The impact of an exercise intervention using low-cost equipment on functional fitness in the community-dwelling older adults: A pilot study

Effect of a 12-Week Strength Training Program on Muscle Strength Measures of Institutionalized Older Adults-A Pilot Study

Institutionalized older adults are characterized by high levels of dependence and low levels of physical activity compared to those living in the community. This combination of factors leads to an increased risk of loss of muscle mass. Sarcopenia can be countered through strength training. The aim of the present study was to evaluate the effect of a strength training program on the physical fitness of institutionalized older adults. This study included a sample of 31 institutionalized older adults (20 females, 11 males) aged between 65 and 96 years (M = 81.64, SD = 8.67). Participants reported an average institutionalization duration of 2.43 years (SD = 2.20), ranging from half a year to ten years. A 12-week strength training program was implemented, with sessions held twice a week. Strength fitness was assessed through the following parameters: handgrip strength, upper limb muscular endurance, lower limb muscular endurance, agility and balance, body mass index, and waist circumference. The results demonstrated that a 12-week strength training program improved physical fitness in terms of lower limb muscular endurance, upper limb muscular endurance, agility, and dynamic balance (p < 0.05).

The Impact of an Outdoor Motor-Cognitive Exercise Programme on the Health Outcomes of Older Adults in Community Settings: A Pilot and Feasibility Study

Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor-cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor-cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, ηp2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults.

Factors associated with balance impairments in the community-dwelling elderly in urban China

BACKGROUND

Identification of factors relevant to balance performance impairments in the elderly population was critical for developing effective interventions and preventions. However, there have been very limited data available based on large scale studies. The present study identified factors that independently contributed to performance impairments in overall balance, domains of static balance, postural stability, and dynamic balance, and individual items.

METHODS

A total of 1984 community-dwelling Chinese elderly from urban areas of Shanghai were recruited. Information on demographic characteristic, exercise, and health status were collected with a face-to-face interview. Balance performances were assessed on site by trained investigators based on the X16 balance testing scale. To identify the effectors, ordinal logistic regression analysis was applied for overall balance, static balance, postural stability, and dynamic balance. Binary logistic regression analysis was used for 16 items.

RESULTS

The community-dwelling elderly residents were aged from 60 to 97 years old. With increases of age, risks of impairments in overall balance increased gradually (ORs from 1.26 to 3.20, all P < 0.01). In the elderly with overweight and obesity, there was higher proportion of balance impairments compared to the elderly with normal BMI (OR = 1.26, P < 0.001). Regular exercise every week was associated with reduced risks of balance impairments (ORs from 0.63 to 0.73, all P < 0.001). Presences with vision lesion (ORs from 1.28 to 1.59, all P < 0.001), moderate hearing impairment (OR = 1.54, P < 0.001), somesthesis dysfunction (ORs from 1.59 to 13.26, all P < 0.001), and cerebrovascular disease (OR = 1.45, P = 0.001) were related to increased risks of balance impairments. Likewise, age, exercise, vision, hearing, somesthesis, and cerebrovascular disease were significantly associated with static balance, postural stability, and dynamic balance. Both overweight and obesity and underweight were associated with higher proportions of dynamic balance impairments. Regular exercise was significantly related to reduced risks of impairments in 15 out of the 16 items.

CONCLUSIONS

In the elderly, age, overweight and obesity, exercise, vision, hearing, somesthesia, and cerebrovascular disease were dominant factors associated with impairments in overall balance, domains of static balance, postural stability, and dynamic balance, and most individual items.

TRIAL REGISTRATION

Not applicable.

Anthropometric Measures, Muscle Resistance, and Balance in Physically Active, Aged Adults

OBJECTIVES

This study aimed to examine the relationship between age, body mass index, muscle strength, and balance in physically active, aged adults.

METHODS

Eighty-five participants were recruited for this study, having an average age of 70.31 years (SD = 9.90), ranging from 50 to 92 years. Twenty-six (30.6%) participants were male and fifty-nine (69.4%) were female. The participants had an average body mass index of 27.30 kg/m² (SD = 3.62), ranging from 20.32 to 38.58 kg/m². Participants undertook the Timed-Up and Go to test balance, and the chair-stand test to assess lower body strength. Hierarchical regression analyses were conducted. Three models (Model 1, 2, and 3) were tested to assess their relationships with balance: M1-Lower body muscle strength; M2-Lower body muscle strength and body mass index; M3-Lower body muscle strength, body mass index, and age.

RESULTS

All hierarchical models displayed significant variance. The third model explained 50.9% of the variance in dynamic balance, [F(3, 81) = 27.94, p < 0.001, R = 0.71, R_a² = 0.51]. The difference in R_a² between the first, second, and third models was statistically significant (p < 0.05). Age, body mass index, and lower body muscle strength had significant (p < 0.05) correlations with balance. In terms of the significant impact of each predictor, age had the strongest association with balance (p < 0.05).

CONCLUSIONS

The results are useful to understand mechanisms or diagnose people at risk of fall.

The Reliability of the Timed Up and Go Test among Portuguese Elderly

Assessment of dynamic balance is typically completed through functional tests, such as the Timed Up and Go (TUG) test, which measures the time it takes for an individual to stand up from a chair, walk a set distance, turn around, and sit back down. This test has been validated in several countries. However, in the Portuguese population there is a gap on testing the reliability of this functional test in a sample of the elderly both living in the community or in nursing homes. Thus, this study aimed at examining the reliability of the TUG in a sample of Portuguese elderly. An Intraclass Correlation Coefficient (ICC) analysis was performed between the first time (T1) and the time score after 16 weeks (T2) in TUG test by 38 males and 79 females aged between 60 and 92 years. The results showed acceptable scores of ICC in community-dwelling and nursing home resident elderly in both moments. In addition, significant differences were found between these groups of older adults, showing that community-dwelling elderly show greater agility and balance capacity compared to those living in nursing homes. Thus, the TUG test can be applied in the Portuguese elderly in both community-dwelling and nursing home resident elderly.

Motivational Correlates, Satisfaction with Life, and Physical Activity in Older Adults: A Structural Equation Analysis

Background: Motivation is a crucial factor in predicting health-related outcomes, and understanding the determinants of motivation can provide valuable insights into how to improve health behaviors and outcomes in older adults. In this study, we aimed to investigate the associations between intrinsic and extrinsic exercise motivation, basic psychological needs, satisfaction with life, and physical activity among the elderly population. Methods: The sample consisted of 268 older adults (59 male, 209 female) aged 65-90 years old (Mage = 68.11, SD = 6.95). All participants reported that they were exercising, on average, 1.65 days (SD = 0.51) per week. Factor analysis was conducted using a two-step approach. First, a confirmatory factor analysis and then a structural equation model considering all variables under analysis was performed. Results: the structural model displayed acceptable fit to the data: χ2/df = 3.093; CFI = 0.913; TLI = 0.908; SRMR = 0.071; RMSEA 0.079 [0.066, 0.092]. Significant direct effects were found as theoretically proposed, namely: (a) intrinsic motivation were positively and significantly associated with basic psychological need satisfaction (p < 0.001); (b) extrinsic motivation were negatively but not significantly associated with basic psychological needs (p < 0.001); and (c) basic psychological need satisfaction were positively and significantly associated with satisfaction with life (p < 0.001) and physical activity (p < 0.001). Conclusions: Intrinsic motivation and basic psychological needs play a crucial role in shaping exercise behavior and overall well-being. By understanding these motivation and needs, exercise and health professionals can work towards fulfilling them and achieving a greater sense of satisfaction in the life of the elderly and promote exercise adherence.

Effects of Muscle Strength, Agility, and Fear of Falling on Risk of Falling in Older Adults

Falls are a major public health problem among older adults because they lead to premature mortality, loss of autonomy, and increased dependence on others. However, these associations have not been explored using procedures that analyze the sequential effects between risk factors of falling. The present study aimed to examine the effects of muscle strength, agility, and fear of falling on risk of falling using path analysis in community-dwelling older adults. In total, 49 elderly (female = 33, male = 16) participants aged between 65 and 76 years (M = 68.38 years; SD = 6.22) were included for analysis. Muscle strength, agility, fear of falling, and risk of falling were assessed using validated instruments for the older adult population. The proposed model shows that muscle strength was negatively associated with agility. Consequently, agility was negatively associated with fear of falling. The same trend appeared between fear of falling and risk of falling. The effect sizes were between small and medium for agility (R² = 0.16), fear of falling, (R² = 0.29), and risk of falling (R² = 0.03). The main finding of the present study was that muscle strength was significantly correlated with agility, which, in turn, predicted fear of falling. Consequently, lower scores for fear of falling explained lower risk of falling in community-dwelling older adults. While muscle strength is a crucial component of physical fitness, only with adequate levels of agility can older adults possess the efficacy and ability to perform daily tasks.

Effects of a 24-Week Low-Cost Multicomponent Exercise Program on Health-Related Functional Fitness in the Community-Dwelling Aged and Older Adults

Background and Objectives: This study aimed to examine the effects of a low-cost multicomponent exercise program on health-related functional fitness in the community-dwelling aged and older adults. As a second objective, this study compared the exercise program between aged adults (<65 years) and those considered elderly (≥65 years). Materials and Methods: Forty-eight participants were included in the exercise program, and their mean age was 64.73 years (±5.93 years). The Senior Fitness Tests were performed by each participant. A dynamometer was used to assess hand grip strength, and body composition was assessed considering the body mass index. Paired-sample t test was used to compare data at baseline and after the exercise program, considering the total sample. Afterwards, a 2 × 2 analysis of variance was used to examine differences within and between groups. Results: Statistically significant improvements in the chair stand (t = -14.06; p < 0.001; d = 0.42), arm curl (t = -12.10; p < 0.001; d = 0.58), 2 min step test (t = -9.41; p < 0.001; d = 0.24), timed up and go test (t = 5.60; p < 0.001; d = 0.19), and hand grip strength (t = -3.33; p < 0.001; d = 0.15) were observed. There were also significant differences in the back scratch (t = -6.68; p < 0.001; d = 0.18) and chair sit and reach test (t = 5.04; p < 0.001; d = 0.05), as well as body mass index (p < 0.05). No significant differences were found between groups (p > 0.05). Conclusion: This study provides evidence that a 24-week low-cost community-based exercise program can improve functional fitness in aged and in older adults. The exercise program supplied the necessary data to construct further randomized controlled trials that can be performed in the community in an environmentally sustainable fashion and applied, not only to the elderly, but also to those transitioning to this age group.