Correlation Between Executive Function and Walk While Crossing Over an Obstacle Under Different Gait Phases

Background and Purpose

Dual walking task such as crossing over an obstacle may serve as an excellent tool for predicting early cognitive decline. Thus, this study aimed to investigate correlation between walking while crossing over an obstacle and executive functions under different gait phases to validate the use of walking with an obstacle for predicting early cognitive decline.

Methods

A cross-sectional study was conducted on 48 elderly individuals from 2 day-care centers and 3 welfare-centers in Seoul and Gyeonggi, Korea. Executive function tests (Trail Making Test, Stroop test) and dual walking tests (gait speed, cadence, stance time, gait cycle time) were performed and compared using partial correlation analysis.

Results

There were significant correlations between executive function and most of the gait variables (stance time, cadence, and gait cycle time) (p<0.05) when crossing over an obstacle while walking. Especially, stance time exhibited significant correlations with most executive functions (p<0.05).

Conclusions

When evaluating executive function during walking with an obstacle, post-obstacle-crossing phase and stance time need to be observed.

Effects of yoga on physical and psychological health among community-dwelling older adults: A systematic review and meta-analysis

OBJECTIVES

To synthesise and critically appraise the quality of existing evidence about the effects of yoga on physical and psychological outcomes among older adults.

DESIGN

A systematic review and meta-analysis.

PARTICIPANTS

Participants aged 60 and above.

MEASUREMENTS

Nine English and two Chinese electronic bibliographic databases, including MEDLINE OvidSP, PsycINFO, AMED, EMBASE, Global Health, PubMed, Scopus, CINAHL, Cochrane Library, Hyread and WanFang databases, were searched. Randomised controlled trials (RCT) of yoga on physical and psychological outcomes among older adults were included. Meta-analysis was conducted for outcomes studied in three or more studies, otherwise narrative synthesis was performed.

RESULTS

Fifteen studies were included for review. The results of meta-analysis after sensitivity analysis showed that yoga significantly improved balance (SMD = 0.81, 95% CI: 0.48-1.14, p < .001, II2  = 59%), flexibility (SMD = 0.38, 95% CI: 0.07-0.68, p = .020, II2 34%), muscle strength (SMD = 0.49, 95% CI: 0.18-0.79, p = .002, I2 43%) and depressive symptoms (SMD = 0.50, 95% CI = 0.09-0.91, p = .01, I2 0%). There was insufficient data for meta-analysis on gait and other psychological outcomes. Narrative synthesis suggested that yoga has positive effects on reducing anxiety, but its effects on improving gait and reducing stress among older adults were inconclusive.

CONCLUSION

The results of this review supported the beneficial effects of yoga on physical outcomes among older adults, but the heterogeneity across studies was relatively high. Evidence related to the effect on psychological outcomes was limited.

Life's Essential 8: Optimizing Health in Older Adults

The population worldwide is getting older as a result of advances in public health, medicine, and technology. Older individuals are living longer with a higher prevalence of subclinical and clinical cardiovascular disease (CVD). In 2010, the American Heart Association introduced a list of key prevention targets, known as "Life's Simple 7" to increase CVD-free survival, longevity, and quality of life. In 2022, sleep health was added to expand the recommendations to "Life's Essential 8" (eat better, be more active, stop smoking, get adequate sleep, manage weight, manage cholesterol, manage blood pressure, and manage diabetes). These prevention targets are intended to apply regardless of chronologic age. During this same time, the understanding of aging biology and goals of care for older adults further enhanced the relevance of prevention across the range of functions. From a biological perspective, aging is a complex cellular process characterized by genomic instability, telomere attrition, loss of proteostasis, inflammation, deregulated nutrient-sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. These aging hallmarks are triggered by and enhanced by traditional CVD risk factors leading to geriatric syndromes (eg, frailty, sarcopenia, functional limitation, and cognitive impairment) which complicate efforts toward prevention. Therefore, we review Life's Essential 8 through the lens of aging biology, geroscience, and geriatric precepts to guide clinicians taking care of older adults.

Regional Differences in Self-Reported Health, Physical Activity and Physical Fitness of Urban Senior Citizens in Austria

The aim of this study is to compare data on the health status, self-reported exercise and non-exercise physical activity as well as fitness parameters, such as grip strength, of people in retirement in two cities that are both considered urban centres according to the statistical office of the European Union (EUROSTAT), but differ by geographic location. Self-reported physical activity questionnaires and objective assessments of physical fitness indicators collected by sports scientists were used and examined for differences. A total of 210 people (66.3 years ± 2.3) in Salzburg (n = 90) and Vienna (n = 120) was analysed. While no differences were found in self-reported health, there were differences in self-reported exposure to self-reported exercise and non-exercise physical activity, with the Viennese population being more inactive than their more western comparison group. In addition, the objective indicators for muscle strength, balance and flexibility of the lower extremities differed significantly in favour of the more western Austrian population. We recommend assessing the situation of older people in Austria regarding their physical activity and fitness on a regional basis, even if they live in cities of the same category. Future projects should therefore aim to consider specific regional needs during development and incorporate both subjective and objective indicators when monitoring the success of such programs.

Physical activity and subjective well-being of older adults during COVID-19 prevention and control normalization: Mediating role of outdoor exercise environment and regulating role of exercise form

Since the outbreak of the COVID-19 pandemic, the physical and mental health of older adults has been threatened. Promoting physical and mental health through physical activity has therefore become a strategy for healthy aging. In order to better understand the impact of the participation of older adults in physical activity, this paper selects different types of physical activity, and examines the relationship between them and subjective well-being through the analysis of the mediation effect of outdoor exercise environment and the regulating effect of exercise form. In this cross-sectional study, a questionnaire survey was conducted in mainland China. The main data come from 903 older adults in five urban areas in Chengdu, Sichuan Province. The surveys were carried out using the Physical Activity Rating Scale, Newfoundland Subjective Well-Being Scale, Exercise Environment Scale, and Exercise Form Scale. SPSS was used for statistical analysis, linear regression analysis was adopted for processing data, and AMOS was used to establish a mediation model. The mediating variable is the outdoor exercise environment, and the moderating variable is exercise form; gender, age, education level, and monthly income were used as control variables. The study results showed that different physical activities (tai chi; health qigong; walking and jogging) were significantly, positively correlated with the subjective well-being of older adults (tai chi: R = 0.351, p < 0.01; health qigong: R = 0.340, p < 0.01; walking and jogging: R = 0.245, p < 0.01); among the activities, tai chi had the strongest effect on the subjective well-being of older adults (R = 0.351, p < 0.01). Outdoor exercise environment played a mediating role between different physical activity types and subjective well-being of older adults [tai chi: β = 0.030, 95% CI (0.005, 0.031); health qigong: β = 0.018, 95% CI (0.000, 0.021); walking and jogging: β = 0.034, 95% CI (0.008, 0.035)]. Exercise form moderated the subjective well-being of older adults in different physical activities (tai chi: 0.006, p < 0.05; health qigong: 0.006, p < 0.05; walking and jogging: 0.009, p < 0.001). The results of this study demonstrate that the outdoor exercise environment plays a mediating role between different physical activities and the subjective well-being of older adults, and the form of exercise can also moderate the impact of different physical activities on the subjective well-being of older adults. This study has enlightening significance for psychological intervention with older adults facing stress, anxiety and depression.

Associations of Health-Related Physical Fitness with Waist Circumference and Abdominal Obesity Risk in Taiwanese Adults

In this study, we aimed to determine the associations among health-related physical fitness measurements, waist circumference (WC), and abdominal obesity risk in Taiwanese adults. We conducted a cross-sectional study based on data from the 2017 Taiwan Scientific Physical Fitness Survey (the TSPFS). We collected the responses from 17,973 participants (7907 men and 10,066 women) aged 23–64 years for this study. The participants completed the study protocol with a standardized structural questionnaire and a series of health-related physical fitness measurements. The fitness measurements included cardiorespiratory fitness (measured by a 3-min progressive knee-up and step test), muscular fitness (measured by a hand grip strength test), and flexibility (measured by a sit-and-reach test). Our anthropometric measurements included height, weight, WC, hip circumference (HC), body mass index (BMI), and waist-to-hip ratio (WHR). We identified the quartiles of the health-related physical fitness results as the dependent variable in the multiple linear and multiple logistic regression analysis to determine the associations of the physical fitness measurements with WC distribution and abdominal obesity risk. We also considered the dose–response relationship. We found that cardiorespiratory fitness, relative grip strength, and flexibility were each significantly negatively associated with WC, but absolute grip strength was significantly positively associated with WC. We also found that higher levels of cardiorespiratory fitness, relative grip strength, and flexibility were each associated with a lower risk of abdominal obesity. Moreover, our secondary finding was of a dose–response relationship between physical fitness performance, WC, and abdominal obesity risk. In short, health-related physical fitness was an effective predictor of waist circumference for both sexes of Taiwanese adults, and higher levels of health-related physical fitness were associated with lower risks of abdominal obesity in Taiwanese adults.

Are flexibility and muscle-strengthening activities associated with functional limitation?

This retrospective cohort study examined the relationship between self-reported participation in flexibility and muscular strengthening activities and the development of functional limitation (i.e., once an individual has difficulty with or becomes unable to perform activities of daily living). Data were obtained from 1318 adults (mean age 49.5 ​± ​9.7 years; 98.7% Caucasian; 14.9% female) enrolled in the Aerobics Center Longitudinal Study from 1979 to 2004 and free of functional limitation at baseline. Mail-back health surveys were used to prospectively determine incident functional limitation. Participation in muscle-strengthening and flexibility activities was assessed via self-report. Adjusted logistic regression analyses were used to determine the odds ratios (OR) and corresponding 95% confidence intervals for developing functional limitation during follow-up based on participation in general and specific categories of flexibility (‘Stretching’, ‘Calisthenics’, or ‘Exercise Class’) and muscle-strengthening activities (‘Calisthenics’, ‘Free Weights’, ‘Weight Training Machines’, or ‘Other’). Overall, 42.6% of the sample reported incident functional limitation. After adjusting for potential confounders (e.g., age, sex, cardiometabolic risk factors), those who reported performing muscle-strengthening activities in general (n ​= ​685) were at lower risk of developing functional limitation [OR ​= ​0.79 (0.63–1.00)]. In addition, the specific flexibility activities of stretching (n ​= ​491) and calisthenics (n ​= ​122) were associated with 24% and 38% decreased odds of incident functional limitation, respectively. General muscle-strengthening, stretching, and calisthenics activities are prospectively associated with decreased risk of incident functional limitation in generally healthy, middle-aged and older adults. Thus, both public health and rehabilitation programs should highlight the importance of flexibility and muscle-strengthening activities during adulthood to help preserve functional capacity.

The Effect of Convergence Gamification Training in Community-Dwelling Older People: A Multicenter, Randomized Controlled Trial

OBJECTIVES

It is necessary to improve the health of older adults through exercise, but there is no concrete way to implement it or an environment in which they can exercise continuously. Our objective was to confirm the safety and efficacy of information technology (IT) convergence gamification exercise equipment for older adults. We tried to demonstrate equivalence to conventional exercise by comparing the functional improvement.

DESIGN

Randomized controlled trial, with 8-week-long IT convergence exercises 3 times a week vs conventional exercise.

SETTING AND PARTICIPANTS

40 community-dwelling participants aged 60-85 years.

METHOD

Participants were randomly divided into a conventional exercise group (group 1) and an IT convergence exercise group (group 2). Both groups were trained for 8 weeks, and functional assessment was performed before training (pre-evaluation), after training, and after 4 weeks of rest.

RESULTS

There were functional improvements in both groups. A comparison of the differences in the functional assessment between pre-evaluation and after 8 weeks of training yielded the following results. In group 1, the mean Five Times Sit to Stand Test-30 seconds was scored as 3.60 ± 2.56 (P < .015); Five Times Sit to Stand Test-5 times, -1.75 ± 2.04 s (P < .015); Berg Balance Scale, 1.05 ± 1.39 (P < .015); Timed Up-and-Go test, -0.64 ± 0.64 s (P < .015); and 10-m Walking Test, -0.35 ± 0.47 s (P < .015). And in group 2, the mean Five Times Sit to Stand Test-30 seconds (s) was scored as 3.70 ± 2.62 (P < .015), Five Times Sit to Stand Test-5 times, -1.65 ± 1.59 s (P < .015); Berg Balance Scale, 1.05 ± 1.00 (P < .015); Timed Up-and-Go test, -0.93 ± 0.68 s (P < .015); 10-m Walking Test, -0.41 ± 0.489 s (P < .015); Chair Sit and Reach test, 2.23 ± 3.19 cm (P < .015); and Korean version of the Falls Efficacy Scale-International, -1.05 ± 1.43 (P < .015).

CONCLUSION AND IMPLICATIONS

The results of this study suggest that the IT convergence gamification exercise equipment such as balpro110 has exercise effects similar to conventional exercise and also has advantages as an alternative to exercise for older adults in the next generation.

A randomized-controlled trial comparing supervised aerobic training to resistance training followed by unsupervised exercise on physical functioning in older breast cancer survivors

INTRODUCTION

This study compared the relative efficacy of aerobic training to resistance training on physical functioning in older breast cancer survivors and determined whether benefits could be maintained by transitioning to unsupervised home-based training.

MATERIALS AND METHODS

Early-stage, post-treatment, older (≥65 years) breast cancer survivors (n = 114; mean age 72 years) were randomized to 12 months of supervised aerobic (n = 37), resistance (n = 39) or stretching (active control; n = 38) training followed by 6 months of unsupervised home-based training. Outcomes included aerobic capacity by 6-min walk distance (6MWD; m), maximal upper and lower body strength (1-repetition maximum; kg); physical function by short physical performance battery (SPPB), SF-36 and Late Life Function and Disability Instruments.

RESULTS

Over 12-months of supervised exercise, all groups improved in muscle strength and SPPB scores, but resistance trained women also improved 6MWD. Improvements in upper and lower body strength in the resistance group were significantly greater than those in the stretching control (+2.5 kg vs. +1.8 kg; p = 0.05) and aerobic groups (+8.3 kg vs +2.7 kg; p = 0.047), respectively, with trends for greater improvements in 6MWD (+57.9 m vs. +22.5 m; p = 0.057) and self-report physical function (+4.8 vs. -4.4; 0.066) in resistance trained women versus controls. Compared to values at 12 months, there were no changes during unsupervised training in any measure within or between groups, except for self-reported advanced lower extremity function which improved in the resistance group and fell in the aerobic group (+1.3 vs. -3.1; p = 0.043).

DISCUSSION

Supervised exercise can improve strength and physical functioning among older breast cancer survivors. Resistance training may lead to better improvements compared to aerobic or flexibility training, whether in a supervised or unsupervised setting. Clinicaltrials.govNCT00662103.

Physical Activity and Exercise for Older People Living with HIV: A Scoping Review

INTRODUCTION

Improvements in physical, mental, and overall quality of life are well documented in younger HIV populations who exercise. Exercise guidelines exist for younger HIV populations, but none for older people living with HIV (OPLWH), especially 50 years of age and older. Our aim was to map the existing literature on the effects of exercise and physical activity prescriptions for OPLWH.

METHODS

We conducted a scoping review using the methodological framework proposed by the Joanna Briggs Institute. Online searches on five research databases yielded 503 published articles. Fifteen studies met the study's inclusion criteria.

RESULTS

The most commonly used parameters of exercise included aerobic and strength training, as well as a combination of both. The physical, psychological and Quality of Life (QoL) impact of physical activity and its effect on OPLWH is evidently beneficial. Overall, a positive correlation between exercise and physical, mental and functional status was observed. No adverse side effects, or safety and efficacy concerns, during the use of exercise were reported.

CONCLUSION

This review confirms the dearth of evidence on physical activity and exercise in the context of OPLWH. Of greater concern is the fact that there were no studies conducted in sub-Saharan Africa, the global region with by far the highest HIV burden.

Microarray profiling of gene expression in C2C12 myotubes trained by electric pulse stimulation

Electric pulse-stimulated C2C12 myotubes are gaining interest in the field of muscle physiology and biotechnology because electric pulse stimulation (EPS) enhances sarcomere structure development and active tension generation capability. Recently, we found that termination of EPS results in the rapid loss of active tension generation accompanied by disassembly of the sarcomere structure, which may represent an in vitro muscle atrophy model. To elucidate the molecular mechanism underlying this rapid loss of active tension generation and sarcomere structure disassembly after termination of EPS, we performed transcriptomic analysis using microarray. After termination of EPS, 74 genes were upregulated and 120 genes were downregulated after 30 min; however, atrophy-related genes were not found among these genes. To further assess the effect of EPS on gene expression, we re-applied EPS after its termination for 8 h and searched for genes whose expression was reversed. Four genes were upregulated by termination of EPS and downregulated by the re-application of EPS, whereas two genes were downregulated by termination of EPS and upregulated by the re-application of EPS. Although none of these genes were atrophy- or hypertrophy-related, the results presented in this study will contribute to the understanding of gene expression changes that mediate rapid loss of active tension generation and sarcomere structure disassembly following termination of EPS in C2C12 myotubes.

Effects of a power training program in the functional capacity, on body balance and lower limb muscle strength of elderly with type 2 diabetes mellitus

BACKGROUND

The effects of interventions with muscle power training on balance and functionality in individuals with type 2 diabetes mellitus (T2DM) are still poorly investigated. We evaluated the efficacy of a twelve-week power training program in the functional capacity, balance and lower limb muscle power and strength of elderly with T2DM.

METHODS

Twenty-one subjects (14 women and seven men) were allocated into two groups. One of the groups (PTG) performed a power training program twice a week (N.=11; age 70.5±7.8 years old), and the other was an active control group (CG) that performed a weekly stretching session (N.=10; age 66±3.2 years old). Outcomes of interest were assessed at baseline and after 12 weeks, these included functional capacity, balance, muscle strength and power.

RESULTS

The PTG participants improved their dynamic balance (P=0.027) and decrease in the time to perform the gait speed test (P<0.001), evaluated by the short physical performance battery (SPPB). Also showed a statically significant change muscle power (P=0.034) and maximal dynamic knee extension strength (P=0.023), with increments of 24% and 34%, respectively, in comparison to the CG. Both groups showed significant changes in the performance of the five-times-sit-to-stand test (P<0.001) and the SPPB score (P=0.001).

CONCLUSIONS

The power training program was able to promote improvements in some functional parameters as on the body balance and functional capacity and muscle strength of the elderly with T2DM. The training method was effective and safe, with no adverse effects during sessions.

Physical activity and exercise for older people living with HIV: a protocol for a scoping review

BACKGROUND

Older people living with HIV (OPLWH) are expected to live longer in the era of antiretroviral treatment, but at the same time, they are at risk for developing various health complications as a consequence of a life with the infection, exposure to medications that carry their own toxicity and side effects, and the natural effects of aging on the immune system. Because senescence is an inherent process that can be accelerated by HIV, it is important to identify strategies that can modify this phenomenon. Emerging data suggests that while physical activity and exercise may not have a positive impact on viral replication and on the immune system of people living with HIV, it can elicit improvements in cardiorespiratory fitness, strength, body composition, and overall quality of life. The purpose of this study is to map out empirical evidence on the effects of physical activity and exercise in OPLWH.

METHODS

The scoping review methods will be guided by the framework proposed by the Joanna Briggs Institute guidelines. Literature searches will be conducted in the following electronic databases (from inception onwards): PubMed/MEDLINE, Cochrane Library, and Google Scholar. Peer-reviewed journal papers will be included if they are written in English, involved human participants aged 50 years, and older with HIV and described a measure for physical, mental, or functional status of physical activity/exercise and/or the recommendations in OPLWH. Quantitative, qualitative, and mixed-method studies will be included in order to consider different aspects of measuring the effects of physical activity and exercise (e.g., quality of life, functional status, activities of daily living). Two reviewers will screen all citations and full-text articles. We will abstract data, organize them into themes and sub-themes, summarize them, and report the results using a narrative synthesis. The study methodological quality (or bias) will be appraised using a Mixed Methods Appraisal Tool.

DISCUSSION

The evidence gathered from the selected studies will be discussed in relation to the research questions using a narrative to identify and explore emergent themes. The review will provide a baseline of evidence on exercise and physical activity interventions for OPLWH. It will highlight gaps regarding the use of exercise and physical activity and contribute to the design of an effective intervention approach to the rehabilitation of OPLWH.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework (https://osf.io/728kp/).

Bend Don't Break: Stretching Improves Scores on a Battery of Fall Assessment Tools in Older Adults

CONTEXT

Falls and loss of autonomy are often attributed in large part to musculoskeletal impairments in later adulthood. Age-related declines in flexibility contribute to late adulthood musculoskeletal impairment. The novel sitting-rising test has been proposed to be a quick, effective screening of musculoskeletal fitness, fall risk, and all-cause mortality in older adults. The timed up and go and 5 times sit-to-stand tests are two of the 3 most evidence-supported performance measures to assess fall risk.

OBJECTIVE

This study aimed to determine if 5 weeks of flexibility training could increase sitting-rising test, timed up and go, and 5 times sit-to-stand scores in community-dwelling older adults.

PARTICIPANTS

Forty-seven adults aged 60 years and older (mean age = 66.7 y, SD = 4.1) participated in this study. Participants completed a static stretching protocol consisting of 3 weekly 1-hour stretching sessions.

RESULTS

The protocol improved flexibility as seen in sit-and-reach scores and improved scores on all outcome variables. Specifically, there was a significant increase in sitting-rising test scores from preintervention (M = 7.45, SD = 1.45) to postintervention (M = 8.04, SD = 1.36), t(42) = -5.21, P < .001. Timed up and go scores demonstrated a significant decrease from preintervention (M = 8.85, SD = 1.32) to postintervention (M = 8.20, SD = 1.35), t(46) = 5.10, P < .001. Five times sit-to-stand scores demonstrated a significant decrease from preintervention (M = 12.57, SD = 2.68) to postintervention (M = 10.46, SD = 2.06), t(46) = 6.62, P < .001. Finally, significant increases in sit-and-reach scores were associated with improved functional performance (r = -.308, P = .03).

CONCLUSION

Findings suggest that flexibility training can be an effective mode of low-level exercise to improve functional outcomes. Static stretching may help to improve musculoskeletal health, promote autonomy, and decrease mortality in community-dwelling older adults.

The Effects of Different Exergame Intensity Training on Walking Speed in Older Women

Objective: It is not known if the intensity in which exergames are performed can change gait parameters at different walking speeds. This study was designed to determine if a training program based on exergame exercises performed at different intensities (moderate vs. vigorous) influences walking speed and gait parameters in older adult women. Methods: After applying the inclusion criteria, 20 participants (69.5 ± 5.4 years) were randomized into two groups: moderate (11-13 perceived exertion) and vigorous (14-16 perceived exertion). Walking speed and gait parameters at self-selected walking speed (SSWS) and maximal walking speed (MWS) were evaluated before and after 3 months of exergame training. The walking speed and gait parameters were measured with an instrumented walkway. The walking speed reserve (WSR) was calculated as a difference and ratio. Results: There was pre-to-post effect of walking speed at self-selected walking pace (pre = 112.1 ± 16.4 cm.s^-1; post = 124.8 ± 16.4 cm.s^-1), in WSR calculated as ratio (pre = 1.35 ± 0.08; post = 1.28 ± 0.09), in a number of gait parameters at SSWS (step length, stride length, stride velocity, step time, stride time, swing time, stance time, single support, double support, gait cycle time, and cadence) and at MWS (step time, stride time, swing time, single support, double support, gait cycle time, and cadence). Conclusion: Irrespective of the exercise intensity, exergame training improved walking speed only at a self-selected walking pace and some gait parameters at self-selected and MWS in older women.

Pilates versus resistance training on trunk strength and balance adaptations in older women: a randomized controlled trial

Background

The neuromuscular decline impact in the functional independence of older women is determining the necessity of implementing new strategies focused on core strength training and postural stability maintenance to promote healthy aging.

Objectives

To define whether Pilates or resistance training is better at improving (a) core isometric and isokinetic muscular strength, and (b) static and dynamic balance, in older women.

Methods

This was a cluster randomized controlled trial. Physically independent older women (60–80 years) from day centers were randomly allocated to Pilates, Muscular and Control Groups (PG, MG and CG) using a block randomization method. Only the research staff performing the assessment and statistical analysis were blinded. Exercise groups trained twice a week (1 h per session) for 18 weeks in a moderate-to-vigorous intensity. Core strength (primary outcome): trunk and hip isometric and hip isokinetic muscular strength (Biodex System III Pro Isokinetic Dynamometer), alongside one leg static balance (portable force platform Kistler 9286AA) and dynamic balance (timed up and go (TUG)) were assessed.

Results

A total of 60 participants were randomized (PG, n = 20; MG, n = 20; CG, n = 20) and 49 completed the trial (PG, n = 16; MG, n = 19; CG, n = 14). Regarding hip isometric extension strength, PG was statistically better than CG (P = 0.004). There were no differences between groups regarding isokinetic strength or balance. Intra-group comparisons showed significant improvements (P < 0.05) in the dynamic balance and trunk and hip isometric extension strength for PG and MG, whereas every hip isokinetic measurement was improved in MG. Exercise programs did not produce any adverse event.

Conclusions

The Pilates training program was more effective for improving isometric hip and trunk extension strength, while the Muscular training program generated greater benefits on trunk and hip isokinetic strength. Moreover, both training programs showed moderate effects for the TUG.

Clinical Trial Registration

The trial was registered at ClinicalTrials.gov (identifier: NCT02506491).

Exercise for reducing falls in people living with and beyond cancer

BACKGROUND

Current treatment modalities for cancer have been successful in achieving improved survivorship; however, they come with a number of long-term adverse effects. Accidental falls are a common and clinically significant adverse event in people living with and beyond cancer and rates are higher than in the rest of the population.

OBJECTIVES

To assess the effects of prescribed or provided exercise for reducing accidental falls, and falls risk factors of strength, flexibility and balance, in people living with and beyond cancer.

SEARCH METHODS

We searched the following electronic databases from inception to 10 July 2018, with no restrictions: CENTRAL, MEDLINE, Embase, and seven other databases. We searched clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform (ICTRP) for ongoing trials, and reference lists of reviews and retrieved articles for additional studies.

SELECTION CRITERIA

We included all randomised controlled trials investigating exercise interventions versus no treatment, usual care or non-exercise interventions on falls incidence or falls risk factors in adults living with and beyond cancer (18 years of age or older at diagnosis). We excluded cross-over studies and studies in acute or inpatient hospice care.

DATA COLLECTION AND ANALYSIS

At least two review authors independently completed data extraction for included papers. We used Covidence software to manage screening, data collection and extraction. We assessed evidence using GRADE and presented results in a 'Summary of findings' table.

MAIN RESULTS

Eleven studies (835 participants) compared exercise to usual care. No studies compared exercise with no treatment or non-exercise interventions. The quality of the evidence was very low for the primary outcome rates of falls, and very low to low for the secondary outcomes. We downgraded the evidence due to study limitations (risk of bias), and issues of imprecision due to small sample sizes, inconsistency and indirectness. All studies were at high risk of bias for blinding of participants and personnel due to inability to blind participants to an exercise intervention. Risk of bias was generally low or unclear for other categories.There was generally little information on the important outcomes comparing exercise to usual care.Rates of falls and number of fallers: one study (223 participants) measured accidental falls, but reported neither the rate of falls or the number of fallers; there was no difference in the number of falls between exercise and usual care (very low-quality evidence).Strength: 10 studies (813 participants) reported on strength outcomes. Two analyses favoured exercise over usual care: quadriceps strength (2 studies, 72 participants; mean difference (MD) 8.99 kg, 95% confidence interval (CI) 1.29 to 16.70; low-quality evidence), and leg press (4 studies, 388 participants; MD 21.1 kg, 95% CI 8.47 to 33.74; low-quality evidence). In one analysis of the Sit-to-Stand Test, there was no difference between exercise and usual care (4 studies, 214 participants; standardised mean difference (SMD) -0.45, 95% CI -1.05 to 0.14; very low-quality evidence).Flexibility: one study (21 participants) reported on flexibility for Sit-and-Reach Distance (MD 2.05 cm, 95% CI 0.59 to 3.51; very low-quality evidence).Balance: five studies (350 participants) measured three different balance outcomes. Two analyses favoured exercise over usual care: postural balance (4 studies, 127 participants; standardised mean difference (SMD) 0.44, 95% CI 0.08 to 0.79; very low-quality evidence), and Backward Walk Test (2 studies, 280 participants; SMD -0.24, 95% CI -0.48 to -0.01; low-quality evidence). There was no difference between exercise and usual care for the Timed Up-and-Go Test (1 study, 15 participants; MD -0.35 seconds, 95% CI -1.47 to 0.77; low-quality evidence).Number of people sustaining a fall-related fracture: the quality of the evidence for exercise reducing fall-related fractures was very low.Adverse events: a single study (223 participants) noted some temporary muscle soreness on initiation of exercise or when there was an increase in the weight lifted. As no occurrence data were reported, we could not assess this variable further. No studies reported musculoskeletal injury. Analysis indicated that there was very low-quality evidence that exercise did not increase fatigue.

AUTHORS' CONCLUSIONS

There is a paucity of evidence for exercise training to reduce fall rates in people living with and beyond cancer. Exercise training may improve strength, flexibility and balance for people in this population, but the evidence is very low quality.

Acute effects of stretching exercise on the soleus muscle of female aged rats

It has been shown that stretching exercises can improve the flexibility and independence of the elderly. However, although these exercises commonly constitute training programs, the morphological adaptations induced by stretching exercises in aged skeletal muscle are still unclear.

OBJECTIVE

To assess the acute effects of passive mechanical static stretching on the morphology, sarcomerogenesis and modulation of important components of the extracellular matrix of the soleus muscle of aged female rats.

METHODS

Fifteen old female rats with 26 months were divided into two groups: stretching (n=8, SG) and control (n=7, CG): The stretching protocol consisted of 4 repetitions each of 1 min with 30s interval between sets. Stretching was performed on the left soleus muscle, 3 times a week for 1 week. After three sessions, the rats were anesthetized to remove the left soleus muscle, and then euthanized. The following analyses were carried out: muscle fiber cross-sectional area and serial sarcomere number; immunohistochemistry for the quantification of collagen I, III and TGFβ-1.

RESULTS

a decrease in muscle fiber cross-sectional area of the SG was observed when compared to the CG (p=0.0001, Kruskal-Wallis); the percentage of type I collagen was significantly lower in the SG when compared to the CG (p=0.01, Kruskal-Wallis), as well as the percentage of TGFβ-1 (p=0.04, Kruskal-Wallis); collagen III was significantly higher in the SG than in the CG (7.06±6.88% vs 4.92±5.30%, p=0.01, Kruskal-Wallis).

CONCLUSION

Although the acute stretching induced muscle hypotrophy, an antifibrotic action was detected.

Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia

For well over twenty centuries the muscle wasting (sarcopenia) and weakness (dynapenia) that occurs with old age has been a predominant concern of mankind. Exercise has long been suggested as a treatment to combat sarcopenia and dynapenia, as it exerts effects on both the nervous and muscular systems that are critical to positive physiological and functional adaptations (e.g., enhanced muscle strength). For more than two decades scientists have recognized the profound role that progressive resistance exercise training can have on increasing muscle strength, muscle size and functional capacity in older adults. In this review article we discuss how resistance exercise training can be used in the management and prevention of sarcopenia and dynapenia. We first provide an overview of the evidence for this notion and highlight certain critical factors- namely exercise intensity, volume and progression- that are key to optimizing the resistance exercise prescription. We then highlight how many, if not most, of the commonly prescribed exercise programs for seniors are not the 'best practices', and subsequently present easy-to-read guidelines for a well-rounded resistance exercise training program designed for the management and prevention of sarcopenia and dynapenia, including example training programs for the beginner through the advanced senior resistance exerciser. These guidelines have been written for the academician as well as the student and health care provider across a variety of disciplines, including those in the long term care industry, such as wellness instructors or activity directors.

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

AIMS

The transtheoretical model was applied to promote behavioural change and test the effects of a group senior elastic band exercise programme on the functional fitness of community older adults in the contemplation and preparation stages of behavioural change.

BACKGROUND

Forming regular exercise habits is challenging for older adults. The transtheoretical model emphasizes using different strategies in various stages to facilitate behavioural changes.

DESIGN

Quasi-experimental design with pre-test and post-tests on two groups.

METHODS

Six senior activity centres were randomly assigned to either the experimental or control group. The data were collected during 2011. A total of 199 participants were recruited and 169 participants completed the study (experimental group n = 84, control group n = 85). The elastic band exercises were performed for 40 minutes, three times per week for 6 months. The functional fitness of the participants was evaluated at baseline and at the third and sixth month of the intervention. Statistical analyses included a two-way mixed design analysis of variance, one-way repeated measures analysis of variance and an analysis of covariance.

RESULTS

All of the functional fitness indicators had significant changes at post-tests from pre-test in the experimental group. The experimental group had better performances than the control group in all of the functional fitness indicators after three months and 6 months of the senior elastic band exercises.

CONCLUSION

The exercise programme provided older adults with appropriate strategies for maintaining functional fitness, which improved significantly after the participants exercising regularly for 6 months.

Effect of exercise performance by elderly women on balance ability and muscle function

[Purpose] The aim of this study was to investigate the effect of an exercise intervention on the balance ability and muscle function of elderly women. [Subjects] The subjects were randomly divided into a control group (n=10) and an exercise group (n=10). [Methods] The subjects participated in an elastic band exercise program lasting for 8 weeks, exercising for 40 minutes, four days a week with resting terms of 60 sec. Subjects used a band corresponding to 60% of the strength of the color band with which repetitive exercise was possible up to twelve times. The subjects performed elastic band exercises, with variations to the number of band exercises according to the improvement of their physical fitness levels. When fifteen repetitive elastic band exercises could be performed with no damage of the body, we changed the band for one which was one level up from the former one and subjects used the same band for the upper body and lower body. [Results] Leg muscular strength measured as sit-stand repetitions in 30 s significantly increased in the exercise group after the intervention compared to before the intervention. Leg muscular endurance measured as the number of knee ups in 2 minutes significantly increased in the exercise group after the intervention compared to before the intervention. Balance measured by one-leg standing time with the eyes open significantly improved in the exercise group after the intervention compared to before the intervention. [Conclusion] Balance ability and muscle function significantly improved in the exercise group and showing that the intervention is effective at improving balance, muscle strength, and muscle endurance of elderly women.

A nurse-led case management program on home exercise training for hemodialysis patients: A randomized controlled trial

BACKGROUND

Patients on maintenance hemodialysis suffer from diminished physical health. Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being. However, nurses seldom include an exercise intervention in the care plan for hemodialysis patients.

OBJECTIVES

The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients.

DESIGN

The study was a randomized, two-parallel group trial.

SETTINGS

Hemodialysis units in two tertiary hospitals in Nanjing, mainland China.

PARTICIPANTS

One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and randomly assigned to either the study group (n=57) or the control group (n=56).

METHODS

Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks. The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks. The intervention was to facilitate patients in performing regular exercise at home. Outcome measures, including gait speed, 10-repetition sit-to-stand performance, and quality of life were collected at baseline, and at 6 and 12 weeks into the program.

RESULTS

The results revealed that patients in the study group demonstrated greater increases in normal gait speed [F(1,111)=4.42, p=0.038] than the control group. For the study group, a mean increase of 12.02 (±3.03)centimeters/second from baseline to week 12 was found. With regard to the fast gait speed, there was a marginally significant between-group effect [F(1,111)=3.93, p=0.050]. The study group showed a mean improvement of 11.08 (±3.32)cm/s, from baseline to week 12. Patients from both groups showed improvements in their 10-repetition sit-to-stand performance. The between-group differences approached significance [F(1,111)=3.92, p=0.050], with the study group showed greater improvement than the control group. The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88)s from baseline to week 12. Significant improvements in quality of life across three time points were found only in the study group.

CONCLUSIONS

Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients.

Effects of Resistance Exercise Using Thera-band on Balance of Elderly Adults: A Randomized Controlled Trial

[Purpose] This study investigated the effects of resistance exercise using Thera-band on balance of elderly adults. [Methods] Subjects (age range, 60–70 years) were randomly assigned to an experimental (n=12) or control group (n=12). The experimental group performed stretching and resistance exercises, and the control group performed stretching exercises only. Before and after the 5-week intervention, the participants’ static and dynamic balance were evaluated using the Berg Balance Scale, the Timed Up & Go Test, and the Tetrax Portable Multiple System (Tetrax Ltd., Ramat Gan, Israel) after 5 weeks. [Results] After the intervention, the values of the Tetrax in the weight distribution index with eyes open and that with eyes closed and the stability test index with eyes open were significantly lower in the resistance exercise group than in the control group, and the pre-test values were was significantly higher than the post-test values. However, there were no significant differences between groups in the values of the Berg Balance Scale, the Timed Up & Go Test, and the Tetrax stability test index with the eyes closed. [Conclusion] The findings of this study indicate that resistance exercise using the Thera-band is possible to improve the static and dynamic balance of elderly adults.

Interventions to maintain mobility: What works?

Mobility, in broad terms, includes everything from the ability to move within your immediate environment (e.g., get out of bed) to the ability to drive across the country. Mobility is essential to maintaining independence and wellbeing, particularly for older adults. This is highlighted by the large number of interventions developed for older adults with the goal of maintaining such mobility. The current paper reviews the state of the science with respect to mobility interventions. Inclusion criteria for the review were: (1) articles must have been peer-reviewed; (2) interventions were evaluated in a randomized controlled trial (RCT); (3) studies included a mobility outcome such as lifespace, driving, or walking ability; (4) studies included a sample of healthy community-dwelling older adults (e.g., not investigations of disease conditions); and (5) studies must have reported enough empirical data and detail such that results could potentially be replicated. Three main types of interventions were identified: cognitive training, educational interventions, and exercise interventions. A detailed summary and evaluation of each type of intervention, and the current evidence regarding its effectiveness in maintaining mobility, are discussed. Several interventions show clear evidence of effectiveness, and thus are prime areas for translation of results to the older population. Needs and issues for future intervention research are also detailed.

Age-related changes in physical fall risk factors: results from a 3 year follow-up of community dwelling older adults in Tasmania, Australia

As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, and placing an escalating burden on health care systems. Sixty-nine independent community-dwelling adults (60-85 years, 18 males) had their leg strength, physical activity levels and their annual fall rate assessed at two timepoints over three years, (summer 2010 and summer 2013) monitoring balance. Force platform measures of medio-lateral sway range increased significantly under conditions of eyes open (mean difference MD 2.5 cm; 95% CI 2.2 to 2.8 cm) and eyes closed (MD 3.2 cm; 95% CI 2.8 to 3.6 cm), respectively (all p < 0.001) indicating worsening static balance control. Dynamic balance showed similar changes (p < 0.036). Leg strength was not significantly different between visits (p > 0.26). Physical activity reduced significantly (MD -909 Cal/week; 95% CI -347 to -1,470 Cal/week; p = 0.002) during the course of the study. Participants maintained aerobic activities, however resistance and balance exercise levels decreased non-significantly. The likelihood of falling was higher at the end of the study compared to the first timepoint (odds ratio 1.93, 95% CI 0.94 to 3.94; p = 0.07). Results of this study indicate that despite maintenance of leg strength there was an increase in medio-lateral sway over a relatively short time frame, with higher than expected increases in fall rates.

The Association between Seasonal Variation in Vitamin D, Postural Sway, and Falls Risk: An Observational Cohort Study

Introduction. Low serum vitamin D levels are associated with increased postural sway. Vitamin D varies seasonally. This study investigates whether postural sway varies seasonally and is associated with serum vitamin D and falls. Methods. In a longitudinal observational study, eighty-eight independently mobile community-dwelling older adults (69.7 ± 7.6 years) were evaluated on five occasions over one year, measuring postural sway (force platform), vitamin D levels, fall incidence, and causes and adverse outcomes. Mixed-methods Poisson regression was used to determine associations between measures. Results. Postural sway did not vary over the year. Vitamin D levels varied seasonally (P < 0.001), peaking in summer. Incidence of falls (P = 0.01) and injurious falls (P = 0.02) were lower in spring, with the highest fall rate at the end of autumn. Postural sway was not related to vitamin D (P = 0.87) or fall rates, but it was associated with fall injuries (IRR 1.59 (CI 1.14 to 2.24, P = 0.007). Conclusions. Postural sway remained stable across the year while vitamin D varied seasonally. Participants with high values for postural sway demonstrated higher rates of injurious falls. This study provides important evidence for clinicians and researchers providing interventions measuring balance outcomes across seasons.

Effects of a group-based exercise program on muscle strength and postural control among community-dwelling elderly women: a randomized-controlled trial

OBJECTIVES: Verify if a group-based low intensity exercise training program could significantly improve physical variables related to muscle strength and postural control among community-dwelling elderly women. METHODS: This study was a non-blinded randomized-controlled trial. Thirty-seven women were allocated according a computer generated randomization list in two groups: Control (n=18; mean age 68.9(5.7)) and Exercise (n=19; mean age 67.8(4.9)). Main outcome measures were body sway during quiet stance, and knee and ankle isometric peak torque and isokinetic peak torque, power and time acceleration. Exercise group performed a group-based training program on two days per week for 12 weeks. Each training session consisted of stretching exercises, ankle and knee muscle strengthening and balance training. Control group did not undergo any training. RESULTS: Control group did not present significant differences for variables analyzed. Effect size to peak torque and power for non-dominant knee flexors at 60º/s (0.85 and 0.8, respectively), peak torque and power for non-dominant knee flexors and time acceleration for non-dominant knee extensors at 120º/s (0.8, -0.9 and 1.19, respectively) may be considered large after training. CONCLUSION: Low-intensity group-based exercise training program may be effective to improve knee isometric peak torque and knee and ankle isokinetic peak torque, power and time acceleration. Trial registration: ACTRN12610000042044.

The dose-response relationship of balance training in physically active older adults

A 6-wk group balance-training program was conducted with physically active older adults (based on American College of Sports Medicine requirements) to investigate the effect of dose-related static and dynamic balance-specific training. All participants, age 60-87 yr, continued their regular exercise program while adding balance training in 1 of 3 doses: three 20-min sessions/wk (n = 20), one 20-min session/wk (n = 21), or no balance training (n = 19). Static balance (single-leg-stance, tandem), dynamic balance (alternate stepping, limits of stability), and balance confidence (ABC) were assessed pre- and posttraining. Significant interactions were observed for time in single-leg stance, excursion in limits of stability, and balance confidence, with the greatest increase observed in the group that completed 3 training sessions/wk. The results demonstrate a dose-response relationship indicating that those who are already physically active can improve balance performance with the addition of balance-specific training.

Resistance training in patients with limb-girdle and becker muscular dystrophies

INTRODUCTION

In this study we investigated the effect of strength training in patients with limb-girdle muscular dystrophy (LGMD) and Becker muscular dystrophy (BMD).

METHODS

In 2 studies we compared the effect of low-intensity training (LOIT; n = 8) and high-intensity training (HIT; n = 4) in muscles of the upper and lower extremities. Patients were tested for maximal strength and endurance before and after the training program.

RESULTS

LOIT training over 6 months resulted in increased biceps strength and endurance. HIT training increased endurance and strength in wrist flexion and extension and in elbow flexion. One patient discontinued HIT training due to muscle soreness and mildly increased plasma CK levels without strength deterioration.

CONCLUSIONS

Both LOIT and HIT increased muscle strength and endurance in some of the muscles tested and were well tolerated in most patients. Our findings suggest that supervised resistance training may be considered in the management of patients with LGMD2 and BMD.

Flexibility training and functional ability in older adults: a systematic review

Background. As indicated in a recent systematic review relating to Canada's Physical Activity Guidelines for Older Adults, exercise interventions in older adults can maintain or improve functional abilities. Less is known about the role of flexibility in the maintenance or improvement of functional abilities, and there currently does not exist a synthesis of the literature supporting a consensus on flexibility training prescription. Purpose. To systematically review the effects of flexibility-specific training interventions on measures of functional outcomes in healthy older adults over the age of 65 years. Methods. Five electronic databases were searched for intervention studies involving concepts related to aging, flexibility, functional outcomes, and training interventions. After evaluating the articles for relevance, 22 studies were considered. Results. The results suggested that while flexibility-specific interventions may have effects on range of motion (ROM) outcomes, there is conflicting information regarding both the relationship between flexibility interventions and functional outcomes or daily functioning. Conclusions. Due to the wide range of intervention protocols, body parts studied, and functional measurements, conclusive recommendations regarding flexibility training for older adults or the validity of flexibility training interventions as supplements to other forms of exercise, or as significant positive influences on functional ability, require further investigation.

Resistance Training in Older Adults

Sarcopenia is associated with substantial health and economic consequences and is emerging as a major public health problem in the older population. The effects of sarcopenia may increase the risk for adverse health outcomes in older adults, and strategies need to be developed to maintain healthy aging. Although several intervention strategies have been proposed, resistance training (RT) has been suggested as the most effective stimulus for optimizing improvements in physical function and body composition with age. Although RT has been established as a safe and efficacious intervention for the prevention and treatment of sarcopenia, very few older adults regularly participate in RT programs. Community-based RT programs may be a feasible strategy because of their accessibility, cost-effectiveness, and lower-intensity training stimuli. However, the effects of these interventions on health outcomes in older adults have not been adequately reviewed. This report will describe the health effects associated with sarcopenia and summarize the major findings from community-based RT interventions on different health outcomes in older adults. Finally, it is suggested that all older adults who demonstrate the ability to safely participate in RT comply with the guidelines recommended by the American College of Sports Medicine.

Is whole-body vibration beneficial for seniors?

Normal aging processes result in losses of functional flexibility and muscular strength, which increase seniors’ fall risk and dependence on others. A relatively new intervention to reduce and/or reverse the adverse effects of aging is whole-body vibration (WBV) exercise. The purpose of this article is to review the established effects of WBV exercise exclusively with the aging population. A systematic search utilizing PubMed and Sport Discus databases uncovered journal articles specific to seniors and whole-body vibration. An extensive hand search supplemented the database results to find other relevant articles. Twenty-seven articles were obtained; all articles have been published in the past 8 years, reflecting the recent and growing interest in this area. Researchers have determined that WBV training can reduce fall risk and improve postural control in seniors. It has also been determined that WBV training can be as effective as conventional resistance training to improve seniors’ lower body strength. However, little is known about the effect of WBV exercise on flexibility and upper body strength in the aging population. More research is required to establish how effective WBV training is on these specific components and how it may affect seniors’ quality of life.

Longitudinal invariance and construct validity of the abbreviated late-life function and disability instrument in healthy older adults

OBJECTIVE

To cross-validate the psychometric properties of the abbreviated Late-Life Function and Disability Instrument (LL-FDI), a measure of perceived functional limitations and disability.

DESIGN

Baseline and 12-month follow-up assessments conducted across the course of a 12-month exercise program.

SETTING

University research community.

PARTICIPANTS

Older healthy adults (N=179; mean ± SD age, 66.43±5.67y) at baseline; 145 were retained at follow-up.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

LL-FDI and functional performance measures.

RESULTS

Factor analyses confirmed the factor structure of the abbreviated LL-FDI, and all subscales met minimal criteria for temporal invariance. Significant correlations also were found between functional limitations subscales and an array of physical function performance measures, supporting the scale's construct validity.

CONCLUSIONS

The abbreviated LL-FDI with some modifications appears to be temporally invariant in community-dwelling older adults. Additionally, moderate relationships between functional limitations and functional performance provide further support for these being conceptually distinct constructs.

The effect of contralateral training: Influence of unilateral isokinetic exercise on one-legged standing balance of the contralateral lower extremity in adults

PURPOSE

To investigate the effects of unilateral isokinetic exercises on the one-legged standing balance of the contralateral lower extremity.

SUBJECTS

A volunteer sample of 32 healthy adults (12 men and 20 women) was randomized to training and control groups.

METHODS

The training group received unilateral hip isokinetic exercises of the dominant leg for two weeks. Contralateral single-limb balance was measured before and after intervention, including three stability index scores of balance using Biodex Stability System: Anterior-Posterior Stability Index (APSI), Medio-lateral Stability Index (MLSI), and Overall Stability Index (OSI) scores.

RESULTS

Comparison of pre-test and post-test data revealed significant improvements in APSI, MLSI, and OSI scores in the training group (p<0.05), but not in the control group. The gains of stability scores from pre- to post-test, were also significantly greater (p<0.05) in the training group than the control group.

CONCLUSION

These results suggest that contralateral training with unilateral isokinetic exercises increases the one-legged standing balance of the contralateral limb following a short duration of training.

Cardiovascular and metabolic effects of community based resistance training in an older population

Ageing is associated with decreases in strength and cardiovascular fitness, and increased cardiovascular risk factors. The aim of the current study was to determine the effectiveness of 16 weeks of community based resistance compared to flexibility training on strength, cardiovascular fitness and cardiovascular and metabolic parameters in a group of previously sedentary, healthy older men and women. A randomised controlled crossover intervention study. Forty nine healthy sedentary participants (23 males; age 66.7 ± 4.3 years; weight 78.6 ± 15.4 kg; mean ± SD) completed 16 weeks of supervised community-based resistance training and 16 weeks of flexibility training in a randomised order. Prior to and following each intervention, participants were assessed for muscle strength, cardiovascular fitness (VO(2 peak)), fasted blood lipids and blood glucose, insulin and insulin resistance. Resistance training resulted in significant increases in knee extension (+25.7 Nm; p < 0.001) and knee flexion strength (+8.9 Nm; p = 0.048) and decreases in fasting total cholesterol (-0.51 mmol L(-1); p = 0.001), HDL cholesterol (-0.12 mmol L(-1); p = 0.035), LDL cholesterol (-0.35 mmol L(-1); p = 0.022), glucose (-0.42 mmol L(-1); p < 0.001), insulin (-1.28 μU/mL; p = 0.049) and insulin resistance (-0.50 μU/mL; p = 0.004) compared to the flexibility protocol. No significant changes between the treatments were observed in VO(2peak) (+2.04 mL kg(-1)min(-1); p = 0.12). Community based resistance training is suitable for improving strength and reducing cardiovascular and metabolic risk factors in healthy older individuals.