Muscle strengthening activities and mortality with considerations by hearing sensitivity

Assessment of muscle-strengthening exercise in public health surveillance for adults: A systematic review

There is strong scientific evidence that muscle-strengthening exercise (i.e. use of weight machines, push-ups, sit-ups) is independently associated with a reduced risk of multiple chronic diseases (e.g. diabetes, hypertension, cardiovascular disease). However, prevalence rates for meeting the muscle-strengthening exercise guideline (≥2 times/week) are significantly lower (~20%) than those reported to meet the aerobic physical activity guideline (e.g. walking, jogging, cycling) (~50%). It is therefore important to understand public health surveillance approaches to assess muscle-strengthening exercise. The aim of this review was to describe muscle-strengthening exercise assessment in public health surveillance. Informed by the PRISMA guidelines, an extensive keyword search was undertaken across 7 electronic data bases. We identified 86,672 possible articles and following screening (n = 1140 in full-text) against specific inclusion criteria (adults aged ≥18 years, English, studies containing <1000 participants), extracted data from 156 manuscripts. Fifty-eight different survey systems were identified across 17 countries. Muscle-strengthening exercise frequency (85.3%), duration (23.7%) and intensity (1.3%) were recorded. Muscle-strengthening exercise questions varied significantly, with some (11.5%) requiring a singular 'yes' vs 'no' response, while others (7.7%) sought specific details (e.g. muscle groups targeted). Assessments of duration and intensity were inconsistent. Very few studies measured the validity (0.6%) and reliability (1.3%) of muscle-strengthening exercise questions. Discrepancy exists within the current assessment systems/surveys used to assess muscle-strengthening exercise in public health surveillance. This is likely to impede efforts to identify at risk groups and trends within physical activity surveillance, and to accurately assess associations between muscle-strengthening exercise and health-related outcomes.

Walk, Talk and Listen: a pilot randomised controlled trial targeting functional fitness and loneliness in older adults with hearing loss

BACKGROUND

Age-related hearing loss (HL) is a prevalent disability associated with loneliness, isolation, declines in cognitive and physical function and premature mortality. Group audiological rehabilitation (GAR) and hearing technologies address communication and cognitive decline. However, the relationship between loneliness, physical function and GAR among older adults with HL has not been studied.

OBJECTIVES

Explore the impact of a group exercise and socialisation/health education intervention and GAR on physical function and loneliness among older adults with HL.

TRIAL DESIGN

A Young Men's Christian Association (YMCA)-based, 10-week, single-blind, pilot randomised controlled trial (RCT).

PARTICIPANTS

Ambulatory adults aged 65 years or older with self-reported HL.

INTERVENTIONS

Seventy-one participants were screened. Thirty-five were randomised to intervention (strength and resistance exercise, socialisation/health education) and GAR (hearing education, communication strategies, psychosocial support) or control (n=31): GAR only.

OUTCOMES

Ninety-five per cent of eligible participants were randomised. GAR and exercise adherence rates were 80% and 85%, respectively. 88% of participants completed the study. Intervention group functional fitness improved significantly (gait speed: effect size: 0.57, 30 s Sit to Stand Test: effect size: 0.53). Significant improvements in emotional and social loneliness (effect size: 1.16) and hearing-related quality of life (effect size: 0.76) were related to GAR attendance and poorer baseline hearing-related quality of life. Forty-two per cent of participants increased social contacts outside the study.

DISCUSSION

Walk, Talk and Listen was feasible and acceptable. Exercise and socialisation/health education improved loneliness and key fitness measures but provided no additional benefit to GAR only for loneliness. This is the first preliminary evidence about the benefits of exercise on fitness and GAR on loneliness among older adults with HL.

IMPLICATIONS

This pilot trial provides key information on the sample size required for a larger, longer term RCT to determine the enduring effects of this holistic intervention addressing the negative psychosocial and musculoskeletal downstream effects of HL among older adults.

Targeting the psychosocial and functional fitness challenges of older adults with hearing loss: a participatory approach to adaptation of the walk and talk for your life program

OBJECTIVE

Explore the acceptability of a socialisation, health education and falls prevention programme (Walk and Talk for Your Life: WTL) as an adjunct to group auditory rehabilitation (GAR) and how it might be adapted for older adults with hearing loss (HL).

DESIGN

Content theme analysis (CTA) of guided interviews explored the experience of HL, the acceptability of a WTL programme and suggestions on how to adapt the WTL programme to better suit the needs of older adults with HL.

STUDY SAMPLE

Twenty-eight (20 women, 8 men) adults (>55 years of age) with HL were interviewed. Seventeen had participated in past WTL programmes and eleven were sampled from the community.

RESULTS

Interviewees reported difficulty socialising and a tendency to withdraw from social interactions. Addition of GAR to a WTL programme was found to be highly acceptable. Interviewees suggested that to best suit their needs, sessions should take place in a location with optimal acoustics; include small groups integrating hearing-impaired and hearing-intact participants; include appropriate speaking ground rules; and include an option for partner involvement.

CONCLUSIONS

The adapted WTL programme provides a holistic and unique approach to the treatment of HL that has the potential to positively impact the hearing-impaired elderly.

Relationship Between Objectively Measured Physical Activity, Cardiovascular Disease Biomarkers, and Hearing Sensitivity Using Data From the National Health and Nutrition Examination Survey 2003-2006

PURPOSE

Limited research has examined the interrelationships among cardiometabolic parameters, physical activity, and hearing function, which was this study's purpose.

METHOD

Data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 were used in the path analyses. Physical activity and hearing function were both objectively measured. Various cardiometabolic parameters were assessed from a blood sample. Adults 30-85 years (N = 1,070) constituted the analytic sample.

RESULTS

Physical activity was negatively associated with triglycerides (β = -0.11, p < .05) and insulin (β = -0.27, p < .05); triglycerides (β = 0.01, p < .05), and insulin (β = 0.05, p < .05) were positively associated with high-frequency pure-tone average (HPTA). The direct path from physical activity to HPTA was nonsignificant (β = 0.01, p = .99).

CONCLUSION

Physical activity was associated with select cardiovascular disease risk factors. Several cardiovascular disease risk factors were associated with hearing function.

A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training

It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally 'aerobic' (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in 'muscle strengthening activities' though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.

Targeting functional fitness, hearing and health-related quality of life in older adults with hearing loss: Walk, Talk 'n' Listen, study protocol for a pilot randomized controlled trial

BACKGROUND

Hearing loss (HL) is a disability associated with poorer health-related quality of life including an increased risk for loneliness, isolation, functional fitness declines, falls, hospitalization and premature mortality. The purpose of this pilot trial is to determine the feasibility and acceptability of a novel intervention to reduce loneliness, improve functional fitness, social connectedness, hearing and health-related quality of life in older adults with HL.

METHODS

This 10-week, single-blind, pilot randomized control trial (RCT) will include a convenience sample of ambulatory adults aged 65 years or older with self-reported HL. Following baseline assessments, participants will be randomized to either intervention (exercise, health education, socialization and group auditory rehabilitation (GAR)) or control (GAR only) groups. The intervention group will attend a local YMCA twice a week and the control group once a week. Intervention sessions will include 45 min of strengthening, balance and resistance exercises, 30 min of group walking at a self-selected pace and 60 min of interactive health education or GAR. The control group will attend 60-min GAR sessions. GAR sessions will include education about hearing, hearing technologies, enhancing communication skills, and psychosocial support. Pre-post trial data collection and measures will include: functional fitness (gait speed, 30-s Sit to Stand Test), hearing and health-related quality of life, loneliness, depression, social participation and social support. At trial end, feasibility (recruitment, randomization, retention, acceptability) and GAR will be evaluated.

DISCUSSION

Despite evidence suggesting that HL is associated with declines in functional fitness, there are no studies aimed at addressing functional fitness declines associated with the disability of HL. This pilot trial will provide knowledge about the physical, mental and social impacts on health related to HL as a disability. This will inform the feasibility of a larger RCT and preliminary evidence about the initial effects of a novel, community-based, holistic intervention addressing both the negative psychosocial and functional physical effects of HL among older adults.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02662192 . Registered on 14 January 2016.

Effect of physical activity on mortality risk among Americans with retinopathy

Background: Previous work demonstrates that retinopathy is associated with increased mortality risk, with physical activity inversely associated with retinopathy and all-cause mortality. However, no study has evaluated the effects of physical activity on mortality among those with existing retinopathy, which was this study’s purpose.

Methods: Data from the 2005-2006 National Health and Nutrition Examination Survey were utilized, with follow-up through 2011. Retinopathy was objectively-measured using the Canon Non-Mydriatic Retinal Camera CR6-45NM. Physical activity was objectively-measured via up to 7 days of accelerometry assessment.

Results: Six-hundred and seventy one adults (40-85 years) with complete data on the study variables constituted the analytic sample. During the follow-up period, 91 deaths occurred. In the sample, 35 886 person-months occurred with a mortality incidence rate of 2.5 deaths per1000 person-months. Among participants with mild retinopathy, those who met physical activity guidelines at baseline had a 63% reduced risk of all-cause mortality (HR _adjusted = 0.37; 95% CI:0.18-0.75; P = 0.007). Notably, physical activity was not associated with mortality risk among those with moderate/severe retinopathy (HR _adjusted = 0.371.72; 95% CI: 0.62-4.76; P = 0.27).

Conclusion: Physical activity is associated with reduced mortality risk among those with mild retinopathy, but not among those with moderate/severe retinopathy.