Applying the transtheoretical model to promote functional fitness of community older adults participating in elastic band exercises

Effects of elastic band resistance training on the physical and mental health of elderly individuals: A mixed methods systematic review

OBJECTIVES

Elastic band resistance training in elderly individuals can improve physical fitness and promote mental health in addition to other benefits. This systematic review aimed to review, summarize, and evaluate quantitative, qualitative, and mixed methodological studies on the use of elastic band resistance training in elderly individuals, and to investigate the influence of elastic band resistance training on the physical and mental health of elderly individuals, as well as their preferences and obstacles in training.

METHODS

A convergent separation approach was used to synthesize and integrate the results, specifically the mixed systematic review approach recommended by the Joanna Briggs Institute. The extensive search strategy included electronic database searches in the Cochrane Library, PubMed, Embase, Web of Science, Google Scholar, MEDLINE, and CINAHL. The researchers rigorously screened the literature, extracted and analyzed the data, and evaluated the quality of the included studies using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Twenty-eight studies were included, of which 25 were quantitative studies, 2 were qualitative studies, and 1 was a mixed-methods study. A total of 1,697 subjects were investigated across all studies. Quantitative evidence supports the notion that elastic band resistance training can improve upper and lower limb flexibility, endurance, upper strength, physical balance, and cardiopulmonary function and enhance the mental health of elderly individuals. Participants in the qualitative study reported some preferences and obstacles with band resistance training, but most participants reported physical benefits.

CONCLUSIONS

Despite the heterogeneity between studies, this review is the first systematic review to comprehensively evaluate the effectiveness of elastic band resistance training in older adults. It not only shows the influence of elastic band resistance training on the physical and mental health of the elderly, but also emphasizes the preference and obstacles of elderly individuals face.

Differences among Sociodemographic Variables, Physical Fitness Levels, and Body Composition with Adherence to Regular Physical Activity in Older Adults from the EXERNET Multicenter Study

The aim of this study was to explore the differences among between adherence to physical activity (PA) and sociodemographic variables, body composition, and physical fitness levels in older adults (>65 years). A number of 2712 participants (2086 female; 76.92%) ranging from 65 to 92 years, participated in the study. Stages of change (SoC) for PA from the transtheoretical model of change (TTM), together with different sociodemographic variables, physical fitness tests (Senior Fitness Test), and waist and hip circumferences were evaluated. Significant differences were found in age, gender, educational level, current income, physical fitness test, and body composition (all of them, p < 0.05), according to the different SoC. Greater adherence to PA practice (action and maintenance stages) was related to better academic level, higher economic income, the male gender, better results in the physical fitness test, and healthier anthropometrics perimeters. Future research is needed to identify the relationship between these variables longitudinally.

Effect of educational intervention on improvement of physical activities of middle-aged women

BACKGROUND

Regular physical activity has important health benefits for women. The present study aimed to investigate the effect of theory-based educational interventions on the improvement of physical activities of middle-aged women.

METHODS

This experimental study was conducted on 160 middle-aged women referred to Ahwaz health centers Iran in 2017 who were selected through the cluster sampling method. They were randomly divided into two groups: intervention (n = 80) and control (n = 80). The educational intervention for the experimental group consisted of 4 consultation and 4 follow-up sessions. The study outcomes included physical activity change, self-efficacy, decision-making balance, and the International Physical Activity Questionnaire, which were measured before the intervention and 2 months after that. The data were analyzed using the SPSS19 software as well as the Chi-square, independent t-test and paired t-test.

RESULTS

After the intervention, the mean scores of preparedness for change, decision-making balance, perceived self-efficacy, pre-thinking, thinking, preparation, practice and maintenance were significantly different in both the experimental and control groups (P value < 0.05). The t-test showed that after the educational intervention, the mean score of physical activity was significantly higher in the experimental group than in the control group (726.3 ± 201.6 and 339.8 ± 90.2, respectively) (P value < 0.001).

CONCLUSION

The findings of this study showed that the theory-based educational intervention was effective on the improvement of the middle-aged women's physical activities. Therefore, it is suggested that a theory-based educational program be designed and implemented in order to increase the physical activities of this group.

Transtheoretical Model for Physical Activity in Older Adults: Systematic Review

Healthy aging makes the practice of physical activity (PA) a necessity. However, PA guidelines achievement in older adults is scarce. The use of behavioral theories such as Transtheoretical Model (TTM), helps in older adults PA promotion. The aim of this review was to identify the use of TTM for PA in older adults (>60 years). PubMed, SPORTdiscus, and Medline databases were used to conduct the search. All steps of the process followed the recommendations of the PRISMA flow-diagram. We identified eight studies: Six were descriptive cross-sectional studies, one prospective-cohort study and one with a quasi-experimental design. Only two papers evaluated the four behavior change dimensions within the same study, three evaluated the processes of change and the decisional balance, four evaluated the exercise self-efficacy and all assessed the stages of change for PA behavior. From this review, we can conclude that TTM is a useful and suitable behavior model in creating, developing, and evaluating interventions with the aim of acquiring and improving PA habits in the older adults. However, there is paucity of research in this area, and more studies including the four behavioral change dimensions are needed to analyze the effect of TTM on the promotion of PA in the older adults.

Decision-tables for choosing commonly applied inferential statistical tests in comparative and correlation studies

BACKGROUND

Nurse researchers are increasingly using a wide variety of inferential statistical tests. However, novice researchers might find choosing tests for their studies difficult, as a result of this variety.

AIM

To present structured decision-tables to help choose which statistical tests to use in comparative and correlation studies.

DISCUSSION

The wide spectrum of statistical techniques the authors identified in nursing research helped them to construct overview tables that researchers could use as a simple tool to help choose appropriate statistical tests for their studies.

CONCLUSION

The decision-tables provided in this paper are unique in that they are composed of commonly applied statistical techniques identified in nursing studies and structured to simplify the pathway to statistical test decision-making for a broad spectrum of study designs.

IMPLICATIONS FOR PRACTICE

Novice nurse researchers can use the decision-tables presented in this paper as a starting point to explore with research colleagues or supervisors the appropriate choice of statistical techniques.

Texting Older Sisters to Step: The TOSS Study

The purpose of our two-phase study was to develop acceptable text messages to increase physical activity. Four focus groups (two for each phase) were conducted with older African American women who had access to texting-capable mobile phones and were in the contemplation stage for physical activity. The mean age of Phase 1 participants (n = 12) was 71 and ranged from 65 to 86 years. Content analysis was used to identify fundamental themes that were later used to develop text messages. Six categories emerged from the data and 31 text messages were developed based on focus group input and national recommendations. The mean age of Phase 2 participants (n = 9) was 67 and ranged from 65 to 75 years. Descriptive statistics revealed 100% of participants understood all messages. When messages were evaluated individually, a minimum of 78% felt each message motivated activity and 67% said lengths were perfect. Findings identified messages that were relevant and potentially motivational to stimulate physical activity among this population.

Meridian Cuffing Exercises Improved Functional Fitness and Cardiopulmonary Functioning of Community Older Adults

This study was aimed to test the effects of a meridian cuffing exercise, the Healthy Beat Acupunch (HBA) regimen, on the functional fitness and cardiopulmonary functioning of community older adults. A single-blind, cluster randomized controlled trial was conducted. We randomly allocated eight community care centers to the intervention or control group and recruited 228 participants who completed the study (intervention: four centers, n = 111; control: four centers, n = 117). The intervention group underwent a 40-min session of HBA regimen 3 times per week for 6 months. Functional fitness and cardiopulmonary functioning were assessed at baseline, 3 months, and 6 months of the intervention. The intervention group demonstrated significantly greater improvements in functional fitness and cardiopulmonary functioning than the control group between baseline and either 3 months or 6 months. We suggest that activities designed to promote health among community older adults include acupunch exercises.

Physical and mental health status and their correlations among older wheelchair users with dementia in long-term care facilities

PURPOSE

To investigate the physical health (daily functioning and functional fitness) and mental health (depression and behavioral dysfunction) of older wheelchair users with dementia in long-term care facilities, examine the correlations between physical and mental health, and identify the independent variables of their daily functioning.

METHODS

A descriptive correlational method was adopted, which was conducted in six long-term care facilities in three cities, south Taiwan. Participants comprised 98 older wheelchair users with dementia. Data were collected using structured questionnaires (Mini-Mental State Examination, Barthel Index, Cornell Scale for Depression in Dementia, and Clifton Assessment Procedures for the Elderly Behavior Rating Scale) and from functional fitness testing (cardiopulmonary functioning, body flexibility, joint mobility, and muscle strength and endurance).

RESULTS

Older adults with dementia who had high depression scores were likely to have more behavioral dysfunctions, poorer performance in shoulder flexion and abduction, and lower upper limb muscle strength and endurance. More behavioral dysfunctions were associated with poorer daily functioning, lung capacity, body flexibility, shoulder flexion, and upper limb muscle strength and endurance. Those with better lung capacity, body flexibility, upper limb muscle strength, and endurance were likely to have high daily functioning scores (all p < .05). The key independent variables associated with daily functioning were behavioral dysfunction, lower body flexibility, and lung capacity, which together explained 59.3% of the total variance.

CONCLUSIONS

Further research should develop appropriate activity-based intervention programs for older wheelchair users with dementia to delay their deterioration and promote their physical and mental health.

Resistance Band Exercises Reduce Depression and Behavioral Problems of Wheelchair-Bound Older Adults with Dementia: A Cluster-Randomized Controlled Trial

OBJECTIVES

To test the effects of a 15-month wheelchair-bound resistance band exercise program on depression and behavioral problems of wheelchair-bound older adults with dementia.

DESIGN

Single-blind, cluster-randomized controlled trial with repeated measures.

SETTING

Eight nursing homes in southern Taiwan.

PARTICIPANTS

Wheelchair-bound nursing home older adults with dementia who participated voluntarily (N = 150) were cluster-randomized to two groups (experimental or control group); 127 completed the study (experimental: four nursing homes, n = 65; control: four nursing homes, n = 62).

INTERVENTION

The resistance band exercises were conducted three times per week in 40-minute sessions in the following two sequences: volunteer-led sessions for the first 6 months (Stage I) followed by DVD-guided sessions for the next 9 months (Stage II).

MEASUREMENTS

Depression, as measured using the Cornell Scale for Depression in Dementia, and behavioral problems, as measured using the Clifton Assessment Procedures for the Elderly-Behavior Rating Scale, of participants were observed at six time points at 3-month intervals: pretest, two posttests at Stage I, and three posttests at Stage II.

RESULTS

By the sixth month of the study, experimental group participants were significantly less depressed and had fewer behavioral problems than control group participants (all P < .05). These small but statistically significant differences persisted throughout the 9 months of the DVD-guided sessions (all P < .05).

CONCLUSION

Volunteer-led sessions followed by DVD-guided sessions of resistance band exercise is effective and practical in institutional settings.

Feasible modalities and long-term effects of elastic band exercises in nursing home older adults in wheelchairs: A cluster randomized controlled trial

BACKGROUND

Physical activity holds promise for mobility-impaired older adults to prevent further disabilities and improve their health. However, staffing constraints have made it challenging to promote physical activity in long-term care facilities.

OBJECTIVES

To test the feasibility and effects of 12 months Wheelchair-bound Senior Elastic Band (WSEB) group-exercises that were led by volunteers for the first six months followed by the DVD-guided for another six months on functional fitness, activities of daily living (ADL), and sleep quality of nursing home older adults in wheelchairs.

DESIGN

Cluster randomized controlled trial with two groups, pre-test and post-tests.

SETTINGS

Ten nursing homes, Taiwan.

PARTICIPANTS

127 participants participated voluntarily; 107 of them completed the study.

INCLUSION CRITERIA

(1) aged 65 years and over, (2) using wheelchairs for mobility, (3) living in facility for at least three months, (4) cognitively intact, and (5) heavy or moderate dependency in ADL. Majority of participants were middle-old older adults (75-84 years old, 53.2%), female (51.4%), and had chronic illnesses (98.1%).

METHODS

Participants were randomly assigned by facility to either the experimental (five nursing homes, n=56) or control group (five nursing homes, n=51). The WSEB program was conducted three times per week and 40 min per session in two stages: volunteer-led for the first six months (stage I) followed by the DVD-guided modality for another six months (stage II). The primary outcomes (functional fitness: lung capacity, body flexibility, range of joint motion, and muscle strength and endurance) and the secondary outcomes (ADL measured by the Barthel Index; sleep quality measured by the Pittsburgh Sleep Quality Index) of the participants were measured at three time points: pre-test, at the six-month interval, and at the end of 12 months of the study. No blinding was applied.

RESULTS

All of the functional fitness indicators of the experimental group participants improved significantly (p<.05), and were all better than the control group at six-month and 12-month of the study (p<.05). No symptoms of discomfort occurred during interventions.

CONCLUSIONS

Nursing home older adults in wheelchairs who received WSEB exercise training had better functional fitness, ADL, and sleep quality than those who did not. It was a feasible way of carrying out this exercise program by using the volunteer-led followed by the DVD-guided modalities. The program can be applied in institutional settings routinely.