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Taylor J, Walsh S, Kwok W, Pinheiro MB, de Oliveira JS, Hassett L, Bauman A, Bull F, Tiedemann A, Sherrington C. A scoping review of physical activity interventions for older adults. Int J Behav Nutr Phys Act 2021; 18:82. [PMID: 34193157 PMCID: PMC8243293 DOI: 10.1186/s12966-021-01140-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To inform implementation and future research, this scoping review investigates the volume of evidence for physical activity interventions among adults aged 60+. Our research questions are: (1) what is the evidence regarding interventions designed to increase total physical activity in adults aged 60+ years, in accordance with three of the four strategic objectives of GAPPA (active societies, active environments, active people); (2) what is the current evidence regarding the effectiveness of physical activity programmes and services designed for older adults?; and (3) What are the evidence gaps requiring further research? METHODS We searched PEDro, MEDLINE, CINAHL and Cochrane from 1 January 2010 to 1 November 2020 for systematic reviews and meta-analyses of physical activity interventions in adults aged 60+. We identified interventions designed to: (1) increase physical activity; and (2) deliver physical activity programmes and services in home, community or outpatient settings. We extracted and coded data from eligible reviews according to our proposed framework informed by TIDieR, Prevention of Falls Network Europe (PROFANE), and WHO's International Classification of Functioning, Disability and Health (ICF). We classified the overall findings as positive, negative or inconclusive. RESULTS We identified 39 reviews of interventions to increase physical activity and 342 reviews of programmes/services for older adults. Interventions were predominantly structured exercise programmes, including balance strength/resistance training, and physical recreation, such as yoga and tai chi. There were few reviews of health promotion/coaching and health professional education/referral, and none of sport, workplace, sociocultural or environmental interventions. Fewer reported outcomes of total physical activity, social participation and quality of life/well-being. We noted insufficient coverage in diverse and disadvantaged samples and low-middle income countries. CONCLUSIONS There is a modest but growing volume of evidence regarding interventions designed to increase total physical activity in older adults, although more interventional studies with long term follow-up are needed, particularly for GAPPA 1. Active Societies and GAPPA 2. Active Environments. By comparison, there is abundant evidence for GAPPA 3. specific programmes and services, but coverage of sport and workplace interventions, and diverse samples and settings is lacking. Comprehensive reviews of individual studies are now needed as well as research targeting neglected outcomes, populations and settings.
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Affiliation(s)
- Jennifer Taylor
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia.
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Sarah Walsh
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wing Kwok
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Marina B Pinheiro
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Juliana Souza de Oliveira
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Sydney, Australia
| | - Fiona Bull
- Physical Activity Unit, Department of Health Promotion, Division of Universal Health Coverage and Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Hetherington S, Henwood T, Swinton P, Keogh J, Gardiner P, Tuckett A, Rouse K. Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study. Arch Phys Med Rehabil 2018; 99:1525-1532. [PMID: 29626427 DOI: 10.1016/j.apmr.2018.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/07/2018] [Accepted: 03/04/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. DESIGN Intervention study. SETTING Community-based older adult-specific exercise clinic. PARTICIPANTS Older adults (N=245) with complex care needs who were receiving government-funded aged care support. INTERVENTIONS Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. MAIN OUTCOME MEASURES The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. RESULTS At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=-.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. CONCLUSIONS This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults.
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Affiliation(s)
| | - Tim Henwood
- School of Human Movement and Nutritional Sciences, The University of Queensland, Brisbane, Australia; Southern Cross Care (SA and NT), Adelaide, South Australia, Australia
| | - Paul Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond Institute of Health & Sport, Bond University, Gold Coast, Queensland, Australia; Human Potential Centre, AUT University, Auckland, New Zealand; Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Paul Gardiner
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia; Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Anthony Tuckett
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Kevin Rouse
- Burnie Brae Ltd, Brisbane, Queensland, Australia
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