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Ferrari L, Bochicchio G, Bottari A, Scarton A, Cavedon V, Milanese C, Lucertini F, Pogliaghi S. Feasibility and effectiveness of a 6-month, home-based, resistance exercise delivered by a remote technological solution in healthy older adults. Arch Gerontol Geriatr 2024; 127:105559. [PMID: 39018967 DOI: 10.1016/j.archger.2024.105559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/30/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Aging is characterized by a physiological decline in physical function, muscle mass, strength, and power. Home-based resistance training interventions have gained increasing attention from scientists and healthcare system operators, but their efficacy is yet to be fully determined. AIMS to verify the safety, feasibility, and efficacy of a home-based resistance training program delivered by innovative technological solution in healthy older adults. METHODS 73 participants (36 females) were randomly allocated to either a control (C) or an intervention (I) group consisting of a 6-months home-based resistance training program delivered through an innovative technological solution, which included a wearable inertial sensor and a dedicated tablet. The safety and feasibility of the intervention were assessed by recording training-related adverse events and training adherence. Body composition, standing static balance, 10-meter walking, and loaded 5 sit-to-stand tests were monitored to quantify efficacy. RESULTS No adverse events were recorded. Adherence to the training program was relatively high (61 % of participants performed the target 3 sessions) in the first trimester, significantly dropping during the second one. The intervention positively affected walking parameters (p < 0.05) and maximal force (p = 0.009) while no effect was recorded on body composition, balance, and muscle power. CONCLUSIONS The home-based device-supported intervention was safe and feasible, positively affecting walking parameters and lower limbs' maximal force. This approach should be incentivized when barriers to participation in traditional resistance exercise programs are present.
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Affiliation(s)
- Luca Ferrari
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy; University of Urbino, Department of Biomolecular Sciences, 61029 Urbino, Italy
| | - Gianluca Bochicchio
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy
| | - Alberto Bottari
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy
| | - Alessandra Scarton
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy
| | - Valentina Cavedon
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy
| | - Chiara Milanese
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy
| | - Francesco Lucertini
- University of Urbino, Department of Biomolecular Sciences, 61029 Urbino, Italy
| | - Silvia Pogliaghi
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, 37131 Verona, Italy; University of Western Ontario, Research Associate Canadian Center for Activity and Ageing, ON N6A 3K7, London, Canada.
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Liang IJ, Perkin OJ, McGuigan PM, Spellanzon B, Robb M, Liu CY, Lin LL, Thompson D, Western MJ. The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis. BMC Geriatr 2024; 24:800. [PMID: 39354428 PMCID: PMC11443890 DOI: 10.1186/s12877-024-05393-4] [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: 06/05/2024] [Accepted: 09/18/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults. METHODS We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes. RESULTS Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups. CONCLUSIONS This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.
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Affiliation(s)
- Ian Ju Liang
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Oliver J Perkin
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Polly M McGuigan
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
| | - Bruno Spellanzon
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
| | - Molly Robb
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
| | - Chien-Yu Liu
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Linda L Lin
- Graduate Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| | - Dylan Thompson
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Max J Western
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK.
- Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK.
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Kennard AL, Rainsford S, Hamilton KL, Glasgow NJ, Pumpa KL, Douglas AM, Talaulikar GS. Patient perspectives and preferences for rehabilitation among people living with frailty and chronic kidney disease: a qualitative evaluation. BMC Nephrol 2024; 25:304. [PMID: 39272062 PMCID: PMC11401252 DOI: 10.1186/s12882-024-03740-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Understanding the patient perspective of frailty is critical to offering holistic patient-centred care. Rehabilitation strategies for patients with advanced chronic kidney disease (CKD) and frailty are limited in their ability to overcome patient-perceived barriers to participation, resulting in high rates of drop-out and non-adherence. The aim of this study was to explore patient perspectives and preferences regarding experiences with rehabilitation to inform a CKD/Frailty rehabilitation model. METHODS This qualitative study involved two focus groups, six individual semi-structured interviews and three caregiver semi-structured interviews with lived experience of advanced kidney disease and frailty. Interviews were recorded, transcribed, and coded for meaningful concepts and analysed using inductive thematic analysis using constant comparative method of data analysis employing Social Cognitive Theory. RESULTS Six major themes emerged including accommodating frailty is an act of resilience, exercise is endorsed for rehabilitation but existing programs have failed to meet end-users' needs. Rehabilitation goals were framed around return to normative behaviours and rehabilitation should have a social dimension, offering understanding for "people like us". Participants reported on barriers and disruptors to frailty rehabilitation in the CKD context. Participants valued peer-to-peer education, the camaraderie of socialisation and the benefit of feedback for maintaining motivation. Patients undertaking dialysis described the commodity of time and the burden of unresolved symptoms as barriers to participation. Participants reported difficulty envisioning strategies for frailty rehabilitation, maintaining a focus on the immediate and avoidance of future uncertainty. CONCLUSIONS Frailty rehabilitation efforts in CKD should leverage shared experiences, address comorbidity and symptom burden and focus on goals with normative value.
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Affiliation(s)
- Alice L Kennard
- College of Health and Medicine, Australian National University, Canberra, Australia.
- Department of Renal Medicine, Canberra Health Services, Building 15, Yamba Drive, Garran, Canberra, ACT, 2605, Australia.
| | - Suzanne Rainsford
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Kelly L Hamilton
- Department of Renal Medicine, Canberra Health Services, Building 15, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
| | - Nicholas J Glasgow
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Kate L Pumpa
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia
| | - Angela M Douglas
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia
| | - Girish S Talaulikar
- College of Health and Medicine, Australian National University, Canberra, Australia
- Department of Renal Medicine, Canberra Health Services, Building 15, Yamba Drive, Garran, Canberra, ACT, 2605, Australia
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Hao Q, Brooks D, Ellerton C, Goldstein R, Lee AL, Alison JA, Dechman G, Haines KJ, Harrison SL, Holland AE, Marques A, Spencer L, Stickland MK, Skinner EH, Camp PG, Ma J, Beauchamp MK. Pulmonary rehabilitation with balance training for fall reduction in chronic obstructive pulmonary disease: a randomized controlled trial. BMC Pulm Med 2024; 24:408. [PMID: 39182033 PMCID: PMC11344953 DOI: 10.1186/s12890-024-03215-2] [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: 05/18/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Available evidence suggests that adults with chronic obstructive pulmonary disease (COPD) performed substantially worse than healthy controls on many balance measures and balance training can improve the balance measures in this population. We conducted this study to determine the effects of incorporating balance training into pulmonary rehabilitation (PR) on the incidence of falls at 12 months follow-up in high fall risk adults with COPD. METHODS We conducted a prospective international multi-center randomized controlled trial. Eligible participants were adults with COPD at a high risk of future falls and were randomly assigned (1:1) to the intervention or control group. The intervention included personalized balance training for a targeted total of 90 min per week. Both the intervention and control groups received usual PR (2-3 times per week for 8-12 weeks). The primary outcome was the incidence of falls at 12-month follow-up using monthly fall diary calendars. Negative binomial regression or recurrent events models were used to examine the effects of the intervention on fall events. Multiple imputations were performed to deal with missing values. RESULTS Of 258 participants who were enrolled in the trial, 178 provided falls information (intervention group = 91, control group = 87) and were included in the main analysis. Forty-one participants (45%) experienced at least one fall event in the intervention group and 33 (38%) in the control group (p = 0.34). The mean incidence of falls at 12 months was similar between the two groups (128 versus 128 per 100 person-years; mean difference: 0.30, 95% CI: -0.76 to 1.36 per 100 person-years). The results are robust after multiple imputations for missing data (n = 67). CONCLUSIONS PR incorporating balance training compared to PR alone did not reduce the incidence of falls over the 12-month period in high fall risk adults with COPD. TRIAL REGISTRATION The study was registered with ClinicalTrials.gov (NCT02995681) on 14/12/2016.
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Affiliation(s)
- Qiukui Hao
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, IAHS, 1400 Main St. W, Hamilton, ON, L8S 1C7, Canada
| | - Dina Brooks
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, IAHS, 1400 Main St. W, Hamilton, ON, L8S 1C7, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Annemarie L Lee
- Institute for Breathing and Sleep, Melbourne, VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Jennifer A Alison
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Allied Health, Sydney Local Health District, Sydney, Australia
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Kimberley J Haines
- Physiotherapy Department, Western Health, Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Anne E Holland
- Institute for Breathing and Sleep, Melbourne, VIC, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia
- Respiratory Research, Monash University, Melbourne, VIC, Australia
| | - Alda Marques
- Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Lissa Spencer
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Michael K Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | - Elizabeth H Skinner
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
- Physiotherapy Department, Western Health, Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
| | - Pat G Camp
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Marla K Beauchamp
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, IAHS, 1400 Main St. W, Hamilton, ON, L8S 1C7, Canada.
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
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Ekici HS, Collins J, Kafadar AH, Yildirim MC, Phillips BE, Gordon AL. The effect of pre-operative exercise training on post-operative cognitive function: a systematic review. Eur Geriatr Med 2024:10.1007/s41999-024-01028-4. [PMID: 39128969 DOI: 10.1007/s41999-024-01028-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 07/24/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND With population aging and advances in surgical and anesthetic procedures, the incidence of surgery in patients over the age of 65 years is increasing. One post-operative complication often encountered by older surgical patients is post-operative cognitive dysfunction (POCD). Preoperative exercise training can improve the overall physiological resilience of older surgical patients, yet its impact on post-operative cognition is less well-established. METHODS Six databases (Medline (OVID); EMBASE (OVID); EMCARE (OVID); CINAHL (EBSCOHost), the Cochrane Library, and PubMed) were searched for studies reporting the effect of pre-operative physical training on post-operative cognition. The quality of evidence was assessed using the Mixed Methods Assessment Tool. RESULTS A total of 3983 studies were initially identified, three of which met the inclusion criteria for this review. Two studies were pilot randomized trials, and one was a prospective randomized trial. Two of the studies were high-quality. Each study used a different type of physical exercise and cognition assessment tool. Across the studies, post-operative cognition (p = 0.005) and attention (p = 0.04) were found to be better in the intervention groups compared to control, with one study reporting no difference between the groups. CONCLUSION Preoperative physical training may improve post-operative cognitive function, although more research with a consistent endpoint is required. Future studies should focus on patients at high risk of POCD, such as older adults, and explore the impact of different exercise regimes, including frequency, intensity, time, and type.
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Affiliation(s)
- Hatice S Ekici
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK.
| | - Jemima Collins
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK
| | - Aysegul H Kafadar
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Mehmet C Yildirim
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK
| | - Bethan E Phillips
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK
- NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Adam L Gordon
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK
- NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK
- Department of Medicine of the Elderly, University Hospitals of Derby and Burton NHS Foundation Trust, Royal Derby Hospital, Derby, UK
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Rihova M, Jandova T, Vetrovsky T, Machacova K, Kramperova V, Steffl M, Hospodkova P, Marchelek-Myśliwiec M, Holmerova I. Adherence and Retention Rates to Home-Based Video Exercise Programs in Older Adults-Systematic Review and Meta-Analysis. Telemed J E Health 2024. [PMID: 39072676 DOI: 10.1089/tmj.2024.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
Introduction: This systematic review and meta-analysis aimed to investigate adherence and retention rates to home-based video exercise programs and identify key factors associated with these rates in older adults to understand the effectiveness of home-based video exercise interventions. Methods: We searched PubMed, Web of Science, and Scopus for articles addressing adherence to and retention of home-based video exercise programs. The study was conducted following PRISMA recommendations. Results: A total of 26 articles, including 1,292 participants older than 65, were included in the final qualitative and quantitative syntheses. The weighted mean of the retention rate was 91.1, and of the attendance rate was 85.0, with low I2 = 3.5, not significant p = 0.409 heterogeneity. The generalized regression models showed a positive effect of session duration on the attendance rate (%), where the possible change from <20 min to >60 min duration could decrease the attendance rate (%) B = -24.390 (p <0.001). The delivery method had a significant effect, where the absence of live contact with the coach in web-based or DVD-delivered interventions could decrease the attendance rate (%) compared to the online sessions B = -11.482 (p = 0.010). The lockdown during the COVID-19 pandemic had a positive effect on both the attendance rate (%) B = 10.321 (p = 0.019) and retention rate (%) B = 9.577 (p = 0.032). Conclusions: This systematic review and meta-analysis indicate that supervised home-based video exercise programs lasting less than 60 min might be a suitable and sustainable exercise mode to keep older adults active, especially in times resembling feelings of confinement.
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Affiliation(s)
- Marcela Rihova
- Longevity Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Tereza Jandova
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Katerina Machacova
- Longevity Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Veronika Kramperova
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michal Steffl
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Petra Hospodkova
- Department of Biomedical Technology, Faculty Biomedical Engineering, Czech Technical University, Kladno, Czech Republic
| | | | - Iva Holmerova
- Longevity Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
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Gómez-Redondo P, Valenzuela PL, Morales JS, Ara I, Mañas A. Supervised Versus Unsupervised Exercise for the Improvement of Physical Function and Well-Being Outcomes in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med 2024; 54:1877-1906. [PMID: 38647999 PMCID: PMC11258164 DOI: 10.1007/s40279-024-02024-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Unsupervised exercise intervention (UNSUP) appears to be a practical and beneficial strategy for older adults, although its feasibility and effectiveness compared to supervised exercise intervention (SUP) remains unknown. We aimed to compare the safety, attendance/adherence rates, and effectiveness of SUP versus UNSUP on physical function and well-being outcomes in older adults. METHODS A systematic search was conducted in PubMed, Web of Science, CINAHL, SPORTDiscus, and APA PsycINFO up to September 2022 for randomized controlled trials comparing SUP versus UNSUP in older adults (≥ 60 years). Safety and attendance/adherence rates were registered as indicators of feasibility, and meta-analyses were performed for physical function and well-being outcomes. Sub-analyses were performed for those studies that applied a similar intervention in both groups and for those studies where participants performed ≥ 66% of the sessions in the assigned condition. RESULTS Thirty-four studies were included (n = 2830). No serious adverse events were reported, with similar attendance rates (81%) for both SUP and UNSUP. Compared with UNSUP, SUP induced significant higher benefits on knee extension strength (standardized mean difference (SMD) = 0.18, p = 0.002), sit-to-stand test (STS, SMD = 0.25, p = 0.050), timed-up-and-go test (TUG, SMD = 0.21, p = 0.035), usual gait speed (SMD = 0.29, p = 0.026), lean mass (mean difference = 1.05 kg, p < 0.001) and health-related quality of life (HRQoL, SMD = 0.21, p = 0.035), albeit only knee extension strength remained significant in sensitivity analyses. Sub-analyses revealed superior benefits of SUP on knee extension strength when only considering those studies that applied a similar intervention in both SUP and UNSUP groups. However, no significant benefits were found for the remaining outcomes. Beneficial effects of SUP over UNSUP were also observed for knee extension strength, STS, functional reach test, TUG, usual gait speed, lean mass, and HRQoL when separately analyzing those studies in which participants performed ≥ 66% of the sessions in the assigned condition. CONCLUSIONS Current evidence suggests that both SUP and UNSUP programs are safe and could exert benefits on physical function and HRQoL. However, despite being associated with similar attendance rates, SUP might offer some additional benefits, although further high-quality research (i.e., accounting for confounding factors such as presence of supervised sessions in UNSUP or vice versa, as well as equating the exercise dose) is necessary to confirm these findings. PROSPERO REGISTRATION NUMBER CRD42022326420.
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Affiliation(s)
- Paola Gómez-Redondo
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital, 12 de Octubre (imas12), Madrid, Spain
- Biology Systems Department, University of Alcalá, Madrid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerto Real University Hospital, University of Cadiz, Cadiz, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.
- CIBER On Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain.
- Center UCM-ISCIII for Human Evolution and Behavior, 28029, Madrid, Spain.
- Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain.
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Hirata K, Ito M, Nomura Y, Kawashima C, Yoshida T, Yamada Y, Tillin NA, Power GA, Akagi R. Home-based resistance training performed at either fast or slow speeds improves power output in older adults. Exp Gerontol 2024; 190:112430. [PMID: 38608793 DOI: 10.1016/j.exger.2024.112430] [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: 02/07/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE We investigated the effect of an unsupervised, body mass- home-based resistance training program in older adults performed at either a fast or slow contractile speed on changes to muscle-power, -volume, -architecture, and fatigue resistance of the knee extensors. METHODS Thirty-two male older adults (age 65-88 years) were separated into 1) fast-speed exercise (Fast-group), 2) slow-speed exercise (Slow-group), and 3) no exercise (Control-group) groups. Participants in the exercise groups performed 30-45 repetitions of knee-extension and sit-to-stand exercises 3 times a week for 8 weeks with different exercise speed between the groups. Before and after the intervention period, the following variables were measured: Isotonic power, isometric strength, twitch contractile properties, muscle-activity, -architecture, and -quality, neuromuscular fatigue resistance of the knee extensors, and thigh muscle volume. RESULTS Peak power was increased in both the Fast-group (+24 %, P < 0.01, d = 0.65) and Slow-group (+12 %, P < 0.05, d = 0.33) but not in the Control-group. Training increased pennation angle of the vastus lateralis in both the Fast-group (+8 %, P < 0.01, d = 0.42) and Slow-group (+8 %, P < 0.01, d = 0.42), while only the Fast-group showed increase in pennation angle of the rectus femoris (+12 %, P < 0.01, d = 0.64) and thigh muscle volume (+16 %, P < 0.01, d = 0.52). There was no time × group interaction effect for the other neuromuscular measures. CONCLUSIONS Unsupervised, body mass- and home-based resistance training performed at either fast or slow speeds can improve muscle power in older adults, while fast-speed exercise may be preferable over slow-speed owing to the relatively greater improvement of muscle-power, -volume, -architecture, and better time efficiency.
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Affiliation(s)
- Kosuke Hirata
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba-shi, Ibaraki, Japan.
| | - Mari Ito
- Airweave Inc., Nukata-gun, Aichi, Japan; Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan
| | - Yuta Nomura
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan
| | - Chiho Kawashima
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan
| | - Tsukasa Yoshida
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu-shi, Osaka, Japan
| | - Yosuke Yamada
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu-shi, Osaka, Japan
| | - Neale A Tillin
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Ryota Akagi
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan; College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan.
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9
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Blechschmied R, Hermse M, Gäbler M, Elferink-Gemser M, Hortobágyi T, Granacher U. Sequencing Effects of Concurrent Strength and Endurance Training on Selected Measures of Physical Fitness in Young Male Soccer Players: A Randomized Matched-Pairs Trial. SPORTS MEDICINE - OPEN 2024; 10:62. [PMID: 38782805 PMCID: PMC11116357 DOI: 10.1186/s40798-024-00726-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Various physical fitness qualities such as muscle strength, speed and endurance are related to soccer performance. Accordingly, the combination of strength and endurance training (i.e., concurrent training [CT]) is an often-encountered training regimen in soccer. Less is known about the effects of CT sequencing on performance in young soccer players. The aim of this study was to assess the sequencing effects of strength and intermittent endurance training applied within the same training session (intrasession) on measures of physical fitness and soccer performance in young soccer players. METHODS Fifty male adolescent soccer players volunteered to participate in this study which was conducted in the Netherlands in 2019. Players were randomly assigned to a strength-endurance (SE) or an endurance-strength (ES) group in matched pairs based on their countermovement jump (CMJ) performance at baseline. Both groups completed a 12-weeks in-season training program with two weekly CT sessions. Training sessions consisted of 15 min plyometric exercises and 15 min soccer-specific intermittent endurance training. Both groups performed the same training volumes and the only difference between the groups was the CT intrasession sequencing scheme (SE vs. ES). Pre and post intervention, proxies of muscle power (CMJ, squat jump [SJ]), linear sprint speed (30-m sprint test), agility (Illinois test with / without ball), and soccer performance (ball kicking velocity) were tested. RESULTS Data from 38 players aged 14.8 ± 1.0 years (body height 172.9 ± 8.1 cm, body mass: 57.0 ± 7.2 kg, soccer experience: 8.8 ± 2.8 years, age from peak-height-velocity [PHV]: +1.2 ± 1.0 years) were included. Significant main time effects were found for CMJ (p = 0.002, d = 0.55), SJ (p = 0.004, d = 0.51), the Illinois agility test with ball (p = 0.016, d = 0.51), and ball kicking velocity (p = 0.016, d = 0.51). Significant group-by-time interactions were observed for 30-m linear sprint speed (p < 0.001, d = 0.76) with ES showing greater improvements (p = 0.006, d = 0.85, Δ-5%). CONCLUSIONS Both CT-sequencing types improved performance in the tests administered. The intrasession CT sequencing (SE vs. ES) appears not to have a major impact on physical fitness adaptations, except for linear sprint speed which was in favor of ES.
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Affiliation(s)
- Roland Blechschmied
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Sandfangweg 4, 79102, Freiburg, Germany
| | - Matthijs Hermse
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Martijn Gäbler
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marije Elferink-Gemser
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, 1123, Hungary
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, 7622, Hungary
- Department of Neurology, Somogy County Kaposi Mór Teaching Hospital, Kaposvár, 7400, Hungary
- Institute of Sport Research, Sports University of Tirana, Tirana, Albania
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Sandfangweg 4, 79102, Freiburg, Germany.
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10
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Moreno-Mateos A, Barbero Iglesias FJ, Sánchez Muñoz A, Gutiérrez Díaz Y, Moreno Pascual C. Compared Block Periodized and Non-Periodized Physical Activity Programs in Older Adults. Sports (Basel) 2024; 12:119. [PMID: 38786988 PMCID: PMC11125595 DOI: 10.3390/sports12050119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The periodization of physical exercise to optimize objectives is common in competitive sports. However, physical exercise programs for older adults only sometimes present periodization in their programming. Therefore, this article aims to research the results of applying the sports periodized method to older adults. METHODS A total of 137 participants over 60 years old performed a physical exercise program; 71 participated in a multi-component non-periodized program as the Control Group (CG), and 66 participated in a program periodized in blocks as the Experimental Group (EG). The block periodization program was oriented to the development of strength and was carried out in 86 sessions thrice weekly for eight months. Anthropometric assessments were made using weight, height, Body Mass Index, and electrical bioimpedance; and functional evaluations were made through standardized tests: Short Performance Physical Battery (SPPB), Timed Up & Go (TUG), handgrip, and a two-minute stair test. RESULTS After the intervention, the EG significantly improved TUG, weight, and BMI. On the other hand, the CG showed significant improvements in fat weight, BMI, and the 2 min stair test. The SPPB did not show changes after the intervention. CONCLUSION The periodization of physical exercise for older adults does not significantly impact functional capacity in this population group.
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Affiliation(s)
| | | | - Antonio Sánchez Muñoz
- Education College, Pontificia University of Salamanca-EGIIOFID, 37007 Salamanca, Spain;
| | | | - Carlos Moreno Pascual
- Department of Nursey and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain;
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11
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Hager AGM, Mathieu N, Carrard S, Bridel A, Wapp C, Hilfiker R. Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial. BMC Geriatr 2024; 24:311. [PMID: 38570773 PMCID: PMC10993430 DOI: 10.1186/s12877-024-04927-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults. METHODS This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling. Four hundred and five participants were randomly allocated into 3 groups: experimental group (n = 166) with the Test&Exercise partially supervised programme based on empowerment delivered with a tablet, illustrated manual and cards, reference group (n = 158) with the Otago partially supervised programme prescribed by a physiotherapist delivered with an illustrated manual and control group (n = 81) with the Helsana self-administrated programme delivered with cards. Experimental and reference groups received partially supervised programmes with 8 home sessions over 6 months. Control group received a self-administered program with a unique home session. The 3 groups were requested to train independently 3 times a week for 12 months. Primary outcome was the incidence rate ratio of self-reported falls over 12 months. Secondary outcomes were fear of falling, basic functional mobility and balance, quality of life, and exercise adherence. RESULTS A total of 141 falls occurred in the experimental group, 199 in the reference group, and 42 in the control group. Incidence rate ratios were 0.74 (95% CI 0.49 to 1.12) for the experimental group and 0.43 (95% CI 0.25 to 0.75) for the control group compared with the reference group. The Short Physical Performance Battery scores improved significantly in the experimental group (95% CI 0.05 to 0.86; P = 0.027) and in the reference group (95% CI 0.06 to 0.86; P = 0.024) compared with the control group. CONCLUSION The self-administered home-based exercise programme showed the lowest fall incidence rate, but also the highest dropout rate of participants at high risk of falling. Both partially supervised programmes resulted in statistically significant improvements in physical performance compared with the self-administered programme. TRIAL REGISTRATION NCT02926105. CLINICALTRIALS gov. Date of registration: 06/10/2016.
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Affiliation(s)
- Anne-Gabrielle Mittaz Hager
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland.
- School of Health Sciences, HES-SO Valais-Wallis, Rathaustrasse 25, 3941, Leukerbad, Switzerland.
| | - Nicolas Mathieu
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
| | - Sophie Carrard
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
| | - Alice Bridel
- Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland
| | - Christina Wapp
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Roger Hilfiker
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
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12
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Rhim HC, Ward RE, Travison TG, Latham N, Bean JF. Defining Clinically Meaningful Cut Points for Leg Power Impairment Using Physical Performance in Older Adults: A Secondary Analysis From Boston RISE. Arch Phys Med Rehabil 2024; 105:690-695. [PMID: 37769931 PMCID: PMC10965500 DOI: 10.1016/j.apmr.2023.09.010] [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: 02/09/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To identify clinically meaningful thresholds of leg power impairment identified by the stair climb power test (SCPT). DESIGN Cross-sectional analysis using the baseline data from an observational cohort study. SETTING The Boston Rehabilitative Impairment Study of the Elderly. PARTICIPANTS Community-dwelling older adults (N=413). MAIN OUTCOME MEASURES SCPT and the Short Physical Performance Battery (SPPB). RESULTS Using the receiver operating characteristic curves and Youden's J statistics, the optimal threshold for the SCPT associated with mobility limitation as defined by an SPPB score ≤9 was 3.07 Watts/kg for men with a sensitivity of 74%, a specificity of 73% and, an area under the curve (AUC) value of 0.78. For women, the optimal threshold was 2.59 Watts/kg with a sensitivity of 83%, a specificity of 69%, and an AUC value of 0.81. The classification and regression tree sensitivity analysis demonstrated similar thresholds, 2.88 Watts/kg and 2.53 Watts/kg for men and women, respectively. CONCLUSIONS The study identified clinically meaningful thresholds of impairment for the SCPT for mobility limited older primary care patients. These thresholds may be used to inform rehabilitation care to improve functional mobility of older adults and should be validated in larger more representative clinical trials.
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115; Spaulding Rehabilitation Hospital, Charlestown, MA
| | - Rachel E Ward
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115; New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA; Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
| | - Thomas G Travison
- Center for Analytic Sciences in Aging, Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA
| | - Nancy Latham
- Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Jonathan F Bean
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115; Spaulding Rehabilitation Hospital, Charlestown, MA; New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA.
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13
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Gómez-Redondo P, Valenzuela PL, Martínez-de-Quel Ó, Sánchez-Martín C, Cerezo-Arroyo M, Moreno-Manzanaro D, Alegre LM, Guadalupe-Grau A, Ara I, Mañas A. The role of supervision and motivation during exercise on physical and mental health in older adults: a study protocol for a randomized controlled trial (PRO-Training project). BMC Geriatr 2024; 24:274. [PMID: 38509514 PMCID: PMC10953175 DOI: 10.1186/s12877-024-04868-8] [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: 12/18/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Although supervised exercise is frequently recommended for older adults, its superiority over unsupervised exercise remains uncertain. Furthermore, whether motivational techniques could help to enhance the effectiveness of the latter remains to be elucidated. The present randomized controlled trial aims to determine the role of supervision and motivational strategies on the safety, adherence, efficacy, and cost-effectiveness of different exercise programs for improving physical and mental health in older adults. METHODS Participants (n = 120, aged 60-75 years) will be randomly allocated into five groups: 1-Control (CON), 2-Supervised exercise without motivational intervention (SUP), 3- Supervised exercise with motivational intervention (SUP +), 4- Unsupervised exercise without motivational intervention (UNSUP) and 5- Unsupervised exercise with motivational intervention (UNSUP +). Over 24 weeks, all exercise groups will participate in a multicomponent exercise program three times/week (performed in group classes at a center for SUP and SUP + , or home without supervision but with the help of a mobile app for UNSUP and UNSUP +), while the CON group will maintain their usual lifestyle. The motivational intervention (for SUP + and UNSUP + groups) will be based on the self-determination theory, including strategies such as phone calls, interactive workshops, motivational messages, informative infographics and videos. Primary outcomes will include safety, adherence, costs, and lower-body muscular function using a leg press machine. Secondary outcomes will include upper-body muscular function, physical and cardiorespiratory function, blood pressure and heart rate, body composition, health-related quality of life, cognitive performance, anxiety, depression, physical activity levels, sleep and sedentarism, biochemical markers, motivators and barriers to exercise. Assessments will be conducted at baseline, mid-intervention (i.e., week 13), at the end of the intervention (i.e., week 25), and 24 weeks later (i.e., week 49). DISCUSSION The findings of this trial might provide valuable insights into the role of supervision and motivational strategies on the effectiveness of exercise programs for older adults. Additionally, the study could contribute to developing cost-effective interventions, supporting the design of future public policies for healthy aging. TRIAL REGISTRATION NCT05619250. Registered 16 November 2022.
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Affiliation(s)
- Paola Gómez-Redondo
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital, 12 de Octubre (imas12), Madrid, Spain
- Department of Systems Biology, University of Alcalá, Madrid, Spain
| | - Óscar Martínez-de-Quel
- Didactics of Languages, Arts and Physical Education Department, Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, 28040, Madrid, Spain
| | - Coral Sánchez-Martín
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Mónica Cerezo-Arroyo
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - David Moreno-Manzanaro
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Amelia Guadalupe-Grau
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain.
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain.
- Didactics of Languages, Arts and Physical Education Department, Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain.
- Center UCM-ISCIII for Human Evolution and Behavior, 28029, Madrid, Spain.
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14
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Noguchi KS, Wiley E, Moncion K, Fliss MD, Beauchamp MK, Phillips SM, Thabane L, Tang A. Therapeutic Quality Affects Physical Fitness Benefits of Home Exercise Interventions in Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression. J Geriatr Phys Ther 2024:00139143-990000000-00046. [PMID: 38436969 DOI: 10.1519/jpt.0000000000000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
BACKGROUND AND PURPOSE The international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool is a new instrument developed to evaluate the therapeutic quality of exercise interventions. Home-based exercise has been shown to improve physical fitness in older adults, but its effects may be influenced by therapeutic quality. The purpose of this systematic review was to describe the therapeutic quality of home-based exercise interventions for community-dwelling older adults and examine the relationship between therapeutic quality and changes in physical fitness. METHODS Six electronic databases and 2 clinical trial registries were searched for randomized controlled trials investigating the effects of home-based exercise on physical fitness in community-dwelling older adults (≥60 years). Therapeutic quality was evaluated using the i-CONTENT tool for items of patient selection, type of exercise, safety, type/timing of outcomes, exercise dose, and adherence. International Consensus on Therapeutic Exercise aNd Training items were used to explain heterogeneity in meta-regression analyses. Risk of bias, certainty of evidence and credibility of analyses were assessed. RESULTS Thirty-six trials (n = 6157 participants) were identified. Most studies (≥66.7%) had high or probably high therapeutic quality for i-CONTENT items, except exercise dose (47.2%) and adherence (16.7%). Interventions improved upper- (N = 20 trials; standardized mean difference [SMD] = 0.39; 95% CI, 0.13-0.64; low certainty of evidence) and lower-body strength (N = 28; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty), and aerobic fitness (N = 8; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty). For exercise dose, low- or probably low-quality studies negatively influenced effects on upper- (estimated β = -.48; P = .049; moderate credibility) and lower-body strength (estimated β = -.77; P = .048; moderate credibility). For adherence, low- or probably low-quality studies negatively influenced effects on aerobic fitness (estimated β = -.97; P = .02; low credibility). CONCLUSIONS Home-based exercise may improve upper- and lower-body strength, as well as aerobic fitness in older adults. However, the effectiveness of interventions is affected by inadequate dosing of exercise programs and adherence issues. Physical therapists should have the best available evidence to support their clinical decision making, especially when designing and monitoring home programs.
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Affiliation(s)
- Kenneth S Noguchi
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Kevin Moncion
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Matthew D Fliss
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Marla K Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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15
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Kearney N, Connolly D, Begic S, Mockler D, Guinan E. Feasibility metrics of exercise interventions during chemotherapy: A systematic review. Crit Rev Oncol Hematol 2024; 195:104272. [PMID: 38272152 DOI: 10.1016/j.critrevonc.2024.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Exercise has been shown to play an important role in managing chemotherapy-related side effects, preserving skeletal muscle mass, and attenuating decline in cardiorespiratory fitness associated with chemotherapy treatment, however, the feasibility of how these exercise programs are being delivered has yet to be synthesized. The objective of this review was to measure the rates of recruitment, adherence, and retention to exercise programs delivered for cancer patients during chemotherapy. METHODS Relevant studies were identified through a search of MEDLINE, Cochrane, EMBASE and CINAHL databases from January 2002 to July 2022 using keywords relating to exercise interventions during chemotherapy. Title and abstract screening, full text review, data extraction, and quality assessment were all performed independently by two reviewers. RESULTS A total of 36 studies were included in the review. The mean recruitment rate for the included studies was 62.39% (SD = 19.40; range 25.7-95%). Travel was the most common reason for declining recruitment in these trials. Adherence rates ranged from 17-109%, however the definition of adherence varied greatly between studies. Mean retention rates for the exercise groups was 84.1% (SD = 12.7; range 50-100%), with chemotherapy side effects being the most common reason why participants dropped out of these trials. CONCLUSION Multiple challenges exist for cancer patients during chemotherapy and careful consideration needs to be given when designing an exercise program for this population. Future research should include public and patient involvement to ensure exercise programs are pragmatic and patient centred.
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Affiliation(s)
- Neil Kearney
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland.
| | - Deirdre Connolly
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sanela Begic
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Library, Trinity Centre for Health Sciences, Dublin, Ireland
| | - Emer Guinan
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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16
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Kamoun A, Yahia A, Farjallah MA, Maaloul R, Marzougui H, Bouaziz M, Souissi N, Elleuch MH, Hammouda O. Concurrent training associated with moderate walnut consumption improved isokinetic strength, subjective sleep quality, cognitive performance and postural balance in elderly active men: a randomized controlled trial. Aging Clin Exp Res 2024; 36:50. [PMID: 38421528 PMCID: PMC10904559 DOI: 10.1007/s40520-023-02646-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/27/2023] [Indexed: 03/02/2024]
Abstract
AIMS To investigate the effects of concurrent training (resistance and endurance) associated with moderate walnut consumption on isokinetic strength, subjective sleep quality, cognitive performance and postural balance in physically active elderly men. METHODS Twenty healthy elderly men were divided into two matched groups, in a randomized controlled experiment. They have participated in three training sessions per week: concurrent (strength and endurance) training + ad libitum diet with walnuts (15 g/day for 6 weeks, CTW: n = 10) and concurrent training + ad libitum diet (CT: n = 10). Isokinetic strength, Spiegel questionnaire, Montreal cognitive assessment and postural balance parameters were assessed 48 h pre- and post-intervention. RESULTS Absolute peak torque of knee extensors and knee flexors significantly increased compared to pre-training in CTW (15.2% ± 6.7; 13.2% ± 2.3, p < 0.05, respectively) and CT (10.6% ± 6.8; 7.4% ± 2.9, p < 0.05, respectively). Subjective sleep quality increased compared to pre-training for CTW and CT (24% ± 14.4; 10.5% ± 9.4, p < 0.05, respectively) with a significantly greater increase in CTW (p < 0.05). Cognitive performance measured by Montreal cognitive assessment (MoCA) increased only in CTW compared to baseline (7.7% ± 2.5, p < 0.05). Postural balance parameters with dual task decreased only in CTW compared to baseline. CONCLUSIONS The present study clearly revealed that concurrent training alone or associated with daily walnut (15 g) consumption for 6 weeks significantly increased knee isokinetic strength, support leg standing parameters and sleep quality. Meanwhile, cognitive performance evaluated by MoCA test and postural balance with dual task were improved for CTW group only.
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Affiliation(s)
- Anis Kamoun
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
- Research Laboratory of Evaluation and Management of Musculoskeletal System Pathologies, University of Sfax, LR20ES09, Sfax, Tunisia
| | - Abdelmonem Yahia
- Research Laboratory of Evaluation and Management of Musculoskeletal System Pathologies, University of Sfax, LR20ES09, Sfax, Tunisia
| | - Mohamed Amine Farjallah
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Université Sorbonne Paris Nord, Hypoxie et Poumon, H&P, INSERM, UMR 1272, Bobigny, F-93000, France
- Département STAPS, Université Sorbonne Paris Nord, Bobigny, France
| | - Rami Maaloul
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Houssem Marzougui
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohamed Bouaziz
- Laboratoire d'Electrochimie Et Environnement, ENIS, Université de Sfax, LR14ES08, Sfax, Tunisia
| | - Nizar Souissi
- Research Unit: Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
| | - Mohamed Habib Elleuch
- Research Laboratory of Evaluation and Management of Musculoskeletal System Pathologies, University of Sfax, LR20ES09, Sfax, Tunisia
| | - Omar Hammouda
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia.
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, 200 Avenue de la République, 92000, Nanterre, France.
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Mehrabi S, Drisdelle S, Dutt HR, Middleton LE. "If I want to be able to keep going, I must be active." Exploring older adults' perspectives of remote physical activity supports: a mixed-methods study. Front Public Health 2024; 12:1328492. [PMID: 38327585 PMCID: PMC10847274 DOI: 10.3389/fpubh.2024.1328492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Pandemic-related public health restrictions limited older adults' physical activity programs and opportunities. Physical activity supports shifted to remote options, however, information on their adoption and effectiveness is limited. This study aims to describe the remote supports received by older adults and their perceived effectiveness. Additionally, it aims to describe facilitators and barriers to remote supports for physical activity among older adults, particularly those reliant on technology. Methods This study used an explanatory, sequential, mixed-methods design. Community-dwelling older adults (≥ 60 years) were recruited to partake in a web-based survey and an optional semi-structured follow-up interview informed by the COM-B model. Participant characteristics, perceived effectiveness of remote supports, and the presence and severity of barriers were described. Changes in physical activity levels before and during the pandemic were analyzed using the Wilcoxon signed-rank test. Qualitative data underwent inductive thematic analysis. Results Fifty seven older adults (68.3 ± 7.1 years, 43 Female) completed the survey, of which 15 participants (67.4 ± 5.8 years, 12 Female) participated in interviews. The majority were Caucasian, highly educated, and resided in Canada. Total physical activity levels showed no statistically significant change from before to during the pandemic (p = 0.74); however, at-home exercise participation and technology usage increased. Pre-recorded and real-time virtual exercise supports were perceived as most effective. Main barriers included limited contact with exercise professionals, limited access to exercise equipment or space, and decreased mental wellness. Thematic analysis identified five main themes: (i) Enabled by knowledge and resources; (ii) Diverse motivations for physical activity; (iii) Fostering participation through social connection; (iv) Supervision and safety: enabling adherence; and (v) Virtual exercise: a sustainable option with technological considerations. Conclusion Virtual platforms show promise in supporting older adults' physical activity at home, especially for those with limited in-person access. Our study suggests that both real-time and pre-recorded virtual exercise supports are feasible, depending on technological capacity and support. While interactive real-time virtual programs allow interaction with professionals and peers, pre-recorded programs provide timing flexibility. Further research is needed to establish best practices for safe and effective virtual exercise programming, promoting its long-term adoption for supporting a wider range of older adults.
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Affiliation(s)
- Samira Mehrabi
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sara Drisdelle
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Hanna R Dutt
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Research Institute for Aging, Waterloo, ON, Canada
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18
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Daniele de Araújo Silva J, Cândido Mendes Maranhão D, Machado Ferreira Tenório de Oliveira L, Luiz Torres Pirauá A. Comparison between the effects of virtual supervision and minimal supervision in a 12-week home-based physical exercise program on mental health and quality of life of older adults: Secondary analysis from a randomized clinical trial. Geriatr Gerontol Int 2023; 23:864-870. [PMID: 37743056 DOI: 10.1111/ggi.14673] [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: 06/21/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023]
Abstract
AIM The objective of this study was to compare the effects of virtual supervision and minimal supervision in a 12-week home-based physical exercise program on the mental health and quality of life of community-dwelling older adults. METHODS This study presents a secondary analysis of a randomized clinical trial conducted during the COVID-19 pandemic. The sample comprised 38 elderly men and women (81.6% women, mean age 68 ± 6.4 years; mean weight 69.8 ± 12.1 km) without physical and/or cognitive impairments. The volunteers were divided into two groups: one group received virtual supervision (monitored via videoconference), while the other group received minimal supervision (monitored through weekly text messages). Both groups followed the same home-based physical exercise program, consisting of three sessions per week, differing only in the supervision strategy. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-21) in conjunction with the POMS questionnaire, which evaluates mood, and quality of life was assessed using the WHOQOL-OLD questionnaire. RESULTS Our findings demonstrated statistically significant superiority of virtual supervision compared with minimal supervision in relation to depression (-2.92, 95% confidence interval = -5.22 to -0.63). Conversely, minimal supervision exhibited superiority over virtual supervision regarding quality of life (-6.70, 95% confidence interval = -11.66 to -1.73). CONCLUSIONS Virtual supervision yielded better outcomes for the depression indicator, while minimal supervision favored the quality of life of older adults at the conclusion of the 12-week home-based physical exercise program. Geriatr Gerontol Int 2023; 23: 864-870.
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19
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Megasari IM, Mat S, Singh DKA, Tan MP. Prospective sarcopenia outcomes associated with physical performance in individuals aged 55 years and over in Malaysia. Front Public Health 2023; 11:1226642. [PMID: 37900031 PMCID: PMC10613088 DOI: 10.3389/fpubh.2023.1226642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background While the potential of physical performance tests as screening tools for sarcopenia is evident, limited information on relevant reference values for sarcopenia detection. In this study, we aimed to establish the prospective relationship between physical performance tests, including time up and go (TUG), functional reach (FR), gait speed (GS), and hand grip strength (HGS) with five-year sarcopenia risk and to determine suitable cut-off values for screening activities. Method This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs. Result Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia. Conclusion The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.
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Affiliation(s)
- Intan Meinar Megasari
- Centre for Healthy Ageing and Wellness, Physiotherapy program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Centre for Healthy Ageing and Wellness, Physiotherapy program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness, Physiotherapy program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
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20
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Jiménez-Lupión D, Chirosa-Ríos L, Martínez-García D, Rodríguez-Pérez M, Jerez-Mayorga D. Effects of Power Training on Functional Capacity Related to Fall Risk in Older Adults: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023; 104:1514-1525. [PMID: 36868491 DOI: 10.1016/j.apmr.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/12/2023] [Accepted: 01/27/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVE Functional capacity is 1 of the main risk factors for falls among older adults. The aim of this systematic review and meta-analysis was to determine the effect of power training on functional capacity test (FCT) related to fall risk in older adults. DATA SOURCES Systematic searches were conducted in 4 databases, including PubMed, Web of Science, Scopus, and SPORTDiscus, from inception to November 2021. STUDY SELECTION Randomized controlled trials (RCTs) assessing the effect of power training on functional capacity compared with another type of training program or control group in older adults with the ability to exercise independently. DATA EXTRACTION Two independent researchers evaluated eligibility and used the PEDro scale to assess risk of bias. The information extracted was related to article identification (authors, country and year of publication), participant characteristics (sample, sex, and age), strength training protocols (exercises/intensity/weeks), and the outcome of the FCT used related to fall risk. The Cochran Q statistic and I2 statistics was used to assess heterogeneity. Random-effects model were conducted to pool the effect sizes expressed as mean differences (MD). DATA SYNTHESIS Twelve studies (478 subjects) were selected for systematic review. A meta-analysis comprised 6 studies (217 subjects) where the outcome measure was the 30-second Sit to Stand (30s-STS) test, and another comprised 4 studies (142 subjects) where the outcome measure was the timed Up and Go (TUG) test. There was an improvement in performance in favor of the experimental group in both the TUG subgroup (MD -0.31 s; 95% CI -0.63, 0.00 s; P=.05), and the 30s-STS subgroup (MD 1.71 reps; 95% CI -0.26, 3.67 reps; P=.09). CONCLUSIONS In conclusion, power training increases functional capacity related to fall risk further than other types of exercise in older adults.
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Affiliation(s)
- Daniel Jiménez-Lupión
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Luis Chirosa-Ríos
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Darío Martínez-García
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Manuel Rodríguez-Pérez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Daniel Jerez-Mayorga
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain; Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile.
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21
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Sadaqa M, Németh Z, Makai A, Prémusz V, Hock M. Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a systematic review with narrative synthesis. Front Public Health 2023; 11:1209319. [PMID: 37601180 PMCID: PMC10435089 DOI: 10.3389/fpubh.2023.1209319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Objective To present a systematic review of randomized controlled trials which summarizes the effects of community-based resistance, balance, and multi-component exercise interventions on the parameters of functional ability (e.g., lower extremities muscle strength, balance performance and mobility). Methods This PROSPERO-registered systematic review (registration no. CRD42023434808) followed the PRISMA guidelines. Literature search was conducted in Cochrane, Embase, Ovid Medline, PEDro, Pubmed, Science Direct, Scopus and Web of Science. We included RCTs that investigated the following interventions: lower extremity strengthening, balance and multi-component exercise interventions on ambulatory community-dwelling adults aged ≥65 years. Results Lower extremity strengthening exercises revealed significant effects on the strength of lower extremity, balance outcomes and mobility. Balance exercises reduce the rate of injurious falls, improve static, dynamic and reactive balance, lower extremity strength as well as mobility. Multi-component exercise training reduces medically-attended injurious falls and fallers, incidence of falls, fall-related emergency department visits as well as improves mobility, balance, and lower extremity strength. Conclusion Physical exercises are effective in improving the components of balance, lower extremity strength, mobility, and reducing falls and fall-related injuries. Further research on fall prevention in low-income countries as well as for older adults in vulnerable context is needed.
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Affiliation(s)
- Munseef Sadaqa
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Zsanett Németh
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Alexandra Makai
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
| | - Viktória Prémusz
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
- Physical Activity Research Group, Szentágothai Research Centre, Pécs, Hungary
| | - Márta Hock
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
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22
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Costa SN, Ferreira LHB, Bento PCB. Effects of Home-Based Exercise Programs on Mobility, Muscle Strength, Balance, and Gait in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2023; 31:693-704. [PMID: 36623512 DOI: 10.1123/japa.2022-0221] [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: 06/29/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Individual unsupervised home-based exercise programs can enhance muscle strength, physical function, gait, and balance in older adults. However, the effectiveness of such programs may be limited by the lack of supervision. This study aims to verify the effectiveness of individual unsupervised home-based programs, compare the effects of individual unsupervised home-based to supervised programs, and verify the influence of supervision over individual unsupervised home-based programs on the physical function of older adults. METHODS A systematic literature search was performed in four electronic databases, and the trials involved randomized controlled comparing the home-based programs to supervised, control groups, or home-based + supervised evaluating the muscle strength, physical function, gait, and balance in older adults. RESULTS Eleven studies met the inclusion criteria. The meta-analysis revealed no differences between home-based program versus supervised program in gait, mobility, and balance, revealing a trend of significance to supervised program on strength (standardized mean difference [SMD] = 0.27, p = .05). The analysis revealed effects in mobility (SMD = 0.40, p = .003), balance (SMD = 0.58, p = .0002), and muscle strength (SMD = 0.36, p = .02) favoring home-based program versus control group. Significant effects between home-based program versus home-based + supervised program were observed in balance (SMD = 0.74, p = .002) and muscle strength (SMD = 0.58, p = .01) in favor of home-based + supervised program. CONCLUSION Home-based programs effectively improve older adults' physical function compared with control groups. However, supervised programs were more effective for muscle strength.
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Affiliation(s)
- Sabrine Nayara Costa
- Physical Education Department, Federal University of Paraná (UFPR), Curitiba,Brazil
| | | | - Paulo C B Bento
- Physical Education Department, Federal University of Paraná (UFPR), Curitiba,Brazil
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23
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Nascimento MDM, Maduro PA, Rios PMB, Nascimento LDS, Silva CN, Kliegel M, Ihle A. The Effects of 12-Week Dual-Task Physical-Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085498. [PMID: 37107780 PMCID: PMC10139030 DOI: 10.3390/ijerph20085498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
This study aims to investigate the effects of dual-task physical-cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time-group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical-cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
- Correspondence: ; Tel.: +55-(87)-21016856
| | - Paula Andreatta Maduro
- University Hospital of the Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Pâmala Morais Bagano Rios
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Lara dos Santos Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Carolina Nascimento Silva
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
| | - Andreas Ihle
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Pedersen BS, Kodal LS, Kaalund AB, Holm-Yildiz S, Pedersen MM, Dysgaard T. Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review. Front Physiol 2023; 14:1158039. [PMID: 37089431 PMCID: PMC10116572 DOI: 10.3389/fphys.2023.1158039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction: Polyneuropathy (PNP) is a chronic progressive disease that over time can lead to damage of sensory, motor and/or autonomic peripheral nerves. Symptoms vary from predominantly sensory to severe sensorimotor affection both proximally and distally. This can result in considerable functional impairments that affect activities of daily living. In other neurological patients, strength training has shown to improve strength and functional outcomes. Since medical treatment only exists for very few percentages of the underlying causes it is obvious to consider if strength training could be a potential treatment for functional impairments. To date little is known on the effect of strength training in patients with PNP.Aim: The aim of this scoping review was to summarize research on strength training and outcomes on physical function in patients with PNP.Methods: We systematically searched five data bases; Pubmed, Embase, Cinahl, Cochrane library and Web of science. Studies on strength training (load ≥70% of 1RM) in patients with PNP were included. The search was carried out in November 2022.Results: 362 articles were screened by title and abstract, 101 articles were full text screened. Eight studies were included. Patients with Charcot-Marie-Tooth (CMT), chronic inflammatory polyneuropathy (CIDP) and diabetic polyneuropathy (DPN) were represented in the studies (five RCTs, two case-series, and one cross-over trial). The methodological quality ranged from fair-poor in seven studies, one study reached good quality. Results from the studies indicated that strength training in CMT, CIDP and DPN may improve strength. However, various outcomes were used to evaluate strength training, so direct comparisons were difficult.Discussion: In this scoping review we summarized research on strength training and outcomes evaluated in interventions in patients with PNP. Eight studies were included, they indicated that strength training may be beneficial for patients with PNP. However, due to low methodological strength of most studies a recommendation for patients with PNP cannot be made. Thus, the low number of studies with relatively low quality, where various functional outcomes were used, underscores the importance of future studies to evaluate the effect of strength training on relevant functional outcomes and strength in patients with PNP.
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Affiliation(s)
- Britt Stævnsbo Pedersen
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- *Correspondence: Britt Stævnsbo Pedersen,
| | - Louise Sloth Kodal
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anna Bundgaard Kaalund
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sonja Holm-Yildiz
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Merete Pedersen
- Department of Clinical Research and Physical Medicine and Rehabilitation Research Copenhagen (PMR-C), Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Dysgaard
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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25
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Uematsu A, Tsuchiya K, Fukushima H, Hortobágyi T. Effects of Motor-Cognitive Dual-Task Standing Balance Exergaming Training on Healthy Older Adults' Standing Balance and Walking Performance. Games Health J 2023. [PMID: 36944151 DOI: 10.1089/g4h.2022.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Objective: This study examined the effects of motor-cognitive dual-task exergaming standing balance training on healthy older adults' static, dynamic, and walking balance. Methods: Twenty-four adults older than 70 years (control group: n = 9, males = 6, balance training group: n = 15, males = 8) completed the experiment. Dual-tasking standing balance training comprised the accurate control of a ping-pong ball on a tray held with both hands, while standing on one leg (analog training) and three modules of Wii Fit™ exergaming (digital training). The duration of balance training was ∼15 minutes per day, 2 days per week for 8 weeks, in total 16 sessions. We measured one-leg standing time, functional reach distance, walking balance evaluated by the distance walked on a narrow beam (4-cm long, 4-cm wide, and 2-cm high) with single and dual tasking, habitual and maximal walking speed, and muscle strength of the hip extensor, hip abductor, hip adductor, knee extensor, and plantarflexor muscle groups in the right leg at baseline and after 8 weeks. Results: Control group decreased, but balance training group increased one-leg standing time. Only the balance training group improved functional reach distance and hip and knee extensor strength. There was no change in walking speed and walking balance in either group. In the balance training group, changes in maximal speed correlated with changes in dual-tasking walking balance and changes in one-leg standing time correlated with changes in single-tasking walking balance. Conclusion: These results suggest that 16 sessions of motor-cognitive dual-task standing exergaming balance training substantially improved healthy older adults' static and dynamic balance and leg muscle strength but failed to improve walking speed and walking balance. Balance exercises specific to walking balance need to be included in balance training to improve walking balance.
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Affiliation(s)
- Azusa Uematsu
- Faculty of Sociology, Otemon Gakuin University, Ibaraki, Japan
| | - Kazushi Tsuchiya
- Department of Rehabilitation Medicine, Yoshioka Hospital, Tendo, Japan
| | | | - Tibor Hortobágyi
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
- Somogy Country Kaposi Mór Teaching Hospital, Káposvar, Hungary
- Center for Human Movement Sciences, University of Groningen, Groningen, The Netherlands
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Arguello D, Rogers E, Denmark GH, Lena J, Goodro T, Anderson-Song Q, Cloutier G, Hillman CH, Kramer AF, Castaneda-Sceppa C, John D. Companion: A Pilot Randomized Clinical Trial to Test an Integrated Two-Way Communication and Near-Real-Time Sensing System for Detecting and Modifying Daily Inactivity among Adults >60 Years-Design and Protocol. SENSORS (BASEL, SWITZERLAND) 2023; 23:2221. [PMID: 36850822 PMCID: PMC9965440 DOI: 10.3390/s23042221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 05/14/2023]
Abstract
Supervised personal training is most effective in improving the health effects of exercise in older adults. Yet, low frequency (60 min, 1-3 sessions/week) of trainer contact limits influence on behavior change outside sessions. Strategies to extend the effect of trainer contact outside of supervision and that integrate meaningful and intelligent two-way communication to provide complex and interactive problem solving may motivate older adults to "move more and sit less" and sustain positive behaviors to further improve health. This paper describes the experimental protocol of a 16-week pilot RCT (N = 46) that tests the impact of supplementing supervised exercise (i.e., control) with a technology-based behavior-aware text-based virtual "Companion" that integrates a human-in-the-loop approach with wirelessly transmitted sensor-based activity measurement to deliver behavior change strategies using socially engaging, contextually salient, and tailored text message conversations in near-real-time. Primary outcomes are total-daily and patterns of habitual physical behaviors after 16 and 24 weeks. Exploratory analyses aim to understand Companion's longitudinal behavior effects, its user engagement and relationship to behavior, and changes in cardiometabolic and cognitive outcomes. Our findings may allow the development of a more scalable hybrid AI Companion to impact the ever-growing public health epidemic of sedentariness contributing to poor health outcomes, reduced quality of life, and early death.
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Affiliation(s)
- Diego Arguello
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Ethan Rogers
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Grant H. Denmark
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA
| | - James Lena
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Troy Goodro
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Quinn Anderson-Song
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Gregory Cloutier
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Charles H. Hillman
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Arthur F. Kramer
- College of Science, Northeastern University, Boston, MA 02115, USA
- Beckman Institute, University of Illinois, Urbana, IL 61801, USA
| | | | - Dinesh John
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
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Newman L, Fornusek C, Hackett D. An exploratory study of exercise behaviours and barriers to participation in people with Charcot-Marie-Tooth disease: a focus on resistance training. J Exerc Rehabil 2023; 19:35-44. [PMID: 36910678 PMCID: PMC9993004 DOI: 10.12965/jer.2346020.010] [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: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
The aim of this study was to explore and describe the exercise behaviours and barriers in people with Charcot-Marie-Tooth disease (CMT), with a particular focus on resistance training (RT). Ninety-four Australian adults with a diagnosis of CMT completed an online survey. Fifty-seven percent of respondents reported performing some form of RT each week. Those performing RT engaged in more aerobic activity (P≤0.01) and were involved in longer periods of structured exercise (P<0.01) compared to those not performing RT. The RT group was more likely to perceive their exercise levels as acceptable (P<0.01), that following a program was important (P=0.02), and that exercise is beneficial (P=0.04). The RT group were more likely to have been advised to exercise (P=0.02). Common barriers to exercise were fatigue (64.9%), pain (57.4%), motivation (51.1%), and time (46.8%). RT status did not influence the type of barriers experienced. Weekly RT time was positively associated with exercise satisfaction (r=0.43, P<0.01) and walking distance prior to resting (r=0.29, P=0.04). The findings suggest that positive exercise experiences, advice, assistance from a trainer, and potentially greater resources may influence participation in RT for people with CMT.
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Affiliation(s)
- Laura Newman
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Che Fornusek
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Daniel Hackett
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Effects of an exercise program combining unsupervised home exercises and supervised group-based exercises on fall-related variables in older adults: a randomized controlled trial. Eur Geriatr Med 2023; 14:59-67. [PMID: 36515868 DOI: 10.1007/s41999-022-00724-3] [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: 05/16/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The aim was to measure the effects of the home exercises supported with supervision on the fall-related variables in older people. METHODS Seventy-five individuals over the age of 65 were enrolled. They were allocated to a "minimally supervised home exercise group" (group 1) or a "home exercise group" (group 2). Falls efficacy, fear of falling (FOF), fall risk, functional mobility, balance performance, and depression were assessed using the Falls Efficacy Scale International (FES-I), visual analog scale (VAS-FOF), the Elderly Falls Screening Test (EFST), the Timed Up and Go Test (TUGT), Tinetti's Balance Performance Oriented Mobility Assessment (BPOMA), and the Geriatric Depression Scale Short Form (GDS-SF), respectively. Participants performed a four-day weekly exercise program for eight weeks. Group 1 was supervised one day per week on a group basis. RESULTS Results are based on 75 subjects (group 1 n = 37, group 2 n = 38). Analysis of variance revealed significant interactions only for FES-I, VAS-FOF, TUGT, and BPOMA. The difference between groups was significant only for TUGT score; group 1 had better scores at 8 weeks and 6 months. FES-I, VAS-FOF, and BPOMA were significantly improved in both groups. EFST and GDS improved in the total sample but not at the group level. CONCLUSION Supervised home exercise seems to be superior only for functional mobility (TUGT). Further studies with a larger sample are needed to draw conclusions about depression and fall risk. The intervention was feasible and atendible. TRIAL REGISTRATION ClinicalTrials.gov" NCT05337839. Retrospectively registered.
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Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults. J Clin Med 2023; 12:jcm12020450. [PMID: 36675379 PMCID: PMC9864613 DOI: 10.3390/jcm12020450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.
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Biomechanical demands of exercises commonly performed by older adults in falls prevention programs. Clin Biomech (Bristol, Avon) 2023; 101:105863. [PMID: 36549050 DOI: 10.1016/j.clinbiomech.2022.105863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Tailored, challenging and progressed exercise programs addressing risk factors are recommended for preventing falls in community-dwelling older adults. Knowing the biomechanical demands of exercises commonly performed in efficacious falls prevention programs provides evidence for exercise prescription. METHODS Twenty-one non-sedentary older adults (10 men, 11 women, mean age 69 [SD 5] years) performed five standing exercises (hip abduction, side-step, squat, forward lunge, and side lunge). A biomechanical analysis of the dominant limb was performed to calculate peak joint angles and net joint moments at the ankle, knee and hip in multiple planes. Repeated-measures one-way analyses of variance followed by post-hoc comparisons were performed to identify differences in the calculated variables between exercises. FINDINGS Peak hip abduction moments during hip abduction were greater than during the forward lunge and squat (P < 0.001). During the side-step, peak plantar flexion moments were greater than the squat and peak hip abduction moments were greater than the squat and forward lunge (P < 0.001). During the squat, peak hip flexion was greatest (P < 0.001) while peak plantar flexion (P < 0.001) and hip abduction moments (P ≤ 0.002) were less than all other exercises. During the forward lunge, peak hip extension moments (P < 0.001) were greatest. During the side lunge, peak knee extension moments were greater than all other exercises (P < 0.001). INTERPRETATION These biomechanical data will allow clinicians to tailor exercises for falls prevention to efficiently challenge but not overload muscle groups and minimize exercise prescription redundancies.
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Xing L, Bao Y, Wang B, Shi M, Wei Y, Huang X, Dai Y, Shi H, Gai X, Luo Q, Yin Y, Qin D. Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies. Front Neurol 2023; 14:1128092. [PMID: 36908603 PMCID: PMC9996061 DOI: 10.3389/fneur.2023.1128092] [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: 12/20/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.
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Affiliation(s)
- Liwei Xing
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China.,The First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yi Bao
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Binyang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Mingqin Shi
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Xiaoyi Huang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Youwu Dai
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Hongling Shi
- Department of Rehabilitation Medicine, The Third People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Xuesong Gai
- Department of Rehabilitation Medicine, The First People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Qiu Luo
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Yong Yin
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
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Pereira da Silva Alves II, Santos Bueno GA, Brito Elmescany R, Aparecida Borges L, Kran Pinto D, Correia Martins A, de Menezes RL. Motor Reaction Time, Sarcopenia and Functional Skills in Elderly Women: A Cross-Sectional Study. J Nutr Health Aging 2023; 27:878-884. [PMID: 37960911 DOI: 10.1007/s12603-023-1983-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 11/15/2023]
Abstract
IMPORTANCE Aging generates changes over the years. Because of this, the musculoskeletal system is directly degraded and suffer deficits in its performance in elderly patients with Sarcopenia, as this condition is characterized by a decrease in muscle mass and function. OBJECTIVE Correlate the motor reaction time and functional skills of non-sarcopenic, pre-sarcopenic and sarcopenic elderly women, and analyze influence on the risk of falls. DESIGN Cross-sectional observational analytical study, following the methodological strategies of STROBE (Strengthening the Reporting of Observational Studies in Epidemiology), carried out under the approval of the Research Ethics Committee of the Unievangélica University, no. 3.694.235/2019. SETTING Participants were evaluated regarding: cognitive status, level of physical activity, fear of falling, body composition, motor reaction time, static and dynamic balance, gait kinetics, strength and endurance of the lower limbs and finally handgrip strength. PARTICIPANTS A total of 59 volunteer elderly women were assessed following the diagnostic criteria for sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). RESULTS The results show that there was a greater difference in motor reaction time between the non-sarcopenic and sarcopenic elderly women due to the executing organ being damaged by the presence of sarcopenia, causing motor response to slowdown. Functional deficit, fear of falling and greater risk of falls were observed in the sarcopenic group, under the harmful influence of increased motor reaction time. CONCLUSION Sarcopenic elderly women present increased motor reaction time, that is, slowed motor responses due to decreased muscle mass, strength and impaired musculature, which generate functional deficits that contribute to an increased risk of falls.
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Affiliation(s)
- I I Pereira da Silva Alves
- Guilherme Augusto Santos Bueno, Postgraduate Program in Health Sciences and Technologies, University of Brasilía, Federal District, Brazil,
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Ratcliffe J, Tokarchuk L. The potential of remote XR experimentation: Defining benefits and limitations through expert survey and case study. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2022.952996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Experimentation using extended reality (XR) technology is predominantly conducted in-lab with a co-present researcher. Remote XR experiments, without co-present researchers, have been less common, despite the success of remote approaches for non-XR investigations. In order to understand why remote XR experiments are atypical, this article outlines the perceived limitations, as well as potential benefits, of conducting remote XR experiments, through a thematic analysis of responses to a 30-item survey of 46 XR researchers. These are synthesized into five core research questions for the XR community, and concern types of participant, recruitment processes, potential impacts of remote setup and settings, the data-capture affordances of XR hardware and how remote XR experiment development can be optimized to reduce demands on the researcher. It then explores these questions by running two experiments in a fully “encapsulated” remote XR case study, in which the recruitment and experiment processes is distributed and conducted unsupervised. It discusses the design, experiment, and results from this case study in the context of these core questions.
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Ryu HS, So WY. The Effects of 24 Weeks of Non-Face-to-Face Home Exercise on Body Composition, Physical Fitness, Cardiovascular Function, and Blood Profiles in Pre-Metabolic Syndrome Korean Adults: A Pilot Study. Healthcare (Basel) 2022; 10:healthcare10101963. [PMID: 36292410 PMCID: PMC9601698 DOI: 10.3390/healthcare10101963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/01/2022] [Accepted: 10/06/2022] [Indexed: 11/04/2022] Open
Abstract
Background: This study assessed Korean residents’ health improvements by reducing chronic disease morbidity through customized health management. After identifying each participant’s strength and health through physical examinations and blood pressure tests, the effects of 24 weeks of online, non-face-to-face home workouts on body composition, physical fitness, cardiovascular function, and blood profiles in Korean adults with pre-metabolic syndrome were determined. Methods: Adults living in Chungcheongbuk-do, aged 19−65, and at the pre-metabolic syndrome stage were recruited at the Jeungpyeong-gun Public Health Center, Chungcheongbuk-do, Korea. For 24 weeks, from February 2022 to July 2022, they exercised for 60−70 min, three times a week, on average, at a maximum heart rate of 60−70%. The “Mobile Healthcare” application was used to record exercise time, number of exercises, number of sets, and Rating of Perceived Exertion at the end of each exercise. Body composition, physical fitness, cardiovascular function, and blood profiles were measured before and after participation. Results: There were no significant differences in weight, body mass index, body fat, waist-to-hip ratio, waist circumference, systolic blood pressure, diastolic blood pressure, resting heart rate levels, or glucose levels after participation in the workout (p > 0.05). However, muscle strength/handgrip strength, sitting-rising test results, single-leg balance, triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol showed a statistically significant difference (p < 0.05). Conclusions: Although the 24 weeks of non-face-to-face home workouts did not positively affect body composition or cardiovascular function, it improved physical fitness and dyslipidemia.
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Affiliation(s)
| | - Wi-Young So
- Correspondence: ; Tel.: +82-43-841-5991; Fax: +82-43-841-5990
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35
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Muscle Strength and Balance as Mediators in the Association between Physical Activity and Health-Related Quality of Life in Community-Dwelling Older Adults. J Clin Med 2022; 11:jcm11164857. [PMID: 36013095 PMCID: PMC9409764 DOI: 10.3390/jcm11164857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
Lower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.
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36
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Shafizadeh M, Parvinpour S, Ali K. Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review. SPORT SCIENCES FOR HEALTH 2022; 19:1-14. [PMID: 35967546 PMCID: PMC9360689 DOI: 10.1007/s11332-022-00993-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
Abstract
Aims The aim of this review study was to examine the effectiveness of home-based and community-based exercise programmes in the rate of falls and improving physical functioning in community-dwelling older adults. Methods All types of home-based and community-based exercise interventions were searched. From 1186 studies identified, 14 studies were selected for the umbrella review. Most studies had high methodological quality. The types of interventions were multi-functional programmes (n = 11 studies) and Otago Exercise Programme (OEP) (n = 3 studies). Results The results showed that home-based and community-based exercise interventions can reduce falls by 22-32%. Studies that included meta-analysis showed that the clinical significance of home-based interventions in fall prevention and improving physical function was moderate to high. Conclusions In conclusion, home-based and community-based exercise interventions are a safe, effective, and feasible method of fall prevention that could be implemented with minimum supervision by allied health professionals to maximise autonomy, self-efficacy, and adherence in community-dwelling older adults.
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Affiliation(s)
| | - Shahab Parvinpour
- Motor Behavior Department, Faculty of Physical Education and Sport Sciences, Kharazmi University, No.43.South Mofatteh Ave, Tehran, 15719-14911 Iran
| | - Khalid Ali
- Brighton and Sussex Medical School, Brighton, UK
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37
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Schaller N, Krusemark H, Mende E, Weiß M, Spanier B, Zelger O, Bischof J, Haller B, Halle M, Siegrist M. Bestform-F - Best Function of Range of Motion: A Feasibility Study of a Multimodal Exercise Training Program for Older Adults in Retirement Homes. Clin Interv Aging 2022; 17:1069-1080. [PMID: 35846178 PMCID: PMC9286070 DOI: 10.2147/cia.s367858] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Mobility is a crucial factor for independence and quality of life in old age. Nevertheless, many old people in retirement homes do not meet the physical activity recommendations. The aim of the Bestform-F – Best Function of Range of Motion feasibility study (bestform-F) was to evaluate the feasibility of implementing a machine-based multimodal exercise training program in older residents in retirement homes. Materials and Methods The participants (n = 77) were recruited from two retirement homes and took part in a six-month multimodal exercise training program (2x/week, 45 minutes) on pneumatic strength training machines, a balance platform and bicycle ergometers. Feasibility criteria were recruitment number ≥ 35 participants within six months, dropout rate < 40% of participants within six months of exercise, and training adherence ≥ 50% of participants taking part in at least 50% of offered training sessions. Additionally, physical performance, fear of falling, cognitive function, and quality of life were assessed at baseline and after six months. Results For the bestform-F study, 77 (85.6 ± 6.6 years; 78% women) out of 215 eligible residents from two senior residences were recruited. The dropout rate over six months was 10% (8/77 participants). The training adherence rate for the finishing participants was 77% (53/69 participants). In addition to the achieved feasibility criteria, significant improvements were recorded in the Chair Stand Test, Six-Minute Walk Test, and fear of falling after six months. Conclusion All feasibility criteria have been fulfilled. The high number of recruited participants, the low dropout rate, and high adherence to the training program confirm the feasibility of a multimodal machine-based exercise training program offered to residents in retirement homes. The results provide a basis for a cluster-randomized controlled trial aimed at further investigating the efficacy of the bestform-F program.
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Affiliation(s)
- Nina Schaller
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Helge Krusemark
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Esther Mende
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Michael Weiß
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Bianca Spanier
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Otto Zelger
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Jan Bischof
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Monika Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
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Kim T, Xiong S. Effectiveness and Usability of a Novel Kinect-Based Tailored Interactive Fall Intervention System for Fall Prevention in Older People: A Preliminary Study. Front Public Health 2022; 10:884551. [PMID: 35712291 PMCID: PMC9194826 DOI: 10.3389/fpubh.2022.884551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Falls are prevalent among older people and can lead to serious health problems. We newly developed a novel Kinect-based tailored interactive fall intervention system, which seamlessly integrates multifactorial fall risk assessment and tailored intervention programs to prevent falls in older people. This preliminary study aimed to examine the effectiveness and usability of this developed system for fall prevention in older people. Thirty community-dwelling older women participated in this experiment; they were allocated to an intervention group (IG) or a control group (CG) for a quasi-randomized trial (15 people each). Participants in IG followed an 8-week tailored intervention (40 min/session × 2 sessions/week × 8 weeks) using the Kinect-based interactive fall intervention system, while participants in CG maintained their habitual activities. Various outcome measures were evaluated at baseline (Week 0), interim (Week 4), and post-intervention (Week 8). Experimental results showed that IG led to significant improvements in TUG-Timed Up and Go (p = 0.010), BBS-Berg Balance Scale (p = 0.011), and Montreal Cognitive Assessment-MoCA (p = 0.022) between baseline and post-intervention. In comparison to the baseline, TUG and BBS were even significantly improved at interim (p = 0.004 and 0.047, respectively). There were no significant changes in static balance-related performance outcomes and the Short Falls Efficacy Scale-SFES after the intervention. Whereas in CG, most performance measures did not show significant changes during the 8-week period, TUG completion time became significantly longer at post-intervention in comparison to interim (p = 0.028) and fear of falling was also significantly higher at post-intervention than baseline (p = 0.021). These findings suggest that the Kinect-based 8-week tailored interactive fall interventions effectively improved older people's physical and cognitive abilities. Regarding the usability of the developed system, the average System Usability Scale (SUS) score was 83.5 out of 100, indicating excellent system usability. The overall mean Computer Literacy Scale (CLS) score was 2.5 out of 26, showing that older participants in this study had very limited experience with computers. No significant correlation between SUS and CLS scores demonstrated that newly developed Kinect-based tailored interactive fall intervention system was easy to use for older people, regardless of their computer experience. This novel system should help health professionals and older people proactively manage the risk of falls.
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Affiliation(s)
- Taekyoung Kim
- Department of Industrial and Systems Engineering, College of Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Shuping Xiong
- Department of Industrial and Systems Engineering, College of Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
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Tekin F, Cetisli-Korkmaz N. Effectiveness of a Telerehabilitative Home Exercise Program on Elder Adults’ Physical Performance, Depression and Fear of Falling. Percept Mot Skills 2022; 129:714-730. [DOI: 10.1177/00315125221087026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our aim in this study was to analyze the effects of a home exercise program of calisthenic exercises delivered through telerehabilitation on physical performance, depression, and risk of falling in elder adults. Our participants were elder adults aged 65 and over, divided into exercise and control groups. We initiated a 4-week telerehabilitation calisthenic exercise program in the exercise group following initial assessments, while our control group received no formal exercise training. Both groups were evaluated online before and after this 4-week period with the Geriatric Depression Scale (GDS), Modified Falls Efficacy Scale (MFES), and Short Physical Performance Battery (SPPB). In total, 255 elder adults participated, with 132 (males = 72, females = 60) allocated to calisthenic exercise and 123 (males = 66, females = 57) allocated to the control group. While the groups did not differ significantly on any of our parameters before the exercise, there were statistically significant post-exercise group differences in GDS ( p ≤ .001) and MFES ( p ≤ .001) scores related to remarkable physical improvements achieved in the calisthenic exercise group. The exercise group showed significant increases in their scores on the SPPB Balance Test ( p = .049), SPPB Chair Test ( p = .009), and SPPB Total ( p = .002) while there was no significant increase in any of these scores among control group participants ( p > .05). Thus, calisthenic exercises performed via telerehabilitation significantly improved elder adults’ physical performance, fear of falling, and depression. Telerehabilitation is a useful remote means of assessing, inducing, and following-up exercise training, particularly during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Fatih Tekin
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
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Home-Based Physical Activity as a Healthy Aging Booster before and during COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074317. [PMID: 35410000 PMCID: PMC8998434 DOI: 10.3390/ijerph19074317] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 12/11/2022]
Abstract
The role of physical activity in improving overall aspects of health regardless of age is well documented. Due to the coronavirus disease 2019 outbreak, preventive measures to limit airborne infection have been introduced, with people, especially older adults, advised to stay at home, thus increasing sedentary lifestyle and the risk of chronic diseases. As one of the few possible ways to stay active is home-based training, this review aims to provide evidence on alternative and feasible home-based activity programs as a tool to improve the fitness level in older adults, especially when preventive measures are needed to ensure isolation and limit interpersonal contacts. During quarantine, older adults, especially those with chronic diseases, are recommended to regularly exercise. Combined balance and muscle-strengthening training has proven to be particularly useful in limiting falls and mobility limitations. In addition, the use of virtual reality systems seems to be a potential strategy in remaining physically active, reducing physical inactivity time and significantly increasing the compliance of the older adults with physical activity programs. In conclusion, home-based programs induce improvements in physical functions in general and quality of life in older people with or without co-morbidities, and it can be considered in the future as one of the feasible and economic ways to increase physical well-being. This may be of unique importance in the setting of coronavirus disease 2019 enforced limitations in out-of-home activity.
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Lima CA, Perracini MR, Funabashi M, Weber S, Beaupre L. Domains of Balance Training Delivered in Rehabilitation Programs Following Hip Fracture Surgery in Older Adults: A Systematic Review. J Geriatr Phys Ther 2022; 45:90-106. [PMID: 33534338 DOI: 10.1519/jpt.0000000000000286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this systematic review was to assess the domains and characteristics of balance training (BT) interventions delivered in rehabilitation programs following hip fracture to identify potential treatment gaps. METHODS Manual and electronic searches (Web of Science, Medline, EMBASE, CINAHL, and ProQuest) were conducted. We selected randomized controlled trials with older adults following hip fracture surgery that included either specific BT or gait, mobility, or transfer training. Two independent reviewers extracted data and rated the methodological quality using the Physiotherapy Evidence Database scale. A third reviewer provided consensus. Extracted BT data included balance domain, progression, frequency, duration, intensity, level of supervision, setting, and rehabilitation phase. RESULTS AND DISCUSSION We included 17 trials from 19 studies; 11 studies were rated as moderate to high methodological quality, but only 8 were considered to have high-quality BT components. Half of the interventions included only one balance domain, with stability during movement being the most commonly included domain. The primary balance progression utilized was reducing hand support. Dual task, anticipatory postural adjustment, reactive strategies, and perceptual training domains were rarely included. Balance training duration and intensity were poorly described. Although most programs were home-based with minimal levels of supervision, a few extended beyond postacute phase of rehabilitation. CONCLUSION Further consideration should be given to include more challenging BT domains with planned progressions to maximize patient recovery through hip fracture rehabilitation programs.
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Affiliation(s)
- Camila Astolphi Lima
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- Master's and Doctoral Programs in Gerontology, Faculty of Medicine, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
| | - Martha Funabashi
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Ontario, Toronto, Canada
| | - Sydnie Weber
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Lauren Beaupre
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Bai X, Soh KG, Omar Dev RD, Talib O, Xiao W, Soh KL, Ong SL, Zhao C, Galeru O, Casaru C. Aerobic Exercise Combination Intervention to Improve Physical Performance Among the Elderly: A Systematic Review. Front Physiol 2022; 12:798068. [PMID: 35058805 PMCID: PMC8764279 DOI: 10.3389/fphys.2021.798068] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023] Open
Abstract
The benefits of aerobic exercise for the elderly are well-known. They extend beyond cardiovascular changes and can reduce the inactivity-induced loss of strength, mobility, balance, and endurance that are vital for the safe performance of daily activities in older adults. However, the benefits of combined aerobic exercise with other exercises such as strength/resistance, multi-component and aerobic exercise remain unknown. The purpose of this study is to examine the effects of combined aerobic exercise on physical performance among the elderly, as opposed to single aerobic exercise. We searched four databases of SCOPUS, PubMed, EBSCOhost, and CINAHL Plus to find 18 articles that met criteria. Data was extracted using PICOs extraction tool and summarized using a narrative synthesis approach. Studies have shown that aerobics combined resistance/strength training (CEX), multi-component training (ME), and dance combined training has positive and significant effects on the physical performance (upper body strength and lower body strength, dynamic balance, fall risk, mobility, gait, agility, flexibility) of the elderly. CEX had additional benefits compared to aerobic training (AER) and resistance/strength training (RES) in gait speed, lower limb strength, and trunk fat. Furthermore, CEX was more effective than AER in improving sitting and stretching, elbow flexion, knee flexion, shoulder flexion and stretching, strength and body fat, function reach test, 30-s chair standing test and 6-min walking test, self-evaluation of body function. Therefore, the combination of multiple components contributes to the overall improvement in physical fitness of the elderly, thus preventing them from losing balance and reducing susceptibility to injury. Clinical Trial Registration: [https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42021213147].
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Affiliation(s)
- Xiaorong Bai
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Roxana Dev Omar Dev
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Othman Talib
- Department of Science and Technical Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Wensheng Xiao
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Kim Lam Soh
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Swee Leong Ong
- School of Nursing Science, Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | - Chenyang Zhao
- Human Resources Office, Wuxi Vocational Institute of Arts and Technology, Wuxi, China
| | - Ovidiu Galeru
- Faculty of Movement, Sports, and Health Sciences, "Vasile Alecsandri" University of Bacau, Bacǎu, Romania
| | - Catalina Casaru
- Department of Physical Education and Athletic Training, University of West Alabama, Livingston, CA, United States
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Kim Y, Vakula MN, Bolton DAE, Dakin CJ, Thompson BJ, Slocum TA, Teramoto M, Bressel E. Which Exercise Interventions Can Most Effectively Improve Reactive Balance in Older Adults? A Systematic Review and Network Meta-Analysis. Front Aging Neurosci 2022; 13:764826. [PMID: 35115917 PMCID: PMC8804322 DOI: 10.3389/fnagi.2021.764826] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/24/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Reactive balance is the last line of defense to prevent a fall when the body loses stability, and beneficial effects of various exercise-based interventions on reactive balance in older adults have been reported. However, their pooled evidence on the relative effects has yet to be described. OBJECTIVE To review and evaluate the comparative effectiveness of various exercise-based interventions on reactive balance in older adults. METHODS Nine electronic databases and reference lists were searched from inception to August 2021. Eligibility criteria according to PICOS criteria were as follows: (1) population: older adults with the mean age of 65 years or above; (2) intervention and comparison: at least two distinct exercise interventions or one exercise intervention with a no-exercise controlled intervention (NE) compared in each trial; (3) outcome: at least one measure of reactive balance; (4) study: randomized controlled trial. The main network meta-analysis was performed on data from the entire older adult population, involving all clinical conditions as well as healthy older adults. Subgroup analyses stratified by characteristics of participants (healthy only) and reactive balance outcomes (simulated slip or trip while walking, simulated forward falls, being pushed or pulled, and movable platform) were also conducted. RESULTS Thirty-nine RCTs (n = 1388) investigating 17 different types of exercise interventions were included in the network meta-analysis. Reactive balance training as a single intervention presented the highest probability (surface under the cumulative ranking (SUCRA) score) of being the best intervention for improving reactive balance and the greatest relative effects vs. NE in the entire sample involving all clinical conditions [SUCRA = 0.9; mean difference (95% Credible Interval): 2.7 (1.0 to 4.3)]. The results were not affected by characteristics of participants (i.e., healthy older adults only) or reactive balance outcomes. SUMMARY/CONCLUSION The findings from the NMA suggest that a task-specific reactive balance exercise could be the optimal intervention for improving reactive balance in older adults, and power training can be considered as a secondary training exercise.
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Affiliation(s)
- Youngwook Kim
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
| | - Michael N. Vakula
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
| | - David A. E. Bolton
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
| | - Christopher J. Dakin
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
| | - Brennan J. Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
| | - Timothy A. Slocum
- Department of Special Education and Rehabilitation Counseling, Utah State University, Logan, UT, United States
| | - Masaru Teramoto
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT, United States
| | - Eadric Bressel
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
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The Effects of Different Exercise Intensities on the Static and Dynamic Balance of Older Adults: A randomised Controlled Trial. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2022. [DOI: 10.18276/cej.2022.3-04] [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] Open
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Center based versus home based geriatric rehabilitation on sarcopenia components: a systematic review and meta-analysis. Arch Phys Med Rehabil 2022; 103:1663-1675.e3. [DOI: 10.1016/j.apmr.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/09/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022]
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Santhagunam SN, Li EPH, Buschert K, Davis JC. A theoretical framework to improve adherence among older adults to recommendations received at a falls prevention clinic: A narrative review. Appl Nurs Res 2021; 62:151493. [PMID: 34814997 DOI: 10.1016/j.apnr.2021.151493] [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: 07/08/2021] [Accepted: 08/27/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Falls impose a prominent public health problem among older adults. Falls are preventable through multi-factorial interventions offered by a Falls Prevention Clinic. Yet, adherence to recommendations is often average or low, particularly for lifestyle recommendations. To achieve full health benefits from such a multifactorial intervention, improving adherence is critical. PURPOSE Our primary objective was to conduct a narrative review to develop a theoretical framework, categorized by intrinsic and extrinsic factors that impact adherence to falls prevention interventions, considering a Falls Prevention Clinic setting. MATERIALS AND METHODS We conducted a comprehensive literature review of all peer-reviewed manuscripts published between 1998 through August 2020 among older adults (i.e., aged 60 years and older) who fall. We used the following search engines: Pubmed, CINAHL, Embase, MedLine, Cochrane and Google Scholar. RESULTS The theoretical framework categorizes two dominate factors (comprised of specific domains) that affect adherence among older adults who fall. Intrinsic factors comprised of three domains included: demographics (age, gender, ethnicity), individual factors (participation, control, behavioural habits) and health factors (physical health, mental state, perceived severity). Extrinsic factors comprised of four domains included: caregiver factors (family dynamics, miscarried helping) medication factors (availability, accessibility, drug handling, reliability), health system (costs, communication, relationship with doctors, attention) and environmental factors (public health policy interventions). Intrinsic factors such as high socioeconomic status, high health literacy, being married and extrinsic factors such as low healthcare cost, better communication and useful policy interventions were associated with greater adherence. CONCLUSION This theoretical model elucidates priority factors to target for promoting adherence to reduce falls, decrease mortality and, lower fall-related healthcare costs.
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Affiliation(s)
- Shree Nithi Santhagunam
- Social & Economic Change Laboratory, Faculty of Management, University of British Columbia-Okanagan Campus, Kelowna, British Columbia, Canada
| | - Eric P H Li
- Social & Economic Change Laboratory, Faculty of Management, University of British Columbia-Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kim Buschert
- Social & Economic Change Laboratory, Faculty of Management, University of British Columbia-Okanagan Campus, Kelowna, British Columbia, Canada
| | - Jennifer C Davis
- Social & Economic Change Laboratory, Faculty of Management, University of British Columbia-Okanagan Campus, Kelowna, British Columbia, Canada; Centre for Hip Health & Mobility, Vancouver, British Columbia, Canada. https://twitter.com/DrJenniferDav1
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Costa SN, Boiko Ferreira LH, Barauce Bento PC. The effects of supervision on three different exercises modalities (supervised vs. home vs. supervised+home) in older adults: Randomized controlled trial protocol. PLoS One 2021; 16:e0259827. [PMID: 34780532 PMCID: PMC8592418 DOI: 10.1371/journal.pone.0259827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Multicomponent physical exercise programs are a viable strategy for treating physical decline resulting from the aging process in older populations and can be applied in supervised and home-based modalities. However, the magnitude of the intervention effects in terms of physical function development may vary according to the modalities application due to different supervision degrees. OBJECTIVE This study aims to compare the effects of supervision in a multicomponent exercise program in different application modalities (supervised vs. home vs. supervised+home) in neuromuscular adaptations, muscle strength, gait, physical function, and quality of life, analyzing the differences between intensity, volume, and density of home and supervised sessions in community older adults. METHODS This protocol is a randomized controlled clinical trial with a sample of 66 older adults divided into three groups: supervised exercise (SUP = 22), home-based exercise (HB = 22), and supervised plus home-based exercise (SUP+HB = 22). The multicomponent exercise program will last 12 weeks, three times per week, for 60 min per session and include warm-up, balance, muscle-strengthening, gait, and flexibility exercises. The study's primary outcomes will be neuromuscular function, composed of the assessment of muscle isokinetic strength, muscle architecture, and neuromuscular electrical activation. The secondary outcome will be physical function, usual and maximum gait speed with and without dual-task, and quality of life. All outcomes will be assessed at baseline and post-intervention (week 12). CONCLUSION This study will be the first clinical trial to examine the effects of different supervision levels on home-based exercises compared to supervised protocols. The results of this study will be essentials for planning coherent and viable home-based programs for older adults. TRIAL REGISTRATION Brazilian Registry of Clinical Trials. Number RBR- 7MZ2KR. https://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-7mz2kr.
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Affiliation(s)
- Sabrine Nayara Costa
- Physical Education Departament, Federal University of Paraná (UFPR), Curitiba, Brazil
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Rosado H, Bravo J, Raimundo A, Carvalho J, Marmeleira J, Pereira C. Effects of two 24-week multimodal exercise programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling: a randomized controlled trial. BMC Public Health 2021; 21:408. [PMID: 34758759 PMCID: PMC8582089 DOI: 10.1186/s12889-021-10448-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Falls in older adults are considered a major public health problem. Declines in cognitive and physical functions, as measured by parameters including reaction time, mobility, and dual-task performance, have been reported to be important risk factors for falls. The aim of this study was to investigate the effects of two multimodal programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling. METHODS In this randomized controlled trial, fifty-one participants (75.4 ± 5.6 years) were allocated into two experimental groups (EGs) (with sessions 3 times per week for 24 weeks), and a control group: EG1 was enrolled in a psychomotor intervention program, EG2 was enrolled in a combined exercise program (psychomotor intervention program + whole-body vibration program), and the control group maintained their usual daily activities. The participants were assessed at baseline, after the intervention, and after a 12-week no-intervention follow-up period. RESULTS The comparisons revealed significant improvements in mobility and dual-task performance after the intervention in EG1, while there were improvements in reaction time, mobility, and dual-task performance in EG2 (p ≤ 0.05). The size of the interventions' clinical effect was medium in EG1 and ranged from medium to large in EG2. The comparisons also showed a reduction in the fall rate in both EGs (EG1: -44.2%; EG2: - 63.0%, p ≤ 0.05) from baseline to post-intervention. The interventions' effects on reaction time, mobility, and dual-task performance were no longer evident after the 12-week no-intervention follow-up period. CONCLUSIONS The results suggest that multimodal psychomotor programs were well tolerated by community-dwelling older adults and were effective for fall prevention, as well as for the prevention of cognitive and physical functional decline, particularly if the programs are combined with whole-body vibration exercise. The discontinuation of these programs could lead to the fast reversal of the positive outcomes achieved. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03446352. Date of registration: February 07, 2018.
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Affiliation(s)
- Hugo Rosado
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
| | - Jorge Bravo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Joana Carvalho
- Faculdade de Desporto, Universidade do Porto, Praça de Gomes Teixeira, Porto, Portugal
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Universidade do Porto, Praça de Gomes Teixeira, Porto, Portugal
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Catarina Pereira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
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Markotegi M, Irazusta J, Sanz B, Rodriguez-Larrad A. Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program. Exp Gerontol 2021; 155:111580. [PMID: 34601075 PMCID: PMC8492068 DOI: 10.1016/j.exger.2021.111580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 lockdowns restricted physical activity levels for individuals in many countries. In particular, older adults experienced limited access to their usual activities, including physical exercise programs. How such restrictions and interruptions in physical exercise programs might impact the physical and mental health of older adults has not yet been studied. We sought to analyse changes in the physical and mental health of older adults enrolled in a group-based multicomponent physical exercise (MPE) program that was interrupted due to the COVID-19 pandemic. We followed 17 participants of this program from October 2018 to October 2020, including the interruption of the program during the pandemic. The MPE program included strength, balance, and stretching exercises. We compared anthropometric and cardiovascular parameters, physical fitness, frailty, quality of life, and psychoaffective status of participants before and during the COVID-19 pandemic. Most parameters followed the same pattern, improving after 8 months of the first MPE season (Oct. 2018-Jun. 2019), worsening after 4 months of summer rest, improving from October 2019 to January 2020 in the second MPE season (Oct. 2019-Jan. 2020), and severely worsening after 7 months of program interruption. We show that an MPE program has clear benefits to the physical and psychoaffective health of older adults, and interruption of these programs could adversely impact participants. These results highlight the need to maintain physical exercise programs or facilitate engagement in physical activity and reduce sedentary behaviour in older adults, particularly in situations such as the COVID-19 pandemic.
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Affiliation(s)
- Mikel Markotegi
- Fundación Siel Bleu, Spain; Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
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Evaluating the YMCA Move for Health Program in Individuals With Osteoarthritis and Assessing Maintenance During the COVID-19 Pandemic. J Aging Phys Act 2021; 30:598-609. [PMID: 34564068 DOI: 10.1123/japa.2021-0217] [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: 06/08/2021] [Revised: 08/04/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
Osteoarthritis is the most common condition to co-occur with other chronic health conditions and a broad exercise program on management of chronic conditions may be suitable for this group. This study evaluated the 12-week YMCA Move for Health exercise program among adults with osteoarthritis or with/at risk of chronic health conditions using a mixed-methods study design based on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Participants (n = 66) completed the exercise program at the YMCAs in Cambridge, Kitchener, and Waterloo. Assessments included physical function, health-related quality of life, symptoms of arthritis, and physical activity levels and were conducted at baseline (B), postprogram (PP), and 3-month postprogram. Due to interruption by COVID-19, a subgroup of participants completed the 3-month postprogram assessments after the onset of the pandemic. At PP, participants with OA showed significant improvements in level of disability (B = 0.63 ± 0.45 and PP = 0.55 ± 0.47; p = .049), pain (B = 4.3 ± 2.5 and PP = 3.6 ± 2.4; p = .026), fatigue (B = 3.9 ± 3.1 and PP = 2.8 ± 2.6; p = .003), and several domains related to health-related quality of life. Despite interruption by the COVID-19 pandemic and poor maintenance of physical activity levels, nearly all improvements related to level of disability, symptoms of arthritis, and health-related quality of life observed at PP were maintained 3-months postprogram. The Move for Health program proved to be a feasible and effective community program for people with osteoarthritis. Additional supports may be needed to maintain physical activity levels after the program.
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