Adherence of older women with strength training and aerobic exercise

Physical and mental health predicts better adherence to exercise intervention in older women: A post-hoc analysis

Background

Adherence to exercise is crucial for promoting health and maintaining functioning.

Aims

To investigate predictors of adherence to exercise in the initially free supervised fall prevention RCT and its low-cost, self-sustained continuation among elderly women.

Methods

In the 2-year Kuopio Fall Prevention Study RCT, 457 women (aged 71-84) were offered a free initial 6-month supervised weekly training program (gym, Tai Chi) in the municipal facilities. Women's adherence during this period was categorized into high (≥80 %) and low (<80 %). In the next six months, their free access to the premises continued without supervision. For the second year, low-cost access was offered with unsupervised independent training in these facilities. The second-year adherence was based on purchasing(yes/no) a gym card to continue exercising. Information on baseline health, functioning, and lifestyle was obtained by mailed questionnaires and physical tests.

Results

For the first six months, over 60 % of the women had high adherence. Only 26 % continued into the second year. For both follow-up years, active training history was related to better adherence. Initial predictors were related to mental health i.e. having less often fear of falls limiting one's mobility, ability to cope with external, not internal hostility, and being in a loving relationship. In the second year, predictors were related to younger age, having less frequent fear of falls, better functional capacity i.e. better strengths (grip and leg extension) and faster Timed "Up and Go" -test.

Conclusion

Better mental and physical health, better functional capacity and active training background were associated with higher adherence to exercise intervention in older women.

Efficacy of a theory-based and setting-based intervention in promoting strength training among older adults in Hong Kong: A clustered randomized controlled trial

The present study aimed to examine the efficacy of an intervention, based on the Health Belief Model (HBM) and social support, in promoting strength training (ST) among older adults. A two-arm clustered randomized controlled trial (RCT) was conducted among 235 older adults from eight elderly centers in Hong Kong. The intervention group engaged in a 6-month intervention comprising ST sessions, exercise consultations, social gatherings, and a buddy program, while the control group participated in social gatherings. Assessments were conducted at baseline (Month 0), post-intervention (Month 6), and 3-month follow-up (Month 9), with primary outcome being the prevalence of meeting the American College of Sports Medicine (ACSM) recommendations of ST. Results showed that the intervention group reported significantly higher prevalence of meeting ACSM recommendations for ST at both post-intervention and follow-up. Linear mixed models showed significant interaction effect between condition and time on perceived susceptibility of sarcopenia and muscle strength and significant condition effect on self-efficacy for ST, perceived severity of sarcopenia, perceived barriers of ST, and intention to perform ST. Findings suggest that the intervention, guided by HBM and social support, improves older adults' ST participation, muscle strength, perceptions on sarcopenia, and self-efficacy for ST, which offers great potential for broader application in other settings.

Active video games for improving health-related physical fitness in older adults: a systematic review and meta-analysis

Background

The global population is experiencing a rapid rise in the quantity and percentage of older people. In an effort to enhance physical activity among older adults, active video games (AVGs) are being suggested as a compelling alternative and are currently under scrutiny to evaluate their efficacy in promoting the health of older people.

Objective

This review aims to synthesize current studies and formulate conclusions regarding the impact of AVGs on the health-related physical fitness of older adults.

Methods

Seven databases (PubMed, Web of Science, SCOPUS, SPORTDiscus, EMBASE, MEDLINE, and CINAHL) were searched from inception to January 21, 2024. Eligible studies included randomized controlled trials examining the effect of AVGs compared to control conditions on health-related physical fitness outcomes in older adults. The methodological quality of the included trials was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE approach. A random-effects model was used to calculate effect sizes (ES; Hedge's g) between experimental and control groups.

Results

The analysis included 24 trials with a total of 1428 older adults (all ≥ 60 years old). Compared to controls, AVGs produced significant increases in muscular strength (moderate ES = 0.64-0.68, p < 0.05) and cardiorespiratory fitness (moderate ES = 0.79, p < 0.001). However, no significant effects were found for body composition (trivial ES = 0.12-0.14; p > 0.05) and flexibility (trivial ES = 0.08; p = 0.677). The beneficial effects of AVGs were greater after a duration of ≥ 12 vs. < 12 weeks (cardiorespiratory fitness; ES = 1.04 vs. 0.29, p = 0.028) and following ≥ 60 minutes vs. < 60 minutes of session duration (muscular strength; ES = 1.20-1.24 vs. 0.27-0.42, p < 0.05).

Conclusion

AVGs appear to be an effective tool for enhancing muscular strength and cardiorespiratory fitness in older adults, although their impact on improving body composition and flexibility seems limited. Optimal improvement in cardiorespiratory fitness is associated with a longer duration of AVGs (≥ 12 weeks). Moreover, a session duration of ≥ 60 minutes may provide greater benefits for the muscular strength of older adults.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=482568, identifier CRD42023482568.

Exploring exercise adherence and quality of life among veteran, novice, and dropout trainees

Introduction

The purpose of this study was to identify and reveal the different contexts, variables, and factors that may influence adherence to physical activity among veteran, novice, and dropout trainees, such as the frequency of the weekly training units, the trainees preferred type of exercise, the purpose of the physical activity, and the relationship between support and supervision by fitness instructors and professionals. This study also examined the relationships between trainees, seniority and the strength of the habit and adherence to physical activity, the effects of personal variables such as age and gender on adherence to physical activity, and how the seniority and adherence of trainees may affect their quality of life.

Methods

A total of 460 participants drawn from the broader Israeli exercise community, which encompasses a diverse range of individuals within the general adult population, were engaged in this study. These participants included seasoned exercisers, individuals who had recently initiated exercise routines, and those who had previously engaged in physical activity. Each participant completed a comprehensive set of questionnaires, including the Self-Report Habit Index, the Exercise Adherence Rating Scale, and the World Health Organization (WHO) Quality of Life Scale. In addition to the questionnaire responses, demographic data and inquiries concerning their physical activity were also collected.

Results

The results show that the average frequency of the weekly training units of veteran trainees was significantly higher than that of novice trainees: 3.95 and 2.93, respectively (p < 0.0001). We found no significant differences between novice and veteran trainees regarding their training goal preferences (p = 0.07). Veteran trainees who had been in training for more than a year appeared to have higher self-efficacy since 31.16% reported receiving no supervision compared to 16.67% among novice trainees. In addition, people over 45 appear to have more health-related goals compared to their younger counterparts (p < 0.001). The quality of life scores of the trainees was related to their seniority in physical training, but only by a small magnitude (R2 = 0.06), p < .001). Those who trained in resistance training showed the greatest rate of adherence in relation to flexibility and aerobic training (p < 0.001), and women preferred more body toning and had more weight loss goals than men (p < 0.001).

Discussion

The results indicate that there are central and important factors that may affect adherence to physical activity, and that all these aspects must be taken into account when planning a training program or when there is a desire to maintain or increase adherence to physical activity. The research findings indicate that the main factors that can influence adherence to physical activity are identifying and increasing the trainee's self-efficacy, maintaining weekly training units with sufficient frequency to form a habit and incorporating resistance training into the training regime, as resistance training has shown high levels of adherence. Moreover, it seems that people with different degrees of experience in physical training have distinct and varied training goals, and there is no one goal that fits all. In addition, specific factors such as age and gender must also be taken into account, because the age and gender of the trainees may significantly affect the goals of physical training.

The acute and repeated bout effects of multi-joint eccentric exercise on physical function and balance in older adults

PURPOSE

Eccentric muscle actions generate high levels of force at a low metabolic cost, making them a suitable training modality to combat age-related neuromuscular decline. The temporary muscle soreness associated with high intensity eccentric contractions may explain their limited use in clinical exercise prescription, however any discomfort is often alleviated after the initial bout (repeated bout effect). Therefore, the aims of the present study were to examine the acute and repeated bout effects of eccentric contractions on neuromuscular factors associated with the risk of falling in older adults.

METHODS

Balance, functional ability [timed up-and-go and sit-to-stand], and lower-limb maximal and explosive strength were measured in 13 participants (67.6 ± 4.9 year) pre- and post-eccentric exercise (0, 24, 48, and 72 hr) in Bout 1 and 14 days later in Bout 2. The eccentric exercise intervention was performed on an isokinetic unilateral stepper ergometer at 50% of maximal eccentric strength at 18 step‧min-1 per limb for 7 min (126 steps per limb). Two-way repeated measures ANOVAs were conducted to identify any significant effects (P ≤ 0.05).

RESULTS

Eccentric strength significantly decreased (- 13%) in Bout 1 at 24 hr post-exercise; no significant reduction was observed at any other time-point after Bout 1. No significant reductions occurred in static balance or functional ability at any time-point in either bout.

CONCLUSION

Submaximal multi-joint eccentric exercise results in minimal disruption to neuromuscular function associated with falls in older adults after the initial bout.

Comparison of Exergames Versus Conventional Exercises on the Health Benefits of Older Adults: Systematic Review With Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Conventional exercises (CEs) can provide health benefits for older adults, but the long-term exercise adherence rate is low. As an emerging, stimulating, and self-motivating strategy, exergames (EGs) are defined as combinations of exercises and games that users carry out through physical actions. They can promote exercise, but the health effects of EGs versus CEs on the physical function and mental health (cognitive function, depression, and quality of life) of older adults remain controversial.

OBJECTIVE

The aim of the study is to compare the health benefits of EGs versus those of CEs for the physical function and mental health of older adults.

METHODS

A comprehensive search was conducted from the earliest available date to February 2023 in the following 6 databases: PubMed, Web of Science, Embase, Cochrane, CINAHL, and PsycINFO. All English-language randomized controlled trials comparing the effects of EGs versus those of CEs on the physical function and mental health of older adults, with nearly same physical activity between the 2 interventions, were included. Risk of bias was independently evaluated by 2 authors using the Cochrane risk of bias in randomized trials tool. Two authors independently extracted data. We followed the Cochrane Handbook of Systematic Reviews of Interventions to process and analyze the data for meta-analysis. Standardized mean differences (SMDs) and 95% CIs were used for continuous data, and random models were used for analyses.

RESULTS

We included 12 studies consisting of 919 participants in total. Of these, 10 studies were eventually included in the meta-analysis. The results showed that EGs versus CEs exhibited no significant differences in physical (P=.13; τ2=0.31; χ26=26.6; I2=77%; SMD=0.37; 95% CI -0.11 to 0.86) or cognitive function (P=.63; τ2=0.01; χ23=3.1; I2=4%; SMD=0.09; 95% CI -0.27 to 0.44) effects.

CONCLUSIONS

Our findings indicate no significant difference between EGs and CEs in improving the physical function and cognitive function of older adults. Future studies are required to compare the effects of EGs versus those of CEs on cognitive function according to cognitive status, quantify the "dose-effect" relationship between EGs and health benefits, and evaluate the effects of different types and devices of EGs with regard to the health benefits of older adults.

TRIAL REGISTRATION

PROSPERO CRD42022322734; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322734.

Effects of 12-Week Progressive Sandbag Exercise Training on Glycemic Control and Muscle Strength in Patients with Type 2 Diabetes Mellitus Combined with Possible Sarcopenia

Patients with type 2 diabetes mellitus (T2DM) are at a three-fold increased risk of developing sarcopenia compared to those without diabetes. The objective of this study was to investigate whether an intervention involving progressive sandbag exercises is beneficial to patients with T2DM and possible sarcopenia in terms of enhancing muscle strength and controlling blood sugar levels. Forty patients with T2DM and possible sarcopenia (age > 50 years) were recruited and randomly divided into resistance training and control groups. Resistance exercises for the upper and lower extremities were performed using sandbags (0.5 kg at the beginning to 1 kg after 1 month). Patients in the control group were asked to maintain their usual daily lifestyle. After 12 weeks, the training group were significant better than the control group in terms of glycosylated hemoglobin, the five times sit-to-stand test, skeletal muscle mass and calf circumference, and the physiological domain of the World Health Organization Quality of Life Questionnaire. In conclusion, these simple home exercises are beneficial to patients with T2DM combined with possible sarcopenia. This approach can assist patients in controlling their levels of glycosylated hemoglobin as well as improve physical fitness and quality of life.

The Effect of Exergame Training on Physical Functioning of Healthy Older Adults: A Meta-Analysis

Exergames have attracted increasing attention from both the public and researchers. Although previous systematic reviews provided evidence that exergame training is beneficial for improving balance or mobility in older adults, multidimensional physical function measurements, including balance, upper body strength, lower body strength, aerobic endurance, and gait, might help us achieve more robust and reliable results. This meta-analysis aims to quantify the effects of exergame training on overall and specific physical function in healthy older adults. We systematically searched exergame training studies published between January 1985 and June 2021. Forty-eight studies were included in the present meta-analysis, with a total of 1099 participants included in the training group and 1098 participants in the control group. Random-effects meta-analyses found that older adults obtained a small benefit in overall physical function performance (g = 0.43, 95% confidence interval [CI] = 0.33 to 0.53), moderate benefits in balance (g = 0.59, 95% CI = 0.46 to 0.71), upper body strength (g = 0.65, 95% CI = 0.20 to 1.10), lower body strength (g = 0.51, 95% CI = 0.37 to 0.65), and aerobic endurance (g = 0.65, 95% CI = 0.44 to 0.86), a small benefit in gait (g = 0.33, 95% CI = 0.08 to 0.59), and negligible effects on upper body flexibility (g = 0.13, 95% CI = -0.06 to 0.32) and lower body flexibility (g = 0.10, 95% CI = -0.45 to 0.67) from exergame training. The mini-mental state examination score was positively associated with the overall training efficacy (β = 0.08, P = 0.01), while body mass index and the sample size in the training group were negatively associated with the overall training efficacy (β = -0.01, P < 0.01; β = -0.004, P < 0.01). The current meta-analytic findings revealed that exergame training produced general benefits for overall physical function and different effects on specific physical function domains in older adults.

Effect of combined locomotor training and aerobic exercise on increasing handgrip strength in elderly with locomotive syndrome: A randomised controlled trial

Background

Elderly with the locomotive syndrome is at high risk for fall and fractures. Thus multimodal therapy is needed to minimize the risk.

Objective

Analyzing the effect of combined locomotor training and aerobic exercise on muscle strength in elderly with locomotive syndrome stage 1.

Methods

This study used a pre-test and post-test design with 20 participants (treatment group = 10 participants and control group = 10 participants). The treatment group was given combined locomotor training and aerobic exercise, while the control group was only given aerobic exercise for eight weeks. Locomotor training was provided three times/week with progressive increase of set and repetition at each activity. Meanwhile, aerobic exercise was given seven times/week for 30 min per session. Participants were examined for muscle strength (handgrip strength) before and after the intervention. The analysis included paired t-test and an independent t-test with a p-value <0.05.

Results

The participants' mean age was 73.85 ± 4.75 years, with treatment group = 75.4 ± 4.88 years and control group = 72.3 ± 4.30 years (t = 1.508; 95% CI = −1.220 – 7420; p = 0.149). The HGS values in the treatment group were 13.89 ± 5.27 (pre-test) and 19.06 ± 4.54 (post-test; t = 11.765; 95% CI = −6.164 to −4.176; p < 0.001). Meanwhile, the HGS values in the control group at pre-test and post-test were 11.27 ± 2.17 and 13.03 ± 2.54, respectively (t = 2.057; 95% CI = −1.600 – 0.076; p = 0.070). The ΔHGS values of treatment and control group were 5.17 ± 1.39 and 1.76 ± 2.07, respectively (t = 4.329; 95% CI = 1.755–5.065; p < 0.001).

Conclusion

Combined locomotor training and aerobic exercise have increased muscle strength, as proven by increased handgrip strength.

•

Combined locomotor training and aerobic exercise minimize fall risk and fracture in the elderly.

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Combined locomotor training and aerobic exercise are effective for the management of locomotive syndrome stage 1.

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Combined locomotor training and aerobic exercise reduce the GLFS-25 score.

Effects of an App-Based Physical Exercise Program on Selected Parameters of Physical Fitness of Females in Retirement: A Randomized Controlled Trial

Modern technologies enable new options in the delivery of physical exercise programs. Specially designed app-based programs can be used to help older people in particular to integrate physical exercise into their daily lives. This study examines the influence of an app-based physical exercise program on selected parameters of physical fitness, such as muscular strength, balance, and flexibility. The women (n = 110) were on average 65.3 (± 1.5) years old and, compared to age-specific norm values, healthy. The 14-week intervention consisted of an app-based, unsupervised physical exercise program, in which the exercise frequency and duration of sessions were self-selected. The physical exercise program consisted of simple, functional exercises such as arm circles, squats, lateral raises. The participants were provided with an elastic resistance band and an exercise ball allowing them to increase exercise intensity if needed. Participants were randomly assigned to intervention group (IG) and control group (CG). 71% of the IG used the physical exercise program at least 1.2 times per week, whereas 25% of the IG showed usage rates above four times per week. Significant effects were found in the domains of muscular strength and flexibility. While IG could maintain their performance in isometric muscular strength tests and increased their flexibility, CG faced a decrease in those parameters. Thus, this app-based physical exercise program had positively influenced muscular strength and flexibility in women over 60 years of age.

Effects of yoga and aerobic exercise on wellbeing in physically inactive older adults: randomized controlled trial (FitForAge)

OBJECTIVE

To compare the effects of yoga and aerobic exercise (AE) on wellbeing in physically inactive, but otherwise healthy older adults. A secondary objective was to assess and compare the frequency of adverse events associated with yoga and AE.

DESIGN

Twelve-week, three-group, parallel randomized controlled trial with blinded follow-up assessment.

INTERVENTIONS

Participants were supported to complete ≥3 Hatha yoga classes/week or ≥3 AE sessions/week. A wait-list control (WLC) group continued usual daily activities.

MAIN OUTCOME MEASURE

Change in wellbeing, assessed using the Satisfaction with Life Scale (SWLS) and Life Satisfaction Index-Z (LSI),at baseline and at 12-week follow up.

RESULTS

In total, 82 adults (mean age 72.5 years, range 65-85, 77% female) were recruited. Of these, 27 were randomized to yoga, 29 to aerobic exercise and 26 to wait-list control. Medium-magnitude treatment effects (Hedges' g) were seen for yoga versus WLC and AE versus WLC(SWLS, g = 0.65 and 0.56; LSI, g = 0.54 and 0.54, respectively). In per-protocol analyses, larger effect sizes were found (SWLS, g = 0.72 and 0.66; LSI, g = 0.76 and 0.76, respectively). Adverse events were less frequent in the yoga group (6/27; 22%) compared to AE (10/27; 37%).

CONCLUSIONS

Among physically inactive older adults, participation in yoga or AE was associated with beneficial effects on subjective wellbeing when compared to a non-active control group. Yoga was associated with fewer injuries and may be especially suitable for older adults (DRKS 00015093).

Effects of an Information and Communication Technology-Based Fitness Program on Strength and Balance in Female Home Care Service Users

There is evidence that training for strength and balance prevents decline in physical function in old age when the training is personally instructed. It is an open question whether interventions that deliver training via up-to-date technologies can achieve long-term effects. This study examined the effects of an 8-month fitness training program delivered via information and communication technology (ICT) on lower-body strength and balance in female home care users (n = 72) aged 75 years on average. For statistical analysis, the test group was divided into two subgroups, one who used the program at least 8 times per month (n = 26) and another one who used the program less often (n = 17) compared with a control group that received no exercise program (n = 29). It was found that regular ICT-exercisers exhibited positive effects over time on lower-body strength and balance compared to a decrease in both indicators in irregular exercisers and the control group. The authors see potential in offering exercise programs to people of advanced age via ICT to counteract physical decline in old age.

Staying Strong Together: Older People Engaging in Resistance Training With a Peer

The aim of this qualitative exploratory study was to investigate older adults' perceptions of having a peer to encourage their participation in resistance training. The participants were recruited from a retirement village to undergo a 6-week resistance training program. Some participants attended a center; others participated in their home. Data were collected via semistructured interviews and analyzed thematically using a six-phase framework to obtain the participants' perspectives about the peer support they received. The participants (n = 21) had divergent views about peer support, with some finding it enabling, while others did not find it helpful. Overall, the participants suggested that peer support could be beneficial if offered as a choice. Further research is needed to determine whether peer support assists in sustaining resistance training engagement among older adults when the aspect of choice is included.

Cognitive Function and Functional Mobility Predict Exercise Adherence in Older Adults Who Fall

INTRODUCTION

Strength and balance exercises prevent falls. Yet, exercise adherence is often low. To maximize the benefit of exercise on falls prevention, we aimed to identify baseline cognitive and mobility factors that predict adherence to the Otago Exercise Program (OEP) - a home-based exercise program proven to prevent falls.

METHODS

We conducted a secondary longitudinal analysis of data from a randomized clinical trial (RCT) (OEP compared with usual care) among 172 participants who were assigned to the OEP intervention of the RCT. Adherence to the OEP was calculated as a percent score (i.e., [frequency of strength and balance retraining session per week/3 strength and balance retraining sessions per week] × 100). Executive function (i.e., mental flexibility) was measured using the Trail Making Tests (Part A and B: TMT B - TMT A) and the Digit Symbol Substitution Test (DSST). Short-term memory and encoding was measured using the Verbal Digits Forward test. Executive function (i.e., inhibition and working memory) was measured using the Stroop Color-Word Test and the Verbal Digits Forward minus Verbal Digits Backward test. Mobility was assessed using the Short Performance Physical Battery and the Timed Up and Go test. We used general estimation equations analysis to determine the predictors of adherence to the OEP.

RESULTS

Better set shifting (β = -0.06, z = -2.43, [SE = 0.02] p = 0.018] predicted greater OEP adherence. Greater attention and short-term memory (β = -6.99, z = -2.37 [SE = 2.95]) predicted poorer OEP adherence. Response inhibition, processing speed, working memory, and mobility assessed by the SPPB were not associated with adherence. Poorer baseline Timed Up and Go (β = 1.48 z = 1.94, [SE = 0.76]; p < 0.001), predicted better OEP adherence.

CONCLUSION

Specific cognitive processes (i.e., executive function of set shifting, attention, and short-term memory) and functional mobility predicted exercise adherence. Further research needs to explore the pathways that explain why better attention and short-term memory predicted lower adherence and why poorer functional mobility led to better OEP adherence.

A 'case-mix' approach to understand adherence trajectories for a falls prevention exercise intervention: A longitudinal cohort study

OBJECTIVE

We identified adherence-based case-mixes from participants' longitudinal adherence to falls prevention exercise interventions over 12 months. Second, we identified modifiable baseline predictors (cognition, mobility and functional status) based on participants' case-mix adherence trajectories.

STUDY DESIGN AND OUTCOME MEASURES

This study was a 12-month longitudinal secondary analysis of data from 172 participants who received the Otago Exercise Program (OEP) in a randomized controlled trial. Adherence to the OEP was ascertained monthly via self-report. Case-mixes, groups of individuals who followed similar adherence trajectories, were visually defined using 12-month longitudinal trajectories; we used latent class growth modeling. Baseline predictors of adherence were examined for the following categories: 1) cognition, 2) mobility and 3) functional status.

RESULTS

Four distinct case-mixes were identified. The "non-adherent" case-mix (18 %) was distinguished by a non-adherent and decreasing adherence trajectory over time. The "low adherence" case-mix (45 %) did not have complete adherence or consistent adherence over the 12-month follow-up. The "moderate adherence" case-mix (27 %) was characterized by a stable (i.e., non-variable) adherence trajectory with a slightly increasing pattern at midpoint. The "high adherence" case-mix (10 %) demonstrated consistent and high adherence over the 12-month follow-up. For individuals with "moderate adherence", the Digit Symbol Substitution Test (DSST) significantly predicted adherence (relative risk ratio (RRR) = 1.12 (0.95 CI: 1.0-1.26); p = 0.049). For individuals with "high adherence", the Digits Forward minus Digits Backward (RRR = 0.43 (0.95 CI: 0.23-0.79); p = 0.002) and Instrumental Activities of Daily Living (RRR = 0.36 (0.95 CI: 0.16-0.81); p = 0.01) significantly predicted adherence.

CONCLUSIONS

Cognitive profile and activities of daily living at baseline may predict the longitudinal pattern of adherence.

A Pilot Study of the Feasibility and Effects of Table Tennis Training in Parkinson Disease

Objective

To investigate feasibility and effects of table tennis training on balance control and physical function in individuals with Parkinson disease.

Design

Single group, observational, before-after trial.

Setting

Table tennis training in a gymnasium.

Participants

Community-dwelling individuals with Parkinson disease (N=9; 5 men, 4 women) with an average age of 66.9 years, average time since diagnosis of 8.6 years, and a modified Hoehn and Yahr score between 2 and 2.5 participated in this study. Participants were recruited via newspaper advertisement, at the patient organization, and at the university hospital outpatient clinic. Eight participants completed the study. One participant withdrew for logistical reasons.

Interventions

Group training program consisting of 2 table tennis training sessions per week (120min each) for 10 weeks.

Main Outcome Measures

The primary outcome was feasibility, including attendance rate, drop-out rate, a final questionnaire assessing the participants' experience during the intervention, and any adverse events. The primary effect outcome was the Mini Balance Evaluation Systems Test (Mini-BESTest). Secondary effect outcomes were Parkinson's disease questionnaire-8, European quality of life questionnaire, Montgomery Åsberg Depression Rating Scale (MADRS), Unified Parkinson's Disease Rating Scale, 10-meter walk test, generic walking scale, activities-specific balance confidence scale, and physical activity measured with an accelerometer and the Frändin-Grimby scale.

Results

The average attendance rate was 84%. There were no adverse events reported. The participants reported that the training improved well-being. The mean total score on the Mini-BESTest before and after intervention was 21.2 versus 23.3 (P=.093). Statistically significant positive effects without adjustment for multiple comparisons were found for MADRS and the Frändin-Grimby scale.

Conclusions

This study demonstrates that table tennis training is safe and feasible, and may have the potential to improve balance control, mental well-being, and self-reported physical activity level. Further studies are required before table tennis can be considered an evidence-based recommendation for individuals with Parkinson disease.

Effect of an intensive intervention on the increase of physical activity and the decrease of sedentary lifestyle in inactive postmenopausal

BACKGROUND

During the transition to menopause, women experience different psychological, hormonal, and physical alterations that can affect their health. Physical activity is considered an important strategy in the prevention and control of such changes.

AIM

To evaluate the short-term effect of an intensive intervention, based on a combined exercise programme using a Smartband, on the increase of physical activity and the decrease of sedentary lifestyle in postmenopausal and inactive women.

DESIGN

Randomized clinical trial with two parallel groups.

METHODS

In total, 100 postmenopausal and inactive women aged 45-70 years will be randomized to a control group or an intervention group. Both groups will be given a standardized advice about physical activity. The intervention group will carry out a supervised 12-week programme of aerobic and muscle strengthening exercise; moreover, the women in this group will receive a Smartband to assist them in the intervention. The main result will be the increase of physical activity and the decrease of sedentary lifestyle, measured with an accelerometer for 1 week. This programme will be conducted by a nurse and a physiotherapist of the health centre. The study was approved by the Drug Research Ethics Committee of the Salamanca Health Service on 15 February 2019. The project was funded by the Autonomous Government of Castile and Leon and by the Carlos III Health Institute.

DISCUSSION

Physical activity is an important strategy to consider when addressing the changes caused by menopause, although the current evidence shows that further studies should be carried out with longer intervention periods and new technologies.

IMPACT

This study will allow determining the effectiveness of the intensive intervention based on a combined programme of physical activity using a Smartband in postmenopausal and inactive women.

TRIALS REGISTRATION

ClinicalTrials.gov with identifying code NCT03872258.

Effects of physical activity in muscle ultrasound evaluation of an older adult population – a pilot study

INTRODUCTION: Population aging has become an increasing challenge in society and inactive aging populations are especially challenging. OBJECTIVE: The main aim of this study is to conduct ultrasound evaluation of the effects of an intervention program on muscle architecture in older adults. METHODS: A total of thirty-four individuals of both sexes aged over 60 years were divided into two groups as follows: an intervention group (n = 18), who took part in a physical activity program for 8 weeks, three sessions per week, lasting approximately 20 min on each occasion, and a control group, whose members were encouraged to maintain their usual daily routines (outdoor aerobic exercise) (n = 16). Only six of the 18 participants from the intervention group were available for a second evaluation session. All the participants were submitted to bilateral quadriceps muscle ultrasound evaluations; thickness and echo-intensity of muscles were analyzed. RESULTS: Muscle thickness showed a significant negative correlation with age and echo-intensity showed a significant positive correlation with age. Echo-intensity showed a significant negative correlation with muscle thickness. Comparing the groups at the baseline evaluation, there were no significant differences between them (p < 0.05) for either measurement. CONCLUSIONS: We can highlight three points regarding post-intervention status in the intervention group: 1. There were significant differences in echo-intensity. It is therefore essential to establish early strategies to promote active aging, thus preventing dependence and inactivity in the older adult population; 2. Ultrasound is a good method for evaluating the musculoskeletal system and its changes in response to aging and physical activities; 3 Physical activities are important to maintain the muscles healthy and the older adult population independent.

Motivation theory-based physical activity programme for older adults in residential care facility: A modified Delphi and single-group pretest-posttest study

BACKGROUND

Physical inactivity exposes older adults living in long-term care institutions to a high risk of health deterioration. Developing effective behaviour change interventions based on a theoretical framework is a pressing concern.

AIMS

This study developed an 'Easy Walking' intervention programme based on the Wheel of Motivation and aimed to: (1) develop the intervention programme for promoting self-efficacy of older adults living in long-term care facilities; and (2) examine the perceived helpfulness of the intervention programme for encouraging walking behaviours.

METHODS

This study consisted of two stages. In the first stage, a three-round modified Delphi process was conducted with ten experts to rate the eight motivators in the Wheel of Motivation. The Easy Walking programme was designed accordingly. In the second stage, a single-group pretest-posttest study design was employed to evaluate the Easy Walking programme. Structured questionnaires were used to collect data on the changes in self-efficacy and on the perceived helpfulness regarding the programme.

RESULTS

The Easy Walking intervention programme features eight factors that influence motivation. Thirty older adults participated in and evaluated the programme. The results showed a significant difference in self-efficacy (t = -7.02, p < .001) of the older adults. Regarding the perceived usefulness of the intervention, the mean scores for each item ranged from 3.73 to 4.93 points. 'Safe environment' was perceived to be the most helpful factor for encouraging walking behaviours.

CONCLUSION

The Easy Walking programme enhanced the self-efficacy of institutionalised older adults and was perceived as helpful in physical activity engagement. Nursing professionals in long-term care institutions could implement the Easy Walking programme to be part of daily nursing activities.

Efficacy of a Culture-Specific Dancing Programme to Meet Current Physical Activity Recommendations in Postmenopausal Women

This study investigated the efficacy of participation in culture-specific dancing to meet current physical activity recommendations and increase cardio-respiratory fitness in postmenopausal women. Sedentary postmenopausal women (n = 24), aged 63 ± 8 years and with BMI of 28 ± 3 kg/m² completed a 4-week Scottish dancing study. The dancing sessions of approximately 75 min were performed twice a week and each session was based on five Scottish dances performed in 3 sets. Heart rate (HR) measurements were obtained during all dances to evaluate whether the intervention achieves the criteria of moderate to vigorous aerobic exercise intensity. Body composition, waist circumference, and HR during Chester Step test were measured before and after dancing intervention. HR achieved during individual dances ranged from 64 ± 5% to 80 ± 5% of HRmax and the mean HR of the five dances corresponded to 72 ± 7% of HRmax. Post-intervention mean HR was lower throughout Level 2 (Pre, 112 ± 13 bpm; Post, 106 ± 13 bpm; p = 0.005) and Level 3 (Pre, 122 ± 14 bpm; Post, 115 ± 14 bpm; p = 0.006) of the Chester test compared with baseline values. The intervention had no impact on body weight or body fat but reduced waist circumference (Pre, 94 ± 8 cm; Post, 91 ± 9 cm; p = 0.006). Thus, traditional Scottish dancing should be advocated to sedentary postmenopausal women, emphasising its potential in meeting current physical activity recommendations in relation of weekly duration and exercise intensity and improving cardiorespiratory fitness.

Study protocol of a randomized intervention study to explore effects of a pure physical training and a mind-body exercise on cognitive executive function in independent living adults age 65-85

BACKGROUND

Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to a significant burden for individuals, families, and the health care system. Executive functions are most susceptible to age-related decline. Despite the well-known benefits of regular exercise on cognitive health, older adults tend to be less physically active than other age groups. Thus, there is a need to identify strategies that attract older adults and can enhance cognitive vitality.

AIMS

This article describes the protocol of a study designed to evaluate whether two interventions, a pure physical exercise and a mind-body exercise, can improve cognitive executive function in independent-living older adults. In addition, the study will explore barriers/facilitators related to adherence.

METHODS

After baseline assessment, participants will be randomly assigned to one of three groups (strength training, Awareness Through Movement^®, or a control group). Participants of the two active groups will attend the interventions for 12 weeks. The control group continues with the usual everyday life. Assessments will include three measures of executive function of the NIH Toolbox, and are administered at baseline, post-intervention and at 3-month follow-up. The primary outcomes are the changes in cognitive executive function performances. Secondary outcomes include adherence, self-efficacy for exercise, symptoms of depression, mindfulness and enjoyment. Attendance will be used as a measure of adherence.

DISCUSSION AND CONCLUSION

If successful, the interventions could provide low-cost strategies for older adults to maintain cognitive vitality and has the potential to impact current exercise guidelines.

Effect of Aerobic Exercise Training and Essential Amino Acid Supplementation for 24 Weeks on Physical Function, Body Composition, and Muscle Metabolism in Healthy, Independent Older Adults: A Randomized Clinical Trial

BACKGROUND

Essential amino acids (EAA) and aerobic exercise (AE) acutely and independently stimulate skeletal muscle protein anabolism in older adults.

OBJECTIVE

In this Phase 1, double-blind, placebo-controlled, randomized clinical trial, we determined if chronic EAA supplementation, AE training, or a combination of the two interventions could improve muscle mass and function by stimulating muscle protein synthesis.

METHODS

We phone-screened 971, enrolled 109, and randomized 50 independent, low-active, nonfrail, and nondiabetic older adults (age 72 ± 1 years). We used a 2 × 2 factorial design. The interventions were: daily nutritional supplementation (15 g EAA or placebo) and physical activity (supervised AE training 3 days/week or monitored habitual activity) for 24 weeks. Muscle strength, physical function, body composition, and muscle protein synthesis were measured before and after the 24-week intervention.

RESULTS

Forty-five subjects completed the 24-week intervention. VO2peak and walking speed increased (p < .05) in both AE groups, irrespective of supplementation type, but muscle strength increased only in the EAA + AE group (p < .05). EAA supplementation acutely increased (p < .05) muscle protein synthesis from basal both before and after the intervention, with a larger increase in the EAA + AE group after the intervention. Total and regional lean body mass did not change significantly with any intervention.

CONCLUSIONS

In nonfrail, independent, healthy older adults AE training increased walking speed and aerobic fitness, and, when combined with EAA supplementation, it also increased muscle strength and EAA-stimulated muscle protein synthesis. These increases occurred without improvements in muscle mass.

Measurement System for Unsupervised Standardized Assessment of Timed "Up & Go" and Five Times Sit to Stand Test in the Community-A Validity Study

Comprehensive and repetitive assessments are needed to detect physical changes in an older population to prevent functional decline at the earliest possible stage and to initiate preventive interventions. Established instruments like the Timed "Up & Go" (TUG) Test and the Sit-to-Stand Test (SST) require a trained person (e.g., physiotherapist) to assess physical performance. More often, these tests are only applied to a selected group of persons already functionally impaired and not to those who are at potential risk of functional decline. The article introduces the Unsupervised Screening System (USS) for unsupervised self-assessments by older adults and evaluates its validity for the TUG and SST. The USS included ambient and wearable movement sensors to measure the user's test performance. Sensor datasets of the USS's light barriers and Inertial Measurement Units (IMU) were analyzed for 91 users aged 73 to 89 years compared to conventional stopwatch measurement. A significant correlation coefficient of 0.89 for the TUG test and of 0.73 for the SST were confirmed among USS's light barriers. Correspondingly, for the inertial data-based measures, a high and significant correlation of 0.78 for the TUG test and of 0.87 for SST were also found. The USS was a validated and reliable tool to assess TUG and SST.

The Mediating Effect of Different Exercise Programs on the Immune Profile of Frail Older Women with Cognitive Impairment

Background:

Frail individuals experience an accelerated immunosenescence, and exercise has been identified as a therapy to promote a better inflammatory environment.

Objective:

To analyze the effects of 28-weeks of two different exercise protocols on the functional fitness and immune profiles of institutionalized pre-frail and frail women with mild cognitive impairment.

Methods:

Participants residing in care homes (n=60, 81±7.84 years old) were randomized into three groups: a chair elastic band muscle-strength exercise (CSE, n=21; 81±4.79), a chair multimodal exercise (CME, n=20; 80±8.19), and a control non-exercise (CGne, n=19; 80±10.01). Both CME and CSE groups performed progressive circuit-training exercise sessions. The controls did not change their usual lifestyle. The Fried protocol and the Mini-Mental State Examination questionnaire were used to identify the frail subgroups and the participants with mild cognitive impairment. Data for anti and pro-inflammatory markers and physical fitness were analyzed pre and post-interventions.

Results:

After the intervention, a significant effect of time and time by group for sIgA and time by group for IL- 10 levels were found (p > 0.05). Within-group analysis showed a significant moderate decrease in the TNF-α to IL-10 ratio for the CME group and an increase in the controls (p > 0.05) and a slight reduction in the IL-6 and IL- 1β concentrations. The controls showed a negative trend towards a decrease in physical fitness and a trend for increased levels in the pro-inflammatory markers IL-6 and IL-1β.

Conclusions:

The evidence regarding the use of systematic and moderate long-term exercise as therapy for promoting a better balance between pro- and anti-inflammatory environments and a decrease in the inflammatory index for the CME group were the most promising results from this study.

Patient-Reported Outcome Measures (PROMs) to Support Adherence to Falls Prevention Clinic Recommendations: A Qualitative Study

PURPOSE

We examined how patient-reported outcome measures (PROMs) support patients' adherence to fall prevention recommendations in a novel primary care setting - the Falls Prevention Clinic.

PATIENTS AND METHODS

Using a patient-oriented qualitative study design, we recruited patient partners to our study team to assist in developing focus group prompts. A trained facilitator conducted five semi-structured interviews with a total of 21 Falls Prevention Clinic participants. A trained facilitator prompted participants about: their views on the EuroQol 5 domain - 5 level (EQ-5D-5L) PROM, their preferences for PROM administration and feedback, the presentation of PROM questionnaire data, the use of comparative data and the EQ-5D-5L in improving adherence to recommendations, and other information they would need to improve adherence. Participants' responses were coded according to three stages of qualitative analysis: open, axial and selective coding using an iterative and comparative approach.

RESULTS

"Opportunity" and "Development" emerged as higher-level themes for the participants' perspectives on how the EQ-5D-5L may be helpful for their appointments. "Frequency" described how often the participants believed the EQ-5D-5L should be administered and feedback provided. "Challenges", "Benefits", "Patients' Understanding", "Relevance of Data", and "Usefulness of Data" provided insight on how PROMs data presentation was viewed by patients. "Performance", "Resources", "Knowledge", "Role in Behaviour Change" highlighted the participants' ideas for the role of the EQ-5D-5L and additional information in supporting their adherence to falls prevention recommendations. Participants emphasized that patients would value further support information to facilitate their adherence.

CONCLUSION

This patient-oriented qualitative study, among individuals at high risk of future falls, sheds light on the importance of timely, understandable feedback, integrated with other clinical feedback in supporting adherence.

Effects of Different Dispositions of Resistance Exercises on Subjective Perception of Effort, Discomfort and Affectivity in Older Women

AbstractThe purpose of the study was to verify the effect of two dispositions of resistance exercises on rate of perceived of effort (RPE), discomfort and affectivity in older women. Twenty older women (68.0±6.6 years, 69.8±12.7 kg, and 155.9±7.0 cm) performed in a balanced and randomized design two experimental conditions, namely: a circuit (CIRC) fashion and another in a traditional (TRAD) fashion. In both conditions, six resistance exercises in the following order were performed: push press with kettlebell, swing with kettlebell, plantar flexion, squatting, ladder displacement and shoulder flexion with naval rope, with the same load and three sets of 15 repetitions/exercise. In the CIRC condition, the exercises were performed in stations, with no interval among them, and at the end of the last exercise, a three-minute interval was performed. For the TRAD condition the exercises were performed in consecutive sets, with intervals of 90s between the sets and the exercises. After 15 min of the closure of each session, the RPE (OMNI), feeling (Hardy and Rejeski) and a discomfort scale were applied. There was no significant difference (P>0.05) among  the sessions for PSE (TRAD = 6.0±1.2 vs. CIRC = 6.1±0.9), feeling (TRAD = 3.7±1.6 vs. CIRC = 3.6±1.2) and discomfort (TRAD = 5.2±1.4 vs. CIRC = 5.1±1.3). The results suggest that PSE, discomfort and affective response to resistance exercises are similar when performed in CIRC or TRAD in older women. Keywords: Exercise. Aging. Physical exertion. ResumoO objetivo do estudo foi verificar o efeito de duas diferentes disposições de execução de exercícios resistidos sobre a percepção subjetiva de esforço (PSE), o desconforto e a afetividade em mulheres idosas. Vinte mulheres idosas (68,0±6,6 anos, 69,8±12,7 kg e 155,9±7,0 cm) foram distribuídas de forma balanceada e aleatorizada para duas condições experimentais: disposição de circuito (CIRC) e disposição tradicional (TRAD). Em ambas as condições, seis exercícios resistidos foram executados na seguinte ordem: push press com kettlebell, swing com kettlebell, flexão plantar, agachamento, deslocamento em escada e flexão de ombros com corda naval, com mesma carga e três séries de 15 repetições/exercício. Na condição CIRC os exercícios foram executados em forma de estações, sem intervalo entre os exercícios e, ao final de cada série foi concedido intervalo de três minutos. Para condição TRAD os exercícios foram executados em séries consecutivas, com intervalos de 90s entre os exercícios e as séries. Após 15 min do termino de cada sessão foram aplicadas as escalas de PSE (OMNI), sentimento (Hardy e Rejeski) e desconforto. Não ocorreram diferenças significativas (P>0,05) entre as sessões para PSE (TRAD = 6,0±1,2 vs CIRC = 6,1±0,9), sentimento (TRAD = 3,7±1,6 vs CIRC = 3,6±1,2) e desconforto (TRAD = 5,2±1,4 vs CIRC = 5,1±1,3). Os resultados sugerem que a PSE, o desconforto e a resposta afetiva aos exercícios resistidos são semelhantes quando realizados em CIRC ou TRAD em mulheres idosas. Palavras-chave: Exercício Físico. Envelhecimento. Esforço Físico.

Effect of Yoga versus Light Exercise to Improve Well-Being and Promote Healthy Aging among Older Adults in Central India: A Study Protocol for a Randomized Controlled Trial

Background: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga’s effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60–80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied. Discussion: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences.Trial Registration: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.

Effects of yoga on well-being and healthy ageing: study protocol for a randomised controlled trial (FitForAge)

INTRODUCTION

Due to ageing populations worldwide, the burden of disability is increasing. It is therefore important to develop interventions that improve healthy ageing, reduce disability onset and enhance life quality. Physical activity can promote healthy ageing and help maintain independence, yet many older adults are inactive. Yoga is a form of physical activity that aims to improve health and may be particularly suitable for older adults. Research indicates positive effects of yoga on several health-related outcomes; however, empirical studies examining the benefits of yoga on well-being among the elderly remain scarce. This study protocol reports the methodology for a 12-week yoga programme aimed to improve health and well-being among physically inactive older adults.

METHODS AND ANALYSIS

Three group parallel, single-blind randomised controlled trial. Two comparison groups are included: aerobic exercise and a non-active wait-list control. In total, 180 participants aged 65-85 years will be recruited. Assessments will be performed at baseline and postintervention (12-week follow-up). The primary outcome is subjective well-being. Secondary outcomes include physical activity/sedentary behaviour, mobility/fall risk, cognition, depression, anxiety, mood, stress, pain, sleep quality, social support and cardiometabolic risk factors. Data will be analysed using intention-to-treat analyses, with mixed linear modelling.

ETHICS AND DISSEMINATION

This study is approved by the Ethical Review Board in Stockholm (2017/1862-31/2). All participants must voluntarily agree to participate and are free to withdraw from the study at any point. Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. A summary of key results will be publicly available through newspaper articles.

TRIAL REGISTRATION NUMBER

DRKS00015093, U1111-1217-4248.

Barriers to resistance training among college-aged women

OBJECTIVE

To examine resistance training (RT) barriers among college-aged women.

PARTICIPANTS

Female college students (n = 223) from a Midwestern university.

METHODS

Data were collected in September 2014. Participants completed a survey assessing demographics, current and past RT habits, and barriers to resistance training. Descriptive statistics were used to examine barrier agreement. Differences between current and past RT participation, residency, and class standing were analyzed.

RESULTS

A majority of participants were Caucasian (78.9%) and, on average, 19.7 ± 1.5 years of age; 52% participated in RT and 46.6% met RT recommendations. Women who did not report current RT participation reported significantly higher mean agreement with all barriers, compared to those who do RT. Highest agreement was observed within socially based barriers.

CONCLUSION

A majority of college-aged women are not meeting RT recommendations. Providing educational programs and avenues for finding same-sex RT partners may be most beneficial for overcoming common RT barriers.

Effect of resistance training with different frequencies and subsequent detraining on muscle mass and appendicular lean soft tissue, IGF-1, and testosterone in older women

OBJECTIVE

To analyse the effect of resistance training (RT) frequency on muscle mass, appendicular lean soft tissue, insulin-like growth factor 1 (IGF-1), testosterone, and their changes with detraining in older women.

METHODS

Forty-five physically independent older women (≥ 60 years) were randomly assigned to perform RT either two (G2X, n = 21) or three times/week (G3X, n = 24), during 12 weeks (8 exercises, 1 set of 10-15 repetition maximum). Muscle mass and appendicular lean soft tissue, IGF-1, testosterone, and dietary intake were measured at pre-training, post-training, and after detraining (12 weeks).

RESULTS

Muscle mass and appendicular lean soft tissue significantly increased post-training (G2X = +5.5% and G3X = +5.8%, P < .0001) with no differences between groups, and gains were retained after detraining (G2X = 100% and G3X = 99%, P < .0001). IGF-1 and dietary intake did not change for the groups during the study. Testosterone did not change post-training but significantly decreased after detraining (G2X = -21% and G3X = -50%, P < .0001).

CONCLUSION

We conclude that lower RT frequency is as effective as higher frequency to improve muscle mass and appendicular lean soft tissue, and to maintain testosterone and IGF-1. Additionally, detraining may reduce testosterone regardless of RT frequency. These results are specifically for community-dwelling older women and may not be generalized to other populations.

Chronic Effects of Resistance Training in Breast Cancer Survivors

Objective. To analyse effects of resistance training (RT) in breast cancer survivors (BCS) and how protocols and acute variables were manipulated. Methods. Search was made at PubMed, Science Direct, and LILACS. All articles published between 2000 and 2016 were considered. Studies that met the following criteria were included: written in English, Spanish, or Portuguese; BCS who have undergone surgery, chemotherapy, and/or radiotherapy; additional RT only; analysis of muscle performance, body mass composition (BMC), psychosocial parameters, or blood biomarkers. Results. Ten studies were included. PEDro score ranged from 5 to 9. Rest interval and cadence were not reported. Two studies reported continuous training supervision. All reported improvements in muscle strength, most with low or moderate effect size (ES), but studies performed with high loads presented large ES. Five described no increased risk or exacerbation of lymphedema. Most studies that analysed BMC showed no relevant changes. Conclusions. RT has been shown to be safe for BCS, with no increased risk of lymphedema. The findings indicated that RT is efficient in increasing muscle strength; however, only one study observed significant changes in BMC. An exercise program should therefore consider the manipulation of acute and chronic variables of RT to obtain optimal results.

Effects of a chair-yoga exercises on stress hormone levels, daily life activities, falls and physical fitness in institutionalized older adults

The aim of this study was to assess the changes mediated by exercise on activities of daily life and falls, physical fitness, salivary cortisol and alpha amylase in older adults living in social and health care givers centers.

METHODS

Sample consisted in 35 women (83.81 ± 6.6 years old) were divided into two groups: chair-yoga exercises group (CY, n = 20) and control group (CG, n = 15). All subjects were evaluated before and after 14-weeks. CY was involved in exercise classes two times per week, while the GC did not participate in any exercise.

RESULTS

Fear of falling decreased in both groups, cortisol increased and alpha-amylase decreased in the CG. No significant changes occurred in physical fitness outcomes.

CONCLUSION

CY practice was able to maintain the physical fitness scores and stress hormone levels, but was not able to improve the subject's perception on the ability to perform the instrumental activities of daily life.

Translating Strong for Life Into the Community Care Program: Lessons Learned

We used a randomized controlled trial to test the implementation of Strong for Life (SFL), a resistance exercise intervention, using 32 home care aides (HCAs) as exercise leaders with their 42 homebound older adult clients enrolled in the Community Care Program, a Medicaid 1915(c) waiver program. Mixed-methods were used to analyze outcomes of program satisfaction rates, training session evaluations, program fidelity, and job descriptive index scores. Results indicate that it is feasible for HCAs to implement SFL safely with clients. Participants viewed SFL as highly satisfactory and HCAs were able to adapt SFL for their clients. HCAs have high job satisfaction, and leading SFL enhances work achievement and pride. Our results show it is possible to train HCAs to implement SFL with their clients in addition to providing usual care services, participation positively affects both care partners, and this is a feasible and practical delivery model to provide exercise for adults receiving home- and community-based services.

Low- and High-Resistance Exercise: Long-Term Adherence and Motivation among Older Adults

BACKGROUND

In terms of motivation and long-term adherence, low-resistance exercise might be more suitable for older adults than high-resistance exercise. However, more data are needed to support this claim.

OBJECTIVE

The objective was to investigate the effect of low- and high-resistance exercise protocols on long-term adherence and motivation.

METHODS

This study was designed as an exploratory 24-week follow-up of a randomized 12-week resistance training intervention in older adults. Participants were free to decide whether or not they continued resistance training at their own expense following the intervention. Fifty-six older adults were randomly assigned to HIGH [2 × 10-15 repetitions at 80% of one repetition maximum (1RM)], LOW (1 × 80-100 repetitions at 20% of 1RM), or LOW+ (1 × 60 repetitions at 20% of 1RM + 1 × 10-20 repetitions at 40% 1RM). Motivation, self-efficacy and the perceived barriers for continuing resistance exercise were measured after cessation of each supervised intervention and at follow-up, while long-term adherence was probed retrospectively at follow-up.

RESULTS

Participants reported high levels of self-determined motivation before, during, and after the supervised intervention, with no differences between groups (p > 0.05). Nevertheless, only few participants continued strength training after the intervention: 17% in HIGH, 21% in LOW+, and 11% in LOW (p > 0.05). The most commonly reported barriers for continuing resistance exercise were perceived lack of time (46%), being more interested in other physical activities (40%), seasonal reasons (40%), and financial cost (28%).

CONCLUSION

The results suggest no difference in long-term adherence after the end of a supervised exercise intervention at high or low external resistances. Long-term adherence was limited despite high levels of self-determined motivation during the interventions. These findings highlight the importance of further research on developing strategies to overcome barriers of older adults to adhere to resistance exercise without supervision.

The change in motivating factors influencing commencement, adherence and retention to a supervised resistance training programme in previously sedentary post-menopausal women: a prospective cohort study

Background

Understanding motivators for exercise participation in post-menopausal women may impact retention to exercise programmes and inform intervention trial designs. The purpose of this investigation was to assess self-reported motivational factors influencing adherence and retention to a 24-week progressive resistance training programme.

Methods

Post-menopausal females (n = 34) were passively recruited to undertake a 24-week progressive resistance training protocol, in small-group sessions, on three non-consecutive days of the week. Attendance was recorded by the researcher. Qualitative reports were sourced from the sample for four phases of the study: pre-study (prior to week 1), recruitment (week 1), during study (weeks 2 – 24), and post-intervention (beyond week 24). Responses were categorised according to ten descriptors: specific health index improvement, education, flexibility of time, social contact, conscience (loyalty to the researcher), wellness, weight management, organisation parameters (pertaining to the study programme) and enjoyment of the exercises.

Results

Of the initial sample, 76.5% (n = 26) met the specified ≥80% attendance criterion. The primary findings were that motivation to volunteer for the study was driven by a perceived need for a structured exercise programme (50% of respondents). A commitment to the researcher was the primary motivator for continued adherence to the study for 50% of participants. Social contact with other participants was cited by 60% of the sample as the primary reason for adherence for the full duration of 24 weeks. A desire to maintain the “wellness” derived from the programme was cited by 60% as a reason for continuing an exercise routine post-study.

Conclusion

This study identified that routine and supervision initially attract women to exercise programmes, while social cohesion of the group setting contributes to retention over time. Understanding the changing nature of motivating factors may contribute to better overall adherence and retention to exercise programmes and interventions.

Sustainable effects of a low-threshold physical activity intervention on health-related quality of life in residential aged care

BACKGROUND

Mobility is a main issue for health-related quality of life in old age. There is evidence for effects of physical activity (PA) interventions on several dimensions of health for the aged and also, some specific evidence for vulnerable populations, like residents of residential aged care. Research on low-threshold PA interventions for users of residential aged care and documentation of their sustainability are scarce. "Low threshold" implies moderate demands on the qualification of trainers and low frequency of conduct, implying low demands on the health status and discipline of users. Yet the investigation of low-threshold interventions in residential aged care seems important as they might foster participation of users and implementation in everyday routines of provider organizations. An initial study (October 2011 to June 2012) had found intervention effects on health-related quality of life. The objective of this study was to examine sustainability of the effects of a low-threshold PA intervention on health-related quality of life in residential aged care.

METHODS

Data collection took place in three residential aged care homes in Vienna, Austria. At 1-year follow-up (June 2013), participants from the intervention group were interviewed using a standardized questionnaire. Using general mixed linear models and Friedman tests followed by paired t- and Wilcoxon signed-rank tests, we compared outcome measures at follow-up with measures obtained at baseline and at the end of the intervention.

RESULTS

At the 1-year follow-up assessment, participants' (mean age 84.7 years; 89.7% female) subjective health status was still significantly increased, equaling a small sustainable intervention effect (Cohen's d=0.38, P=0.02). In comparison with baseline, a significant decline of reported pain/discomfort (P=0.047) was found. Regarding the subdimensions of health-related quality of life, favorable trends could be observed.

CONCLUSION

The study indicates that effects of a low-threshold PA intervention on health-related quality of life in residential aged care can be sustainable. Addressing hindering factors like poor health status and implementing proactive support and individualization of the program to enable PA for residents might foster sustainability of effects.