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Garma LD, Quintela-Fandino M. Applicability of epigenetic age models to next-generation methylation arrays. Genome Med 2024; 16:116. [PMID: 39375688 PMCID: PMC11460231 DOI: 10.1186/s13073-024-01387-4] [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: 06/10/2024] [Accepted: 09/19/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Epigenetic clocks are mathematical models used to estimate epigenetic age based on DNA methylation at specific CpG sites. As new methylation microarrays are developed and older models discontinued, existing epigenetic clocks might become obsolete. Here, we explored the effects of the changes introduced in the new EPICv2 DNA methylation array on existing epigenetic clocks. METHODS We tested the performance of four epigenetic clocks on the probeset of the EPICv2 array using a dataset of 10,835 samples. We developed a new epigenetic age prediction model compatible across the 450 k, EPICv1, and EPICv2 microarrays and validated it on 2095 samples. We estimated technical noise and intra-subject variation using two datasets with repeated sampling. We used data from (i) cancer survivors who had undergone different therapies, (ii) breast cancer patients and controls, and (iii) an exercise-based interventional study, to test the ability of our model to detect alterations in epigenetic age acceleration in response to theoretically antiaging interventions. RESULTS The results of the four epiclocks tested are significantly distorted by the EPICv2 probeset, causing an average difference of up to 25 years. Our new model produced highly accurate chronological age predictions, comparable to a state-of-the-art epiclock. The model reported the lowest epigenetic age acceleration in normal populations, as well as the lowest variation across technical replicates and repeated samples from the same subjects. Finally, our model reproduced previous results of increased epigenetic age acceleration in cancer patients and in survivors treated with radiation therapy, and no changes from exercise-based interventions. CONCLUSION Existing epigenetic clocks require updates for full EPICv2 compatibility. Our new model translates the capabilities of state-of-the-art epigenetic clocks to the EPICv2 platform and is cross-compatible with older microarrays. The characterization of epigenetic age prediction variation provides useful metrics to contextualize the relevance of epigenetic age alterations. The analysis of data from subjects influenced by radiation, cancer, and exercise-based interventions shows that despite being good predictors of chronological age, neither a pathological state like breast cancer, a hazardous environmental factor (radiation), nor exercise (a beneficial intervention) caused significant changes in the values of the "epigenetic age" determined by these first-generation models.
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Affiliation(s)
- Leonardo D Garma
- Breast Cancer Clinical Research Unit, Centro Nacional de Investigaciones Oncológicas-CNIO, Melchor Fernández Almagro, 3, Madrid, 28029, Spain
| | - Miguel Quintela-Fandino
- Breast Cancer Clinical Research Unit, Centro Nacional de Investigaciones Oncológicas-CNIO, Melchor Fernández Almagro, 3, Madrid, 28029, Spain.
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Zhao Y, Chen P, Gong Y, Gu Z, Zhou W. Functional fitness and physical independence in later years: cut-off values and validation. BMC Geriatr 2024; 24:729. [PMID: 39227762 PMCID: PMC11369993 DOI: 10.1186/s12877-024-05313-6] [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: 03/12/2024] [Accepted: 08/19/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND To establish and validate the criterion-referenced standards of functional fitness in predicting physical independence in 80 + years. METHODS A group of 2,749 older community dwellers (60-84 years) were recruited, and 2,050 were identified with moderate-to-high independent living ability according to the proposed minimum composite physical function score. The Senior Fitness Test battery was applied to measure functional fitness at five-year intervals. The declining rate for each fitness dimension was calculated based on the differences between any two adjacent age groups and was adjusted according to the reported degradation rate differences between the cross-sectional and longitudinal studies. RESULTS The age-and-sex-specific criterion-referenced standards were identified for muscle strength, cardiovascular endurance, and dynamic balance that older adults should possess at 60-79 to maintain independent living abilities. Moderate to high consistency (k = 0.622-0.650) and associations (φ = 0.641-0.694) were found between the predicted physical independence by criterion-referenced standards of functional fitness and the results from the composite physical function scale. Moreover, the predicted independent living abilities in later years from the criterion-referenced standards of functional fitness showed high test-retest reliability (Pa = 0.90-0.96). CONCLUSION The criterion-referenced standards for functional fitness are valid and reliable to predict independent living abilities in later years, and provide the threshold to identify the limitations in physical fitness and detect the risks of functional disabilities among older adults in an early stage.
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Affiliation(s)
- Yanan Zhao
- School of Sports Science and Physical Education, Nanjing Normal University, Wenyuan Road 1, Qixia district, Nanjing, 210097, China.
| | - Peiyou Chen
- School of Sports Science and Physical Education, Nanjing Normal University, Wenyuan Road 1, Qixia district, Nanjing, 210097, China
| | - Yuan Gong
- School of Sports Science and Physical Education, Nanjing Normal University, Wenyuan Road 1, Qixia district, Nanjing, 210097, China
| | - Zhongke Gu
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Wensheng Zhou
- School of Physical Education, Jiangsu Second Normal University, Nanjing, China
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Laar RA, Menhas R, Saqib ZA, Wang H. Editorial: Physical activity and a healthy diet as a medicine for obesity. Front Sports Act Living 2024; 6:1477065. [PMID: 39263268 PMCID: PMC11387171 DOI: 10.3389/fspor.2024.1477065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 09/13/2024] Open
Affiliation(s)
- Rizwan Ahmed Laar
- College of Physical Education, Hubei Normal University, Huangshi, China
| | - Rashid Menhas
- Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China
| | - Zulkaif Ahmed Saqib
- College of Urban Transportation and Logistics, Shenzhen Technology University, Shenzhen, China
| | - Huilin Wang
- School of Business, Hunan University of Science and Technology Xiangtan, China
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Morwani-Mangnani J, Rodriguez-Girondo M, Singh-Povel C, Verlaan S, Beekman M, Slagboom PE. Physical activity and fiber intake beneficial for muscle mass and strength preservation during aging: A comprehensive cross-sectional study in the UK biobank cohort. Exp Gerontol 2024; 193:112474. [PMID: 38815706 DOI: 10.1016/j.exger.2024.112474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Aging triggers intricate physiological changes, particularly in whole-body fat-free mass (FFM) and handgrip strength, affecting overall health and independence. Despite existing research, the broader significance of how muscle health is affected by the intricate interplay of lifestyle factors simultaneously during aging needs more exploration. This study aims to examine how nutrition, physical activity, and sleep impact on FFM and handgrip strength in middle-aged men and women, facilitating future personalized recommendations for preserving muscle health. METHODS The cross-sectional analysis of the UK Biobank involved 45,984 individuals (54 % women) aged 40-70 years with a complete dataset. Multiple linear regression explored determinants of FFM and handgrip strength, considering traditional, socio-demographics, medication use and smoking as covariates, with sex and age (younger and older than 55 years) stratifications. RESULTS In older men and women, higher physical activity beneficially affect both FFM (respectively Β = 3.36 × 10-3, p-value = 1.66 × 10-3; Β = 2.52 × 10-3, p-value = 3.57 × 10-4) and handgrip strength (Β = 6.05 × 10-3, p-value = 7.99 × 10-5, Β = 8.98 × 10-3, p-value = 2.95 × 10-15). Similar results were found in fiber intake for FFM in older men and women (respectively B = 3.00 × 10-2, p-value = 2.76 × 10-5; B = 2.68 × 10-2, p-value = 1.78 × 10-9) and handgrip strength (Β = 3.27 × 10-2, p-value = 1.40 × 10-3; Β = 3.12 × 10-2, p-value = 1.34 × 10-5). Other lifestyle factors influence FFM and handgrip strength differently. Key determinants influencing handgrip strength included higher protein intake, lower water intake, higher alcohol intake, and extended sleep duration whereas mainly higher water intake is associated with higher FFM. CONCLUSIONS In both men and women, the main factors associated with FFM and handgrip strength are physical activity and fiber intake, which may underlie a connection between gut and muscle health. Given the observed complexity of muscle health in the age and sex strata, further longitudinal research is needed to provide personalized lifestyle recommendations.
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Affiliation(s)
- Jordi Morwani-Mangnani
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
| | - Mar Rodriguez-Girondo
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Marian Beekman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - P Eline Slagboom
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
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Ibeneme SC, Mah J, Omeje C, Fortwengel G, Nwosu AO, Irem FO, Ibeneme GC, Myezwa H, Nweke M. Effectiveness of pedometer-based walking programmes in improving some modifiable risk factors of stroke among community-dwelling older adults: a systematic review, theoretical synthesis and meta-analysis. BMC Geriatr 2024; 24:516. [PMID: 38872081 PMCID: PMC11177376 DOI: 10.1186/s12877-024-05069-z] [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: 01/04/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at physical activity-related modifiable risk factors. The question arises: What is the effectiveness of pedometer-based walking program interventions in improving modifiable stroke risk factors among community-dwelling older adults? METHOD Eight databases were searched up to December 2nd, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects. RESULTS The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I2=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I2=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I2=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes. CONCLUSION Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals. TRIAL REGISTRATION Registration Number: INPLASY202230118.
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Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria.
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies,University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa.
- Department of Physiotherapy, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria.
- Department of physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - Juliet Mah
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Enugu, Nigeria
| | - Chidimma Omeje
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
| | - Gerhard Fortwengel
- Faculty III, Hochschule Hannover University of Applied Sciences & Arts, 30159, Hannover, Lower Saxony, Germany
| | - Akachukwu Omumuagwula Nwosu
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
| | - Frank Onyemaechi Irem
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
| | - Georgian Chiaka Ibeneme
- Department of Nursing Sciences, Faculty of Health Sciences & Technology, College of Health Sciences, Ebonyi State University, Ebonyi State, Abakaliki, Nigeria
- Department of Nursing Science, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
| | - Hellen Myezwa
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies,University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa
| | - Martins Nweke
- Department of Physiotherapy, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
- Department of physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Bagheri R, Karimi Z, Mousavi Z, Ziaee Bashirzad M, Camera DM, Sadeghi R, Dabbagh VR, Kargarfard M, Dutheil F. High-Protein Diets during either Resistance or Concurrent Training Have No Detrimental Effect on Bone Parameters in Resistance-Trained Males. Nutrients 2024; 16:325. [PMID: 38276563 PMCID: PMC10819948 DOI: 10.3390/nu16020325] [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: 12/28/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The effects of combining resistance training (RT) and concurrent training (CT; resistance + endurance training) with varied protein doses on bone measures remain poorly understood. Hence, we conducted a comparison of the impacts of two high-protein diets (1.6 or 3.2 g kg-1 d-1) over 16 weeks in resistance-trained males, either with CT or RT alone. METHODS A total of forty-eight males, all of whom were resistance-trained, had the following demographics: 26.6 ± 6 years, body mass index: 25.6 ± 2.9 kg m-2 administered either 3.2 g kg-1 d-1 protein (CT2; n = 12; RT2; n = 12) or 1.6 g kg-1 d-1 protein (CT1; n = 12; RT1; n = 12) during 16 weeks (four sessions·w-1). Bone parameters were assessed pre- and post-intervention. RESULTS There was no significant interaction between the intervention group and time for the legs, arms, ribs, or pelvis area BMC and BMD (p > 0.05). For the BMD of the pelvis and the BMC of the right ribs, however, there were significant time effects noted (p < 0.05). Furthermore, there was a significant interaction between the intervention group and time in the lumbar and thoracic spines, with a particular time effect noted for the thoracic spine region (p < 0.05). The regional differences in skeletal responses to the intervention are highlighted by these data. CONCLUSION Our findings show that the intake of two high-protein diets combined with RT and CT during 16 weeks had no adverse effects on bone tissue parameters. While these findings indicate that protein intake between 2 and 3 times the current RDI does not promote bone demineralization when consumed in conjunction with exercise, future studies investigating the long-term effects of chronic high protein intake on bone tissue health are warranted.
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Affiliation(s)
- Reza Bagheri
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan 8174673441, Iran;
| | - Zohreh Karimi
- Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran;
| | - Zeynabalsadat Mousavi
- Nutrition and Food Service, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1416634793, Iran;
| | - Mahdi Ziaee Bashirzad
- Department of Sport Science, Islamic Azad University, Bojnourd Branch, Bojnourd 9417697796, Iran;
| | - Donny M. Camera
- Department of Health and Biostatistics, Swinburne University, Melbourne, VIC 3122, Australia;
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9177949025, Iran; (R.S.); (V.R.D.)
| | - Vahid Reza Dabbagh
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9177949025, Iran; (R.S.); (V.R.D.)
| | - Mehdi Kargarfard
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan 8174673441, Iran;
| | - Frederic Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000 Clermont-Ferrand, France;
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Simonsson E, Levik Sandström S, Hedlund M, Holmberg H, Johansson B, Lindelöf N, Boraxbekk CJ, Rosendahl E. Effects of Controlled Supramaximal High-Intensity Interval Training on Cardiorespiratory Fitness and Global Cognitive Function in Older Adults: The Umeå HIT Study-A Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2023; 78:1581-1590. [PMID: 36972981 PMCID: PMC10460559 DOI: 10.1093/gerona/glad070] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND This study examined the effects of regulated and controlled supramaximal high-intensity interval training (HIT) adapted for older adults, compared to moderate-intensity training (MIT), on cardiorespiratory fitness; cognitive, cardiovascular, and muscular function; and quality of life. METHODS Sixty-eight nonexercising older adults (66-79 years, 44% males) were randomized to 3 months of twice-weekly HIT (20-minute session including 10 × 6-second intervals) or MIT (40-minute session including 3 × 8-minute intervals) on stationary bicycles in an ordinary gym setting. Individualized target intensity was watt controlled with a standardized pedaling cadence and individual adjustment of the resistance load. Primary outcomes were cardiorespiratory fitness (V̇o2peak) and global cognitive function (unit-weighted composite). RESULTS V̇o2peak increased significantly (mean 1.38 mL/kg/min, 95% CI [0.77, 1.98]), with no between-group difference (mean difference 0.05 [-1.17, 1.25]). Global cognition did not improve (0.02 [-0.05, 0.09]), nor differed between groups (0.11 [-0.03, 0.24]). Significant between-group differences in change were observed for working memory (0.32 [0.01, 0.64]), and maximal isometric knee extensor muscle strength (0.07 N·m/kg [0.003, 0.137]), both in favor of HIT. Irrespective of the group, there was a negative change in episodic memory (-0.15 [-0.28, -0.02]), a positive change in visuospatial ability (0.26 [0.08, 0.44]), and a decrease in systolic (-2.09 mmHg [-3.54, -0.64]) and diastolic (-1.27 mmHg [-2.31, -0.25]) blood pressure. CONCLUSIONS In nonexercising older adults, 3 months of watt-controlled supramaximal HIT improved cardiorespiratory fitness and cardiovascular function to a similar extent as MIT, despite half the training time. In favor of HIT, there was an improvement in muscular function and a potential domain-specific effect on working memory. CLINICAL TRIAL REGISTRATION NCT03765385.
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Affiliation(s)
- Emma Simonsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Sofi Levik Sandström
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - Mattias Hedlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Henrik Holmberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bengt Johansson
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Nina Lindelöf
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Carl-Johan Boraxbekk
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Drum SN, Rappelt L, Held S, Donath L. Effects of Trail Running versus Road Running-Effects on Neuromuscular and Endurance Performance-A Two Arm Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4501. [PMID: 36901510 PMCID: PMC10002259 DOI: 10.3390/ijerph20054501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Running on less predictable terrain has the potential to increase the stimulation of the neuromuscular system and can boost aerobic performance. Hence, the purpose of this study was to analyze the effects of trail versus road running on neuromuscular and endurance performance parameters in running novices. Twenty sedentary participants were randomly assigned to either a trail (TRAIL; n = 10) or road running (ROAD; n = 10) group. A supervised and progressive, moderate intensity, and work-load-matched 8 wk endurance running program on TRAIL or ROAD was prescribed (i.e., randomized). Static balance (BESS test), dynamic balance (Y-balance test), gait analysis (RehaGait test, with regard to stride time single task, stride length dual task, velocity single task), agility performance (t-test), isokinetic leg strength (BIODEX), and predicted VO2max were assessed in pre- and post-tests. rANOVA analysis revealed no significant time-group interactions. Large effect sizes (Cohen's d) for pairwise comparison were found for TRAIL in the BESS test (d = 1.2) and predicted (pred) VO2max (d = 0.95). Moderate effects were evident for ROAD in BESS (d = 0.5), stride time single task (d = 0.52), and VO2max predicted (d = 0.53). Possible moderate to large effect sizes for stride length dual task (72%), velocity single task (64%), BESS test (60%), and the Y-balance test left stance (51%) in favor of TRAIL occurred. Collectively, the results suggested slightly more beneficial tendencies in favor of TRAIL. Additional research is needed to clearly elucidate differences between TRAIL and ROAD, not only in novices but also in experienced exercisers.
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Affiliation(s)
- Scott Nolan Drum
- Department of Health Sciences—Fitness Wellness, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ 86001, USA
| | - Ludwig Rappelt
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Cologne, Germany
| | - Steffen Held
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Cologne, Germany
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Powell AJ, Thomas S. Reverse Coding of a Common-Sense Physical Activity Intervention for Older Adults Using Elements of the Behaviour Change Wheel Framework. Health Promot Pract 2023; 24:121-132. [PMID: 35382643 PMCID: PMC9806452 DOI: 10.1177/15248399221081832] [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] [Indexed: 01/05/2023]
Abstract
"Common-sense" physical activity (PA) interventions for older adults may be more effective if developed in accordance with behavior change theory. One way to achieve this is through retrospectively applying a theoretical behavior change framework to "reverse code" an existing intervention and guide its ongoing development. This study aimed to detail a clear and systematic procedure that applied elements of the Behaviour Change Wheel (BCW) framework to reverse code the Active Ageing Pathway (AAP) intervention. The objectives of the procedure were to characterize the content of the AAP and its links to behavior change theory. The content of the AAP was first deconstructed through the examination of "standard operating procedures" documents, in-person observation, and a series of face-to-face discussions with AAP management. Then, the behavior change techniques (BCT) and BCW intervention functions associated with the AAP's content were identified and coded using the BCT Taxonomy version 1. Forty-one active components were identified within the AAP, which involved numerous professionals, and pertained to a diverse and interlinked range of factors, across various modes of delivery. The components were classified under 20 separate BCT labels, which related to eight of the nine BCW intervention functions. These outcomes were demonstrated to have practical applications for identifying gaps in intervention content as well as for guiding future intervention evaluation. This study supports previous work detailing the usefulness of reverse coding procedures as a tool for developing common-sense interventions, and is the first to do so in the context of a PA intervention for older adults.
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Affiliation(s)
- Andrew James Powell
- Bournemouth University, Bournemouth,
UK,Andrew James Powell, Clinical Research
Unit, Department of Medical Sciences and Public Health, Bournemouth University,
10 St Paul’s Lane, Bournemouth, Dorset BH8 8AJ, UK; e-mail:
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Wiley E, Noguchi KS, Moncion K, D’Isabella N, Shkredova DA, Fang H, Richardson J, MacDermid JC, Rodrigues L, Roig M, Tang A. The association between global cognitive function and walking capacity in individuals with broad ranges of cognitive and physical function: Are there sex differences? FRONTIERS IN REHABILITATION SCIENCES 2022; 3:960437. [PMID: 36188989 PMCID: PMC9510638 DOI: 10.3389/fresc.2022.960437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022]
Abstract
IntroductionCognitive function is known to be associated with physical function, where greater walking capacity has been shown to have moderate to strong correlations with global cognitive function and other various domains of cognition in older adults with and without chronic conditions. Biological sex may moderate the relationship between cognitive and physical function, but whether sex differences exist in this association has not been examined in an aging population. The purpose of this study was to examine the associations between global cognitive function (Montreal Cognitive Assessment; MoCA), walking capacity (6-Minute Walk Test distance; 6 MWT) and sex in an aging population with broad ranges of cognitive and physical function.MethodsParticipants were assessed for global cognitive function (MoCA) and walking capacity (6 MWT). Multivariable regression analyses were performed to examine the interaction of sex in the association between MoCA and 6 MWT. First, we presented the unadjusted model (Model 1), then the model adjusted for age, history of stroke, and height (Model 2). To determine if there were sex-based differences in the association between global cognitive function and walking capacity, we included sex and an interaction term between sex*6 MWT distance in Models 3 and 4.ResultsTwenty-three females and 36 males were included in the multivariable regression analyses, respectively. Our sample represented broad ranges of cognitive and physical function levels, where MoCA scores ranged from 13 to 30, and 6 MWT distances from 203 to 750 m. 6 MWT distance was associated with MoCA in models unadjusted (R2 = 0.17; F(1,56) = 11.4; p < 0.01) and adjusted for age, stroke history, and height (R2 = 0.20; F(4,53) = 3.2; p = 0.02). No interaction with sex was found, but a main effect of sex was observed (R2 = 0.26; F(5,21) = 3.72; p = 0.03). When adjusting for age, height and history of stroke, males MoCA scores were 2.9 ± 1.3 less than the mean MoCA scores for females.DiscussionOur findings confirm the positive relationship between cognitive and physical function in older adults. Notably, we also observed superior performance in global cognition among females that was consistent across a broad spectrum of walking capacity.
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Affiliation(s)
- Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Kenneth S. Noguchi
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Kevin Moncion
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Natalie D’Isabella
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Daria A. Shkredova
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
| | - Hanna Fang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Joy C. MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- School of Physical Therapy, Western University, London, ON, Canada
| | - Lynden Rodrigues
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation, Laval, QC, Canada
- School of Physical / Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation, Laval, QC, Canada
- School of Physical / Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Correspondence: Ada Tang
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11
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Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review. J Aging Phys Act 2022; 30:739-743. [PMID: 34808599 DOI: 10.1123/japa.2021-0379] [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: 09/10/2021] [Accepted: 10/06/2021] [Indexed: 01/12/2023]
Abstract
Increasing the physical activity (PA) levels of inactive older adults to promote healthy aging and to reduce preventable health conditions is a public health priority. However, there remains uncertainty on what constitutes the most important components and characteristics of effective PA interventions for older adults, and previous research has largely focused on the cognitive and behavioral strategies they adopt to increase uptake and adherence to PA. This narrative review puts forward the novel idea, with supporting evidence, that the strength, quality, and collaborative nature of the professional-client relationship, a concept drawn from the field of psychotherapy and known as therapeutic alliance, may be a vital and foundational element of effective PA interventions. This article will offer a new understanding, and a new direction of research to aid the future conceptualization, design, and development of interventions that aim to increase the PA levels of older adults.
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12
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Kapoor G, Chauhan P, Singh G, Malhotra N, Chahal A. Physical Activity for Health and Fitness: Past, Present and Future. J Lifestyle Med 2022; 12:9-14. [PMID: 35300039 PMCID: PMC8918377 DOI: 10.15280/jlm.2022.12.1.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/23/2021] [Indexed: 11/22/2022] Open
Abstract
It’s a saying “The early we start, the early we attain good health”. Health is a state of complete physical, mental and social well-being and not merely absence of disease Fitness is an ability to execute daily functional activities with optimal performance, endurance, and strength to manage minimalist of disease, fatigue, stress and reduced sedentary behavior. In the modern era with advancement in technology, erosion of physical activity has drastically led to retardation in health and fitness. Hoods of luxurious and competition among students for scores/grades and professionals for promotions/incentives/benefits have deviated people from concentrating towards their health and putting it secondary. In 2016, across the globe, prevalence of physical inactivity was estimated at 27.5%, among adult population. To support further, in June 2018, WHO reported, 1 in five adults, and 4 of five adolescents to pose reduced physical activity. In the current ongoing pandemic era this scenario has been further negatively impacting the society to suffer from psychosocial, financial and economic loss, contributing to lack of physical activity. Health benefits of physical activity are not limited only to improved cardiorespiratory and muscular fitness, bone and cardiometabolic health, and positive effects on weight status, but it also boosts mental health and social health. Acknowledging the significance and urgency of decreasing insufficient physical activity globally, WHO endorsed a Global Action Plan on Physical Activity (GAPPA) at the World Health Assembly in 2018, wherein the member countries agreed to reach a new target of 15% relative reduction in insufficient physical activity among adolescents by 2030.
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Affiliation(s)
- Gaurav Kapoor
- Department of Physiotherapy, Jayoti Vidyapeeth Women’s University, Rajasthan, India
| | - Priya Chauhan
- Department of Physiotherapy, UIAHS, Chandigarh University, Punjab, India
| | - Gurjant Singh
- Department of Physiotherapy, UIAHS, Chandigarh University, Punjab, India
| | - Nitesh Malhotra
- Department of Physiotherapy, Manav Rachna International University, Faridabad, India
| | - Aksh Chahal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, India
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13
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Powell AJ, Thomas S. How the LiveWell Dorset lifestyle behaviour change service influences older adults’ physical activity behaviour: A generic qualitative study. PUBLIC HEALTH IN PRACTICE 2021; 2:100164. [PMID: 36101637 PMCID: PMC9461534 DOI: 10.1016/j.puhip.2021.100164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022] Open
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14
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Community-Dwelling Older Adults and Physical Activity Recommendations: Patterns of Aerobic, Strengthening, and Balance Activities. J Aging Phys Act 2021; 30:653-665. [PMID: 34653962 DOI: 10.1123/japa.2021-0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022]
Abstract
Though it is known that most older adults do not meet the recommended physical activity (PA) guidelines, little is known regarding their participation in balance activities or the full guidelines. Therefore, we sought to describe PA patterns among 1,352 community-dwelling older adult participants of the Adult Changes in Thought study, a longitudinal cohort study exploring dementia-related risk factors. We used a modified version of the Community Healthy Activities Model Program for Seniors questionnaire to explore PA performed and classify participants as meeting or not meeting the full guidelines or any component of the guidelines. Logistic regression was used to identify factors associated with meeting PA guidelines. Despite performing 10 hr of weekly PA, only 11% of participants met the full guidelines. Older age, greater body mass index, needing assistance with instrumental daily activities, and heart disease were associated with decreased odds of meeting PA guidelines. These results can guide interventions that address PA among older adults.
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15
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Multicomponent Physical Exercise Training in Multimorbid and Palliative Oldest Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178896. [PMID: 34501486 PMCID: PMC8431350 DOI: 10.3390/ijerph18178896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022]
Abstract
Exercise counteracts aging and pathology symptoms, but there is still scarce research on exercise programs for multimorbid and/or palliative old patients (MPO-Ps). In order to analyze whether the multicomponent physical-cognitive training is beneficial for this population, 17 MPO-Ps (81.59 ± 5.63 years) completed a >26 weeks home-based intervention (20-50 min/session, three sessions/week). Twenty-eight supervised and thirty-two autonomous sessions were gradually distributed along three phases: supervised training (ST), reduced supervision training (RST), and autonomous training (AT). Physical function (gait speed, hand grip and lower-limb strength, balance, and agility), mental status (MMSE), and autonomy in daily living (the Barthel Index) were assessed. Categorical analyses regarding the changes in the walking aids used in the test were added to improve the assessment of strength and agility along the intervention. Despite important study limitations, such as the small sample size and lack of a control group, and despite the MPO-Ps' very low baseline fitness and initial exercise intolerance, they benefited from the dual-tasking approach, especially in autonomy, lower-limb strength, and balance. Agility improvements were shown only by categorical analyses. As expected, most benefits increased the supervision (ST phase). Gait speed and cognitive status maintained despite the total autonomy in training in the last phase. Further research with larger samples should confirm if multicomponent physical-cognitive exercise, individualized and tailored on daily-basis, together with technical assistance and medical supervision, benefits this MPO-Ps population, and if it can be prescribed to them with security, in spite some of them already being palliative patients.
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16
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Performance, Health, and Psychological Challenges Faced by Students of Physical Education in Online Learning during COVID-19 Epidemic: A Qualitative Study in China. Healthcare (Basel) 2021; 9:healthcare9081030. [PMID: 34442167 PMCID: PMC8393971 DOI: 10.3390/healthcare9081030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
The spread of COVID-19 has led students to take classes online (rather than face-to-face) worldwide, including in China. For this study, we conducted qualitative focus group discussions to identify the experience of and difficulties faced by online physical education students in higher education taking online classes, including the impact on their physical activity performance, as well as some health problems they face while taking online classes during the quarantine period, such as weight gain, depression, and anxiety. Finally, utilizing Mayer's learning model as a conceptual framework, we propose a method that addresses how to effectively manage an optimal future learning system for physical education students, both during and after the COVID-19 outbreak situation. During the isolation period of COVID-19, the required equipment for the participants was rarely available at home while attending the online classes, which inevitably reduced the number of physical education units that could be conveyed. This resulted in a transfer of attention from competition to underperformance, weight gain, and adverse psychological conditions. We conclude that it is important to review and systematize the methods of online physical education learning, particularly highlighting the cultural and educational characteristics of different countries, and to investigate the effectiveness of online physical education as a whole.
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17
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DeLorey DS. Sympathetic vasoconstriction in skeletal muscle: Modulatory effects of aging, exercise training, and sex. Appl Physiol Nutr Metab 2021; 46:1437-1447. [PMID: 34348066 DOI: 10.1139/apnm-2021-0399] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The sympathetic nervous system (SNS) is a critically important regulator of the cardiovascular system. The SNS controls cardiac output and its distribution, as well as peripheral vascular resistance and blood pressure at rest and during exercise. Aging is associated with increased blood pressure and decreased skeletal muscle blood flow at rest and in response to exercise. The mechanisms responsible for the blunted skeletal muscle blood flow response to dynamic exercise with aging have not been fully elucidated; however, increased muscle sympathetic nerve activity (MSNA), elevated vascular resistance and a decline in endothelium-dependent vasodilation are commonly reported in older adults. In contrast to aging, exercise training has been shown to reduce blood pressure and enhance skeletal muscle vascular function. Exercise training has been shown to enhance nitric oxide-dependent vascular function and may improve the vasodilatory capacity of the skeletal muscle vasculature; however, surprisingly little is known about the effect of exercise training on the neural control of circulation. The control of blood pressure and skeletal muscle blood flow also differs between males and females. Blood pressure and MSNA appear to be lower in young females compared to males. However, females experience a larger increase in MSNA with aging compared to males. The mechanism(s) for the altered SNS control of vascular function in females remain to be determined. Novelty: • This review will summarize our current understanding of the effects of aging, exercise training and sex on sympathetic vasoconstriction at rest and during exercise. • Areas where additional research is needed are also identified.
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Affiliation(s)
- Darren S DeLorey
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
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18
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Older Adults' Choice of Patterns of Outdoor Physical Activity Duration: A Mixed Multinomial Logit Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158199. [PMID: 34360492 PMCID: PMC8346097 DOI: 10.3390/ijerph18158199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/29/2021] [Accepted: 07/31/2021] [Indexed: 12/30/2022]
Abstract
Outdoor physical activity duration is a key component of outdoor physical activity behavior of older adults, and therefore, an important determinant of their total physical activity levels. In order to develop a successful outdoor physical activity program, it is important to identify any heterogeneity in preferences for outdoor physical activity duration patterns among older adults. In addition, more insight is needed in the influence of environmental characteristics on duration choice for creating supportive neighborhood environments matching individuals’ preferences. To this end, a mixed multinomial logit model is estimated based on one-week data collected among 336 respondents aged 60 or over in 2017 in Dalian, China. The present model formulation accounts for heterogeneity in individuals’ preferences and allows for the analysis of substitution and complementary relationships between the different patterns of outdoor physical activity duration. Results indicate that older adults vary significantly in their preferences for each outdoor physical activity duration pattern. Moreover, short walking duration, short exercise duration and medium exercise duration are substitutes for medium walking duration while short walking duration and short exercise duration are complements for medium exercise duration in terms of individuals’ outdoor physical activity duration preferences. In addition, we find that distance to the nearest park, footpath conditions and neighborhood aesthetics are associated with older adults’ outdoor physical activity duration choice.
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Gronek J, Boraczyński M, Gronek P, Wieliński D, Tarnas J, Marszałek S, Tang YY. Exercise in Aging: Be Balanced. Aging Dis 2021; 12:1140-1149. [PMID: 34341697 PMCID: PMC8279522 DOI: 10.14336/ad.2021.0107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/07/2021] [Indexed: 01/12/2023] Open
Abstract
The beneficial effects of exercise are recognized for preventing physical and cognitive decline during the aging process. However, there is still a gap concerning recommended intensity, volume, frequency and mode of exercise especially for older people. The aim of this study was to investigate an appropriate type of physical activity (PA) model for healthy aging. A commentary of the influence of PA and exercise on healthy aging through an online search of the databases Web of Science, PubMed and Google Scholar. Two living groups can be considered as potential references: modern hunter-gatherer small-scale population and master athletes. Greater physical activity is proposed for healthy aging than that recommended by WHO. Additionally, mindfulness meditation techniques during exercise are recommended especially for persons practicing long-duration exercises. Complex and compound exercise and workouts should include challenging exercises adjusted and balanced to provide clients, especially older people, with noticeable changes and progress.
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Affiliation(s)
- Joanna Gronek
- 1Department of Dance, Poznań University of Physical Education, Poland
| | - Michał Boraczyński
- 2Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Poland
| | - Piotr Gronek
- 1Department of Dance, Poznań University of Physical Education, Poland
| | - Dariusz Wieliński
- 3Department of Anthropology and Biometry, Poznań University of Physical Education, Poland
| | - Jacek Tarnas
- 4Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poland
| | - Sławomir Marszałek
- 5Department of Physiotherapy, Poznań University of Physical Education, Poland.,6Department of Physiotherapy, Poznań University of Medical Sciences, Poland
| | - Yi-Yuan Tang
- 7Department of Psychological Sciences, Texas Tech University, USA
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20
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Pardo-Garcia I, Amo-Saus E, Moya-Martinez P. Socioeconomic and Lifestyle Factors Related to Cost and Frequency of Hospitalization in European Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2833. [PMID: 33802180 PMCID: PMC7998278 DOI: 10.3390/ijerph18062833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Individuals' lifestyles play an important role in healthcare costs. A large part of these costs is derived from hospitalizations. With the aim of determine the relationship between lifestyle and the likelihood of hospitalization and associate costs in older adults, this study used the Survey of Health, Aging, and Retirement in Europe. Generalized regression models for panel data were developed and adjusted hospitalization costs derived from the length of hospital stay were also estimated. The average adjusted cost of hospitalization was I$ 9901.50 and the analyses showed that performing weekly physical activity significantly reduces the probability of hospitalization (OR: 0.624) and its costs (I$ 2594.5 less per person per year than subjects who never performed physical activity). Muscle strength plays an important role in this relationship and eating habits are not of great significance. Furthermore, we found interesting differences in the frequency and costs of hospitalization between subjects by country.
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Affiliation(s)
- Isabel Pardo-Garcia
- School of Economics and Business Administration, Castilla-La Mancha University (UCLM), 02071 Albacete, Spain;
- Sociosanitary Research Center, 16071 Cuenca, Spain;
- Research Group of Economy, Food and Society, Castilla La Mancha University, 02071 Albacete, Spain
| | - Elisa Amo-Saus
- School of Economics and Business Administration, Castilla-La Mancha University (UCLM), 02071 Albacete, Spain;
- Research Group of Economy, Food and Society, Castilla La Mancha University, 02071 Albacete, Spain
| | - Pablo Moya-Martinez
- Sociosanitary Research Center, 16071 Cuenca, Spain;
- Research Group of Economy, Food and Society, Castilla La Mancha University, 02071 Albacete, Spain
- School of Social Sciences, Castilla- La Mancha University (UCLM), 16071 Cuenca, Spain
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21
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Saqib ZA, Dai J, Menhas R, Mahmood S, Karim M, Sang X, Weng Y. Physical Activity is a Medicine for Non-Communicable Diseases: A Survey Study Regarding the Perception of Physical Activity Impact on Health Wellbeing. Risk Manag Healthc Policy 2020; 13:2949-2962. [PMID: 33335436 PMCID: PMC7737939 DOI: 10.2147/rmhp.s280339] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background A modifiable risk factor for many diseases is physical inactivity. In this modern era, physical activity is acknowledged as a vital strategy to promote good health. According to the WHO, regular physical activity has various benefits for psycho-physical health. Decreased physical inactivity is happening in China due to the increased participation of the Chinese population in physical activity. The human body needs a specific level of physical activity to maintain good health. Objective The main aim of the present study was to assess the Chinese people’s understanding of physical activity and participation in physical activity as a preventive measure against different diseases. Methods The present study was exploratory and conducted in the Kunshan county-level city in Jiangsu Province, China. A well-designed questionnaire was used to collect the data from the survey participants. A total of 3390 residents were selected from 1300 households through a simple random sampling technique. The collected data were analyzed through SPSS software. Both univariate and bivariate analysis were performed. Results The survey results showed that the majority of women are participating in physical activity. Most of the Kunshan people participate in physical activity one time or more than one time per week. They perform 30–60 minutes of moderate-intensity physical activity to improve physical fitness, recreation, and disease prevention. Fitness walking is the most common type of physical activity among Kunshan people, and most of them participate in physical activity at night. Wilcoxon signed-rank test indicated that post-test ranks are statistically higher than pre-test ranks (P<0.0039, 0.0039, 0.0039, 0.0020, 0.0001, 0.0156, 0.0313). Conclusion The study results showed that physical activity plays a catalyst role in improving human health on a natural path. It reduces the risk factor of non-communicable diseases and promotes general wellbeing. These findings show that physical activity level increases in Chinese society as more people participate in physical activity for health-being.
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Affiliation(s)
- Zulkaif Ahmed Saqib
- Research Institute of Business Analytics & Supply Chain Management, College of Management, Shenzhen University, Shenzhen, Guangdong Province 518060, People's Republic of China
| | - Jianhui Dai
- School of Physical Education and Sports, Soochow University, Suzhou 215006, Jiangsu Province, People's Republic of China
| | - Rashid Menhas
- Research Center of Sports Social Sciences, School of Physical Education and Sports, Soochow University, Suzhou 215006, Jiangsu Province, People's Republic of China
| | - Shahid Mahmood
- College of Management, Shenzhen University, Shenzhen, Guangdong Province 518060, People's Republic of China
| | - Maria Karim
- International Institute of Islamic Economics (IIIE), International Islamic University (IIU), Islamabad, 44000, Islamic Republic of Pakistan
| | - Xuehui Sang
- School of Physical Education and Sports, Soochow University, Suzhou 215006, Jiangsu Province, People's Republic of China
| | - Yu Weng
- School of Physical Education and Sports, Soochow University, Suzhou 215006, Jiangsu Province, People's Republic of China
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Zhang G, Wong IKK, Chen TLW, Hong TTH, Wong DWC, Peng Y, Yan F, Wang Y, Tan Q, Zhang M. Identifying Fatigue Indicators Using Gait Variability Measures: A Longitudinal Study on Elderly Brisk Walking. SENSORS 2020; 20:s20236983. [PMID: 33297364 PMCID: PMC7730469 DOI: 10.3390/s20236983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 12/23/2022]
Abstract
Real-time detection of fatigue in the elderly during physical exercises can help identify the stability and thus falling risks which are commonly achieved by the investigation of kinematic parameters. In this study, we aimed to identify the change in gait variability parameters from inertial measurement units (IMU) during a course of 60 min brisk walking which could lay the foundation for the development of fatigue-detecting wearable sensors. Eighteen elderly people were invited to participate in the brisk walking trials for 60 min with a single IMU attached to the posterior heel region of the dominant side. Nine sets of signals, including the accelerations, angular velocities, and rotation angles of the heel in three anatomical axes, were measured and extracted at the three walking times (baseline, 30th min, and 60th min) of the trial for analysis. Sixteen of eighteen participants reported fatigue after walking, and there were significant differences in the median acceleration (p = 0.001), variability of angular velocity (p = 0.025), and range of angle rotation (p = 0.0011), in the medial–lateral direction. In addition, there were also significant differences in the heel pronation angle (p = 0.005) and variability and energy consumption of the angles in the anterior–posterior axis (p = 0.028, p = 0.028), medial–lateral axis (p = 0.014, p = 0.014), and vertical axis (p = 0.002, p < 0.001). Our study demonstrated that a single IMU on the posterior heel of the dominant side can address the variability of kinematics parameters for elderly performing prolonged brisk walking and could serve as an indicator for walking instability, and thus fatigue.
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Affiliation(s)
- Guoxin Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Ivy Kwan-Kei Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Tommy Tung-Ho Hong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
| | - Yinghu Peng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Fei Yan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Yan Wang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
| | - Qitao Tan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Ming Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
- Correspondence: ; Tel.: +852-2766-4939
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Laar RA, Shi S, Ashraf MA, Khan MN, Bibi J, Liu Y. Impact of Physical Activity on Challenging Obesity in Pakistan: A Knowledge, Attitude, and Practice (KAP) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217802. [PMID: 33113780 PMCID: PMC7662990 DOI: 10.3390/ijerph17217802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
Physical activity (PA) refers to any action produced by skeletal muscle that consumes energy. According to the World Health Organization (WHO), PA is the primary element that can improve health at the community level. Obviously, PA plays an important role in the social, physical, and mental development of men and women, as well as in balancing weight. However, the large-scale negative impacts of physical inactivity on health-related issues are also recognized globally, such as obesity, which is the source of many non-communication diseases (NCDs). In Pakistan alone, 46% of deaths occur due to NCD. The majority of NCD deaths are linked to obesity, and Pakistan is the ninth most obese country in the world. Research on obesity caused by sedentary work in Pakistan is lacking, especially among university employees. To fill this gap, the current study mainly focuses on the rising non-communicable disease (NCD) rates among university employees in Pakistan due to a lack of exercise (obesity, in this case), with the help of a self-designed knowledge, attitude, and practice (KAP) questionnaire. Five universities in the Sindh province of Pakistan were surveyed (n = 276), following the concept of Yin-Yang as a theoretical lens. The results of the current study show that the knowledge, behaviors, and attitudes of university employees have a great influence on their body mass index (BMI). The study shows that Pakistani residents' (especially teaching staff) perceptions and attitudes towards obesity and PA have been instructive, but their practices need to be improved.
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Affiliation(s)
- Rizwan Ahmed Laar
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing 210023, China; (R.A.L.); (Y.L.)
| | - Shusheng Shi
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing 210023, China; (R.A.L.); (Y.L.)
- Correspondence:
| | - Muhammad Azeem Ashraf
- Research Institute of Educational Science, Hunan University, Changsha 410082, China;
| | - Muhammad Naeem Khan
- Department of Sociology, School of social and Behavioral Science, Nanjing University, Nanjing 210023, China;
| | - Jannat Bibi
- School of Physical Education, Shaanxi Normal University, Xi’an 710119, China;
| | - Yibing Liu
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing 210023, China; (R.A.L.); (Y.L.)
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Ignasiak Z, Sebastjan A, Sławińska T, Skrzek A, Czarny W, Król P, Rzepko M, Duda-Biernacka B, Marchewka A, Filar-Mierzwa K, Nowacka-Dobosz S, Dobosz J, Umiastowska D. Functional fitness normative values for elderly polish population. BMC Geriatr 2020; 20:384. [PMID: 33023485 PMCID: PMC7539522 DOI: 10.1186/s12877-020-01787-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 09/23/2020] [Indexed: 12/04/2022] Open
Abstract
Background It’s really important to measure the actual functional physical fitness of elderly independent living persons from different environments to know the level and rate of decrease may inform about the threat of loss of functional independence, hence the need to monitor and assess the senior’s motor realm and adapt to it the appropriate programs and treatments in the care for the elderly person. Methods The study involved 5367 people (mean age 69,63 ± 7,06), including 4164 women (mean age 69,55 ± 7,11) and 1203 men (mean age 69,91 ± 6,86) aged 60 to 93 years old. We have measured basic anthropometric features and physical fitness (by using Senior Fitness Test). Results The average values in individual SFT tests significantly decrease along with age. After age of 80 and 85 there were no sex differences in SFT. The largest deficits concern the dynamic balance and the decrease reaches 69% in men and 62% in women A significantly higher rate of decline in aerobic capacity concerns men (43%) than women (36.9%). A clearly lower rate of loss occurs in the muscular strength of the lower and upper body and does not exceed 30%. Conclusions The results are of great clinical importance for the development of effective prevention and gerontological education programs in terms of promoting active lifestyle and successful ageing, at the same time limiting the economic consequences of treatment and hospitalisation.
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Affiliation(s)
- Zofia Ignasiak
- University School of Physical Education in Wrocław, Al. I.J. Paderewskiego 35, 51-612, Wrocław, Poland
| | - Anna Sebastjan
- University School of Physical Education in Wrocław, Al. I.J. Paderewskiego 35, 51-612, Wrocław, Poland.
| | - Teresa Sławińska
- University School of Physical Education in Wrocław, Al. I.J. Paderewskiego 35, 51-612, Wrocław, Poland
| | - Anna Skrzek
- University School of Physical Education in Wrocław, Al. I.J. Paderewskiego 35, 51-612, Wrocław, Poland
| | | | | | | | | | - Anna Marchewka
- University of Physical Education in Krakow, Kraków, Poland
| | | | | | - Janusz Dobosz
- Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
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25
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Matias C, Nunes C, Francisco S, Tomeleri C, Cyrino E, Sardinha L, Silva A. Phase angle predicts physical function in older adults. Arch Gerontol Geriatr 2020; 90:104151. [PMID: 32563736 DOI: 10.1016/j.archger.2020.104151] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 01/19/2023]
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Yeh PC. Impact of button position and touchscreen font size on healthcare device operation by older adults. Heliyon 2020; 6:e04147. [PMID: 32637675 PMCID: PMC7330495 DOI: 10.1016/j.heliyon.2020.e04147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/09/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022] Open
Abstract
In 1993, Taiwan officially became an aging society. Degradation of physiological function during aging is inevitable; visual and physical reactions are especially vulnerable. Given the popularity of electronic devices and their vigorous development in recent years, touchscreen use is now commonplace. As society ages, many people use devices to monitor their health. Some products have gradually eschewed their traditional interfaces, which have been replaced by touchscreens. Touchscreen operation and interpretation differ between older and younger populations. Here, we focus on healthcare equipment, exploring the effects of button position and touchscreen font size on operation by older people. To understand differences between older and younger people, we invited 32 people aged 18–35 years, and 32 people aged over 65 years, to participate in our experiment. Each subject tested four button positions and four font sizes, thus 16 test interfaces in all. We found that young people found no differences among the 16 interfaces, but the older group did. Larger fonts reduced operation time for older participants. At a font size of 22 pt, the older group performed as well as the young participants. When buttons were positioned at the top of the interface, the performance of the older participants improved. Overall, use of a font size of 22 pt and top-positioned buttons optimized the performance of the older participants while use of a font size of 10 pt and bottom-positioned buttons maximally degraded their performance. Our results can be used to design interfaces appropriate for older people, thus improving their autonomy.
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Conducting a Mixed-Methods Study with Older Adults in Five Languages: Lessons from the Field. Can J Aging 2020; 40:321-330. [PMID: 32616105 DOI: 10.1017/s0714980820000100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
One third of older adults in Canada are foreign-born, yet there is a dearth of literature on this population. When our team set out to engage in a mixed-methods study on the physical activity and mobility of foreign-born older adults (FBOAs), we found limited guidance. The objective of this Research Note is to share the lessons that we learned in implementing a mixed-methods study in five languages, with 49 visible minority FBOAs from diverse ethno-cultural groups. With an emphasis on practical implementation, here we share our reflections on early community engagement, linguistic accessibility and literacy considerations, facilitating communication with the research team, creating a support role for multilingual family members, organisational suggestions, and working with interpreters and monolingual transcribers. The older Canadian population is projected to become increasingly diverse in the coming decades, and it is our hope that this note will further facilitate research in this understudied area.
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Gallè F, Sabella EA, Da Molin G, Parisi EA, Liguori G, Montagna MT, De Giglio O, Tondini L, Orsi GB, Napoli C. Physical Activity in Older Adults: An Investigation in a Metropolitan Area of Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031034. [PMID: 32041269 PMCID: PMC7037864 DOI: 10.3390/ijerph17031034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 01/08/2023]
Abstract
Physical activity (PA) and exercise are fundamental to maintaining health in older adults. World Health Organization guidelines state that older adults should practice at least 150 min/week of moderate/vigorous intensity PA to obtain health benefits. We assessed PA levels among older adults in southern Italy and evaluated possible associated determinants. The study was carried out between September and November 2019 in the metropolitan area of Bari. We collected information from participants over 65 years using a self-administered questionnaire. We investigated associations between sociodemographic characteristics, health conditions, and inactivity/PA levels. A total of 383 individuals completed the questionnaire. Mean body mass index indicated that 45.4% of participants were overweight. Mean time spent in PA was 476.2 ± 297.8 min/week, with women reporting lower levels than men (370.8 ± 210 vs. 555.2 ± 334.3 min/week, p = 0.08). Weekly sitting time was positively related to age. Attending religious or recreational activities was related to moderate PA. Educational level was positively associated with PA while dog ownership represented an obstacle to achieving recommended PA levels in our population. Participants generally met the recommended levels of PA, especially men; the educational level was the main determinant. Interventions aimed at promoting PA among older adults with lower education levels and women are needed in this setting.
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Affiliation(s)
- Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina n. 40, 80133 Naples, Italy; (G.L.); (L.T.)
- Correspondence:
| | - Elita Anna Sabella
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, Piazza Umberto I, 1, 70121 Bari, Italy; (E.A.S.); (G.D.M.)
| | - Giovanna Da Molin
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, Piazza Umberto I, 1, 70121 Bari, Italy; (E.A.S.); (G.D.M.)
| | - Eduardo Alfonso Parisi
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.A.P.); (C.N.)
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina n. 40, 80133 Naples, Italy; (G.L.); (L.T.)
| | - Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (O.D.G.)
| | - Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (O.D.G.)
| | - Luca Tondini
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina n. 40, 80133 Naples, Italy; (G.L.); (L.T.)
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.A.P.); (C.N.)
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Adcock M, Fankhauser M, Post J, Lutz K, Zizlsperger L, Luft AR, Guimarães V, Schättin A, de Bruin ED. Effects of an In-home Multicomponent Exergame Training on Physical Functions, Cognition, and Brain Volume of Older Adults: A Randomized Controlled Trial. Front Med (Lausanne) 2020; 6:321. [PMID: 32047751 PMCID: PMC6997483 DOI: 10.3389/fmed.2019.00321] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
Aging is associated with a decline in physical functions, cognition and brain structure. Considering that human life is based on an inseparable physical-cognitive interplay, combined physical-cognitive training through exergames is a promising approach to counteract age-related impairments. The aim of this study was to assess the effects of an in-home multicomponent exergame training on [i] physical and cognitive functions and [ii] brain volume of older adults compared to a usual care control group. Thirty-seven healthy and independently living older adults aged 65 years and older were randomly assigned to an intervention (exergame training) or a control (usual care) group. Over 16 weeks, the participants of the intervention group absolved three home-based exergame sessions per week (à 30–40 min) including Tai Chi-inspired exercises, dancing and step-based cognitive games. The control participants continued with their normal daily living. Pre- and post-measurements included assessments of physical (gait parameters, functional muscle strength, balance, aerobic endurance) and cognitive (processing speed, short-term attention span, working memory, inhibition, mental flexibility) functions. T1-weighted magnetic resonance imaging was conducted to assess brain volume. Thirty-one participants (mean age = 73.9 ± 6.4 years, range = 65–90 years, 16 female) completed the study. Inhibition and working memory significantly improved post-intervention in favor of the intervention group [inhibition: F(1) = 2.537, p = 0.046, np2 = 0.11, working memory: F(1) = 5.872, p = 0.015, np2 = 0.02]. Two measures of short-term attentional span showed improvements after training in favor of the control group [F(1) = 4.309, p = 0.038, np2 = 0.03, F(1) = 8.504, p = 0.004, np2 = 0.04]. No significant training effects were evident for physical functions or brain volume. Both groups exhibited a significant decrease in gray matter volume of frontal areas and the hippocampus over time. The findings indicate a positive influence of exergame training on executive functioning. No improvements in physical functions or brain volume were evident in this study. Better adapted individualized training challenge and a longer training period are suggested. Further studies are needed that assess training-related structural brain plasticity and its effect on performance, daily life functioning and healthy aging.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Mélanie Fankhauser
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Jennifer Post
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Kai Lutz
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | | | - Andreas R Luft
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland.,Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
| | | | - Alexandra Schättin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Adcock M, Sonder F, Schättin A, Gennaro F, de Bruin ED. A usability study of a multicomponent video game-based training for older adults. Eur Rev Aging Phys Act 2020; 17:3. [PMID: 31938075 PMCID: PMC6955093 DOI: 10.1186/s11556-019-0233-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/19/2019] [Indexed: 12/31/2022] Open
Abstract
Background Aging is often accompanied by a decline in sensory, motor and cognitive functions. These age- and lifestyle-related impairments may lead to reduced daily life functioning including gait disturbances, falling and injuries. Most daily life activities, e.g. walking, are tasks which require the concurrent interplay of physical and cognitive functions. Promising options for combined physical-cognitive training are video game-based physical exercises, so-called exergames. This study aimed to [i] determine the usability of a newly developed multicomponent exergame and [ii] explore its effects on physical functions, cognition and cortical activity. Methods Twenty-one healthy and independently living older adults were included (10 female, 71.4 ± 5.8 years, range: 65–91) and performed 21 training sessions (each 40 min) over seven weeks. The multicomponent exergame included strength and balance training with Tai Chi-inspired and dance exercises. Participants rated the usability of the exergame (System Usability Scale) and reported on their emotional experience (Game Experience Questionnaire). Attendance and attrition rates were calculated to determine training compliance. Before and after the intervention, physical and cognitive functions as well as resting state electroencephalography (EEG) were assessed. Results Results showed a high training attendance rate (87.1%, 18/21 training sessions on average) and a low attrition rate (9.5%, 2 drop-outs). System usability was rated high with a mean score of 75/100. Affective game experience was rated favorable. Gait speed under dual-task condition, lower extremity muscle strength and reaction times in a cognitive task (divided attention) showed significant improvements (p < .05). No significant pre-post differences were found for resting state EEG. Conclusions The newly developed exergame seems usable for healthy older adults. Nevertheless, some aspects of the exergame prototype can and should be improved. The training showed to positively influence physical and cognitive functions in a small convenience sample. Future trials are warranted which evaluate the feasibility and usability of the exergame training in a more “real-life” in-home setting and assess the behavioral and neuroplastic changes in a larger population after a longer training period with comparison to a control group.
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Affiliation(s)
- Manuela Adcock
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Floriana Sonder
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Alexandra Schättin
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Federico Gennaro
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Eling D de Bruin
- 1Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland.,2Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Alfred Nobels Alle 23, 14183 Huddinge, Sweden
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31
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Adcock M, Thalmann M, Schättin A, Gennaro F, de Bruin ED. A Pilot Study of an In-Home Multicomponent Exergame Training for Older Adults: Feasibility, Usability and Pre-Post Evaluation. Front Aging Neurosci 2019; 11:304. [PMID: 31824295 PMCID: PMC6882741 DOI: 10.3389/fnagi.2019.00304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with sensory, motor and cognitive impairments that may lead to reduced daily life functioning including gait disturbances, falls, injuries and mobility restrictions. A strong need exists for implementing effective evidence-based interventions for healthy aging. Therefore, the aim of this study was to (i) evaluate the feasibility and usability of an in-home multicomponent exergame training and (ii) explore its effects on physical functions, cognition and cortical activity. Twenty-one healthy and independently living older adults were included (11 female, 74.4 ± 7.0 years, range: 65-92 years) and performed 24 trainings sessions (each 40 min) over eight weeks. The first part was conducted in a living lab (home-like laboratory environment), the second part at participants' home. The multicomponent exergame included Tai Chi-inspired exercises, dance movements and step-based cognitive games to train strength, balance and cognition. Attendance and attrition rates were calculated and safety during training was evaluated to determine feasibility. Participants rated the usability of the exergame (System Usability Scale) and reported on their game experience (Game Experience Questionnaire). Physical and cognitive functions and cortical activity (resting state electroencephalopathy) were assessed pre and post intervention. Results showed a high training attendance rate for the living lab and the home-based setting (91.7 and 91.0%, respectively) with a rather high attrition rate (28.6%, six drop-outs). Half of the drop-out reasons were related to personal or health issues. System usability was rated acceptable with a mean score of 70.6/100. Affective game experience was rated favorable. Significant improvements were found for minimal toe clearance, short-term attentional span, and information processing speed (p < 0.05). No significant pre-post differences were found for cortical activity. To summarize, the exergame is generally feasible and usable for healthy older adults applied in an in-home setting and provides an overall positive emotional game experience. Nevertheless, flawless technical functionality should be a mandatory consideration. Additionally, the training might have potential positive influence on specific functions in older adults. However, the efficacy has to be evaluated in a future randomized controlled trial assessing the behavioral and neuroplastic changes in a larger population after a longer training period.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Melanie Thalmann
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Alexandra Schättin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Federico Gennaro
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Kepic M. Life Satisfaction After Spousal Loss: The Potential Influence of Age, Gender, and Leisure. ADULTSPAN JOURNAL 2019. [DOI: 10.1002/adsp.12079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marcela Kepic
- Department of Counseling and Human Development, The George Washington University
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Klompstra L, Ekdahl AW, Krevers B, Milberg A, Eckerblad J. Factors related to health-related quality of life in older people with multimorbidity and high health care consumption over a two-year period. BMC Geriatr 2019; 19:187. [PMID: 31277674 PMCID: PMC6612189 DOI: 10.1186/s12877-019-1194-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of multimorbidity is increasing worldwide, and older people with multimorbidity are frequent users of health care services. Since multimorbidity has a significant negative impact on Health-related Quality of Life (HrQoL) and is more common in older age it would be expected that factors related to HrQoL in this group might have been thoroughly researched, but this is not the case. Furthermore, it is important to look at old people living at home, considering the shift from residential to home-based care. Therefore, we aim to investigate factors that are related to HrQoL in older people with multimorbidity and high health care consumption, living at home. METHODS This is a secondary analysis of a RCT study conducted in a municipality in south-eastern Sweden. The study had a longitudinal design with a two-year follow-up period assessing HrQoL, symptom burden, activities of daily living, physical activity and depression. RESULTS In total, 238 older people with multimorbidity and high health care consumption, living at home were included (mean age 82, 52% female). A multiple linear regression model including symptom burden, activities of daily living and depression as independent variables explained 64% of the HrQoL. Higher symptom burden, lower ability in activities of daily living and a higher degree of depression were negatively related to HrQoL. Depression at baseline and a change in symptom burden over a two-year period explained 28% of the change in HrQoL over a two-year period variability. A higher degree of depression at baseline and negative change in higher symptom burden were related to a decrease in HrQoL over a two-year period. CONCLUSION In order to facilitate better delivery of appropriate health care to older people with high health care consumption living at home it is important to assess HrQoL, and HrQoL over time. Symptom burden, activities of daily living, depression and change in symptom burden over time are important indicators for HrQoL. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT01446757 , the trial was registered prospectively with the date of trial registration October 5th, 2011.
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Affiliation(s)
- Leonie Klompstra
- Department of Social and Welfare Studies, Division of Nursing, Linköping University, Linköping, Sweden. .,Department of Social and Welfare Studies, Linköping University, SE 601 74, Norrköping, Sweden.
| | - Anne W Ekdahl
- Section of Geriatric Medicine and Institution of Clinical Research, Helsingborg Hospital, Lund University, Lund, Sweden
| | - Barbro Krevers
- Department of Medicine and Health Sciences, Division of Health Care Analysis, Linköping University, Linkoping, Sweden
| | - Anna Milberg
- Department of Advanced Home Care, Linköping University, Norrköping, Sweden.,Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Jeanette Eckerblad
- Department on Neurobiology and Care Science and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
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The Automatic Assessment of Strength and Mobility in Older Adults: A Test-Retest Reliability Study. ACTA ACUST UNITED AC 2019; 55:medicina55060270. [PMID: 31212695 PMCID: PMC6631724 DOI: 10.3390/medicina55060270] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 11/16/2022]
Abstract
Background: Simple field tests such as the Timed Up and Go test (TUG) and 30 s Chair Stand test are commonly used to evaluate physical function in the elderly, providing crude outcome measures. Using an automatic chronometer, it is possible to obtain additional kinematic parameters that may lead to obtaining extra information and drawing further conclusions. However, there is a lack of studies that evaluate the test-retest reliability of these parameters, which may help to judge and interpret changes caused by an intervention or differences between populations. Thus, the aim of this study was to evaluate the test-retest reliability of the Timed Up and Go test (TUG) and 30 s Chair Stand test in healthy older adults. Methods: A total of 99 healthy older adults participated in this cross-sectional study. The TUG and the 30 s Chair Stand test were performed five times and twice, respectively, using an automatic chronometer. The sit-to-stand-to-sit cycle from the 30 s Chair Stand test was divided into two phases. Results: Overall, reliability for the 30 s Chair Stand test was good for almost each variable (intraclass correlation coefficient (ICC) >0.70). Furthermore, the use of an automatic chronometer improved the reliability for the TUG (ICC >0.86 for a manual chronometer and ICC >0.88 for an automatic chronometer). Conclusions: The TUG and the 30 s Chair Stand test are reliable in older adults. The use of an automatic chronometer in the TUG is strongly recommended as it increased the reliability of the test. This device enables researchers to obtain relevant and reliable data from the 30 s Chair Stand test, such as the duration of the sit-to-stand-to-sit cycles and phases.
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Gaskell L, Williams AE. A qualitative study of the experiences and perceptions of adults with chronic musculoskeletal conditions following a 12-week Pilates exercise programme. Musculoskeletal Care 2019; 17:54-62. [PMID: 30402992 DOI: 10.1002/msc.1365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 08/30/2018] [Accepted: 09/01/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The aim of the present study was to explore the experiences and perceptions of adult patients with chronic musculoskeletal conditions following a Pilates exercise programme. A qualitative approach was taken to both data collection and analysis, with alignment to the philosophy of interpretive phenomenology. Participants included 15 women and seven men with a range of chronic musculoskeletal conditions, including nonspecific low back pain, peripheral joint osteoarthritis and a range of postsurgical conditions. The age range was from 36 years to 83 years, and the mean age was 57 years (standard deviation 14.1 years). METHODS Data were collected via digital recordings of four focus groups in three North-West of England physiotherapy clinics. The data were transcribed verbatim and then analysed using a thematic framework. Data were verified by a researcher and randomly selected participants, and agreement was achieved between all parties. RESULTS The results were organized into five main themes: physical improvements; Pilates promotes an active lifestyle: improved performance at work and hobbies; psychosocial benefits and improved confidence; increased autonomy in managing their own condition; and motivation to continue with exercise. CONCLUSION The study was the first to investigate individual perceptions of the impact of Pilates on the daily lives of people with chronic conditions. The Pilates-based exercise programme enabled the participants to function better and manage their condition more effectively and independently. Further to previous work, the study revealed psychological and social benefits which increase motivation to adhere to the programme and promote a healthier lifestyle.
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Affiliation(s)
- Lynne Gaskell
- Allerton Building, University of Salford, Salford, UK
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Aro AA, Agbo S, Omole OB. Factors influencing regular physical exercise among the elderly in residential care facilities in a South African health district. Afr J Prim Health Care Fam Med 2018; 10:e1-e6. [PMID: 29781682 PMCID: PMC5913764 DOI: 10.4102/phcfm.v10i1.1493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 11/07/2017] [Accepted: 11/17/2017] [Indexed: 11/29/2022] Open
Abstract
Background Physical exercise plays an important role in healthy ageing, but the elderly do not engage in it regularly. Methods In this cross-sectional study, we sampled 139 residents of residential care facility. A questionnaire was used to obtain information on participants’ demography, health problems, nature, motivators and barriers to exercise. Chi-square test examined the relationship between participants’ characteristics and their engagement in regular exercise. Results Of the 139 participants, the majority were females (71.9%), white people (82.7%), aged 70 years or more (70.5%), had at least one health problem (85.6%) and were overweight or obese (60.4%). Approximately 89.2% engaged in some form of physical activities but only 50.3% reported engaging regularly. Participant’s knowledge of the benefits of regular physical activities, opportunities to socialise, encouragement by health care workers and availability of exercise facilities and trainers promote regular physical exercise. Barriers to regular exercise included poor health status, lack of knowledge of the benefits of regular physical activities, lack of opportunities to socialise, lack of encouragement by health care workers and unavailability of exercise facilities and trainers. Factors that predicted exercise were age 60–69 years (p = 0.02), being Afrikaans speaking (p = 0.04) and completing high school (p = 0.03). Conclusion A significant proportion of the elderly do not engage in regular physical exercise, and this behaviour is influenced by personal health status and systems-related motivators and barriers.
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Affiliation(s)
- Abiodun A Aro
- Department of Family Medicine, University of the Witwatersrand.
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George MA, McLay KM, Doyle-Baker PK, Reimer RA, Murias JM. Fitness Level and Not Aging per se, Determines the Oxygen Uptake Kinetics Response. Front Physiol 2018; 9:277. [PMID: 29662455 PMCID: PMC5890239 DOI: 10.3389/fphys.2018.00277] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/08/2018] [Indexed: 11/16/2022] Open
Abstract
Although aging has been associated to slower V˙O2 kinetics, some evidence indicates that fitness status and not aging per se might modulate this response. The main goal of this study was to examine the V˙O2, deoxygenated hemoglobin+myoglobin (deoxy-[Hb+Mb]) kinetics, and the NIRS-derived vascular reperfusion responses in older compared to young men of different training levels (i.e., inactive, recreationally active, and endurance trained). Ten young inactive [YI; 26 ± 5 yrs.; peak V˙O2 (V˙O2peak), 2.96 ± 0.55 L·min−1], 10 young recreationally active (YR; 26 ± 6 yrs.; 3.92 ± 0.33 L·min−1), 10 young endurance trained (YT; 30 ± 4 yrs.; 4.42 ± 0.32 L·min−1), 7 older inactive (OI; 69 ± 4 yrs.; 2.50 ± 0.31 L·min−1), 10 older recreationally active (OR; 69 ± 5 yrs.; 2.71 ± 0.42 L·min−1), and 10 older endurance trained (OT; 66 ± 3 yrs.; 3.20 ± 0.35 L·min−1) men completed transitions of moderate intensity cycling exercise (MODS) to determine V˙O2 and deoxy-[Hb+Mb] kinetics, and the deoxy-[Hb+Mb]/V˙O2 ratio. The time constant of V˙O2 (τV˙O2) was greater in YI (38.8 ± 10.4 s) and OI (44.1 ± 10.8 s) compared with YR (26.8 ± 7.5 s) and OR (26.6 ± 6.5 s), as well as compared to YT (14.8 ± 3.4 s), and OT (17.7 ± 2.7 s) (p < 0.05). τV˙O2 was greater in YR and OR compared with YT and OT (p < 0.05). The deoxy-[Hb+Mb]/V˙O2 ratio was greater in YI (1.23 ± 0.05) and OI (1.29 ± 0.08) compared with YR (1.11 ± 0.03) and OR (1.13 ± 0.06), as well as compared to YT (1.01 ± 0.03), and OT (1.06 ± 0.03) (p < 0.05). Similarly, the deoxy-[Hb+Mb]/ V˙O2 ratio was greater in YR and OR compared with YT and OT (p < 0.05). There was a main effect of training (p = 0.033), whereby inactive (p = 0.018) and recreationally active men (p = 0.031) had significantly poorer vascular reperfusion than endurance trained men regardless of age. This study demonstrated not only that age-related slowing of V˙O2 kinetics can be eliminated in endurance trained individuals, but also that inactive lifestyle negatively impacts the V˙O2 kinetics response of young healthy individuals.
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Affiliation(s)
| | - Kaitlin M McLay
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Patricia K Doyle-Baker
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Faculty of Environmental Design, University of Calgary, Calgary, AB, Canada
| | - Raylene A Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Department of Biochemistry & Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Juan M Murias
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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Physical Activity, Sedentary Time, and Frailty in Older Migrant Women From Ethnically Diverse Backgrounds: A Mixed-Methods Study. J Aging Phys Act 2018; 26:194-203. [PMID: 28605284 DOI: 10.1123/japa.2016-0287] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is limited evidence examining the association between physical activity (PA), sedentary time (ST), frailty, and factors influencing PA behaviors in migrant older women from ethnically diverse backgrounds. The aims of this mixed-methods study were to: 1) examine PA levels and ST across frailty status; 2) identify any differences in PA/ST between ethnic and religious groups; and 3) qualitatively explore factors influencing PA among older (≥60 years) migrant women (n = 60). PA/ST were assessed using accelerometry and frailty status using the frailty phenotype. Key factors influencing PA were explored via semi-structured interviews (n = 36) and analyzed using thematic analysis. Participants were highly sedentary irrespective of frailty status. Moderate-to-vigorous-physical activity (MVPA) was independently associated with frailty. Participants spent 69% of waking time in ST, with only 15% meeting current weekly PA recommendations. Health-related and socio-cultural factors were reported as common barriers to achieving PA recommendations. Maintaining independence, preventing physical decline and depression were key factors promoting PA. Understanding the challenges and needs of this population can help to inform strategies to promote PA and thus optimize physical function.
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Zavidić T, Lovrinić Đ. Elderly Patients Treated in Selected Family Medicine Offices in Central Istria And Their Habits. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2018. [DOI: 10.5799/jcei.413069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Jones GR, Stathokostas L, Young BW, Wister AV, Chau S, Clark P, Duggan M, Mitchell D, Nordland P. Development of a physical literacy model for older adults - a consensus process by the collaborative working group on physical literacy for older Canadians. BMC Geriatr 2018; 18:13. [PMID: 29338694 PMCID: PMC5769546 DOI: 10.1186/s12877-017-0687-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/12/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Arguably the uptake and usability of the physical activity (PA) guidelines for older adults has not been effective with only 12% of this population meeting the minimum guidelines to maintain health. Health promoters must consider innovative ways to increase PA adoption and long-term sustainability. Physical literacy (PL) is emerging as a promising strategy to increase lifelong PA participation in younger age-groups, yet there is relatively little evidence of PL being used to support older adults in achieving the PA guidelines. METHODS An iterative and mixed-methods consensus development process was utilized over a series of six informed processes and meetings to develop a model of physical literacy for adults aged 65 years and older. RESULTS A multi-disciplinary collaborative working group (n = 9) from diverse practice settings across Canada, and representative and reflective of the full range of key elements of PL, was assembled. Three consensus meetings and two Delphi surveys, using an international cohort of 65 expert researchers, practitioners, non-government organizations and older adults, was conducted. 45% responded on the first round and consensus was achieved; however, we elected to run a second survey to support our results. With 79% response rate, there was consensus to support the new PL model for older adults. CONCLUSION Older adults are a unique group who have yet to be exposed to PL as a means to promote long-term PA participation. This new PL model uses an ecological approach to integrate PL into the lifestyles of most older adults. Understanding the interactions between components and elements that facilitate PL will ultimately provide a new and effective tool to target PA promotion and adherence for all older Canadians.
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Affiliation(s)
- Gareth R. Jones
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan Campus, Kelowna, BC V1V 1V7 Canada
| | - Liza Stathokostas
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON N6A 3K7 Canada
| | - Bradley W. Young
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5 Canada
| | - Andrew V. Wister
- Gerontology Department, Simon Fraser University, Vancouver, BC V6B 5K3 Canada
| | - Shirley Chau
- School of Social Work, Faculty of Health & Social Development, University of British ColumbiaOkanagan Campus, Kelowna, BC V1V 1V7 Canada
| | | | - Mary Duggan
- Canadian Society for Exercise Physiology, Ottawa, ON K1R 6Y6 Canada
| | - Drew Mitchell
- Physical Literacy, Sport for Life, Port Moody, BC V3H 4W6 Canada
| | - Peter Nordland
- Canadian Senior Games Association, Edmonton, AB T6H 4J8 Canada
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Jones GR, Jakobi JM. Launching a new initiative. Appl Physiol Nutr Metab 2017; 42:iii-iv. [DOI: 10.1139/apnm-2017-0496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Gareth R. Jones
- School of Health and Exercise Sciences, Faculty of Health and Social Development, Kinesiology Program, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
- School of Health and Exercise Sciences, Faculty of Health and Social Development, Kinesiology Program, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jennifer M. Jakobi
- School of Health and Exercise Sciences, Faculty of Health and Social Development, Kinesiology Program, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
- School of Health and Exercise Sciences, Faculty of Health and Social Development, Kinesiology Program, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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Kuo HT, Lin KC, Lan CF, Li IC. Activities of daily living trajectories among institutionalised older adults: A prospective study. J Clin Nurs 2017; 26:4756-4767. [PMID: 28334483 DOI: 10.1111/jocn.13828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine activities of daily living trajectory groups among older residents in Taiwan, and to determine the relative risks of demographic characteristics and health status in explaining the trajectory group of activities of daily living. BACKGROUND Activity of daily living is a crucial indicator of health status for institutionalised older adults. activities of daily living is a dynamic process and has differences in trajectory groups. DESIGN This study was a 3-year longitudinal analysis of long-term care facility residents in Taiwan. METHODS A total of 364 older residents completed the entire research process. We used group-based trajectory modelling and multinomial logistic models for statistical analysis. RESULTS The result of this study revealed that three activities of daily living trajectory groups among older residents exhibited high dependency with gradually declining function (Group 1, 22.53%), low dependency with gradually declining function (Group 2, 43.13%) and persistent independent function (Group 3, 34.34%). Compared with Group 3, Group 1 was related to the following potential risk factors: older age, female, nonmainland China born and a married status. After considering resident health status in the analysis, three significant factors emerged for Group 1: the number of chronic diseases (odds ratio = 2.45), depressive symptoms (odds ratio = 1.71) and cognitive status (odds ratio = 83.11). Compared with Group 3, Group 2 was related to older age. After adding resident health status to the analysis, two significant factors of Group 2 emerged: the number of chronic diseases (odds ratio = 1.68) and depressive symptoms (odds ratio = 1.74). CONCLUSION The findings of this study indicated that health factors, including the number of chronic diseases, cognitive status and depressive symptoms, were more likely to contribute to the development of a decline pattern of activities of daily living. RELEVANCE TO CLINICAL PRACTICE Appropriate exercise programmes and physical activities, according to residents' personal characteristics and activities of daily living status, is crucial for improving physical functioning, alleviating depression and cognitive defects in institutionalised older adults.
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Affiliation(s)
- Huai-Ting Kuo
- Cardinal Tien Junior College of Healthcare and Management, Yilan County, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Fu Lan
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - I-Chuan Li
- Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan
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Merellano-Navarro E, Collado-Mateo D, García-Rubio J, Gusi N, Olivares PR. Validity of the International Fitness Scale "IFIS" in older adults. Exp Gerontol 2017; 95:77-81. [PMID: 28476584 DOI: 10.1016/j.exger.2017.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 03/14/2017] [Accepted: 05/01/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To validate the "International Fitness Scale" (IFIS) in older adults. METHODS Firstly, cognitive interviews were performed to ensure that the questionnaire was comprehensive for older Chilean adults. After that, a transversal study of 401 institutionalized and non-institutionalized older adults from Maule region in Chile was conducted. A battery of validated fitness tests for this population was used in order to compare the responses obtained in the IFIS with the objectively measured fitness performance (back scratch, chair sit-and-reach, handgrip, 30-s chair stand, timed up-and-go and 6-min walking). RESULTS Indicated that IFIS presented a high compliance in the comprehension of the items which defined it, and it was able of categorizing older adults according to their measured physical fitness levels. The analysis of covariance ANCOVA adjusted by sex and age showed a concordance between IFIS and the score in physical fitness tests. CONCLUSION Based on the results of this study, IFIS questionnaire is a good alternative to assess physical fitness in older adults.
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Affiliation(s)
| | - Daniel Collado-Mateo
- Facultad de Ciencias del Deporte, Universidad de Extremadura, Campus Universitario, Av. de la Universidad, S/N, 10003 Cáceres, Spain
| | - Javier García-Rubio
- Facultad de Educación, Universidad Autónoma de Chile, Av. Pedro de Valdivia 431, Providencia, Región Metropolitana, Chile.
| | - Narcís Gusi
- Facultad de Ciencias del Deporte, Universidad de Extremadura, Campus Universitario, Av. de la Universidad, S/N, 10003 Cáceres, Spain
| | - Pedro R Olivares
- Instituto Superior de Educación Física, Universidad de la Republica, Centro Universitario de Rivera, Ituzaingó 667, Rivera, 40000, Uruguay; Instituto de Actividad Fisica y Salud, Universidad Autónoma de Chile, 5 y Medio Norte 1670, Talca, Chile.
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Falck RS, Davis JC, Milosevic E, Liu-Ambrose T. How much will older adults exercise? A feasibility study of aerobic training combined with resistance training. Pilot Feasibility Stud 2017; 3:2. [PMID: 28138396 PMCID: PMC5267441 DOI: 10.1186/s40814-016-0116-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 12/12/2016] [Indexed: 12/17/2022] Open
Abstract
Background Both aerobic training (AT) and resistance training (RT) have multidimensional health benefits for older adults including increased life expectancy and decreased risk of chronic diseases. However, the volume (i.e., frequency*time) of AT combined with RT in which untrained older adults can feasibly and safely participate remains unclear. Thus, our primary objective was to investigate the feasibility and safety of a high-volume exercise program consisting of twice weekly AT combined with twice weekly RT (i.e., four times weekly exercise) on a group of untrained older adults. In addition, we investigated the effects of the program on physical function, aerobic capacity, muscular strength, and explored factors related to participant adherence. Methods We recruited eight inactive older adults (65+ years) to participate in a 6-week, single-group pre-post exercise intervention, consisting of 2 days/week of AT plus 2 days/week of progressive RT for 6 weeks. We recorded program attendance and monitored for adverse events during the course of the program. Participants were tested at both baseline and follow-up on the following: (1) physical function (i.e., timed-up-and-go test (TUG) and short physical performance battery (SPPB)), (2) aerobic capacity (VO2max) using the modified Bruce protocol; and (3) muscular strength on the leg press and lat pull-down. Post intervention, we performed qualitative semi-structured interviews of all participants regarding their experiences in the exercise program. We used these responses to examine themes that may affect continued program adherence to a high-volume exercise program. Results We recorded an average attendance rate of 83.3% with the lowest attendance for one session being five out of eight participants; no significant adverse events occurred. Significant improvements were observed for SPPB score (1.6; 95% CI: [0.3, 2.9]), VO2max (8.8 ml/kg/min; 95% CI: [2.8, 14.8]), and lat pull-down strength (11.8 lbs; 95% CI: [3.3, 20.2]). Qualitative results revealed two themes that promote older adults’ adherence: (1) convenience of the program and (2) the social benefits of exercise. Conclusions Our findings suggest untrained older adults can be successful at completing twice weekly AT combined with twice weekly progressive RT; however, these exercise programs should be group-based in order to maintain high adherence.
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Affiliation(s)
- Ryan S Falck
- Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9 Canada.,Department of Physical Therapy, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Jennifer C Davis
- Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9 Canada.,Department of Physical Therapy, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Elizabeth Milosevic
- Faculty of Medicine, School of Kinesiology, University of British Columbia, 6081 University Blvd, Vancouver, BC V6T 1Z1 Canada
| | - Teresa Liu-Ambrose
- Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Robert H.N. Ho Research Centre, 5th Floor, 2635 Laurel St, Vancouver, BC V5Z 1M9 Canada.,Department of Physical Therapy, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
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Halaweh H, Willén C, Svantesson U. Association between physical activity and physical functioning in community-dwelling older adults. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2016. [DOI: 10.1080/21679169.2016.1240831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Hadeel Halaweh
- Department of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Physiotherapy & Rehabilitation, Health Professions College, Al-Quds University, Palestine
| | - Carin Willén
- Department of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulla Svantesson
- Department of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bray NW, Smart RR, Jakobi JM, Jones GR. Exercise prescription to reverse frailty. Appl Physiol Nutr Metab 2016; 41:1112-1116. [DOI: 10.1139/apnm-2016-0226] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Frailty is a clinical geriatric syndrome caused by physiological deficits across multiple systems. These deficits make it challenging to sustain homeostasis required for the demands of everyday life. Exercise is likely the best therapy to reverse frailty status. Literature to date suggests that pre-frail older adults, those with 1–2 deficits on the Cardiovascular Health Study-Frailty Phenotype (CHS-frailty phenotype), should exercise 2–3 times a week, for 45–60 min. Aerobic, resistance, flexibility, and balance training components should be incorporated but resistance and balance activities should be emphasized. On the other hand, frail (CHS-frailty phenotype ≥ 3 physical deficits) older adults should exercise 3 times per week, for 30–45 min for each session with an emphasis on aerobic training. During aerobic, balance, and flexibility training, both frail and pre-frail older adults should work at an intensity equivalent to a rating of perceived exertion of 3–4 (“somewhat hard”) on the Borg CR10 scale. Resistance-training intensity should be based on a percentage of 1-repetition estimated maximum (1RM). Program onset should occur at 55% of 1RM (endurance) and progress to higher intensities of 80% of 1RM (strength) to maximize functional gains. Exercise is the medicine to reverse or mitigate frailty, preserve quality of life, and restore independent functioning in older adults at risk of frailty.
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Affiliation(s)
- Nick W. Bray
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Rowan R. Smart
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Jennifer M. Jakobi
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Gareth R. Jones
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
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Time Course of Exercise Training–Induced Muscle Strength Changes in Type 2 Diabetes. Cardiopulm Phys Ther J 2016. [DOI: 10.1097/cpt.0000000000000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sales M, Polman R, Hill KD, Levinger P. A Novel Exercise Initiative for Seniors to Improve Balance and Physical Function. J Aging Health 2016; 29:1424-1443. [PMID: 27511957 DOI: 10.1177/0898264316662359] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the feasibility, effectiveness, and short-term effects of an exercise intervention using a novel exercise park in improving seniors' balance, physical function, and quality of life. METHOD Randomized controlled trial with pre- and post-intervention design (baseline and 18-week intervention) was used. Outcome measures included measures of balance, strength, and function, as well as quality of life and fear of falling. MANCOVA was used to assess differences between groups (control and exercise intervention) over time. RESULTS Intervention group showed significant improvement on single leg stance ( p = .02, 95% confidence interval [CI] = [-8.35, -0.549]), knee strength ( p < .01, 95% CI = [-29.14, -5.86]), 2-min walk ( p = 0.02, 95% CI = [-19.13, -0.859]), and timed sit to stand ( p = .03, 95% CI = [-2.26, -0.143]) tests. DISCUSSION The exercise park program improved physical function and had high adherence and participation rate. Such intervention has been shown to be safe and therefore might enhance participation in exercise programs for older adults.
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The Effects of Exercise on the Physical Fitness of High and Moderate-Low Functioning Older Adult Women. J Aging Res 2016; 2016:8309284. [PMID: 27478640 PMCID: PMC4960339 DOI: 10.1155/2016/8309284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/18/2016] [Accepted: 05/30/2016] [Indexed: 12/21/2022] Open
Abstract
Introduction. Understanding how exercise affects individuals with varying levels of functional ability will provide further insight into the role of exercise during the aging process. It will also aid in the development of exercise programs that are appropriate for a wider spectrum of older adults. Specifically it was the primary aim of this study to determine and compare the effects of 10 weeks of community-based exercise on the cardiovascular endurance, muscular strength, flexibility, and balance fitness components of older adult women with high and moderate-low levels of physical function. Methods. Participants were placed in either the high functioning (n = 13) or moderate/low functioning (n = 17) groups based on their level of physical functioning. Fitness components were measured by the Senior Fitness Test and physical function was determined by the Composite Physical Function scale. Results. The results of the 3 × 2 mixed ANOVA statistical analysis showed no significant interaction effect for time ⁎ group for any of the six subtests (chair stand, arm curls, 2-minute step, chair sit-and-reach, back scratch, and 6-foot up-and-go) of the SFT. However, the main effect of time was significant for all fitness components and the main effect of group was significant for all fitness components except lower extremity flexibility. Discussion. Community-based exercise programs offering a variety of exercise types to people with varying levels of functional ability can be useful in maintaining or improving fitness and independence. These programs may also be capable of improving the self-efficacy of lower functioning older adults toward performing daily tasks.
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Lauenroth A, Ioannidis AE, Teichmann B. Influence of combined physical and cognitive training on cognition: a systematic review. BMC Geriatr 2016; 16:141. [PMID: 27431673 PMCID: PMC4950255 DOI: 10.1186/s12877-016-0315-1] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 07/14/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Numerous daily activities require simultaneous application of motor and cognitive skills (dual-tasking). The execution of such tasks is especially difficult for the elderly and for people with (neuro-) degenerative disorders. Training of physical and cognitive abilities helps prevent or slow down the age-related decline of cognition. The aim of this review is to summarise and assess the role of combined physical-and-cognitive-training characteristics in improving cognitive performance and to propose an effective training scheme within the frame of a suitable experimental design. METHODS A systematic electronic literature search was conducted in selected databases. The following criteria were compulsory for inclusion in the study: 1. A (Randomized) Controlled Trial (RCT or CT) design; 2. Implementation of combined physical and cognitive training, either simultaneously (dual task) or subsequently - at least one hour per weekly over four weeks or more; 3. Cognitive outcomes as a study's endpoint. RESULTS Twenty articles met the inclusion criteria. It appears that either simultaneous or subsequently combined physical and cognitive training is more successful compared to single physical or single cognitive exercise. Training characteristics like length, frequency, duration, intensity and level of task difficulty seem to determine cognitive performance. However, the articles show that cognitive improvement seems to remain somewhat confined to trained cognitive functions rather than generalising to other cognitive or daily-living skills. CONCLUSION Due to methodological heterogeneity among studies, results need to be treated with caution. We critically discuss the role of training characteristics and propose a potentially effective training intervention within an appropriate experimental design.
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Affiliation(s)
- Andreas Lauenroth
- Network Aging Research (NAR), University of Heidelberg, Germany, Bergheimer Straße 20, 69115, Heidelberg, Germany.
| | - Anestis E Ioannidis
- Network Aging Research (NAR), University of Heidelberg, Germany, Bergheimer Straße 20, 69115, Heidelberg, Germany
| | - Birgit Teichmann
- Network Aging Research (NAR), University of Heidelberg, Germany, Bergheimer Straße 20, 69115, Heidelberg, Germany
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