply a three-group (2 intervention groups and 1 control group), double-blinded, randomized controlled trial (RCT) to examine the effect of different forms of walking interventions on Saudi Arabia older adults' frailty, cognitive function and quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions. DISCUSSION This study aims to determine whether supervised group walking and non-supervised individual walking lead to different effects. Given the limited evidence in the literature regarding Saudi Arabia older adults' physical fitness and health, it is worthwhile to explore the effect of walking, as well as the forms of walking on improving the overall physical fitness and psychological status of older adults in Saudi Arabia. The findings of the current study could also create awareness of the government and the general public in Saudi Arabia of the ageing problems and the effective ways of achieving better intervention results. TRIAL REGISTRATION The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05151575; Date of first posted: 12/07/2021).
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Affiliation(s)
- Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Palash Karmakar
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
| | - Mezna A Almarzooqi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Leaders Development Institute, Ministry of Sport, Riyadh, Kingdom of Saudi Arabia
| | - Ryan E Rhodes
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, Canada
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Kai-Ling Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Duan Yanping
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Pak Kwong Chung
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Nouf A Alghamdi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Vijayakumaran RK, Daly RM, Tan VPS. "We want more": perspectives of sarcopenic older women on the feasibility of high-intensity progressive resistance exercises and a whey-protein nutrition intervention. Front Nutr 2023; 10:1176523. [PMID: 37743924 PMCID: PMC10513027 DOI: 10.3389/fnut.2023.1176523] [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: 02/28/2023] [Accepted: 07/25/2023] [Indexed: 09/26/2023] Open
Abstract
This qualitative study is nested within a 12-week pilot randomized-controlled, two-arm trial involving high-intensity progressive resistance training (PRT) or PRT with a multi-nutrient, whey-protein supplementation (PRT+WP) in sarcopenic older adults (trial registration no: TCTR20230703001). The aim was to investigate sarcopenic participants' perceptions and barriers to this multi-modal intervention strategy that may accelerate "real-world" implementation. Eighteen older adults (one man) with possible sarcopenia were invited to join the study, of whom 16 women were randomized to a thrice-weekly PRT (n = 8) program (80% of 1-repetitive maximum, six resistance band exercises) only or PRT plus daily weekday milk-based WP supplementation (PRT+WP, n = 8). Muscle strength (handgrip and 5-times sit-to-stand), mass (dual-energy X-ray absorptiometry), performance (Short Physical Performance Battery and stair ascent-descent), and nutrition status (Mini Nutritional Assessment) were assessed for changes. We randomly selected eight women for the semi-structured interview. Post-intervention, eight (50%) women were sarcopenia-free, six (38%) remained in possible sarcopenia, one (6%) improved to sarcopenia, and one (6%) deteriorated from possible to severe sarcopenia. There were no significant between-group differences, but significant within-group improvements (p < 0.05) were detected for handgrip strength (PRT+WP 5.0 kg, d = 0.93; PRT 6.1 kg, d = 0.55), 5-times sit-to-stand time (PRT 2.0 s, d = 1.04), nutrition score (PRT+WP 3.44, d = 0.52; PRT 1.80, d = 0.44), and stair ascent time (PRT+WP 0.97 s, d = 0.77; PRT 0.75 s, d = 0.97). Our thematic analyses identified four main themes, namely, (1) perceived benefits, (2) sustaining behavior changes, (3) challenges in participating, and (4) improved wellbeing. Participants expressed how they initially were skeptical and doubted that they could complete the exercises or tolerate the milk-based WP supplements. However, they reported positive experiences and benefits felt from strength gains, increased confidence, and better physical abilities. Participants were surprised by the zero adverse effects of WP supplements. The women wanted more nutritional information and structured, guided exercise programs and suggested a community-based implementation. In conclusion, our findings showed PRT was well received and may support reduced risks of sarcopenia. No added benefits were seen with the addition of WP supplementation, but a larger sample is required to address this question. Overall, older (previously sarcopenic) Malay women indicated that they want more multi-modal programs embedded in their community.
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Affiliation(s)
- Reena K. Vijayakumaran
- Department of Rehabilitation and Sports Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Vina P. S. Tan
- Exercise & Sports Science, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Rosenberg M, Eckstrom E. Factors that promote resilience for older adults and their informal caregivers during the COVID-19 pandemic. Aging Ment Health 2023; 27:2011-2018. [PMID: 36762673 DOI: 10.1080/13607863.2023.2176819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 01/20/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVES The aim of this cross-sectional, descriptive study was to characterize the impact of modifiable activities on older adult mental health during the COVID-19 pandemic and to understand the interaction between older adult behaviors and the mental health of their informal caregivers. METHODS This study leveraged the National Health and Aging Trends Study and associated Family and Friends survey completed 2020-2021. Participants included 3,257 community dwelling older adults and 2,062 associated unpaid caregivers, weighted sample sizes 26,074,143 and 21,871,408, respectively. RESULTS Older adult engagement in volunteering, religious, or group activities was associated with decreased older adult depression, as was increased walking or vigorous activity. However, online compared to in-person participation correlated with greater loneliness in older adults and anxiety for their caregivers. Finally, increased appreciation by the care recipient correlated with decreased caregiver depression. CONCLUSION Overall, a close interaction exists between caregiver and older adult behavior and psychiatric symptoms. Online activities are not an equivalent substitute for in-person activities during required social isolation; however, they remain superior to no participation. Further, increased walking and caregiver appreciation may ameliorate some of the harms of isolation. Health care providers should continue to promote engagement, exercise, and appreciation as ways to improve older adult and informal caregiver mental health.
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Affiliation(s)
- Mara Rosenberg
- Division of Internal Medicine, Legacy Emanuel and Good Samaritan Hospitals, Portland, OR, USA
| | - Elizabeth Eckstrom
- Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR, USA
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Harwood RH, Goldberg SE, Brand A, van Der Wardt V, Booth V, Di Lorito C, Hoare Z, Hancox J, Bajwa R, Burgon C, Howe L, Cowley A, Bramley T, Long A, Lock J, Tucker R, Adams EJ, O'Brien R, Kearney F, Kowalewska K, Godfrey M, Dunlop M, Junaid K, Thacker S, Duff C, Welsh T, Haddon-Silver A, Gladman J, Logan P, Pollock K, Vedhara K, Hood V, Das Nair R, Smith H, Tudor-Edwards R, Hartfiel N, Ezeofor V, Vickers R, Orrell M, Masud T. Promoting Activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED): randomised controlled trial. BMJ 2023; 382:e074787. [PMID: 37643788 PMCID: PMC10463053 DOI: 10.1136/bmj-2023-074787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To determine the effectiveness of an exercise and functional activity therapy intervention in adults with early dementia or mild cognitive impairment compared with usual care. DESIGN Randomised controlled trial. SETTING Participants' homes and communities at five sites in the United Kingdom. PARTICIPANTS 365 adults with early dementia or mild cognitive impairment who were living at home, and family members or carers. INTERVENTION The intervention, Promoting activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED), was a specially designed, dementia specific, rehabilitation programme focusing on strength, balance, physical activity, and performance of activities of daily living, which was tailored and progressive and addressed risk and the psychological needs of people with dementia. Up to 50 therapy sessions were provided over 12 months. The control group received usual care plus a falls risk assessment. Procedures were adapted during the covid-19 pandemic. MAIN OUTCOME MEASURES The primary outcome was score on the carer (informant) reported disability assessment for dementia scale 12 months after randomisation. Secondary outcomes were self-reported activities of daily living, physical activity, quality of life, balance, functional mobility, fear of falling, frailty, cognition, mood, carer strain, service use at 12 months, and falls between months 4 and 15. RESULTS 365 patient participants were randomised, 183 to intervention and 182 to control. The median age of participants was 80 years (range 65-95), median Montreal cognitive assessment score was 20 out of 30 (range 13-26), and 58% (n=210) were men. Intervention participants received a median of 31 therapy sessions (interquartile range 22-40) and reported completing a mean 121 minutes of PrAISED exercise each week. Primary outcome data were available for 149 intervention and 141 control participants. Scores on the disability assessment for dementia scale did not differ between groups: adjusted mean difference -1.3, 95% confidence interval -5.2 to 2.6; Cohen's d effect size -0.06, 95% confidence interval -0.26 to 0.15; P=0.51). Upper 95% confidence intervals excluded small to moderate effects on any of the range of outcome measures. Between months 4 and 15 the intervention group experienced 79 falls and the control group 200 falls (adjusted incidence rate ratio 0.78, 95% confidence interval 0.5 to 1.3; P=0.3). CONCLUSION The intensive PrAISED programme of exercise and functional activity training did not improve activities of daily living, physical activity, or quality of life; reduce falls; or improve any other secondary health status outcomes, despite good uptake. Future research should consider alternative approaches to maintaining ability and wellbeing in people with dementia. TRIAL REGISTRATION ISRCTN Registry ISRCTN15320670.
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Affiliation(s)
- Rowan H Harwood
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Andrew Brand
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, Gwynedd, UK
| | - Veronika van Der Wardt
- Department of General, Preventative and Rehabilitation Medicine, Philipps-Universität Marburg 35032 Marburg, Germany
| | - Vicky Booth
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Claudio Di Lorito
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Zoe Hoare
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, Gwynedd, UK
| | - Jennie Hancox
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Rupinder Bajwa
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Clare Burgon
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Louise Howe
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Alison Cowley
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Trevor Bramley
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Gamston, Nottingham, UK
| | - Annabelle Long
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Juliette Lock
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Rachael Tucker
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Emma J Adams
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Rebecca O'Brien
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Fiona Kearney
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Katarzyna Kowalewska
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | | | | | - Kehinde Junaid
- Mental Health Services for Older People, Nottinghamshire Healthcare NHS Foundation Trust, Highbury Hospital, Nottingham, UK
| | - Simon Thacker
- Centre for Research and Development, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Carol Duff
- Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK
| | - Tomas Welsh
- The RICE Centre, Research Institute for the Care of Older People, Royal United Hospital, Bath, UK
| | - Annette Haddon-Silver
- Oxford Health NHS Foundation Trust, Research and Development, Warneford Hospital, Oxford, UK
| | - John Gladman
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Pip Logan
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Kavita Vedhara
- Centre for Academic Primary Care, Lifespan and Population Health, University of Nottingham, Nottingham, UK
| | - Victoria Hood
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Gamston, Nottingham, UK
| | - Roshan Das Nair
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
- SINTEF, Torgarden, Trondheim, Norway
| | - Helen Smith
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Gamston, Nottingham, UK
| | - Rhiannon Tudor-Edwards
- Centre for Health Economics and Medicines Evaluation, College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
| | - Ned Hartfiel
- Centre for Health Economics and Medicines Evaluation, College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
| | - Victory Ezeofor
- Centre for Health Economics and Medicines Evaluation, College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
| | - Robert Vickers
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Martin Orrell
- Mental Health Services for Older People, Nottinghamshire Healthcare NHS Foundation Trust, Highbury Hospital, Nottingham, UK
- Institute for Mental Health, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
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Loh DA, Naqiah Hairi N, Mohd Hairi F, Peramalah D, Kandiben S, Abd Hamid MAI, Bulgiba A, Salam M, Said MA, Rizal H, Danaee M, Choo WY. Effects of a Multicomponent Exercise and Therapeutic Lifestyle (CERgAS) Intervention on Gait Function in Lower-Income Urban-Dwelling Older Adults: A Cluster Randomized Controlled Trial. J Aging Phys Act 2023; 31:531-540. [PMID: 36509091 DOI: 10.1123/japa.2022-0047] [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: 04/18/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 12/14/2022]
Abstract
This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were divided into the intervention (n = 163) and control (n = 86) groups. The mean (SD) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6 weeks (T1), 3 months postintervention (T2), and 6 months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p = .001), whereas no significant association were found for group (p = .650) and interaction (p = .348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity.
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Affiliation(s)
- Debbie Ann Loh
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Farizah Mohd Hairi
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Devi Peramalah
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Shathanapriya Kandiben
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Mohd Alif Idham Abd Hamid
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Awang Bulgiba
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Mushtahid Salam
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Mas Ayu Said
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Hussein Rizal
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya,Kuala Lumpur,Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
| | - Wan Yuen Choo
- Centre for Epidemiology and Evidence-based Practice (CEBP), Department of Social and Preventive Medicine, Faculty of Medicine,Universiti Malaya, Kuala Lumpur,Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur,Malaysia
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Raz DJ, Kim JY, Erhunwmunesee L, Hite S, Varatkar G, Sun V. The value of perioperative physical activity in older patients undergoing surgery for lung cancer. Expert Rev Respir Med 2023; 17:691-700. [PMID: 37668168 DOI: 10.1080/17476348.2023.2255133] [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: 04/02/2023] [Revised: 07/24/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION With a median age at diagnosis of 70, lung cancer represents an enormous public health problem among older Americans. An estimated 19,000 people age 65 and older undergo lung cancer surgery annually in the US. Older adults undergoing lung cancer surgery are often frail with limited physiologic reserves, multi-morbidities, and functional impairments. Physical function, dyspnea, and quality of life return to baseline slower in older adults compared with younger adults after lung surgery. AREAS COVERED In this review, we summarize available data about perioperative physical activity interventions that may improve outcomes for older adults undergoing lung cancer surgery. We also review the limitations of existing studies and discuss emerging data on the roles of telehealth and family caregiver inclusion in peri-operative physical activity interventions. EXPERT OPINION We propose that future perioperative physical activity interventions in older adults undergoing lung cancer surgery should include a comprehensive geriatric assessment to guide personalized interventions. Interventions should be conceptually based, with a focus on enhancing self-efficacy, motivation, and adherence through classic behavior change strategies that are proven to impact outcomes. Finally, interventions should be designed with attention to feasibility and scalability. Exercise programs delivered via telehealth (telephone or tele-video) may improve access and convenience for patients.
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Affiliation(s)
- Dan J Raz
- Department of Surgery, City of Hope, CA, USA
| | - Jae Y Kim
- Department of Surgery, City of Hope, CA, USA
| | - Loretta Erhunwmunesee
- Department of Surgery, City of Hope, CA, USA
- Department of Population Sciences, City of Hope, CA, USA
| | - Sherry Hite
- Department of Rehabilitation, City of Hope, CA, USA
| | | | - Virginia Sun
- Department of Surgery, City of Hope, CA, USA
- Department of Population Sciences, City of Hope, CA, USA
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Chen X, Wu L, Feng H, Ning H, Wu S, Hu M, Jiang D, Chen Y, Jiang Y, Liu X. Comparison of Exergames Versus Conventional Exercises on the Health Benefits of Older Adults: Systematic Review With Meta-Analysis of Randomized Controlled Trials. JMIR Serious Games 2023; 11:e42374. [PMID: 37347534 PMCID: PMC10337432 DOI: 10.2196/42374] [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: 09/01/2022] [Revised: 02/08/2023] [Accepted: 05/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Conventional exercises (CEs) can provide health benefits for older adults, but the long-term exercise adherence rate is low. As an emerging, stimulating, and self-motivating strategy, exergames (EGs) are defined as combinations of exercises and games that users carry out through physical actions. They can promote exercise, but the health effects of EGs versus CEs on the physical function and mental health (cognitive function, depression, and quality of life) of older adults remain controversial. OBJECTIVE The aim of the study is to compare the health benefits of EGs versus those of CEs for the physical function and mental health of older adults. METHODS A comprehensive search was conducted from the earliest available date to February 2023 in the following 6 databases: PubMed, Web of Science, Embase, Cochrane, CINAHL, and PsycINFO. All English-language randomized controlled trials comparing the effects of EGs versus those of CEs on the physical function and mental health of older adults, with nearly same physical activity between the 2 interventions, were included. Risk of bias was independently evaluated by 2 authors using the Cochrane risk of bias in randomized trials tool. Two authors independently extracted data. We followed the Cochrane Handbook of Systematic Reviews of Interventions to process and analyze the data for meta-analysis. Standardized mean differences (SMDs) and 95% CIs were used for continuous data, and random models were used for analyses. RESULTS We included 12 studies consisting of 919 participants in total. Of these, 10 studies were eventually included in the meta-analysis. The results showed that EGs versus CEs exhibited no significant differences in physical (P=.13; τ2=0.31; χ26=26.6; I2=77%; SMD=0.37; 95% CI -0.11 to 0.86) or cognitive function (P=.63; τ2=0.01; χ23=3.1; I2=4%; SMD=0.09; 95% CI -0.27 to 0.44) effects. CONCLUSIONS Our findings indicate no significant difference between EGs and CEs in improving the physical function and cognitive function of older adults. Future studies are required to compare the effects of EGs versus those of CEs on cognitive function according to cognitive status, quantify the "dose-effect" relationship between EGs and health benefits, and evaluate the effects of different types and devices of EGs with regard to the health benefits of older adults. TRIAL REGISTRATION PROSPERO CRD42022322734; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322734.
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Affiliation(s)
- Xi Chen
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Lina Wu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Shuang Wu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Dian Jiang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yifei Chen
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yu Jiang
- Changsha Xingsha Hospital, Changsha, China
| | - Xin Liu
- Department of General Practice, 921 Hospital of Joint Logistics Support Force, The Chinese People's Liberation Army, Changsha, China
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Ioannou E, Chen HL, Bromley V, Fosker S, Ali K, Fernando A, Mensah E, Fowler-Davis S. The key values and factors identified by older adults to promote physical activity and reduce sedentary behaviour using co-production approaches: a scoping review. BMC Geriatr 2023; 23:371. [PMID: 37328734 PMCID: PMC10276377 DOI: 10.1186/s12877-023-04005-x] [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: 10/28/2022] [Accepted: 04/26/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Inactivity and sedentary behaviour in older adults adversely impacts physical function, reduces social networks, and could contribute to population healthcare costs. To encourage and support the planning and uptake of physical activity by older adults, it is important to understand what physical activity means to older adults. Therefore, the aim of this scoping review was to collate what older adults have self-identified as the key factors for sustaining and increasing their physical activities. METHODS Arksey and O'Malley's Scoping Review framework was used to guide the review process. SCOPUS, ASSIA, PsychINFO and MEDLINE databases were searched. Studies were eligible for inclusion if they were peer-reviewed, the target population were older adults (aged 55 and above), co-production related research approaches were explicitly stated in the methods and there was a focus on design of physical activity interventions or products to support or enhance physical activity. Assets and values important for physical activity were first extracted from included studies and were subsequently thematically analysed. Themes are presented to provide an overview of the literature synthesis. RESULTS Sixteen papers were included in the analysis. Data from these papers were gathered via designing interventions or services (n = 8), products (n = 2), 'exergames' (n = 2) or mobile applications (n = 4). Outcomes were varied but common themes emerged across papers. Overarching themes identified by older adults were associated with a desire to increase activity when it was accessible, motivational, and safe. In addition, older adults want to enjoy their activities, want independence and representation, want to stay connected with families and friends, be outdoors, familiarity, activities to be tailored and resulting in measurable/observed progress. CONCLUSIONS Population demographics, personal attributes, and life experiences all affect preferences for physical activity. However, the key factors identified by older adults for increasing physical activity were common-even in separate co-production contexts. To promote physical activities in older adults, activities must fundamentally feel safe, provide a sense of social connectedness, be enjoyable and be accessible in terms of cost and ability.
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Affiliation(s)
- Elysa Ioannou
- Sport and Physical Activity Research Centre (SPARC), Sheffield Hallam University, Sheffield, UK
| | - Henglien Lisa Chen
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Vicky Bromley
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Sam Fosker
- Royal London Hospital, London; Founder, Cush Health, London, UK
| | - Khalid Ali
- Brighton and Sussex Medical School, Brighton and Hove, UK
| | - Avanka Fernando
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Ekow Mensah
- University Hospitals NHS Trust, Nottingham, UK
| | - Sally Fowler-Davis
- Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, UK.
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Zhu X, Dong Z, Wu Y, Xu DW. A review of different types of volunteer programs for older adults with and without cognitive impairment. Front Public Health 2023; 11:1164952. [PMID: 37397711 PMCID: PMC10311508 DOI: 10.3389/fpubh.2023.1164952] [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: 02/13/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Theoretical models and empirical evidence suggest an association between volunteering and health outcomes in older adults. However, less is known about existing programs that involve older adults engaging in formal volunteering, especially programs for older volunteers with cognitive impairment. In this review, we summarized and evaluated different types of volunteering-based programs involving older volunteers with and without cognitive impairment. After a non-systematic literature search, we presented eight example volunteer programs. Older volunteers participate in the programs in person or remotely. In five of the programs, older volunteers without cognitive impairment participate in intergenerational engagement, support and referral, home visiting, and dementia care services. The other three programs specifically recruit older volunteers with cognitive impairment and provide intergenerational engagement and individualized volunteer activities. Both strengths and challenges identified in the programs were discussed. Different types of volunteering-based programs are available for engaging older volunteers. For volunteers to remain active during the pandemic or for volunteers who live with cognitive impairment, remote programs can be a valuable alternative. Program effects on older volunteers need to be tested in more rigorously designed studies.
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Affiliation(s)
- Xianghe Zhu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, China
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhiwei Dong
- College of Management, Weifang Medical University, Weifang, China
| | - Yili Wu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, China
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong-Wu Xu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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Adekpedjou R, Léon P, Dewidar O, Al‐Zubaidi A, Jbilou J, Kaczorowski J, Muscedere J, Hirdes J, Heckman G, Girard M, Hébert PC. Effectiveness of interventions to address different types of vulnerabilities in community-dwelling older adults: An umbrella review. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1323. [PMID: 37180567 PMCID: PMC10168691 DOI: 10.1002/cl2.1323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Background Frailty, social isolation, loneliness, and poverty may render older adults vulnerable to social or health stressors. It is imperative to identify effective interventions to address them especially in the context of COVID-19 pandemic. Objective To identify effective community-based interventions to address frailty, social isolation, loneliness, and poverty among community-dwelling older adults. Design Umbrella review. Data Source We systematically searched PubMed, Ovid MEDLINE, Embase, Cochrane CENTRAL, EBM-Reviews, CINAHL via EBSCO, and APA PsycInfo via Ovid from January 2009 to December 2022. Eligibility Criteria We included systematic reviews or quantitative reviews of non-pharmacologic interventions targeting community-dwelling older adults. Data Selection Extraction and Management Two review authors independently screened the titles and abstracts, performed data extraction and appraised the methodological quality of the reviews. We used a narrative synthesis approach to summarize and interpret the findings. We assessed the methodological quality of the studies using AMSTAR 2.0 tool. Results We identified 27 reviews incorporating 372 unique primary studies that met our inclusion criteria. Ten of the reviews included studies conducted in low-middle-income countries. Twelve reviews (46%, 12/26) included interventions that addressed frailty. Seventeen reviews (65%, 17/26) included interventions that addressed either social isolation or loneliness. Eighteen reviews included studies with single component interventions, while 23 reviews included studies with multi-component interventions. Interventions including protein supplementation combined with physical activity may improve outcomes including frailty status, grip strength, and body weight. Physical activity alone or in combination with diet may prevent frailty. Additionally, physical activity may improve social functioning and interventions using digital technologies may decrease social isolation and loneliness. We did not find any review of interventions addressing poverty among older adults. We also noted that few reviews addressed multiple vulnerabilities within the same study, specifically addressed vulnerability among ethnic and sexual minority groups, or examined interventions that engaged communities and adapted programs to local needs. Conclusion Evidence from reviews support diets, physical activity, and digital technologies to improve frailty, social isolation or loneliness. However, interventions examined were primarily conducted under optimal conditions. There is a need for further interventions in community settings and conducted under real world settings in older adults living with multiple vulnerabilities.
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Affiliation(s)
- Rhéda Adekpedjou
- Carrefour de l'innovation et de l'évaluation en santéCentre Hospitalier de l'Université de MontréalMontréalCanada
| | - Pascale Léon
- Carrefour de l'innovation et de l'évaluation en santéCentre Hospitalier de l'Université de MontréalMontréalCanada
| | - Omar Dewidar
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
| | - Ali Al‐Zubaidi
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
| | - Jalila Jbilou
- Centre de formation médicale du Nouveau‐Brunswick et École de psychologie, Faculté des sciences de la santé et des services communautairesUniversité de MonctonNouveau‐BrunswickCanada
| | - Janusz Kaczorowski
- Carrefour de l'innovation et de l'évaluation en santéCentre Hospitalier de l'Université de MontréalMontréalCanada
| | - John Muscedere
- Department of Critical Care MedicineQueens University and Canadian Frailty NetworkKingstonOntarioCanada
| | - John Hirdes
- Centre de formation médicale du Nouveau‐Brunswick et École de psychologie, Faculté des sciences de la santé et des services communautairesUniversité de MonctonNouveau‐BrunswickCanada
| | - George Heckman
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
- Schlegel Research Institute for AgingWaterlooCanada
| | - Magali Girard
- Bureau de Recherche Développement ValorisationUniversité de MontréalMontréalCanada
| | - Paul C. Hébert
- Carrefour de l'innovation et de l'évaluation en santéCentre Hospitalier de l'Université de MontréalMontréalCanada
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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Valenzuela PL, Saco-Ledo G, Morales JS, Gallardo-Gómez D, Morales-Palomo F, López-Ortiz S, Rivas-Baeza B, Castillo-García A, Jiménez-Pavón D, Santos-Lozano A, Del Pozo Cruz B, Lucia A. Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials. THE LANCET. HEALTHY LONGEVITY 2023:S2666-7568(23)00057-0. [PMID: 37182530 DOI: 10.1016/s2666-7568(23)00057-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Physical exercise is effective at attenuating ageing-related physical decline in general, but evidence of its benefits for older adults in residential care, who often have functional dependency, multimorbidity, and polypharmacy, is inconclusive. We aimed to establish the effects of exercise interventions on the physical function of this population. METHODS For this systematic review and network meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Rehabilitation & Sports Medicine Source, and SPORTDiscus to identify randomised controlled trials assessing the effects of exercise interventions (vs usual care) on physical function (ie, functional independence, physical performance, and other related measures, such as muscle strength, balance, or flexibility) in adults aged 60 years or older living in residential care. Relevant studies published in English or Spanish up to Jan 12, 2023, were included in the systematic review. The quality of studies was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX) score. A network meta-analysis was performed for physical function-related outcomes reported in at least ten studies, with subanalyses for specific intervention (ie, exercise type, training volume, and study duration) and participant (eg, having cognitive impairment or dementia, pre-frail or frail status, and being functionally dependent) characteristics. The study protocol was registered on PROSPERO (CRD42021247809). FINDINGS 147 studies (11 609 participants, with mean ages ranging from 67 years [SD 9] to 92 years [2]) were included in the systematic review, and were rated as having overall good quality (median TESTEX score 9 [range 3-14]). In the meta-analysis (including 105 studies, n=7759 participants), exercise interventions were associated with significantly improved overall physical function, with a standardised mean difference [SMD] of 0·13 (95% credible interval [CrI] 0·04-0·21), which was confirmed in all analysed subpopulations. The strongest association was observed with 110-225 min per week of exercise, and the greatest improvements were observed with 170 min per week (SMD 0·36 [95% CrI 0·20-0·52]). No significant differences were found between exercise types. Subanalyses showed significant improvements for almost all analysed physical function-related outcomes (Barthel index, five-times sit-to-stand test, 30-s sit-to-stand test, knee extension, hand grip strength, bicep curl strength, Short Physical Performance Battery, 6-min walking test, walking speed, Berg balance scale, and sit-and-reach test). Large heterogeneity was found between and within studies in terms of population and intervention characteristics. INTERPRETATION Exercise interventions are associated with improved physical function in older adults in residential care, and should, therefore, be routinely promoted in long-term care facilities. FUNDING None. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group, Research Institute of the Hospital 12 de Octubre, Madrid, Spain; Systems Biology Department, University of Alcalá, Madrid, Spain.
| | - Gonzalo Saco-Ledo
- Faculty of Sport Sciences, Universidad Europea de Madrid, 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 Cadiz Research Unit, Puerto Real University Hospital, University of Cadiz, Cadiz, Spain
| | - Daniel Gallardo-Gómez
- Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Departamento de Educación Física y Deporte, Universidad de Sevilla, Seville, Spain
| | - Félix Morales-Palomo
- Exercise Physiology Laboratory, Toledo, University of Castilla-La Mancha, Toledo, Spain
| | | | | | | | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain; Biomedical Research and Innovation Institute of Cadiz Research Unit, Puerto Real University Hospital, University of Cadiz, Cadiz, Spain; CIBER of Frailty and Healthy Ageing, Madrid, Spain; Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group, Research Institute of the Hospital 12 de Octubre, Madrid, Spain; i+HeALTH, Miguel de Cervantes European University, Valladolid, Spain
| | - Borja Del Pozo Cruz
- Biomedical Research and Innovation Institute of Cadiz Research Unit, Puerto Real University Hospital, University of Cadiz, Cadiz, Spain; Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain; Department of Sport Sciences and Clinical Biomechanics, Southern Denmark University, Odense, Denmark
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain; CIBER of Frailty and Healthy Ageing, Madrid, Spain
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Cuadra G, Oliveira JS, Pinheiro MB, Tiedemann A, Sherrington C, Pivotto L, Khalatbari-Soltani S, Sharma S, Costa N. Physical Activity Interventions for Adults Aged 60+ Years in Low- and Middle-Income Countries: A Scoping Review. J Phys Act Health 2023:1-8. [PMID: 37080543 DOI: 10.1123/jpah.2022-0508] [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: 09/21/2022] [Revised: 12/19/2022] [Accepted: 02/28/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Most reviews investigating physical activity interventions for older people consider evidence primarily from high-income countries. This review examined physical activity interventions for older people from low- and middle-income countries. METHODS We searched 9 electronic databases to identify randomized controlled trials or quasi-randomized trials studies investigating physical activity interventions for people aged 60+ in low- and middle-income countries. Following study selection, one reviewer extracted relevant data. A second reviewer double-checked the data extraction of a randomly selected sample of interventions (20%). Data were summarized using descriptive statistics. RESULTS We included 234 studies from 19 countries, investigating 259 distinct physical activity interventions. Studies were mostly conducted in upper middle-income countries (89%), often assessing physical activity interventions through randomized controlled trials (82%). Most studies investigated a mixed population in terms of sex (68%), with a mean age between 65 and 70 years (36%), not selected on the basis of having a specific health condition (55%). The intervention most commonly investigated was structured exercise (63%) and "no intervention" was the most frequent comparator (47%). The outcomes measured more often were intrinsic capacity (59%) and functional ability (51%), whereas physical activity, falls, and social outcomes were rare. Only 2 studies targeted underserved populations. CONCLUSION Although we identified a substantial number of randomized controlled trials, most evidence for physical activity interventions for older people in low- and middle-income countries is limited to upper middle-income countries. Gaps identified included interventions targeting populations with underserved backgrounds, using sport as an intervention, and assessing the impact of physical activity interventions on physical activity, falls, and social outcomes.
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Affiliation(s)
- Gabriela Cuadra
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
| | - Juliana S Oliveira
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney,Australia
| | - Marina B Pinheiro
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney,Australia
| | - Anne Tiedemann
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney,Australia
| | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney,Australia
| | - Luiza Pivotto
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
| | - Saman Khalatbari-Soltani
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney,Australia
| | - Sweekriti Sharma
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney,Australia
| | - Nathalia Costa
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney,Australia
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Blodgett JM, Norris T, Pinto Pereira SM, Hamer M. Does moderate to vigorous physical activity mediate the association between depression and physical function in midlife: Evidence from two British birth cohort studies. J Affect Disord 2023; 326:206-215. [PMID: 36584709 DOI: 10.1016/j.jad.2022.12.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/08/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Mental health and physical health are intrinsically linked, yet the mechanisms are not well understood. We investigated whether moderate-vigorous physical activity (MVPA) mediated the association between depression and physical function (PF) in midlife. METHODS Individuals from two UK birth cohorts born within one week in 1958 (n = 7278) and 1970 (n = 6097) with data on depression (ages 33/34; Malaise Inventory), MVPA (age 42; self-reported) and PF (ages 50/56; Short Form-36 subscale). Covariates included sex, childhood and adulthood social class, maternal mental health, childhood mood, alcohol consumption, smoking habits, sleep, marital status, BMI and long-standing illness/disability. Linear or multinomial logistic regression models examined associations between depression, MVPA and PF. We used a parametric g-computation mediation analysis approach to estimate percent differences in PF. RESULTS Depression was associated with less frequent MVPA and poorer PF. Lower MVPA was associated with worse PF. The direct effect - randomised analogue not operating via MVPA - of depression on PF was -18.8 % (95%CI:--25.8,-11.8) and -15.8 % (20.6,-11.0) in the 1958 and 1970 cohorts, respectively. The indirect effect - operating via MVPA - was -0.5 % (-1.0,-0.03) and -0.2 % (-0.6, 0.3), resulting in a total proportion mediated of 3.1 % (0.1, 6.0) and 0.9 % (-1.6, 3.4). LIMITATIONS MVPA was self-reported. Intermediate confounders and mediators were measured at the same age, however associations did not change in sensitivity analysis considering age 46 MVPA (1958 cohort). CONCLUSIONS Although higher MVPA was protective against poor PF, there was only minor evidence that it mediated the association between depression and PF. Further investigation into other potential mediators of pathways from mental to physical health is needed.
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Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, W1T 7HA London, UK.
| | - Tom Norris
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, W1T 7HA London, UK.
| | - Snehal M Pinto Pereira
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, W1T 7HA London, UK.
| | - Mark Hamer
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, W1T 7HA London, UK.
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Cooley S, Nelson BM, Rosenow A, Westerhaus E, Cade WT, Reeds DN, Vaida F, Yarasheski KE, Paul RH, Ances BM. Exercise Training to Improve Brain Health in Older People Living With HIV: Study Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41421. [PMID: 36943345 PMCID: PMC10131751 DOI: 10.2196/41421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND With the advent of antiretrovirals, people living with HIV are living near-normal lifespans. However, people living with HIV are at greater risk of experiencing cognitive impairment and reduced brain integrity despite well-controlled viremia. A robust literature supports exercise interventions as a method of improving cognition and structural brain integrity in older individuals without HIV. The effects of exercise on cardiometabolic, neurocognitive, and neural structures in middle-aged to older people living with HIV are less well known, with few prospective studies examining these measures. OBJECTIVE This prospective randomized clinical trial will examine the effects of a 6-month exercise training intervention compared to a 6-month stretching intervention (control) on cardiorespiratory fitness, physical function and strength, cognition, and neuroimaging measures of brain volumes and cerebral blood flow in people living with HIV. METHODS Sedentary middle-aged to older people living with HIV (ages≥40; n=150) with undetectable HIV viral load (<20 copies/mL) will be enrolled in the study. At the baseline and final visit, fasting plasma lipid, insulin, glucose, and brain neurotrophic factor concentrations; cardiorespiratory fitness; cognitive performance; brain volumes; and cerebral blood flow via a magnetic resonance imaging scan will be measured. Participants will be randomized in a 2:1 ratio to either the exercise or control stretching intervention. All participants will complete their assigned programs at a community fitness center 3 times a week for 6 months. A professional fitness trainer will provide personal training guidance at all sessions for individuals enrolled in both arms. Individuals randomized to the exercise intervention will perform endurance and strength training exercises, while those randomized to the control intervention will perform stretches to increase flexibility. A midpoint visit (at 3 months) will assess cognitive performance, and at the end point visit, subjects will undergo cardiorespiratory fitness and cognition testing, and a magnetic resonance imaging scan. Physical activity throughout the duration of the trial will be recorded using an actigraph. RESULTS Recruitment and data collection are complete as of December 2020. Data processing, cleaning, and organization are complete as of December 2021. Data analysis began in January 2022, with the publication of study results for primary aims 1 and 2 expected by early 2023. CONCLUSIONS This study will investigate the effects of a 6-month aerobic and resistance exercise training intervention to improve cardiometabolic risk factors, cognitive performance, cerebral structure, and blood flow in sedentary people living with HIV. Results will inform clinicians and patients of the potential benefits of a structured aerobic exercise training program on the cognitive, functional, and cardiometabolic health status of older people living with HIV. Assessment of compliance will inform the development and implementation of future exercise programs for people living with HIV. TRIAL REGISTRATION ClinicalTrials.gov NCT02663934; https://clinicaltrials.gov/ct2/show/NCT02663934. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41421.
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Affiliation(s)
- Sarah Cooley
- Department of Neurology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Brittany M Nelson
- Department of Neurology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Alexander Rosenow
- Department of Neurology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Elizabeth Westerhaus
- Department of Neurology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - W Todd Cade
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, NC, United States
| | - Dominic N Reeds
- Department of Medicine and the Center for Human Nutrition, Washington University in St. Louis, Saint Louis, MO, United States
| | - Florin Vaida
- Division of Biostatistics and Bioinformatics, School of Public Health, University of California San Diego, San Diego, CA, United States
| | - Kevin E Yarasheski
- Division of Endocrinology, School of Medicine, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Robert H Paul
- Department of Psychology, University of Missouri St. Louis, Saint Louis, MO, United States
| | - Beau M Ances
- Department of Neurology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
- Department of Radiology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
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Jofré-Saldía E, Villalobos-Gorigoitía Á, Cofré-Bolados C, Ferrari G, Gea-García GM. Multicomponent Training in Progressive Phases Improves Functional Capacity, Physical Capacity, Quality of Life, and Exercise Motivation in Community-Dwelling Older Adults: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2755. [PMID: 36768119 PMCID: PMC9916387 DOI: 10.3390/ijerph20032755] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To evaluate the effect of a multicomponent progressive training program (MPTP) on functionality, quality of life (QoL) and motivation to exercise (EM) in a group of older adults (OA) of a community. METHODS A total of 55 participants of 69.42 ± 6.01 years of age were randomized into two groups; experimental (EG:35) and control (CG:20), and subjected to 27 weeks of MPTP. Functionality (pre/post-intervention) was assessed using the Short Physical Performance Battery (SPPB), Time Up and Go (TUG), Walking While Talking Test (WWT), Manual Dynamometry (MD), Forced Expiratory Volume in the first second (FEV1), Sit and Reach (SR), Back Scratch (BS), and walk for 2 min (2 mST). QoL was assessed using the SF-36 questionnaire and EM using the BREQ-3. The Kolmogorov-Smirnov and Levene tests were applied. A two-way repeated measures ANOVA was applied. A significance level of p < 0.05 was accepted for all comparisons. RESULTS The EG compared to the CG improved in SPPB (ΔEG/CG: 29.67%/p < 0.001), TUG (ΔEG/CG: 35.70%/p < 0.05), WWT (ΔEG/CG: 42.93%/p < 0.001), MD (ΔEG/CG: 20.40%/p < 0.05), FEV1 (ΔEG/CG: 21.37%/p < 0.05), BS (ΔEG/CG: 80.34%/p < 0.05), 2 mST (ΔEG/CG: 33.02%/p < 0.05), SF-36 (ΔEG/CG: 13.85%/p < 0.001), and Intrinsic Regulation (ΔEG/CG: 27.97%/p < 0.001); Identified by regulation (ΔEG/CG: 9.29%/p < 0.05). CONCLUSION An MPTP improves functionality, QoL and EM, and is a safe and effective method for community OAs.
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Affiliation(s)
- Emilio Jofré-Saldía
- Instituto de Ciencias de la Salud, Universidad de O’Higgins, Rancagua 2841935, Chile
- Facultad de Educación y Ciencias Sociales, Instituto del Deporte y Bienestar, Universidad Andres Bello, Santiago 7550000, Chile
| | | | - Cristián Cofré-Bolados
- School of Physical Activity, Sport and Health Sciences, University of Santiago de Chile, Santiago 9170022, Chile
| | - Gerson Ferrari
- School of Physical Activity, Sport and Health Sciences, University of Santiago de Chile, Santiago 9170022, Chile
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | - Gemma María Gea-García
- Faculty of Sport, Catholic University of Murcia, 30107 Murcia, Spain
- Health, Physical Activity, Fitness and Motor Control Performance Research Group (GISAFFCOM), Catholic University of Murcia, 30107 Murcia, Spain
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Long A, Timmons S, Di Lorito C, Booth V, Logan P. "We Just Don't Know Where They Are": The Geographical Distribution of Exercise Classes for Older People, Including Those Living with Dementia in the East Midlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2142. [PMID: 36767510 PMCID: PMC9915375 DOI: 10.3390/ijerph20032142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Older people living with dementia are advised to exercise to remain independent. Although several exercise classes for older people take place across the UK, there is limited information about the geographical distribution of these classes. This study identified the location and explored the population characteristics of the classes in a UK region, to aid improved access to exercise. Using a geographical information system, data were collected on population characteristics, including size and age, socio-economic status, and rurality of the exercise classes in one area of the UK (East Midlands, population 5 million). The relationship between data sets was explored and a visual representation of these patterns was provided. A systematic internet search identified 520 exercise classes, evenly spread across the region and areas of socio-economic deprivation: 471 (90%) were in urban areas; 428 (80%) were in areas where less than 20% of the population was over 65 years of age; and 13 (2%) stated that they were suitable for people with dementia. People living with dementia are less likely than older people without dementia to have access to exercise classes.
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Affiliation(s)
- Annabelle Long
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Stephen Timmons
- Nottingham University Business School, University of Nottingham, Nottingham NG8 1BB, UK
| | - Claudio Di Lorito
- Nottingham University Business School, University of Nottingham, Nottingham NG8 1BB, UK
| | - Vicky Booth
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham NG7 2UH, UK
| | - Pip Logan
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- Nottingham City Care Partnership, Nottingham NG6 8WR, UK
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Tao A, Ho KHM, Yang C, Chan HYL. Effects of non-pharmacological interventions on psychological outcomes among older people with frailty: A systematic review and meta-analysis. Int J Nurs Stud 2023; 140:104437. [PMID: 36764033 DOI: 10.1016/j.ijnurstu.2023.104437] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Older people with frailty are more likely to experience negative psychological well-being, depressive symptoms, anxiety, and stress. Deterioration of psychological outcomes, in turn, further aggravates the frailty status among this vulnerable population. Considering the undesirable effects of polypharmacy on older people, the use of non-pharmacological intervention has attracted increasing attention. However, the effects of non-pharmacological interventions on psychological outcomes are not clear. AIMS This review aims to systematically identify and synthesise evidence to examine the effectiveness of non-pharmacological interventions on psychological outcomes among older people with frailty. METHODS Eight electronic databases, including PubMed, MEDLINE, EMBASE, CINAHL, APA PsycInfo, Cochrane Library, CNKI and WANFANG were searched from inception to 14 November 2022. Randomised controlled trials and clinical controlled trials of non-pharmacological interventions on psychological outcomes in older people with frailty were included. The quality of the included studies was assessed using The Cochrane Risk of Bias Tool v2. Meta-analysis was performed using the RevMan5.3. The certainty of the evidence was evaluated by GRADE approach. RESULTS A total of 4726 articles were initially identified and screened for title and abstract. Eventually, 13 articles from 11 studies were included in this review. The results of the overall risk of bias indicated that four studies had low risk; five studies had some concerns, and two studies had high risk. Four types of intervention were identified, including physical exercise (n = 3), complementary and alternative medicine (music therapy = 1, acupressure = 1), case management (n = 5), and advance care planning (n = 1). The pooled analysis showed that group-based physical exercise had significant beneficial effects on depressive symptoms (SMD: -0.46, 95% CI: -0.81 to -0.10, p = .01; low certainty). There is no difference between the effects of case management and usual care on depressive symptoms (SMD: 0.02, 95% CI: -0.14 to 0.19, p = .79; high certainty). Narrative synthesis of evidence suggested the effects of complementary and alternative medicine on improving depressive symptoms and general mental status. CONCLUSIONS Psychological outcomes in older people with frailty are understudied. Group-based physical exercise could be a strategy to reduce depressive symptoms among older people with frailty. There is limited evidence showing the effects of complementary and alternative medicine on improving psychological outcomes. More rigorous trials are needed to examine the effects of non-pharmacological interventions on psychological outcomes among older people with frailty. REGISTRATION (PROSPERO): CRD42022303370.
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Affiliation(s)
- An Tao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Ken Hok Man Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Helen Yue Lai Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
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Wong MYC, Ou KL, Chung PK, Chui KYK, Zhang CQ. The relationship between physical activity, physical health, and mental health among older Chinese adults: A scoping review. Front Public Health 2023; 10:914548. [PMID: 36684983 PMCID: PMC9853435 DOI: 10.3389/fpubh.2022.914548] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations.
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Affiliation(s)
- Ming Yu Claudia Wong
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Kai-ling Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Pak Kwong Chung
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Kei Yee Katie Chui
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Chun-qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
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Ghaedi M, Kashfi SM, Ghahremani L, Asadollahi A. Effectiveness of Otago Exercise Program on Successful Aging within Older Women with Migrant Children Referring to Public Health Centers in Shiraz City, Iran. Gerontol Geriatr Med 2023; 9:23337214231172640. [PMID: 37168022 PMCID: PMC10164851 DOI: 10.1177/23337214231172640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 05/13/2023] Open
Abstract
Background: Successful aging (SA) is considered an indicator of satisfaction of older people. This study aimed to evaluate the effectiveness of the Otago Exercise Program (OEP) on SA among older women. Materials and Methods: quasi-experimental research with a control group was conducted in 2021 on 120 older women in Shiraz city, south Iran. Eligible samples were selected by a three-stage cluster sampling method and were classified into two equal intervention and control groups. Eight training sessions (exercises) were conducted for the intervention group using the OEP. SA questionnaire was completed at the beginning and 2 months after the intervention. The data were analyzed using the IBM-SPSS version 26, and the effect sizes were extracted. Results: The mean age of samples in the intervention and control groups was 69.71 + 59.59 and 68.83 + 5.08 years, respectively. Although there was no significant difference in the mean scores of SA between the two groups at the beginning of the study, 2 months after the intervention implementation, the mean scores of SA increased significantly in the intervention group (t = 8.57, p ≤ .001). Conclusion: It seems that OEP is an effective strategy for supporting SA in older people.
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Affiliation(s)
| | | | | | - Abdolrahim Asadollahi
- Shiraz University of Medical Sciences, Shiraz, Iran
- The Middle East Longevity Institute in Abyad Medical Centre, Tripoli, Lebanon
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Khodadad Kashi S, Mirzazadeh ZS, Saatchian V. A Systematic Review and Meta-Analysis of Resistance Training on Quality of Life, Depression, Muscle Strength, and Functional Exercise Capacity in Older Adults Aged 60 Years or More. Biol Res Nurs 2023; 25:88-106. [PMID: 35968662 DOI: 10.1177/10998004221120945] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Aging is generally associated with numerous metabolic and physical changes that augment susceptibility to several chronic conditions, disability, and diminished quality of life. OBJECTIVE The purpose of this meta-analysis was to investigate the efficacy of resistance training on quality of life, depression, muscle strength, and functional exercise capacity in older adults (≥60 years). DATA SOURCES A systematic search was conducted in PubMed, MEDLINE, Cochrane, Google Scholar, and Scopus up to December 20, 2021. RESULTS 21 studies (N = 1610) were included. Resistance training significantly improved physical functioning (standard mean differences (SMD), 0.31; p = 0.02), mental health (SMD, 0.44; p = 0.001), bodily pain (SMD, -0.52; p = 0.004), general health (SMD, 0.43; p = 0.002), social functioning (SMD, 0.25; p = 0.006), and mental component score (SMD, 0.51; p = 0.001) subscales. Moreover, depression (SMD, -1.13; p = 0.01), upper-limb muscle strength (mean difference (MD), 15.26 kg; p = 0.002), lower-limb muscle strength (MD, 48.46 kg; p = 0.02), and handgrip muscle strength (MD, 1.35 kg; p = 0.003) significantly improved following resistance training. No benefits were found for vitality, physical component score, total score of quality of life, and the 6-min walk distance. CONCLUSION Preliminary evidence reveals that resistance training can be effective for improving most domains of quality of life, upper- and lower-limb muscle strength, handgrip strength, and depression in aged people. More proof is hence needed to draw solid conclusions.
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Affiliation(s)
- Sholeh Khodadad Kashi
- Physical Education Department, 108871K.N. Toosi University of Technology, Tehran, Iran
| | - Zahra Sadat Mirzazadeh
- Faculty of Sport Sciences, Department of Sport Management, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Vahid Saatchian
- Department of Physical Education and Sport Sciences, 305467Imam Reza International University, Mashhad, Iran
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Fernandez-Gamez B, Solis-Urra P, Olvera-Rojas M, Molina-Hidalgo C, Fernández-Ortega J, Lara CP, Coca-Pulido A, Bellón D, Sclafani A, Mora-Gonzalez J, Toval A, Martín-Fuentes I, Bakker EA, Lozano RM, Navarrete S, Jiménez-Pavón D, Liu-Ambrose T, Erickson KI, Ortega FB, Esteban-Cornejo I. Resistance Exercise Program in Cognitively Normal Older Adults: CERT-Based Exercise Protocol of the AGUEDA Randomized Controlled Trial. J Nutr Health Aging 2023; 27:885-893. [PMID: 37960912 DOI: 10.1007/s12603-023-1982-1] [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: 06/06/2023] [Accepted: 07/13/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES To provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the resistance exercise program implemented in the AGUEDA (Active Gains in brain Using Exercise During Aging) study, a randomized controlled trial investigating the effects of a 24-week supervised resistance exercise program on executive function and related brain structure and function in cognitively normal older adults. DESIGN AND PARTICIPANTS 90 cognitively normal older adults aged 65 to 80 were randomized (1:1) to a: 1) resistance exercise group; or a 2) wait-list control group. Participants in the exercise group (n = 46) performed 180 min/week of resistance exercise (3 supervised sessions per week, 60 min/session) for 24 weeks. INTERVENTION The exercise program consisted of a combination of upper and lower limb exercises using elastic bands and the participant's own body weight as the main resistance. The load and intensity were based on the resistance of the elastic bands (7 resistances), number of repetitions (individualized), motor complexity of exercises (3 levels), sets and rest (3 sets/60 sec rest), execution time (40-60 sec) and velocity (as fast as possible). SETTINGS The maximum prescribed-target intensity was 70-80% of the participants' maximum rate of perceived exertion (7-8 RPE). Heart rate, sleep quality and feeling scale were recorded during all exercise sessions. Those in the wait-list control group (n = 44) were asked to maintain their usual lifestyle. The feasibility of AGUEDA project was evaluated by retention, adherence, adverse events and cost estimation on the exercise program. RESULTS AND CONCLUSIONS This study details the exercise program of the AGUEDA trial, including well-described multi-language manuals and videos, which can be used by public health professionals, or general public who wish to implement a feasible and low-cost resistance exercise program. The AGUEDA exercise program seems to be feasible by the high retention (95.6%) and attendance rate (85.7%), very low serious adverse event (1%) and low economic cost (144.23 € /participant/24 weeks). We predict that a 24-week resistance exercise program will have positive effects on brain health in cognitively normal older adults.
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Affiliation(s)
- B Fernandez-Gamez
- Beatriz Fernandez-Gamez and Irene-Esteban-Cornejo. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada; Carretera de Alfacar, 21. Granada 18071, Spain; +(34) 958 24 66 51, fax: +(34) 958 24 94 28, E-mail address: and
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Efendi F, Tonapa SI, Has EMM, Ho KHM. Effects of chair-based resistance band exercise on physical functioning, sleep quality, and depression of older adults in long-term care facilities: Systematic review and meta-analysis. Int J Nurs Sci 2022; 10:72-81. [PMID: 36860706 PMCID: PMC9969069 DOI: 10.1016/j.ijnss.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/27/2022] Open
Abstract
Objective Chair-based resistance band exercise (CRBE) is a simple and safe physical activity for persons with limited mobility. This study aimed to review and analyze CRBE effects on physical functioning, sleep quality, and depression among older adults in long-term care facilities (LTCF). Method A systematic search guided by the PRISMA 2020 approach was performed on specific databases: AgeLine, CINAHL, PubMed, Embase, Cochrane Library, Scopus, and Web of Science. The randomized controlled trial studies that trialed CRBE for older adults in LTCF, peer-reviewed articles published in the English language from inception to March 2022 were retrieved. Methodological quality was established using the Physiotherapy Evidence Database scale. The random and fixed effects model were used to generate the pooled effect size. Results Nine studies met the eligibility criteria and were synthesized. The results revealed that CRBE significantly promoted the activity of daily living (six studies; SMD = 0.30, P = 0.001), lung capacity (three studies; MD = 40.35, P < 0.001), handgrip strength (five studies; MD = 2.17, P < 0.001), upper limb muscle endurance (five studies; MD = 2.23, P = 0.012), lower limb muscle endurance (four studies; MD = 1.32, P < 0.001), upper body flexibility (four studies; MD = 3.06, P = 0.022), lower body flexibility (four studies; MD = 5.34, P < 0.001), dynamic balance (three studies; MD = -0.35, P = 0.011), sleep quality (two studies; MD = -1.71, P < 0.001), and reduced depression (two studies; SMD = -0.33, P = 0.035). Conclusion The evidence suggests that CRBE improved physical functioning parameters, and sleep quality, and lowers depression among older adults in LTCF. This study could be used to persuade long-term care facilities to allow people with limited mobility to engage in physical activity.
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Affiliation(s)
- Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia,School of Nursing & Midwifery, La Trobe University, Melbourne, Australia,Corresponding author. Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
| | | | | | - Ken Hok Man Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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