Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the "On the Move" group exercise program in community-dwelling older adults.

PubMed

Brach, Jennifer S; Perera, Subashan; Gilmore, Sandra; VanSwearingen, Jessie M; Brodine, Deborah; Wert, David; Nadkarni, Neelesh K; Ricci, Edmund

2016-09-01

Group exercise programs for older adults often exclude the timing and coordination of movement. Stakeholder involvement in the research process is strongly encouraged and improves the relevance and adoption of findings. We describe stakeholder involvement in the design of a clinical trial of a group-based exercise program that incorporates timing and coordination of movement into the exercises. The study was a cluster randomized, single-blind intervention trial to compare the effects on function, disability and mobility of a standard group exercise program and the "On the Move" group exercise program in older adults residing in independent living facilities and senior apartment buildings, and attending community centers. Exercise classes were twice weekly for 12weeks delivered by study exercise leaders and facility activity staff personnel. The primary outcomes function, disability and mobility were assessed at baseline and post-intervention. Function and disability were assessed using the Late Life Function and Disability Instrument, and mobility using the Six-Minute Walk Test and gait speed. Patient and provider stakeholders had significant input into the study aims, design, sample, intervention, outcomes and operational considerations. A community-based exercise program to improve walking can be developed to address both investigator identified missing components in current exercise to improve walking and stakeholder defined needs and interest for the activity program. Involvement of stakeholders substantially improves the relevance of research questions, increases the transparency of research activities and may accelerate the adoption of research into practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the “On the Move” group exercise program in community-dwelling older adults

PubMed Central

Brach, Jennifer S.; Perera, Subashan; Gilmore, Sandra; VanSwearingen, Jessie M.; Brodine, Deborah; Wert, David; Nadkarni, Neelesh K.; Ricci, Edmund

2016-01-01

Background Group exercise programs for older adults often exclude the timing and coordination of movement. Stakeholder involvement in the research process is strongly encouraged and improves the relevance and adoption of findings. We describe stakeholder involvement in the design of a clinical trial of a group-based exercise program that incorporates timing and coordination of movement into the exercises. Methods The study was a cluster randomized, single-blind intervention trial to compare the effects on function, disability and mobility of a standard group exercise program and the “On the Move” group exercise program in older adults residing in independent living facilities and senior apartment buildings, and attending community centers. Exercise classes were twice weekly for 12 weeks delivered by study exercise leaders and facility activity staff personnel. Outcomes The primary outcomes function, disability and mobility were assessed at baseline and post-intervention. Function and disability were assessed using the Late Life Function and Disability Instrument, and mobility using the Six-Minute Walk Test and gait speed. Stakeholders Patient and provider stakeholders had significant input into the study aims, design, sample, intervention, outcomes and operational considerations. Summary A community-based exercise program to improve walking can be developed to address both investigator identified missing components in current exercise to improve walking and stakeholder defined needs and interest for the activity program. Involvement of stakeholders substantially improves the relevance of research questions, increases the transparency of research activities and may accelerate the adoption of research into practice. PMID:27521806

Phase II randomised controlled trial of a 6-month self-managed community exercise programme for people with Parkinson's disease.

PubMed

Collett, Johnny; Franssen, Marloes; Meaney, Andy; Wade, Derick; Izadi, Hooshang; Tims, Martin; Winward, Charlotte; Bogdanovic, Marko; Farmer, Andrew; Dawes, Helen

2017-03-01

Evidence for longer term exercise delivery for people with Parkinson's disease (PwP) is deficient. Evaluate safety and adherence to a minimally supported community exercise intervention and estimate effect sizes (ES). 2-arm parallel phase II randomised controlled trial with blind assessment. PwP able to walk ≥100 m and with no contraindication to exercise were recruited from the Thames valley, UK, and randomised (1:1) to intervention (exercise) or control (handwriting) groups, via a concealed computer-generated list. Groups received a 6-month, twice weekly programme. Exercise was undertaken in community facilities (30 min aerobic and 30 min resistance) and handwriting at home, both were delivered through workbooks with monthly support visits. Primary outcome was a 2 min walk, with motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale, MDS-UPDRS III), fitness, health and well-being measured. Between December 2011 and August 2013, n=53 (n=54 analysed) were allocated to exercise and n=52 (n=51 analysed) to handwriting. N=37 adhered to the exercise, most attending ≥1 session/week. Aerobic exercise was performed in 99% of attended sessions and resistance in 95%. Attrition and adverse events (AEs) were similar between groups, no serious AEs (n=2 exercise, n=3 handwriting) were related, exercise group-related AEs (n=2) did not discontinue intervention. Largest effects were for motor symptoms (2 min walk ES=0.20 (95% CI -0.44 to 0.45) and MDS-UPDRS III ES=-0.30 (95% CI 0.07 to 0.54)) in favour of exercise over the 12-month follow-up period. Some small effects were observed in fitness and well-being measures (ES>0.1). PwP exercised safely and the possible long-term benefits observed support a substantive evaluation of this community programme. NCT01439022. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

PubMed

Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (p<0.05). Video conferencing-based supervised resistance exercise had positive effects on sarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly. Copyright © 2016 Elsevier Inc. All rights reserved.

Self-perceived health status and sleep quality of older adults living in community after elastic band exercises.

PubMed

Chan, Shu-Ya; Chen, Kuei-Min

2017-07-01

To test the effectiveness of a six-month senior elastic band exercise programme on the self-perceived health status and sleep quality of older adults living in community settings. Health issues common among older adults living in community settings include poor physical and mental health conditions and sleep quality. Engagement in appropriate exercise programmes facilitates alleviating these health issues among older adults. A quasi-experimental design was applied. A convenience sample of older adults was drawn from six senior-citizen activity centres in southern Taiwan. Participants were assigned to either an experimental group (three centres, n = 97) or a control group (three centres, n = 102) based on the senior-citizen activity centres they attended. The participants in the experimental group carried out the Senior Elastic Band exercise programme for six months (three times per week and 40 minutes per session) in addition to their daily activities. The participants in the control group maintained their daily activities. The participants' self-perceived health status and sleep quality were examined at the baseline, three-month interval and six-month interval. In total, 169 participants completed the six-month study: 84 constituted the experimental group and 85 constituted the control group. At the three-month interval, the participants in the experimental group had greater improvements in self-perceived physical health, overall sleep quality, sleep latency and sleep duration compared with those in the control group; these significant changes continued throughout the six-month study. The Senior Elastic Band exercise programme showed promising effects in improving the self-perceived physical health and sleep quality of older adults living in community settings. Healthcare professionals can incorporate the Senior Elastic Band exercise programme as one of the health promotion activities for older adults living in community settings. © 2016 John Wiley & Sons Ltd.

Study of the effects of multimodal exercise program on physical fitness and health perception in community-living Hungarian older adults.

PubMed

Virág, Anikó; Harkányi, Izabella; Karóczi, Csilla K; Vass, Zsolt; Kovács, Éva

2018-05-01

The aim of this study was to investigate the effects on fitness indicators and subjective health-perception of a multimodal exercise program provided by a district in Budapest among community-living seniors. Sixty community-living older adults aged over 60 years formed beginner group (who were at the beginning of the exercise program), advanced group (who had been in the programme for 3-6 months), active group (who had been participating in the exercise program for at least 6 months, in addition to Nordic walking program) and a physically inactive control group. Balance, functional mobility, lower and upper limb strength, lower and upper body flexibility, aerobic endurance and self-reported health perception were measured at baseline, and after a 12-week follow-up period. The beginner group and the advanced group improved in upper body flexibility (beginner Δ=1.2; d=0.83; advanced: Δ=1.7; d=1.39), lower body flexibility (beginner: Δ=1.7, d=0.484; advanced: Δ=1.9; d=1.55), lower limb strength (beginner: Δ=1.47; d=0.84; advanced: Δ=1.57; d=0.72), and functional mobility (beginner: Δ=-0.6; d=0.54; advanced: Δ=-0.4; d=0.90). There were also improvements in aerobic endurance (Δ=11.06; d=0.96) and balance (Δ=1.6; d=0.62) of beginner group. These indicators declined in the control group. Indicators of the active group did not change. The self-perceived health status declined (Δ=-13.9; d=0.73) in the control group but did not change in any exercising groups. This multimodal exercise program can be effective among community-living older adults, even in Hungary, a country where geriatric physical activity is not widespread. Therefore, it would be useful to extend this model program to other settlements as well.

Effects of a Behavioral and Exercise Program on Depression and Quality of Life in Community-Dwelling Older Adults: A Controlled, Quasi-Experimental Study.

PubMed

Azizan, Azilyana; Justine, Maria

2016-02-01

Sedentary behavior and low participation in exercise among older adults can lead to depression and low quality of life (QOL). The current study investigated the effects of behavioral and exercise programs on depression severity and QOL among Malaysian community-dwelling older adults. A controlled, quasi-experimental, pre-posttest design was used. A total of 63 participants were divided into three groups: (a) exercise and behavior group (EBG), (b) exercise only group (EG), and (c) control group (CG). Results showed a significant difference in depression among groups (F(2,58) = 33.49, p < 0.01, η(2) = 0.54; mean, EBG < EG < CG) and in physical (F(2,58) = 5.33, p < 0.01, η(2)= 0.16; mean, EBG > EG > CG) and mental (F(2,58) = 4.08, p < 0.01, η(2) = 0.12; mean, EBG > CG > EG) scores of QOL. A combination of behavioral and exercise programs has superior effects on depression and QOL of older adults. [Journal of Gerontological Nursing, 42(2), 45-54.]. Copyright 2016, SLACK Incorporated.

A pilot diabetes awareness and exercise programme in a multiethnic workforce.

PubMed

Simmons, D; Fleming, C; Cameron, M; Leakehe, L

1996-10-11

To evaluate the acceptability and impact of a pilot diabetes awareness and exercise programme in a mainly Polynesian workforce. Comparison of change in questionnaire and anthropometric measurements in two hospital ancillary workforces. One group (n = 108) received one community diabetes educator presentation, one video presentation and a 4 month exercise programme. The other group (n = 99) served as controls. Baseline diabetes knowledge was poor (total score 26 (SD 13%)) and subjects were largely unfit with a high body mass index (31.5 (7.1) kg/m2). The exercise sessions were well attended, although attendance declined over the 4 months. Increased diabetes knowledge was retained in the intervention group after 6 months when compared with controls (total score 35(14)% vs 26(12)% respectively, p < 0.001). One month after the termination of the programme, the proportion reporting regular exercise activity (at least 30 minutes for 3 days per week) had increased by 2% in the intervention group but declined by 9% in the control group (p < 0.05). Diabetes knowledge and exercise can be increased in unfit subjects by the combination of culturally tailored exercise techniques and community diabetes educator/video presentations.

Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial.

PubMed

Oh, SeJun; Lim, Jong-Min; Kim, Yushin; Kim, MinSeock; Song, WoonGang; Yoon, BumChul

2015-01-01

The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life (QOL) in community-dwelling elderly people with history of falling. Participants were randomly assigned to the water-based exercise group (n=34) or land-based exercise groups (n=32). To identify the effects on physical functions, muscle strength, flexibility, and mobility were measured. QOL and fear of falling were evaluated using the Short Form 36-item questionnaire and the modified falls efficacy scale (M-FES). The measurements were performed before and after the 10-week training period. Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups (p=0.005; p=0.007). However, no statistically significant within-group differences were found in the back scratch test (p=0.766) and chair sit-and-reach test (p=0.870). QOL was significantly different in both groups (health transition: p=0.014, physical functioning: p<0.001, role physical: p<0.001, role emotional: p=0.002, bodily pain: p<0.001, vitality: p<0.001, and mental health: p<0.001). There was a significant difference in the M-FES in both groups (p=0.040). These results indicate that water-based exercises are beneficial to improve the QOL, as well as physical activities, of community-dwelling elderly compared with land-based exercise. Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

PubMed Central

Liu, Chiung-ju; Xu, Huiping; Keith, NiCole R; Clark, Daniel O

2017-01-01

Background Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone. Methods A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50–60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion. Results At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =−0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01). Conclusion Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults. PMID:28769559

Association between exercise habits and subcortical gray matter volumes in healthy elderly people: A population-based study in Japan.

PubMed

Yamamoto, Mikie; Wada-Isoe, Kenji; Yamashita, Fumio; Nakashita, Satoko; Kishi, Masafumi; Tanaka, Kenichiro; Yamawaki, Mika; Nakashima, Kenji

2017-06-01

The relationship between exercise and subcortical gray matter volume is not well understood in the elderly population, although reports indicate that exercise may prevent cortical gray matter atrophy. To elucidate this association in the elderly, we measured subcortical gray matter volume and correlated this with volumes to exercise habits in a community-based cohort study in Japan. Subjects without mild cognitive impairment or dementia (n = 280, 35% male, mean age 73.1 ± 5.9 years) were evaluated using the Mini-Mental State Examination (MMSE), an exercise habit questionnaire, and brain magnetic resonance imaging. Subcortical gray matter volume was compared between groups based on the presence/absence of exercise habits. The MMSE was re-administered 3 years after the baseline examination. Ninety-one subjects (32.5%) reported exercise habits (exercise group), and 189 subjects (67.5%) reported no exercise habits (non-exercise group). Volumetric analysis revealed that the volumes in the exercise group were greater in the left hippocampus (p = 0.042) and bilateral nucleus accumbens (left, p = 0.047; right, p = 0.007) compared to those of the non-exercise group. Among the 195 subjects who received a follow-up MMSE examination, the normalized intra-cranial volumes of the left nucleus accumbens (p = 0.004) and right amygdala (p = 0.014)showed significant association with a decline in the follow-up MMSE score. Subjects with exercise habits show larger subcortical gray matter volumes than subjects without exercise habits in community-dwelling elderly subjects in Japan. Specifically, the volume of the nucleus accumbens correlates with both exercise habits and cognitive preservation.

Effect of aerobic exercise on physical performance in patients with Alzheimer's disease.

PubMed

Sobol, Nanna Aue; Hoffmann, Kristine; Frederiksen, Kristian Steen; Vogel, Asmus; Vestergaard, Karsten; Brændgaard, Hans; Gottrup, Hanne; Lolk, Annette; Wermuth, Lene; Jakobsen, Søren; Laugesen, Lars; Gergelyffy, Robert; Høgh, Peter; Bjerregaard, Eva; Siersma, Volkert; Andersen, Birgitte Bo; Johannsen, Peter; Waldemar, Gunhild; Hasselbalch, Steen Gregers; Beyer, Nina

2016-12-01

Knowledge about the feasibility and effects of exercise programs to persons with Alzheimer's disease is lacking. This study investigated the effect of aerobic exercise on physical performance in community-dwelling persons with mild Alzheimer's disease. The single blinded multi-center RCT (ADEX) included 200 patients, median age 71 yrs (50-89). The intervention group received supervised moderate-to-high intensity aerobic exercise 1 hour × 3/week for 16 weeks. Assessments included cardiorespiratory fitness, single-task physical performance, dual-task performance and exercise self-efficacy. Significant between-group differences in change from baseline (mean [95%CI]) favored the intervention group for cardiorespiratory fitness (4.0 [2.3-5.8] ml/kg/min, P <0.0001) and exercise self-efficacy (1.7 [0.5-2.8] points, P =0.004). Furthermore, an exercise attendance of ≥66.6% resulted in significant positive effects on single-task physical performance and dual-task performance. Aerobic exercise has the potential to improve cardiorespiratory fitness, single-task physical performance, dual-task performance and exercise self-efficacy in community-dwelling patients with mild Alzheimer's disease. Copyright © 2016 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Community-based walking exercise for peripheral artery disease: An exploratory pilot study

PubMed Central

Mays, Ryan J; Hiatt, William R; Casserly, Ivan P; Rogers, R Kevin; Main, Deborah S; Kohrt, Wendy M; Ho, P Michael; Regensteiner, Judith G

2016-01-01

Supervised walking exercise is an effective treatment to improve walking ability of patients with peripheral artery disease (PAD), but few exercise programs in community settings have been effective. The aim of this study was to determine the efficacy of a community-based walking exercise program with training, monitoring, and coaching (TMC) components to improve exercise performance and patient-reported outcomes in PAD patients. This was a randomized, controlled trial including PAD patients who previously received peripheral endovascular therapy or presented with stable claudication. Patients randomized (n=25) to the intervention group received a comprehensive community-based walking exercise program with elements of TMC over 14 weeks. Patients in the control group did not receive treatment beyond standard advice to walk. The primary outcome in the intent-to-treat (ITT) analyses was peak walking time (PWT) on a graded treadmill. Secondary outcomes included claudication onset time (COT) and patient-reported outcomes assessed via the Walking Impairment Questionnaire (WIQ). Intervention group patients (n=10) did not significantly improve PWT when compared with the control group patients (n=10) (mean±standard error: +2.1±0.7 vs. 0.0±0.7 min, p=0.052). Changes in COT and WIQ scores were greater for intervention patients compared with control patients (COT: +1.6±0.8 vs. −0.6±0.7 min, p=0.045; WIQ: +18.3±4.2 vs. −4.6±4.2%, p=0.001). This pilot using a walking program with TMC and an ITT analyses did not improve the primary outcome in PAD patients. Other walking performance and patient self-reported outcomes were improved following exercise in community settings. Further study is needed to determine whether this intervention improves outcomes in a trial employing a larger sample size. PMID:25755148

Effects of music aerobic exercise on depression and brain-derived neurotrophic factor levels in community dwelling women.

PubMed

Yeh, Shu-Hui; Lin, Li-Wei; Chuang, Yu Kuan; Liu, Cheng-Ling; Tsai, Lu-Jen; Tsuei, Feng-Shiou; Lee, Ming-Tsung; Hsiao, Chiu-Yueh; Yang, Kuender D

2015-01-01

A randomized clinical trial was utilized to compare the improvement of depression and brain-derived neurotrophic factor (BDNF) levels between community women with and without music aerobic exercise (MAE) for 12 weeks. The MAE group involved 47 eligible participants, whereas the comparison group had 59 participants. No significant differences were recorded in the demographic characteristics between the participants in the MAE group and the comparison group. Forty-one participants in the MAE group and 26 in the comparison group completed a pre- and posttest. The MAE group displayed significant improvement in depression scores (p = 0.016), decreased depression symptoms in crying (p = 0.03), appetite (p = 0.006), and fatigue (p = 0.011). The BDNF levels of the participants significantly increased after the 12-week MAE (p = 0.042). The parallel comparison group revealed no significant changes in depression scores or BDNF levels. In summary, the 12-week MAE had a significant impact on the enhancement of BDNF levels and improvement of depression symptoms. Middle-aged community women are encouraged to exercise moderately to improve their depression symptoms and BDNF levels.

Beet Root Juice: An Ergogenic Aid for Exercise and the Aging Brain.

PubMed

Petrie, Meredith; Rejeski, W Jack; Basu, Swati; Laurienti, Paul J; Marsh, Anthony P; Norris, James L; Kim-Shapiro, Daniel B; Burdette, Jonathan H

2017-09-01

Exercise has positive neuroplastic effects on the aging brain. It has also been shown that ingestion of beet root juice (BRJ) increases blood flow to the brain and enhances exercise performance. Here, we examined whether there are synergistic effects of BRJ and exercise on neuroplasticity in the aging brain. Peak metabolic equivalent (MET) capacity and resting-state magnetic resonance imaging functional brain network organization are reported on 26 older (mean age = 65.4 years) participants randomly assigned to 6 weeks of exercise + BRJ or exercise + placebo. Somatomotor community structure consistency was significantly enhanced in the exercise + BRJ group following the intervention (MBRJ = -2.27, SE = 0.145, MPlacebo = -2.89, SE = 0.156, p = .007). Differences in second-order connections between the somatomotor cortex and insular cortex were also significant; the exercise + BRJ group (M = 3.28, SE = 0.167) had a significantly lower number of connections than exercise + placebo (M = 3.91, SE = 0.18, p = .017) following the intervention. Evaluation of peak MET capacity revealed a trend for the exercise + BRJ group to have higher MET capacity following the intervention. Older adults who exercised and consumed BRJ demonstrated greater consistency within the motor community and fewer secondary connections with the insular cortex compared with those who exercised without BRJ. The exercise + BRJ group had brain networks that more closely resembled those of younger adults, showing the potential enhanced neuroplasticity conferred by combining exercise and BRJ consumption. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Free radicals and antioxidant enzymes in older adults after regular senior elastic band exercising: an experimental randomized controlled pilot study.

PubMed

Liao, Lin Yu; Chung, Wei Sheng; Chen, Kuei Min

2017-01-01

The aim of this study was to pilot test the effects of regular senior elastic band exercises on the generation of free radicals and antioxidant enzyme activities in older adults. Long-term regular exercises have positive health promotion outcomes. On the contrary, high-intensity, high-speed and short-term exercises in older adults may increase free radicals and cause chronic disease and ageing effect. A prospective randomized controlled pilot study. Data were collected during 2012. Twenty-five older adults were recruited from a community care centre, southern Taiwan and were randomly assigned to either an experimental or control group. Twenty-two participants completed the study: experimental group (n = 10) and control group (n = 12). The experimental group performed 6-month senior elastic band exercises while the control group kept regular daily routines. Both groups received blood tests (thiobarbituric acid-reacting substances and glutathione peroxidase) 30 minutes before the study began and 1 hour after the final intervention treatment. At the end of the 6-month senior elastic band exercises, no statistically significant differences in thiobarbituric acid-reacting substances and glutathione peroxidase values between the experimental and control groups. No significant differences existed in both thiobarbituric acid-reacting substances and glutathione peroxidase values before and after the 6-month senior elastic band exercises either. Regular senior elastic band exercises did not increase the generation of free radicals and antioxidant enzyme activities. Senior elastic band exercises have the potential to be promoted among older adults in the community as an exercise option without adverse effects on free radicals and have potential for mitigating ageing and increasing disease control. © 2016 John Wiley & Sons Ltd.

Effects of a Community-Based, Post-Rehabilitation Exercise Program in COPD: Protocol for a Randomized Controlled Trial With Embedded Process Evaluation.

PubMed

Desveaux, Laura; Beauchamp, Marla K; Lee, Annemarie; Ivers, Noah; Goldstein, Roger; Brooks, Dina

2016-05-11

This manuscript (1) outlines the intervention, (2) describes how its effectiveness is being evaluated in a pragmatic randomized controlled trial, and (3) summarizes the embedded process evaluation aiming to understand key barriers and facilitators for implementation in new environments. Participating centers refer eligible individuals with COPD following discharge from their local PR program. Consenting patients are assigned to a year-long community exercise program or usual care using block randomization and stratifying for supplemental oxygen use. Patients in the intervention arm are asked to attend an exercise session at least twice per week at their local community facility where their progress is supervised by a case manager. Each exercise session includes a component of aerobic exercise, and activities designed to optimize balance, flexibility, and strength. All study participants will have access to routine follow-up appointments with their respiratory physician, and additional health care providers as part of their usual care. Assessments will be completed at baseline (post-PR), 6, and 12 months, and include measures of functional exercise capacity, quality of life, self-efficacy, and health care usage. Intervention effectiveness will be assessed by comparing functional exercise capacity between intervention and control groups. A mixed-methods process evaluation will be conducted to better understand intervention implementation, guided by Normalization Process Theory and the Consolidated Framework for Implementation Research. Based on results from our pilot work, we anticipate a maintenance of exercise capacity and improved health-related quality of life in the intervention group, compared with a decline in exercise capacity in the usual care group. Findings from this study will improve our understanding of the effectiveness of community-based exercise programs for maintaining benefits following PR in patients with COPD and provide information on how best to implement them. If effective, the intervention represents an opportunity to transition patients from institutionally-based rehabilitative management to community-based care. The results of the process evaluation will contribute to the science of translating evidence-based programs into regular practice.

Participating in a virtual reality balance exercise program can reduce risk and fear of falls.

PubMed

Singh, Devinder K A; Rajaratnam, Bala S; Palaniswamy, Vijayakumar; Pearson, Hannah; Raman, Vimal P; Bong, Pei Sien

2012-11-01

The objective of this study was to quantify the effectiveness of virtual reality balance games (VRBG) to decrease risk and fear of falls among women. Thirty six community dwelling women aged 56 and above were randomly divided into experimental (exercises using VRBG focus on improving balance) and control (conventional balance exercises) groups. Both groups attended a twice 6 weekly exercise session for an hour. Risk and fear of falls were measured with Physiological Profile Approach (PPA) and Activity Specific Balance Scale (ABC-6). Pre and post intervention differences between the groups were examined using two way repeated measures ANOVA. Both VRBG and conventional balance exercise groups had significant decrease in PPA (p<0.001) and ABC-6 (p<0.01) after the interventions. However, no significant effects were demonstrated between the groups in PPA (p=0.18) and ABC-6 (p=0.25) post intervention. Time and group interaction effect were not significant for PPA (p=0.18) and ABC-6 (p=0.45). Practising VRBG can increase balance confidence and decrease risk of falls among community dwelling women. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Effects of elastic-band resistance exercise on balance, mobility and gait function, flexibility and fall efficacy in elderly people.

PubMed

Kwak, Cheol-Jin; Kim, You Lim; Lee, Suk Min

2016-11-01

[Purpose] The purpose of this study was to analyze the effects of elastic-band resistance exercise on balance, gait function, flexibility and fall efficacy in the elderly people of rural community. [Subjects and Methods] It is selected by 45 outpatients. They have come into the clinic continually to treat of physical therapy at least 1-2 times for a week. A group treated with both general physical therapy and elastic-band resistance exercise (23 patients), and the other group treated with only general physical therapy (22 patients). Elastic-band resistance exercise is composed of 8 movements of lower extremity joints. It is performed for 30 minutes during 8 weeks by 3 times for a week. It is measured and recorded at the pre and post test that sit and reach test (SRT), functional reach test (FRT), timed up and go test (TUG) for every subjects by measurement equipments. And, subjects performed for the form of performance and question as its rated scale by Berg's balance scale (BBS), dynamic gait index (DGI), activities-specific balance confidence scale (ABC). [Results] In the study, both the elastic-band exercise group and the general physical therapy group showed a significant improvement in balance, gait function, flexibility and fall efficacy. And the group with elastic-band resistance exercise showed more effectiveness than the contrast group in value of variation. [Conclusion] From this study, it was confirmed that elastic-band resistance exercise has influence on balance, gait function, flexibility and fall efficacy are working for agriculture of elderly people of rural community. Based on this result, elastic-band resistance exercise can be better instrument and easier to elderly people of rural community for the improvement in balance, gait function, flexibility and fall efficacy as it performing along with and reciprocal physical therapy.

Adapted physical activity is beneficial on balance, functional mobility, quality of life and fall risk in community-dwelling older women: a randomized single-blinded controlled trial.

PubMed

Kovács, E; Prókai, L; Mészáros, L; Gondos, T

2013-06-01

Exercise programmes have important role in prevention of falls, but to date, we have little knowledge about the effects of Adapted Physical Activity programme on balance of older women. The aim of this study was to investigate the effects of an Adapted Physical Activity programme on balance, risk of falls and quality of life in community-dwelling older women. This was a randomized controlled study. Community, in a local sport centre. Older women aged over 60 years. Seventy-six women were randomised to an exercise group providing Adapted Physical Activity programme for 25 weeks or a control group (in which they did not participate in any exercise programme). The one-leg stance test, Timed Up and Go test, incidence of fall and the quality of life (SF-36V2) were measured at baseline and after 25 weeks. The one-leg stance test and the Timed Up and Go test in the exercise group was significantly better than in the control group after the intervention period (P=0.005; P=0.001, respectively). The Physical Functioning, Vitality and General Health subdomains of quality of life were also significantly better in the exercise group compared to the control group (P=0.004; P=0.005; P=0.038, respectively). Relative risk was 0.40 (90% CI 0.174 to 0.920) and the number needed to treat was 5 (95% CI 2.3 to 23.3). This 25-week Adapted Physical Activity programme improves static balance, functional mobility, as well as Physical Functioning, Vitality and General Health subdomains of quality of life. Based on our results, the Adapted Physical Activity programme may be a promising fall prevention exercise programme improving static balance and functional mobility for community-dwelling older women.

The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people.

PubMed

Lin, Shu-Fen; Sung, Huei-Chuan; Li, Tzai-Li; Hsieh, Tsung-Cheng; Lan, Hsiao-Chin; Perng, Shoa-Jen; Smith, Graeme D

2015-05-01

The aim of this study was to investigate the effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength in community-based older people. Tai-Chi is known to improve functional fitness in older people. Tai-Chi is usually performed with free hands without resistance training and usually focuses on training lower limbs. To date, no study has examined the use of Tai-Chi in conjunction with thera-band resistance exercise in this population. Cluster randomised trial design. Older people at six senior day care centres in Taiwan were assigned to thera-band resistance exercise or control group using a cluster randomisation. The thera-band resistance exercise group (n = 48) received sixty minute thera-band resistance exercise twice weekly for a period of 16 weeks. The control group (n = 47) underwent routine activities in the day care centre, receiving no Tai-Chi or resistance exercise. After receiving the thera-band resistance exercise, intervention participants displayed a significant increase in muscle strength of upper and lower extremities. Significant improvements were recorded on most measures of the Senior Fitness Test, with the exception of the chair-stand and back-scratch test. Thera-band resistance exercise has the potential to improve functional fitness and muscle strength in community-based older people. Thera-band resistance exercise potentially offers a safe and appropriate form of physical activity that nursing staff can easily incorporate into the daily routine of older people in day care centres, potentially improving functional performance and muscle strength. © 2015 John Wiley & Sons Ltd.

The effectiveness of Pilates on balance and falls in community dwelling older adults.

PubMed

Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

2016-10-01

The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p < .05) and the TG (mean difference = 7.45, p = .01). The PG also showed significant improvement in the Activities-Specific Balance Confidence Scale (mean difference = 10.57, p = .008). Both Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of Music Aerobic Exercise on Depression and Brain-Derived Neurotrophic Factor Levels in Community Dwelling Women

PubMed Central

Yeh, Shu-Hui; Lin, Li-Wei; Chuang, Yu Kuan; Liu, Cheng-Ling; Tsai, Lu-Jen; Tsuei, Feng-Shiou; Lee, Ming-Tsung; Hsiao, Chiu-Yueh; Yang, Kuender D.

2015-01-01

A randomized clinical trial was utilized to compare the improvement of depression and brain-derived neurotrophic factor (BDNF) levels between community women with and without music aerobic exercise (MAE) for 12 weeks. The MAE group involved 47 eligible participants, whereas the comparison group had 59 participants. No significant differences were recorded in the demographic characteristics between the participants in the MAE group and the comparison group. Forty-one participants in the MAE group and 26 in the comparison group completed a pre- and posttest. The MAE group displayed significant improvement in depression scores (p = 0.016), decreased depression symptoms in crying (p = 0.03), appetite (p = 0.006), and fatigue (p = 0.011). The BDNF levels of the participants significantly increased after the 12-week MAE (p = 0.042). The parallel comparison group revealed no significant changes in depression scores or BDNF levels. In summary, the 12-week MAE had a significant impact on the enhancement of BDNF levels and improvement of depression symptoms. Middle-aged community women are encouraged to exercise moderately to improve their depression symptoms and BDNF levels. PMID:26075212

Applying the transtheoretical model to promote functional fitness of community older adults participating in elastic band exercises.

PubMed

Yang, Hui-Ju; Chen, Kuei-Min; Chen, Ming-De; Wu, Hui-Chuan; Chang, Wen-Jane; Wang, Yueh-Chin; Huang, Hsin-Ting

2015-10-01

The transtheoretical model was applied to promote behavioural change and test the effects of a group senior elastic band exercise programme on the functional fitness of community older adults in the contemplation and preparation stages of behavioural change. Forming regular exercise habits is challenging for older adults. The transtheoretical model emphasizes using different strategies in various stages to facilitate behavioural changes. Quasi-experimental design with pre-test and post-tests on two groups. Six senior activity centres were randomly assigned to either the experimental or control group. The data were collected during 2011. A total of 199 participants were recruited and 169 participants completed the study (experimental group n = 84, control group n = 85). The elastic band exercises were performed for 40 minutes, three times per week for 6 months. The functional fitness of the participants was evaluated at baseline and at the third and sixth month of the intervention. Statistical analyses included a two-way mixed design analysis of variance, one-way repeated measures analysis of variance and an analysis of covariance. All of the functional fitness indicators had significant changes at post-tests from pre-test in the experimental group. The experimental group had better performances than the control group in all of the functional fitness indicators after three months and 6 months of the senior elastic band exercises. The exercise programme provided older adults with appropriate strategies for maintaining functional fitness, which improved significantly after the participants exercising regularly for 6 months. © 2015 John Wiley & Sons Ltd.

"It is our exercise family": experiences of ethnic older adults in a group-based exercise program.

PubMed

Chiang, Kuan-Chun; Seman, Leslie; Belza, Basia; Tsai, Jenny Hsin-Chun

2008-01-01

Enhance Fitness (EF) (formerly the Lifetime Fitness Program) is an evidence-based community exercise program for older adults. From 1998 to 2005, participation of ethnic older adults increased significantly. However, little research is available about what ethnic older adults want or need to continue participation in exercise programs. The purpose of this study was to examine how physical environment, social environment, and individual biology and behavior influence adherence to exercise for ethnic older adults participating in EF. Six focus groups were conducted with 52 older adults participating in EF. Facilitators asked questions about factors that helped participants continue exercising in EF. Interviews were audiotaped and transcribed. Transcripts were systematically reviewed using content analysis. Focus group participants were Chinese (n = 21, 40%), African American (n = 18, 35%), white (n = 10, 19%), and Japanese (n = 3, 6%). Mean (SD) age was 76 years (7.4). Participants had, on average, participated in EF for 44 months (SD = 37.8). Results revealed four themes related to adherence. First, environmental factors that promoted adherence were location of the classes, transportation, weather, and the facility. Second, design of the exercise program that encouraged adherence included exercise content and type of delivery. Third, social support factors that encouraged adherence were the socializing and support between class participants and support from family, health care providers, and the class instructors. Finally, individual factors that encouraged adherence were personality traits and feelings, past physical activity experience, health benefits, and mental stimulation. Findings from this study suggest strategies for developing community-based physical activity programs for older adults from ethnically diverse communities.

Fourth Collaborative Materials Exercise of the Nuclear Forensics International Technical Working Group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwantes, J. M.; Marsden, O.; Reilly, D.

Abstract The Nuclear Forensics International Technical Working Group is a community of nuclear forensic practitioners who respond to incidents involving nuclear and other radioactive material out of regulatory control. The Group is dedicated to advancing nuclear forensic science in part through periodic participation in materials exercises. The Group completed its fourth Collaborative Materials Exercise in 2015 in which laboratories from 15 countries and one multinational organization analyzed three samples of special nuclear material in support of a mock nuclear forensic investigation. This special section of the Journal for Radioanalytical and Nuclear Chemistry is devoted to summarizing highlights from this exercise.

Efficacy of Wii-Fit on Static and Dynamic Balance in Community Dwelling Older Veterans: A Randomized Controlled Pilot Trial

PubMed Central

Dubbert, Patricia M.

2017-01-01

Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7) years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS)) and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life) were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9) compared to the control group (0.5; 95% CI, −0.3–1.3) at 8 weeks (average intergroup difference (95% CI), 5.5 (4.3–6.7), p < 0.001) after adjusting for baseline. Conclusion. This study establishes that the Wii-Fit exercise program is efficacious in improving balance in community dwelling older Veterans. This trial is registered with ClinicalTrials.gov Identifier NCT02190045. PMID:28261500

Effects of a Behavioral Program on Exercise Adherence and Exercise Self-Efficacy in Community-Dwelling Older Persons

PubMed Central

Azizan, Azliyana; Kuan, Chua Siew

2013-01-01

Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons. PMID:24489539

Effects of a behavioral program on exercise adherence and exercise self-efficacy in community-dwelling older persons.

PubMed

Azizan, Azliyana; Justine, Maria; Kuan, Chua Siew

2013-01-01

Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.

[Effects on salivation, xerostomia and halitosis in elders after oral function improvement exercises].

PubMed

Kim, Young Jin; Park, Kyung Min

2012-12-01

The purpose of this study was to investigate effects of Oral Function Improvement Exercises on salivation, xerostomia and halitosis in elderly people. The participants in the study were 48 female community-dwelling elders in D city. The Oral Function Improvement Exercises were given 3 times a week, for a total of 24 times from August to October 2011. Spitting method, Visual Analogue Scale, and halimeter (mBA-21) were used to evaluate the effects of Oral Function Improvement Exercises on salivation, xerostomia, and halitosis. The data were analyzed using χ²-test and t-test with the SPSS program. The experimental group had significantly better salivation, and less xerostomia and halitosis than the control group. The results indicate that Oral Function Improvement Exercises were effective for salivation, xerostomia and halitosis in the elders. Therefore, it was suggested that Oral Function Improvement Exercise are applicable in a community nursing intervention program to improve the quality of life for elders.

Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management.

PubMed

Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A M; van der Valk, Paul; Brusse-Keizer, Marjolein; Zielhuis, Gerhard; van der Palen, Job

2016-01-01

Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. All included COPD patients participated in four self-management sessions. Additionally, patients in the COPE-active group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained 3 times/week for 6 months and two times/week during the subsequent 5 months. In both periods, one of these weekly training sessions was home-based (unsupervised). No formal physiotherapy sessions were offered to COPE-active patients in the second year. A decision analytical model with a 24-month perspective was used to evaluate cost-effectiveness. Incremental cost-effectiveness ratios (ICER) were calculated and cost-effectiveness planes were created. Data of 77 patients participating in the exercise programme and 76 patients in the control group were analysed. The ICER for an additional patient prevented from deteriorating at least 47.5 meters on the ISWT was €6257. The ICER for an additional patient with a clinically relevant improvement (≥ 500 steps/day) in physical activity was €1564, and the ICER for an additional quality-adjusted life year (QALY) was €10 950. Due to a lack of maintenance of beneficial effects on our primary outcome exercise capacity after 2 years of follow-up and higher costs of the programme, the community-based exercise programme cannot be considered cost-effective compared to self-management programmes only. Nevertheless, the ICERs for the secondary outcomes physical activity and QALY are generally considered acceptable.

Spin exercise improves semantic fluency in previously sedentary older adults.

PubMed

Nocera, Joe R; McGregor, Keith M; Hass, Chris J; Crosson, Bruce

2015-01-01

Studies suggest improvements of neurocognitive function among older adults who undergo aerobic exercise training. This study sought to examine the impact of an aerobic exercise intervention on verbal fluency in sedentary older adults. Twenty community-dwelling older adults were recruited and enrolled in either a spin exercise group or a control condition. Participants were evaluated with an estimated V02max test and on measures of letter, category, and switching verbal fluency both before and after a 12-week intervention period. Spin exercise resulted in a significant improvement in category (semantic) verbal fluency when compared with the control group (15% vs. 2% increase, respectively; P = .001). Spin exercise also resulted in a significant improvement in estimated V02max (P = .005). Also important, the spin exercise group demonstrated a high level of adherence (mean adherence = 82.5%). Spin exercise can be an effective mode of aerobic exercise to improve semantic fluency in previously sedentary older adults.

Barriers to Exercise in People With Parkinson Disease

PubMed Central

Boudreau, Jennifer K.; DeAngelis, Tamara R.; Brown, Lisa E.; Cavanaugh, James T.; Earhart, Gammon M.; Ford, Matthew P.; Foreman, K. Bo; Dibble, Leland E.

2013-01-01

Background Exercise is known to reduce disability and improve quality of life in people with Parkinson disease (PD). Although barriers to exercise have been studied in older adults, barriers in people with chronic progressive neurological diseases, such as PD, are not well defined. Objective The purpose of this study was to identify perceived barriers to exercise in people with PD. Design The study had a cross-sectional design. Methods People who had PD, dwelled in the community, and were at stage 2.4 on the Hoehn and Yahr scale participated in this cross-sectional study (N=260; mean age=67.7 years). Participants were divided into an exercise group (n=164) and a nonexercise group (n=96). Participants self-administered the barriers subscale of the Physical Fitness and Exercise Activity Levels of Older Adults Scale, endorsing or denying specific barriers to exercise participation. Multivariate logistic regression analysis was used to examine the contribution of each barrier to exercise behavior, and odds ratios were reported. Results Three barriers were retained in the multivariate regression model. The nonexercise group had significantly greater odds of endorsing low outcome expectation (ie, the participants did not expect to derive benefit from exercise) (odds ratio [OR]=3.93, 95% confidence interval [CI]=2.08–7.42), lack of time (OR=3.36, 95% CI=1.55–7.29), and fear of falling (OR=2.35, 95% CI=1.17–4.71) than the exercise group. Limitations The cross-sectional nature of this study limited the ability to make causal inferences. Conclusions Low outcome expectation from exercise, lack of time to exercise, and fear of falling appear to be important perceived barriers to engaging in exercise in people who have PD, are ambulatory, and dwell in the community. These may be important issues for physical therapists to target in people who have PD and do not exercise regularly. The efficacy of intervention strategies to facilitate exercise adherence in people with PD requires further investigation. PMID:23288910

Barriers to exercise in people with Parkinson disease.

PubMed

Ellis, Terry; Boudreau, Jennifer K; DeAngelis, Tamara R; Brown, Lisa E; Cavanaugh, James T; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

2013-05-01

Exercise is known to reduce disability and improve quality of life in people with Parkinson disease (PD). Although barriers to exercise have been studied in older adults, barriers in people with chronic progressive neurological diseases, such as PD, are not well defined. The purpose of this study was to identify perceived barriers to exercise in people with PD. The study had a cross-sectional design. People who had PD, dwelled in the community, and were at stage 2.4 on the Hoehn and Yahr scale participated in this cross-sectional study (N=260; mean age=67.7 years). Participants were divided into an exercise group (n=164) and a nonexercise group (n=96). Participants self-administered the barriers subscale of the Physical Fitness and Exercise Activity Levels of Older Adults Scale, endorsing or denying specific barriers to exercise participation. Multivariate logistic regression analysis was used to examine the contribution of each barrier to exercise behavior, and odds ratios were reported. Three barriers were retained in the multivariate regression model. The nonexercise group had significantly greater odds of endorsing low outcome expectation (ie, the participants did not expect to derive benefit from exercise) (odds ratio [OR]=3.93, 95% confidence interval [CI]=2.08-7.42), lack of time (OR=3.36, 95% CI=1.55-7.29), and fear of falling (OR=2.35, 95% CI=1.17-4.71) than the exercise group. The cross-sectional nature of this study limited the ability to make causal inferences. Low outcome expectation from exercise, lack of time to exercise, and fear of falling appear to be important perceived barriers to engaging in exercise in people who have PD, are ambulatory, and dwell in the community. These may be important issues for physical therapists to target in people who have PD and do not exercise regularly. The efficacy of intervention strategies to facilitate exercise adherence in people with PD requires further investigation.

Assessing tribal youth physical activity and programming using a community-based participatory research approach.

PubMed

Perry, Cynthia; Hoffman, Barbara

2010-01-01

American Indian youth experience a greater prevalence of obesity compared with the general U.S. population. One avenue to reverse the trend toward increasing obesity prevalence is through promoting physical activity. The goal of this project was to understand tribal youths' current patterns of physical activity behavior and their beliefs and preferences about physical activity. This assessment used a community-based participatory research approach. Sample included 35 Native youth aged 8-18. A Community Advisory Board was created that specifically developed an exercise survey for this assessment to explore physical activity patterns, preferences, and determinants. Twenty-six youth completed the survey. Descriptive statistics were analyzed, exploring differences by age group. Nine youth participated in 2 focus groups. Qualitative data were analyzed with thematic analysis. Youth distinguished between sports and exercise, with each possessing different determinants. Common motivators were friends, coach, and school, and barriers were lack of programs and school or work. None of the youth reported meeting the recommended 60 min of strenuous exercise daily. This tribal academic partnership responded to a tribal concern by developing an exercise survey and conducting focus groups that addressed tribal-specific questions. The results are informing program development.

Effects of exercise improves muscle strength and fat mass in patients with high fracture risk: A randomized control trial.

PubMed

Chan, Ding-Cheng; Chang, Chirn-Bin; Han, Der-Sheng; Hong, Cian-Hui; Hwang, Jawl-Shan; Tsai, Keh-Sung; Yang, Rong-Sen

2017-10-26

The deterioration of the musculoskeletal system imposes significant impact on physical activity. Exercise is an important strategy which minimizes these changes. It is not clear which type of exercise provides better improvement on low physical performance, low muscle mass and low strength of sarcopenia. We aim to develop an integrated care (IC) model and compare its relative efficacy in limb fat free mass, muscle strength, and physical performance with low extremities exercise (LEE) in community dwelling older adults with high risk of fractures (Fracture Risk Assessment Tool (FRAX ® )) ≧3% for hip fracture, ≧20% for major osteoporotic fracture or 1-min osteoporosis risk test (≧1 point) or fall (≧2 falls in previous year). Patients were assigned randomized to participate in either IC or LEE group (n = 55 each) for 3 months. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise while the LEE group performed machine-based low extremities exercise. Fat free mass, muscle strength, and physical performance were measured at their baseline and 3-months follow-up. Mean age was 73.8 ± 7 years with 69.1% women. Entire cohort demonstrated significant increment in fat free mass, muscle strength (4 indicators) and physical performance (3 indicators). However, between group differences were not significant. With regular supervise exercise; both groups are equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required fewer resources and thus more financially feasible in a community setting. Copyright © 2017. Published by Elsevier B.V.

Using group model building to understand factors that influence childhood obesity in an urban environment.

PubMed

Nelson, David A; Simenz, Christopher J; OʼConnor, Sarah P; Greer, Yvonne D; Bachrach, Ann L; Shields, Tony; Fuller, Brett A; Horrigan, Katie; Pritchard, Kathleen; Springer, Judy B; Meurer, John R

2015-01-01

Despite increased attention, conventional views of obesity are based upon individual behaviors, and children and parents living with obesity are assumed to be the primary problem solvers. Instead of focusing exclusively on individual reduction behaviors for childhood obesity, greater focus should be placed on better understanding existing community systems and their effects on obesity. The Milwaukee Childhood Obesity Prevention Project is a community-based coalition established to develop policy and environmental change strategies to impact childhood obesity in Milwaukee, Wisconsin. The coalition conducted a Group Model Building exercise to better understand root causes of childhood obesity in its community. Group Model Building is a process by which a group systematically engages in model construction to better understand the systems that are in place. It helps participants make their mental models explicit through a careful and consistent process to test assumptions. This process has 3 main components: (1) assembling a team of participants; (2) conducting a behavior-over-time graphs exercise; and (3) drawing the causal loop diagram exercise. The behavior-over-time graph portion produced 61 graphs in 10 categories. The causal loop diagram yielded 5 major themes and 7 subthemes. Factors that influence childhood obesity are varied, and it is important to recognize that no single solution exists. The perspectives from this exercise provided a means to create a process for dialogue and commitment by stakeholders and partnerships to build capacity for change within the community.

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed

Mendes, Romeu; Sousa, Nelson; Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-09-13

The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Participants ( n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program ( n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group ( n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. A significant time * group interaction effect ( p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

A community-based Falls Management Exercise Programme (FaME) improves balance, walking speed and reduced fear of falling.

PubMed

Yeung, Pui Yee; Chan, Wayne; Woo, Jean

2015-04-01

Although effective community falls prevention programmes for the older persons have been described, challenges remain in translating proven interventions into daily practice. To evaluate the efficacy, feasibility and acceptability of a falls prevention programme that can be integrated into daily activities in a group of community-dwelling older adults with risk of falling. A cohort study with intervention and comparison groups was designed to evaluate a 36-week group-based falls prevention exercise programme (FaME) in the community setting. Participants were aged 60 years or older, had fallen in the past 12 months, had fear of falling with avoidance of activities or had deficits in balance control. Primary outcome measures included assessment of balance control and mobility; secondary outcome measures included level of physical activity, assessment of fear of falling and health-related quality of life. There were 48 and 51 participants in the intervention and comparison groups, respectively. There were improvements in measurements of balance, walking speed and self-efficacy. The drop out rate was low (14.6% and 3.9% from the intervention and comparison groups, respectively). Overall compliance in the intervention group was 79%. Factors that motivated continued participation include the regular and long-term nature of the programme helping to reinforce their exercise habits, the simplicity of movements and friendliness of the group. The FaME programme improves balance, walking speed and reduces fear of falling. It could be widely promoted and integrated into regular health and social activities in community settings.

Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.

PubMed

Danilovich, Margaret K; Diaz, Laura; Saberbein, Gustavo; Healey, William E; Huber, Gail; Corcos, Daniel M

2017-01-01

We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.

Translation of a Motor Learning Walking Rehabilitation Program Into a Group-Based Exercise Program for Community-Dwelling Older Adults.

PubMed

Brach, Jennifer S; Francois, Sara J; VanSwearingen, Jessie M; Gilmore, Sandra; Perera, Subashan; Studenski, Stephanie A

2016-06-01

Traditional exercise programs for older adults, which focus on aerobic and strength training, have had only modest effects on walking. Recently, a motor learning exercise program was shown to have greater effects on walking compared with a traditional exercise program. Translating this novel motor learning exercise program into a group exercise program would allow it to be offered as an evidence-based, community-based program for older adults. To translate a walking rehabilitation program based on motor learning theory from one-on-one to group delivery (On the Move) and evaluate multiple aspects of implementation in older adults with impaired mobility. The translation process involved multiple iterations, including meetings of experts in the field (Phase I), focus groups (Phase II), and implementation of the newly developed program (Phase III). Phase III was based on a one-group model of intervention development for feasibility, safety, potential effects, and acceptability. Community sites, including 2 independent living facilities, an apartment building, and a community center. Adults 65 years of age or older who could ambulate independently and who were medically stable. Thirty-one adults, mean age 82.3 ± 5.6 years, were eligible to participate. The group exercise program was held twice a week for 12 weeks. Acceptability of the program was determined by retention and adherence rates and a satisfaction survey. Risk was measured by adverse events and questions on perceived challenge and safety. Mobility was assessed pre- and postintervention by gait speed, Figure of 8 Walk Test, and 6-minute walk test. Modifications to the program included adjustments to format/length, music, education, and group interaction. The 12-week program was completed by 24 of 31 entrants (77%). Adherence was high, with participants attending on average 83% of the classes. Safety was excellent, with only 1 subject experiencing a controlled, noninjurious fall. There was preliminary evidence for improved mobility after the intervention: gait speed improved from 0.76 ± 0.21 to 0.81 ± 0.22 m/s, P = .06; Figure of 8 Walk Test from 13.0 ± 3.9 to 12.0 ± 3.9 seconds, P = .07; and 6-minute walk test from 246 ± 75 to 281 ± 67 m, P = .02. The group-based program was safe and acceptable to older adults with impaired mobility and resulted in potentially clinically meaningful improvements in mobility. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial.

PubMed

Goranitis, Ilias; Bellanca, Leana; Daley, Amanda J; Thomas, Adele; Stokes-Lampard, Helen; Roalfe, Andrea K; Jowett, Sue

2017-01-01

To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. Primary care. Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. Cost per quality-adjusted life-year (QALY). Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms.

Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial

PubMed Central

Goranitis, Ilias; Bellanca, Leana; Daley, Amanda J.; Thomas, Adele; Stokes-Lampard, Helen; Roalfe, Andrea K.

2017-01-01

Objective To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. Design Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. Setting Primary care. Population Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. Methods An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. Main outcome measure Cost per quality-adjusted life-year (QALY). Results Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. Conclusions Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms. PMID:28949974

Perceptions of the activity, the social climate, and the self during group exercise classes regulate intrinsic satisfaction.

PubMed

Maher, Jaclyn P; Gottschall, Jinger S; Conroy, David E

2015-01-01

Engaging in regular physical activity is a challenging task for many adults. Intrinsic satisfaction with exercise classes is thought to promote adherence to physical activity. This study examined the characteristics of exercise classes that impact within-person changes in intrinsic satisfaction over the course of an extended group exercise program. A 30-week physical activity trial was conducted with assessments at the end of each class. Community-living adults (n = 29) were instructed to complete at least six group exercise classes each week and, following each exercise class, complete a questionnaire asking about the characteristics of the class and the participant's evaluation of the class. Intrinsic satisfaction was high, on average, but varied as much within-person from class-to-class as it did between exercisers. Participants reported the greatest intrinsic satisfaction when classes placed greater emphasis on exercisers' involvement with the group task, feelings of competence, and encouragement from the instructor. For the most part, exercise classes that were more intense than usual were perceived by exercisers as less intrinsically satisfying. Some overall characteristics of the exercise classes were also associated with intrinsic satisfaction. The social and motivational characteristics of group exercise classes contribute to exercisers' intrinsic satisfaction with classes and attention to those dynamics, as well as the intensity of the exercise, may improve adherence for exercise regimens.

EXercising with Computers in Later Life (EXCELL) - pilot and feasibility study of the acceptability of the Nintendo® WiiFit in community-dwelling fallers.

PubMed

Williams, Marie A; Soiza, Roy L; Jenkinson, Alison McE; Stewart, Alison

2010-09-13

Falls management programmes have been instituted to attempt to reduce falls. This pilot study was undertaken to determine whether the Nintendo® WiiFit was a feasible and acceptable intervention in community-dwelling older fallers. Community-dwelling fallers over 70 years were recruited and attended for computer-based exercises (n = 15) or standard care (n = 6). Balance and fear of falling were assessed at weeks 0, 4 and 12. Participants were interviewed on completion of the study to determine whether the intervention was acceptable.Eighty percent of participants attended 75% or more of the exercise sessions. An improvement in Berg Score was seen at four weeks (p = 0.02) and in Wii Age at 12 weeks (p = 0.03) in the intervention group. There was no improvement in balance scores in the standard care group. WiiFit exercise is acceptable in self-referred older people with a history of falls. The WiiFit has the potential to improve balance but further work is required. ClinicalTrials.gov - NCT01082042.

Effects of Community-Based Exercise in Children with Severe Burns: A Randomized Trial

PubMed Central

Peña, Raquel; Ramirez, Leybi L.; Crandall, Craig G.; Wolf, Steven; Herndon, David N.; Suman, Oscar E.

2015-01-01

Objective To counteract long-lasting muscle break down, muscle weakness, and poor physical fitness resulting from severe burns, we recommend a 12-week in-hospital exercise training rehabilitation program. Unfortunately, this in-hospital training program requires time away from home, family, school or work). This study was undertaken to evaluate an alternative exercise rehabilitation strategy involving a 12-week community-based exercise training rehabilitation program (COMBEX) carried out at or near the patient and caretaker’s home. Study Design and Participants Pediatric patients (7–18 years) with ≥ 30% of the total body surface area (TBSA) burns were randomized to participate in COMBEX (N=12) or an outpatient exercise program (EX) at the hospital (N=22). Both programs were started after hospital discharge and consisted of 12 weeks of progressive resistive and aerobic exercise. COMBEX was performed in community fitness centers near the patients’ home. Endpoints were assessed at discharge (pre-exercise) and after the 12-week program. Primary endpoints were lean body mass (dual energy x-ray absorptiometry), muscle strength (isokinetic dynamometry), and peak aerobic capacity (indirect calorimetry). Results Demographics, length of hospitalization, and TBSA burned were comparable between groups (p>0.05). Both groups exhibited a significant (p≤0.01 for all) increase (mean ± SEM) in lean muscle mass (EX: 6.9 ± 1.7%; COMBEX: 6.5 ± 1.1%), muscle strength (EX: 67.1 ± 7.0%; COMBEX: 49.9 ± 6.8%), and peak aerobic capacity (EX: 35.5 ± 4.0%; COMBEX: 46.9 ± 7.7%). Furthermore, the magnitude of these increases were not different between groups (P>0.12). Conclusions Both EX and COMBEX are efficacious in improving lean mass, strength, and cardiopulmonary capacity in severely burned children. PMID:26643401

Feasibility, safety and preliminary evidence of the effectiveness of a home-based exercise programme for older people with Alzheimer's disease: a pilot randomized controlled trial.

PubMed

Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Williams, Susan B; Byrne, Karin N; LoGiudice, Dina; Lautenschlager, Nicola T; Dodd, Karen J

2013-05-01

To evaluate the feasibility and safety of a home-based exercise programme for people with Alzheimer's disease, and to provide preliminary evidence of programme effectiveness in improving balance and mobility and reducing falls risk. A randomized controlled trial. Community. Forty people with mild to moderate Alzheimer's disease (mean age 81.9, SD 5.72; 62.5% female). Participants were randomized to a six-month home-based individually tailored balance, strengthening and walking exercise programme (physiotherapist) or a six-month home-based education programme (control) (occupational therapist). Both programmes provided six home-visits and five follow-up phone calls. Balance, mobility, falls and falls risk were measured at baseline and programme completion. Intention-to-treat analysis using a generalized linear model with group allocation as a predictor variable was performed to evaluate programme effectiveness. Feasibility and adverse events were systematically recorded at each contact. Fifty-eight per cent of the exercise group finished the programme, completing an average of 83% of prescribed sessions, with no adverse events reported. Functional Reach improved significantly (P = 0.002) in the exercise group (mean (SD), 2.28 (4.36)) compared to the control group (-2.99 (4.87)). Significant improvement was also observed for the Falls Risk for Older People - Community score (P = 0.008) and trends for improvement on several other balance, mobility, falls and falls risk measures for the exercise group compared to the control group. The exercise programme was feasible and safe and may help improve balance and mobility performance and reduce falls risk in people with Alzheimer's disease.

The effects of 12 weeks Pilates-inspired exercise training on functional performance in older women: A randomized clinical trial.

PubMed

Vieira, Natália Donzeli; Testa, Daniela; Ruas, Paula Cristine; Salvini, Tânia de Fátima; Catai, Aparecida Maria; Melo, Ruth Caldeira

2017-04-01

Recent scientific evidence supports the benefits of Pilates exercises on postural balance and muscle strength of older persons. However, their effects on other aspects of physical fitness, which are also important for independent living in older age, are still unknown. To investigate the effects of a 12-week Pilates-inspired exercise program on the functional performance of community-dwelling older women. Forty community-dwelling older women were randomly enrolled in a Pilates-inspired exercise training (2 times/week, 60 min/session) (PG, n = 21, 66.0 ± 1.4yrs) or kept in the control group (CG; n = 19, 63.3 ± 0.9yrs). The Pilates exercises were conducted in small groups and performed on mats (using accessories such as exercise rubber bands, swiss and exercise balls). The functional performance on one-leg stance (OLS), timed up and go (TUG), five-times-sit-to-stand (STS) and 6-min walk (6 MW) tests was evaluated before and after the 12-week Pilates training or control follow-up period. After 12 weeks, time effects were observed for STS (p = 0.03) and 6 MW tests (p < 0.01). Only among PG subjects did the time spent to rise from a chair and return to a seated position decrease significantly (2.0 s faster, p = 0.02) and the distance walked in 6 min increase (∼30 m, p < 0.01). OLS and TUG performance remained unaltered in both groups. Pilates-inspired exercises improved dynamic balance, lower-extremity strength and aerobic resistance in community-dwelling older women. Therefore, it may be a potentially effective exercise regimen to maintain physical fitness in old age. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of Tai Chi Yunshou exercises on community-based stroke patients with balance dysfunction: a study protocol of a cluster randomized controlled trial.

PubMed

Tao, Jing; Rao, Ting; Lin, Lili; Liu, Wei; Wu, Zhenkai; Zheng, Guohua; Su, Yusheng; Huang, Jia; Lin, Zhengkun; Wu, Jinsong; Fang, Yunhua; Chen, Lidian

2015-02-25

Balance dysfunction after stroke limits patients' general function and participation in daily life. Previous researches have suggested that Tai Chi exercise could offer a positive improvement in older individuals' balance function and reduce the risk of falls. But convincing evidence for the effectiveness of enhancing balance function after stroke with Tai Chi exercise is still inadequate. Considering the difficulties for stroke patients to complete the whole exercise, the current trial evaluates the benefit of Tai Chi Yunshou exercise for patients with balance dysfunction after stroke through a cluster randomization, parallel-controlled design. A single-blind, cluster-randomized, parallel-controlled trial will be conducted. A total of 10 community health centers (5 per arm) will be selected and randomly allocated into Tai Chi Yunshou exercise group or balance rehabilitation training group. Each community health centers will be asked to enroll 25 eligible patients into the trial. 60 minutes per each session, 1 session per day, 5 times per week and the total training round is 12 weeks. Primary and secondary outcomes will be measured at baseline and 4-weeks, 8-weeks, 12-weeks, 6-week follow-up, 12-week follow-up after randomization. Safety and economic evaluation will also be assessed. This protocol aims to evaluate the effectiveness of Tai Chi Yunshou exercise for the balance function of patients after stroke. If the outcome is positive, this project will provide an appropriate and economic balance rehabilitation technology for community-based stroke patients. Chinese Clinical Trial Registry: ChiCTR-TRC-13003641. Registration date: 22 August, 2013 http://www.chictr.org/usercenter/project/listbycreater.aspx .

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

PubMed Central

Reis, Victor Machado; Themudo-Barata, Jose Luis

2017-01-01

Background: The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Methods: Participants (n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program (n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group (n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. Results: A significant time * group interaction effect (p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. Conclusions: A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628. PMID:28902144

Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

PubMed

Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

2016-01-01

Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  < 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention.

Web-Based Telepresence Exercise Program for Community-Dwelling Elderly Women With a High Risk of Falling: Randomized Controlled Trial.

PubMed

Hong, Jeeyoung; Kong, Hyoun-Joong; Yoon, Hyung-Jin

2018-05-28

While physical exercise is known to help prevent falls in the elderly, bad weather and long distance between the home and place of exercise represent substantial deterrents for the elderly to join or continue attending exercise programs outside their residence. Conventional modalities for home exercise can be helpful but do not offer direct and prompt feedback to the participant, which minimizes the benefit. We aimed to develop an elderly-friendly telepresence exercise platform and to evaluate the effects of a 12-week telepresence exercise program on fall-related risk factors in community-dwelling elderly women with a high risk of falling. In total, 34 women aged 68-91 years with Fall Risk Assessment scores >14 and no medical contraindication to physical training-based therapy were recruited in person from a senior citizen center. The telepresence exercise platform included a 15-inch tablet computer, custom-made peer-to-peer video conferencing server system, and broadband Internet connectivity. The Web-based program included supervised resistance exercises performed using elastic resistance bands and balance exercise for 20-40 minutes a day, three times a week, for 12 weeks. During the telepresence exercise session, each participant in the intervention group was supervised remotely by a specialized instructor who provided feedback in real time. The women in the control group maintained their lifestyle without any intervention. Fall-related physical factors (body composition and physical function parameters) and psychological factors (Korean Falls Efficacy Scale score, Fear of Falling Questionnaire score) before and after the 12-week interventional period were examined in person by an exercise specialist blinded to the group allocation scheme. Of the 30 women enrolled, 23 completed the study. Compared to women in the control group (n=13), those in the intervention group (n=10) showed significant improvements on the scores for the chair stand test (95% confidence interval -10.45 to -5.94, P<.001), Berg Balance Scale (95% confidence interval -2.31 to -0.28, P=.02), and Fear of Falling Questionnaire (95% confidence interval 0.69-3.5, P=.01). The telepresence exercise program had positive effects on fall-related risk factors in community-dwelling elderly women with a high risk of falling. Elderly-friendly telepresence technology for home-based exercises can serve as an effective intervention to improve fall-related physical and psychological factors. Clinical Research Information Service KCT0002710; https://cris.nih.go.kr/cris/en/search/ search_result_st01.jsp?seq=11246 (Archived by WebCite at http://www.webcitation.org/6zdSUEsmb). ©Jeeyoung Hong, Hyoun-Joong Kong, Hyung-Jin Yoon. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.05.2018.

Perceptions of the activity, the social climate, and the self during group exercise classes regulate intrinsic satisfaction

PubMed Central

Maher, Jaclyn P.; Gottschall, Jinger S.; Conroy, David E.

2015-01-01

Engaging in regular physical activity is a challenging task for many adults. Intrinsic satisfaction with exercise classes is thought to promote adherence to physical activity. This study examined the characteristics of exercise classes that impact within-person changes in intrinsic satisfaction over the course of an extended group exercise program. A 30-week physical activity trial was conducted with assessments at the end of each class. Community-living adults (n = 29) were instructed to complete at least six group exercise classes each week and, following each exercise class, complete a questionnaire asking about the characteristics of the class and the participant’s evaluation of the class. Intrinsic satisfaction was high, on average, but varied as much within-person from class-to-class as it did between exercisers. Participants reported the greatest intrinsic satisfaction when classes placed greater emphasis on exercisers’ involvement with the group task, feelings of competence, and encouragement from the instructor. For the most part, exercise classes that were more intense than usual were perceived by exercisers as less intrinsically satisfying. Some overall characteristics of the exercise classes were also associated with intrinsic satisfaction. The social and motivational characteristics of group exercise classes contribute to exercisers’ intrinsic satisfaction with classes and attention to those dynamics, as well as the intensity of the exercise, may improve adherence for exercise regimens. PMID:26347696

Automated external defibrillators in public places: position statement from the Faculty of Sport and Exercise Medicine UK.

PubMed

Iqbal, Zafar; Somauroo, John

2015-11-01

Position statements published by the Faculty of Sport and Exercise Medicine UK are quick reference or information documents and include up to 10 short points of clinical relevance for the Sport and Exercise Medicine community as well as for general practitioners and health professionals. The Faculty of Sport and Exercise Medicine (FSEM) UK has published a statement to create greater awareness that the survival rate from Sudden Cardiac Arrest could improve with prompt access to an automated external defibrillator (AED). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Is exercise effective in promoting mental well-being in older age? A systematic review.

PubMed

Windle, Gill; Hughes, Dyfrig; Linck, Pat; Russell, Ian; Woods, Bob

2010-08-01

Promoting the mental well-being of older people has been neglected. To examine the clinical and cost-effectiveness of exercise and physical activity interventions on mental well-being in people aged 65+. Systematic review, meta-analysis, economic model. Reports published in English, identified by searching 25 databases, 11 websites and references lists of systematic reviews. Eligible studies were those with a comparison or control group or offering qualitative evidence; exercise and physical activity interventions for people aged 65 and above living at home, in the community, in supported housing or in residential care homes; including outcome measures of mental well-being, not simply measures of depression or anxiety. Low-quality studies were excluded from the data synthesis. An overall effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14-0.40). The included interventions were designed for older people, targeted those who are sedentary and delivered in a community setting, primarily through a group-based approach led by trained leaders. As a minimum, the evidence would suggest two exercise sessions per week, each of 45 min duration. There is some indication that exercise can also improve the mental well-being of frail elders. Economic evidence indicated incremental cost-effectiveness ratios (compared with minimal intervention) of pound 7300 and pound 12,100 per quality adjusted life year gained for community-based walking and exercise programmes, respectively. Mental well-being in later life is modifiable through exercise and physical activity. To generalise the findings, there is a need for more evidence of effectiveness from older people in the UK.

Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer's Disease: A Pilot Study.

PubMed

Padala, Kalpana P; Padala, Prasad R; Lensing, Shelly Y; Dennis, Richard A; Bopp, Melinda M; Roberson, Paula K; Sullivan, Dennis H

2017-01-01

Balance problems are common in older adults with Alzheimer's disease (AD). The objective was to study the effects of a Wii-Fit interactive video-game-led physical exercise program to a walking program on measures of balance in older adults with mild AD. A prospective randomized controlled parallel-group trial (Wii-Fit versus walking) was conducted in thirty community-dwelling older adults (73±6.2 years) with mild AD. Home-based exercises were performed under caregiver supervision for 8 weeks. Primary (Berg Balance Scale, BBS) and secondary outcomes (fear of falls and quality of life) were measured at baseline, 8 weeks (end of intervention), and 16 weeks (8-weeks post-intervention). At 8 weeks, there was a significantly greater improvement (average inter-group difference [95% CI]) in the Wii-Fit group compared to the walking group in BBS (4.8 [3.3-6.2], p < 0.001), after adjusting for baseline. This improvement was sustained at 16 weeks (3.5 [2.0-5.0], p < 0.001). Analyses of the secondary outcome measures indicated that there was a significantly greater improvement in the Wii-Fit group compared to walking group in Activity-specific Balance Confidence scale (6.5 [3.6-9.4], p < 0.001) and Falls Efficacy Scale (-4.8 [-7.6 to -2.0], p = 0.002) at 8 weeks. However, this effect was not sustained at 16 weeks. Quality of life improved in both groups at 8 weeks; however, there were no inter-group differences (p = 0.445). Home-based, caregiver-supervised Wii-Fit exercises improve balance and may reduce fear of falling in community-dwelling older adults with mild AD.

Physical Exercise Helped to Maintain and Restore Functioning in Chinese Older Adults With Mild Cognitive Impairment: A 5-Year Prospective Study of the Hong Kong Memory and Ageing Prospective Study (HK-MAPS).

PubMed

Ma, Duan Yang; Wong, Candy H Y; Leung, Grace T Y; Fung, Ada W T; Chan, Wai Chi; Lam, Linda C W

2017-04-01

This study investigated the potential of physical exercise habit as a lifestyle modification against cognitive and functional decline at the community level. A total of 454 community-dwelling Chinese older adults without dementia participated in the Hong Kong Memory and Ageing Prospective Study at baseline and follow-up at 5 years. Their cognitive and functional performances were assessed by the Cantonese version of the Mini-Mental State Examination (CMMSE) and the Chinese version of Disability Assessment in Dementia (DAD). Hierarchical multiple regression analyses were performed to examine whether physical exercise was a significant predictor of the follow-up CMMSE and DAD scores after controlling for the covariates. Subgroup analyses were performed with a group of 127 participants with mild cognitive impairment at baseline. Physical exercise habit was a significant predictor for both the follow-up CMMSE scores and DAD scores. Participants with exercise habits of 5 years or more showed better cognitive and functional performances at follow-up. Participants who picked up exercise habits only after the baseline assessment also demonstrated better functioning at follow-up. The same patterns were observed in the subgroup analyses with the mild cognitive impairment group. Results suggested that prolonged exercise habit is required for positive effects on cognition to emerge, but benefits on functioning can be observed when individuals take up an exercise habit later in life or even after the beginning of cognitive decline. These findings are encouraging in promoting an exercise habit among older adults living in the community. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Community-Based Adaptive Physical Activity Program for Chronic Stroke: Feasibility, Safety, and Efficacy of the Empoli Model

PubMed Central

Stuart, Mary; Benvenuti, Francesco; Macko, Richard; Taviani, Antonio; Segenni, Lucianna; Mayer, Federico; Sorkin, John D.; Stanhope, Steven J.; Macellari, Velio; Weinrich, Michael

2010-01-01

Objective To determine whether Adaptive Physical Activity (APA-stroke), a community-based exercise program for participants with hemiparetic stroke, improves function in the community. Methods Nonrandomized controlled study in Tuscany, Italy, of participants with mild to moderate hemiparesis at least 9 months after stroke. Forty-nine participants in a geographic health authority (Empoli) were offered APA-stroke (40 completed the study). Forty-four control participants in neighboring health authorities (Florence and Pisa) received usual care (38 completed the study). The APA intervention was a community-based progressive group exercise regimen that included walking, strength, and balance training for 1 hour, thrice a week, in local gyms, supervised by gym instructors. No serious adverse clinical events occurred during the exercise intervention. Outcome measures included the following: 6-month change in gait velocity (6-Minute Timed Walk), Short Physical Performance Battery (SPPB), Berg Balance Scale, Stroke Impact Scale (SIS), Barthel Index, Hamilton Rating Scale for Depression, and Index of Caregivers Strain. Results After 6 months, the intervention group improved whereas controls declined in gait velocity, balance, SPPB, and SIS social participation domains. These between-group comparisons were statistically significant at P < .00015. Individuals with depressive symptoms at baseline improved whereas controls were unchanged (P < .003). Oral glucose tolerance tests were performed on a subset of participants in the intervention group. For these individuals, insulin secretion declined 29% after 6 months (P = .01). Conclusion APA-stroke appears to be safe, feasible, and efficacious in a community setting. PMID:19318465

Exploring participant appreciation of group-based principles for action in community-based physical activity programs for socially vulnerable groups in the Netherlands.

PubMed

Herens, Marion; Wagemakers, Annemarie; Vaandrager, Lenneke; Koelen, Maria

2015-11-25

Physical inactivity is a core risk factor for non-communicable diseases. In the Netherlands, socially vulnerable groups are relatively less active than groups with higher socio-economic status. Community-based health-enhancing physical activity (CBHEPA) programs aim to empower socially vulnerable groups by improving participants' health and wellbeing through physical activity. CBHEPA programs often revolve around group-based principles for action, such as active participation, enjoyment, and fostering group processes. As such principles are rarely made explicit, our study aims to identify which of the group-based principles for action are considered important by participants. Respondents (n = 76) from ten focus groups scored their individual appreciation of group-based principles for action - active participation, enjoyment, and fostering group processes - on a three-point, statement-based scale. Opinions were further discussed in the focus group. Focus group discussions were transcribed and analysed by a team of investigators. The coding procedures, identifying elements appreciated in group-based principles for action, were thematic and data driven. Statements about participatory programming generated much less consensus in appreciation among respondents than statements about enjoyment and fostering group processes. To some extent, group members participated in the development of program content. Participation in group formation or community initiatives was less frequently perceived as something within group members' control. Enjoyment, expressed as physical and emotional experiences, was found to be an individual driver of group exercise. Fostering group processes, expressed as social support, was found to contribute to enjoyment and learning achievements. Responsive leadership, ensuring responsive guidance, by an enthusiastic exercise trainer acting as a role model, were identified as additional necessary principles for action. Group-based principles for action in CBHEPA programs are not clearly demarcated. Fostering group processes is an overarching principle, conditional for the spin-off in terms of enjoyment and active participation. This, in turn, leads to a sense of ownership among participants, who take up responsibility for the exercise group as well as their individual activity behaviour. CBHEPA programs thrive on participants having fun together and exercise trainers' leadership skills. A professional, competent, responsive exercise trainer plays a key role in the organisation and maintenance of CBHEPA programs.

A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability.

PubMed

Hakim, Renée M; Ross, Michael D; Runco, Wendy; Kane, Michael T

2017-02-01

The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants' measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance ( P <0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility.

Combined pelvic muscle exercise and yoga program for urinary incontinence in middle-aged women.

PubMed

Kim, Gwang Suk; Kim, Eun Gyeong; Shin, Ki Young; Choo, Hee Jung; Kim, Mi Ja

2015-10-01

Urinary incontinence is a major health problem among middle-aged women. Pelvic muscle exercise is one of the primary interventions, but difficulty performing this exercise has led researchers to seek alternative or conjunctive exercise. This study aimed to examine the effect of a combined pelvic muscle exercise and yoga intervention program on urinary incontinence. A single group pre-/post-test design was used. Subjects were recruited from a community health center in Seoul, Korea, and a questionnaire survey was conducted. Fifty-five women participated in the first day of the program, 34 of whom completed the 8 week, twice weekly intervention program. Urinary incontinence was measured by five domains of urinary tract symptoms: filling factor, voiding factor, incontinence factor, sexual function, and quality of life. Also measured were attitude toward pelvic muscle exercise and pelvic muscle strength. Significant improvements were found in attitude toward pelvic muscle exercise, pelvic muscle strength, and incontinence factor. Daily performance of pelvic muscle exercise was positively correlated with improved incontinence factor and with quality of life related to urinary tract symptoms. A combined pelvic muscle exercise and yoga program was effective for improving overall urinary incontinence in community health center attendees in Korea. Further study is needed with a control group, different populations, and a longer intervention period. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

Benefits of home-based rocking-chair exercise for physical performance in community-dwelling elderly women: a randomized controlled trial.

PubMed

Niemelä, Kristiina; Väänänen, Ilkka; Leinonen, Raija; Laukkanen, Pia

2011-08-01

Home-based exercise is a viable alternative for older adults with difficulties in exercise opportunities outside the home. The aim of this study was to investigate the benefits of home-based rocking-chair training, and its effects on the physical performance of elderly women. Community- dwelling women (n=51) aged 73-87 years were randomly assigned to the rocking-chair group (RCG, n=26) or control group (CG, n=25) by drawing lots. Baseline and outcome measurements were hand grip strength, maximal isometric knee extension, maximal walking speed over 10 meters, rising from a chair five times, and the Berg Balance Scale (BBS). The RCG carried out a six-week rocking-chair training program at home, involving ten sessions per week, twice a day for 15 minutes per session, and ten different movements. The CG continued their usual daily lives. After three months, the RCG responded to a mail questionnaire. After the intervention, the RCG improved and the CG declined. The data showed significant interactions of group by time in the BBS score (p=0.001), maximal knee extension strength (p=0.006) and maximal walking speed (p=0.046), which indicates that the change between groups during the follow-up period was significant. Adherence to the training protocol was high (96%). After three months, the exercise program had become a regular home exercise habit for 88.5% of the subjects. Results indicate that home-based elderly women benefit from this easily implemented rocking-chair exercise program. The subjects became motivated to participate in training and continued the exercises. This is a promising alternative exercise method for maintaining physical activity and leads to improvements in physical performance.

Effects of a laughter and exercise program on physiological and psychological health among community-dwelling elderly in Japan: randomized controlled trial.

PubMed

Hirosaki, Mayumi; Ohira, Tetsuya; Kajiura, Mitsugu; Kiyama, Masahiko; Kitamura, Akihiko; Sato, Shinichi; Iso, Hiroyasu

2013-01-01

To examine the effects of a once-weekly laughter and exercise program on physical and psychological health among elderly people living in the community. As a regular exercise program can be difficult to maintain, we provided a more enjoyable program to enhance adherence to exercise. A total of 27 individuals aged 60 years or older, without disabilities, were randomly assigned to either an immediate treatment group (n=14) or a delayed treatment group (n=13). The intervention was a 120-min session consisting of laughter and exercise, carried out once a week for 10 consecutive weeks. Measurements taken at baseline, 3 and 6 months included bodyweight, height, body fat, lean mass, bone mineral density, hemoglobin A1c (HbA(1c)), glucose, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides, as well as self-rated health and psychological factors. All participants completed the 3-month program. Bone mineral density increased significantly in the immediate treatment group compared with the delayed treatment group during the first 3 months (P<0.001). In addition, HbA(1c) decreased significantly (P=0.001), and self-rated health increased significantly (P=0.012). The combination of a laughter and exercise program might have physiological and psychological health benefits for the elderly. Laughter might be an effective strategy to motivate the elderly to participate in physical activity. © 2012 Japan Geriatrics Society.

Perceived exercise barriers, enablers, and benefits among exercising and nonexercising adults with arthritis: results from a qualitative study.

PubMed

Wilcox, Sara; Der Ananian, Cheryl; Abbott, Jill; Vrazel, JoEllen; Ramsey, Cornelia; Sharpe, Patricia A; Brady, Teresa

2006-08-15

Rates of participation in regular exercise are lower among individuals with arthritis than those without arthritis. This study examined perceived exercise barriers, benefits, and enablers in exercising and nonexercising adults with arthritis. Twelve focus groups were conducted with 68 adults with arthritis. Groups were segmented by exercise status, socioeconomic status, and race. Focus group discussions were transcribed verbatim and coded. NVivo software was used to extract themes for exercisers and nonexercisers. A wide range of physical, psychological, social, and environmental factors were perceived to influence exercise. Some of these factors were similar to those in general adult samples, whereas others were unique to individuals with chronic disease. Symptoms of arthritis were barriers to exercise, yet improvements in these outcomes were also seen as potential benefits of and motivations for exercise. Exercisers had experienced these benefits and were more likely to have adapted their exercise to accommodate the disease, whereas nonexercisers desired these benefits and were more likely to have stopped exercising since developing arthritis. Health care providers' advice to exercise and the availability of arthritis-specific programs were identified as needs. This study has implications for how to market exercise to individuals with arthritis and how communities and health care professionals can facilitate the uptake of exercise. These implications are discussed.

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes.

PubMed

Mendes, Romeu; Sousa, Nelson; Themudo-Barata, José; Reis, Victor

2016-01-01

Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic+resistance+agility/balance+flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. This was a non-experimental pre-post evaluation study. Participants (N=43; 62.92±5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Significant improvements in the performance of the 6-Minute Walk Test (Δ=8.20%, p<0.001), 30-Second Chair Stand Test (Δ=28.84%, p<0.001), Timed Up and Go Test (Δ=14.31%, p<0.001), and Chair Sit and Reach Test (Δ=102.90%, p<0.001) were identified between baseline and end-exercise intervention time points. A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: a randomized preliminary study.

PubMed

Bao, Tian; Carender, Wendy J; Kinnaird, Catherine; Barone, Vincent J; Peethambaran, Geeta; Whitney, Susan L; Kabeto, Mohammed; Seidler, Rachael D; Sienko, Kathleen H

2018-01-18

Sensory augmentation has been shown to improve postural stability during real-time balance applications. Limited long-term controlled studies have examined retention of balance improvements in healthy older adults after training with sensory augmentation has ceased. This pilot study aimed to assess the efficacy of long-term balance training with and without sensory augmentation among community-dwelling healthy older adults. Twelve participants (four males, eight females; 75.6 ± 4.9 yrs) were randomly assigned to the experimental group (n = 6) or control group (n = 6). Participants trained in their homes for eight weeks, completing three 45-min exercise sessions per week using smart phone balance trainers that provided written, graphic, and video guidance, and monitored trunk sway. During each session, participants performed six repetitions of six exercises selected from five categories (static standing, compliant surface standing, weight shifting, modified center of gravity, and gait). The experimental group received vibrotactile sensory augmentation for four of the six repetitions per exercise via the smart phone balance trainers, while the control group performed exercises without sensory augmentation. The smart phone balance trainers sent exercise performance data to a physical therapist, who recommended exercises on a weekly basis. Balance performance was assessed using a battery of clinical balance tests (Activity Balance Confidence Scale, Sensory Organization Test, Mini Balance Evaluation Systems Test, Five Times Sit to Stand Test, Four Square Step Test, Functional Reach Test, Gait Speed Test, Timed Up and Go, and Timed Up and Go with Cognitive Task) before training, after four weeks of training, and after eight weeks of training. Participants in the experimental group were able to use vibrotactile sensory augmentation independently in their homes. After training, the experimental group had significantly greater improvements in Sensory Organization Test and Mini Balance Evaluation Systems Test scores than the control group. Significant improvement was also observed for Five Times Sit to Stand Test duration within the experimental group, but not in the control group. No significant improvements between the two groups were observed in the remaining clinical outcome measures. The findings of this study support the use of sensory augmentation devices by community-dwelling healthy older adults as balance rehabilitation tools, and indicate feasibility of telerehabilitation therapy with reduced input from clinicians.

Long-Term Effects of a Stage-Based Intervention for Changing Exercise Intentions and Behavior in Older Adults

ERIC Educational Resources Information Center

Greaney, Mary L.; Riebe, Deborah; Garber, Carol Ewing; Rossi, Joseph S.; Lees, Faith D.; Burbank, Patricia A.; Nigg, Claudio R.; Ferrone, Christine L.; Clark, Phillip G.

2008-01-01

Purpose: We examined the efficacy of an intervention tailored to the individual's stage of change for exercise adoption on exercise stage of change, physical activity, and physical function in community-dwelling older adults. Design and Methods: We randomized participants to a print and telephone intervention or a contact comparison group. Through…

[Development and Evaluation of a Motivational Interviewing Program for Exercise Improvement in Persons with Physical Disabilities].

PubMed

Jeong, Jeong Hee; Jeong, Ihn Sook

2017-06-01

The aims of this study were to develop a motivational interviewing program for exercise improvement in persons with physical disabilities and to examine the effect of this motivational interviewing intervention. The study employed a nonequivalent control group pretest and posttest design. A total of 62 persons with physical disabilities (30 in the experimental group, 32 in the control group) were recruited from 2 community rehabilitation centers. The experimental group received 8 sessions of a group motivational interviewing program, scheduled once a week, with each session lasting 60 minutes. Test measures were completed before the intervention, immediately after the end of the intervention, 2 weeks later, and 6 weeks after the end of the intervention. Measures included self-efficacy for exercise, decisional balance for exercise, stage of change for exercise, regularity of exercise, exercise maintenance, and independent living ability. Data were analyzed using the χ²-test, Fisher's exact test, Independent samples t-test, and repeated measures ANOVA, conducted using IBM SPSS Statistics version 18. The experimental group showed a significant increase in self-efficacy for exercise (F=50.98, p<.001), benefit (pros) of exercise (F=24.16, p<.001), and independent living ability (F=50.94, p<.001), and a significant decrease in loss (cons) of exercise (F=26.50, p<.001). There were significant differences between the two groups in stages of change for exercise (p<.001), regularity of exercise (p<.001), and exercise maintenance (χ²=26.61, p<.001). The motivational interviewing program has the potential to improve exercise levels in persons with physical disabilities. © 2017 Korean Society of Nursing Science

Exercise for Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review

PubMed Central

Arnold, Catherine M.; Sran, Meena M.; Harrison, Elizabeth L.

2008-01-01

Purpose: To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults. Method: A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers. Results: The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance. Conclusions: Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fall-prevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling. PMID:20145768

Home Exercise in a Social Context: Real-Time Experience Sharing Using Avatars

NASA Astrophysics Data System (ADS)

Aghajan, Yasmin; Lacroix, Joyca; Cui, Jingyu; van Halteren, Aart; Aghajan, Hamid

This paper reports on the design of a vision-based exercise monitoring system. The system aims to promote well-being by making exercise sessions enjoyable experiences, either through real-time interaction and instructions proposed to the user, or via experience sharing or group gaming with peers in a virtual community. The use of avatars is explored as means of representation of the user’s exercise movements or appearance, and the system employs user-centric approaches in visual processing, behavior modeling via history data accumulation, and user feedback to learn the preferences. A preliminary survey study has been conducted to explore the avatar preferences in two user groups.

An individualized exercise programme with and without behavioural change enhancement strategies for managing fatigue among frail older people: a quasi-experimental pilot study.

PubMed

Liu, Justina Y-W; Lai, Claudia Ky; Siu, Parco M; Kwong, Enid; Tse, Mimi My

2017-04-01

To evaluate the feasibility and preliminary effects of an individualized exercise programme with and without behavioural change enhancement strategies for frail older people with fatigue. A three-arm, single-blinded, quasi-experimental pilot study. Community health centres. A total of 79 frail older people with fatigue, mean age 79.32 years (±7.72). The combined group received a 16-week combined intervention consisting of exercise training and a behavioural change enhancement programme. The exercise group received exercise training and health talks, whereas the control group received only health talks. Feasibility was assessed through the participants' recruitment, retention, attendance and adherence, feedback, and reports of adverse events. The preliminary effects were assessed by the participants' level of fatigue, physical endurance, self-efficacy, and self-perceived compliance with exercise. Feasibility was achievable with high recruitment (87.2%) and low overall attrition (7.1%) rates. A similar reduction in fatigue was identified in all groups, but a trend of greater improvement in physical endurance was observed in the combined group than in the other two groups. The combined group also had a significantly better attendance rate [F(2,76) = 5.64, p < 0.01)] and higher self-perceived exercise compliance than the exercise group. The combined intervention has the potential to enhance the participants' adherence to exercise regimens by improving their attendance in training sessions and their self-perceived exercise compliance. They are important to maintaining an appropriate level of engagement in daily exercises, especially at the beginning stages of behavioural change, when the participants are establishing the habit of exercising daily.

The Healthy Mind, Healthy Mobility Trial: A Novel Exercise Program for Older Adults.

PubMed

Gill, Dawn P; Gregory, Michael A; Zou, Guangyong; Liu-Ambrose, Teresa; Shigematsu, Ryosuke; Hachinski, Vladimir; Fitzgerald, Clara; Petrella, Robert J

2016-02-01

More evidence is needed to conclude that a specific program of exercise and/or cognitive training warrants prescription for the prevention of cognitive decline. We examined the effect of a group-based standard exercise program for older adults, with and without dual-task training, on cognitive function in older adults without dementia. We conducted a proof-of-concept, single-blinded, 26-wk randomized controlled trial whereby participants recruited from preexisting exercise classes at the Canadian Centre for Activity and Aging in London, Ontario, were randomized to the intervention group (exercise + dual-task [EDT]) or the control group (exercise only [EO]). Each week (2 or 3 d · wk(-1)), both groups accumulated a minimum of 50 min of aerobic exercise (target 75 min) from standard group classes and completed 45 min of beginner-level square-stepping exercise. The EDT group was also required to answer cognitively challenging questions while doing beginner-level square-stepping exercise (i.e., dual-task training). The effect of interventions on standardized global cognitive function (GCF) scores at 26 wk was compared between the groups using the linear mixed effects model approach. Participants (n = 44; 68% female; mean [SD] age: 73.5 [7.2] yr) had on average, objective evidence of cognitive impairment (Montreal Cognitive Assessment scores, mean [SD]: 24.9 [1.9]) but not dementia (Mini-Mental State Examination scores, mean [SD]: 28.8 [1.2]). After 26 wk, the EDT group showed greater improvement in GCF scores compared with the EO group (difference between groups in mean change [95% CI]: 0.20 SD [0.01-0.39], P = 0.04). A 26-wk group-based exercise program combined with dual-task training improved GCF in community-dwelling older adults without dementia.

QOL models constructed for the community-dwelling elderly with ikigai (purpose in life) as a composition factor, and the effect of habitual exercise.

PubMed

Demura, Shinichi; Kobayashi, Hidetsugu; Kitabayashi, Tamotsu

2005-09-01

The purpose of this study was to construct QOL models for the elderly that included ikigai as a composition factor and to clarify differences in two kinds of models, one constructed for the elderly with habitual exercise and the other for those without it. The subjects were 1,566 healthy community-dwelling independent people aged 60 years or more (752 males, 814 females). First, the ratio of subjects with ikigai was calculated. The ratios of subjects with different kinds of objects of ikigai were also calculated. Next, structural equation models (SEM) were constructed on the basis of social, physical, and mental QOL and ikigai. Fits of the models were evaluated. To examine whether the presence or absence of habitual exercise caused any difference in the QOL model, subjects were divided into 4 groups according to whether they were male or female and whether they had or did not have an exercise habit. Multi-population group simultaneous analysis was then performed among the four groups. More than 85% of the subjects had objects of ikigai. Ikigai is an important factor for comprehending the QOL of the elderly. It was possible to construct QOL models for the elderly with ikigai as a composition factor. The effect of physical QOL on mental QOL was negligible in females irrespective of whether they had an exercise habit. The effect of social QOL on mental QOL was profound in aged females with an exercise habit. The effect of the living situation on mental QOL was profound in aged females without an exercise habit. The effect of mental QOL on ikigai was more marked in subjects without an exercise habit than in those with an exercise habit.

The evaluation of a strength and balance exercise program for falls prevention in community primary care.

PubMed

Hawley-Hague, Helen; Roden, Amy; Abbott, Jo

2017-08-01

We aimed to evaluate a strength and balance program delivered in the community. There is little evidence of implementation of evidence-based exercise in practice. The program was a step-down model, designed to encourage long-term exercise in community classes. The program consisted of a fully funded referral only evidence-based 12-week strength and balance (Community Otago) class, followed by an evidence-based continuous open-access community strength and balance class (Active Always). The program was offered to patients: 1) after formal falls rehabilitation (falls and fracture service); 2) after falls rehabilitation in intermediate care; and 3) referred by a GP who were not eligible for rehabilitation (preventative measure). Outcome evaluation used descriptive statistics to report changes in function, confidence in balance, hospital attendance/admission for falls/fractures and transition to community classes. Focus groups established participant experience/satisfaction. Seventy-nine participants were included, aged 56-96, and 53 (67%) were women. About 63.3% of patients transitioned to Active Always classes, demonstrating improvement in maintenance. Follow-up scores from baseline attendance at falls and fracture service to 12-weeks follow-up (24 weeks) in Community Otago showed the majority of patients improved their function (Timed up and Go), confidence (ConfBal) and lowered their falls risk (Tinetti). Follow-up of participants from Community Otago baseline to the end of 12-weeks showed improvement in function and confidence, but only a third of participants lowered their falls risk. Focus groups data suggest that continuity of delivery, the role of the instructor, health professional, and social and physical outcomes were essential for maintenance. A supportive environment can be created which encourages older adults' continued participation in group-based strength and balance, helping the delivery of evidence-based practice.

A randomized controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson's disease: study rationale and protocol.

PubMed

Peters, Catherine; Currin, Michelle; Tyson, Sara; Rogers, Anthea; Healy, Susan; McPhail, Steven; Brauer, Sandra G; Heathcote, Katharine; Comans, Tracy

2012-01-09

Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson's disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.

Enrollees Choose Priorities for Medicare

ERIC Educational Resources Information Center

Danis, Marion; Biddle, Andrea K.; Goold, Susan Dorr

2004-01-01

Purpose: The purpose of this study was to demonstrate the feasibility and results of ascertaining Medicare enrollees' priorities for insured medical benefits. Design and Methods: Structured group exercises were conducted with Medicare enrollees from clinical and community settings in central North Carolina. By participating in a decision exercise,…

Aerobic-synergized exercises may improve fall-related physical fitness in older adults.

PubMed

Chang, Yu-Chen; Wang, Jung-Der; Chen, Ho-Cheng; Hu, Susan C

2017-05-01

The purpose of the present study was to determine whether a synergistic exercise model based on aerobics with additional fall-preventive components could provide extra benefits compared with the same duration of aerobic-synergistic exercise alone. A total of 102 adults aged 65 years and over from three geographically separated communities were assigned to three groups: the general aerobic exercise (GAE) group (N.=44), the GAE plus ball game group (BG group; N.=30) and the GAE plus square-stepping exercise group (SSE group; N.=28). Each group participated in one hour of exercise intervention and two hours of leisure activities twice weekly for 12 weeks. Each exercise session consisted of one hour of combined exercises performed in the following order: 10 minutes of warm-up activities, 20 minutes of aerobics, 20 minutes of the respective exercise model, and 10 minutes of cool-down activities. Functional fitness tests, including aerobic endurance, leg strength, flexibility, reaction time, static balance and mobility, were measured before and after the intervention. Paired t-tests and mixed model analyses were conducted to compare the differences in each measurement within and among the groups. All of the groups exhibited significantly positive effects (P<0.05), including improvements in aerobic endurance, leg muscle strength, static balance, and mobility, after the intervention. There were no significant differences in these improvements in the other two groups compared with group GAE. However, group BG and group SSE showed significantly greater improvements in mobility compared with group GAE (P<0.05). We conclude that a combination of aerobics and selected fall-prevention exercises performed over a consistent period may improve mobility without compromising the fundamental benefits of aerobics. Future studies using randomized control trials with recorded fall events and a longer period of follow-up are indicated to validate the effects of fall prevention exercises.

Community exercise program use and changes in healthcare costs for older adults.

PubMed

Ackermann, Ronald T; Cheadle, Allen; Sandhu, Nirmala; Madsen, Linda; Wagner, Edward H; LoGerfo, James P

2003-10-01

Regular exercise is associated with many health benefits. Community-based exercise programs may increase exercise participation, but little is known about cost implications. A retrospective, matched cohort study was conducted to determine if changes in healthcare costs for Medicare-eligible adults who choose to participate in a community-based exercise program were different from similar individuals who did not participate. Exercise program participants included 1114 adults aged > or = 65 years, who were continuously enrolled in Group Health Cooperative of Puget Sound (GHC) between October 1, 1997 and December 31, 2000 and who participated in the Lifetime Fitness (exercise) Program Copyright (LFP) at least once; three GHC enrollees who never attended LFP were randomly selected as controls for each participant by matching on age and gender. Cost and utilization estimates from GHC administrative data for the time from LFP enrollment to December 31, 2000 were compared using multivariable regression models. The average increase in annual total healthcare costs was less in participants compared to controls (+642 dollars vs +1175 dollars; p=0.05). After adjusting for differences in age, gender, enrollment date, comorbidity index, and pre-exposure cost and utilization levels, total healthcare costs for participants were 94.1% (95% confidence interval [CI], 85.6%-103.5%) of control costs. However, for participants who attended the exercise program at an average rate of > or = 1 visit weekly, total adjusted follow-up costs were 79.3% (95% CI, 71.3%-88.2%) of controls. Including a community exercise program as a health insurance benefit shows promise as a strategy for helping some Medicare-eligible adults to improve their health through exercise.

Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.

PubMed

Sherrington, Catherine; Michaleff, Zoe A; Fairhall, Nicola; Paul, Serene S; Tiedemann, Anne; Whitney, Julie; Cumming, Robert G; Herbert, Robert D; Close, Jacqueline C T; Lord, Stephen R

2017-12-01

Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects. Update of a systematic review with random effects meta-analysis and meta-regression. Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched from January 2010 to January 2016. We included randomised controlled trials that compared fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group. 99 comparisons from 88 trials with 19 478 participants were available for meta-analysis. Overall, exercise reduced the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, p<0.001, I 2 47%, 69 comparisons) with greater effects seen from exercise programmes that challenged balance and involved more than 3 hours/week of exercise. These variables explained 76% of the between-trial heterogeneity and in combination led to a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, p<0.001). Exercise also had a fall prevention effect in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I 2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I 2 21%, 3 comparisons). There was no evidence of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital. Exercise as a single intervention can prevent falls in community-dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger effects. The impact of exercise as a single intervention in clinical groups and aged care facility residents requires further investigation, but promising results are evident for people with Parkinson's disease and cognitive impairment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Sing Your Lungs Out—a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study

PubMed Central

McNaughton, Amanda; Weatherall, Mark; Williams, Mathew; McNaughton, Harry; Aldington, Sarah; Williams, Gayle; Beasley, Richard

2017-01-01

Objective Singing group participation may benefit patients with chronic obstructive pulmonary disease (COPD). Previous studies are limited by small numbers of participants and short duration of generally hospital-based singing group intervention. This study examines the feasibility of long-term participation in a community singing group for patients with COPD who had completed pulmonary rehabilitation (PR). Methods This was a feasibility cohort study. Patients with COPD who had completed PR and were enrolled in a weekly community exercise group were recruited to a new community-based singing group which met weekly for over 1 year. Measurements at baseline, 4 months and 1 year comprised comprehensive pulmonary function tests including lung volumes, 6 min walk test (6MWT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and hospital admission days for acute exacerbation of COPD (AECOPD) for 1 year before and after the first singing group session. Findings There were 28 participants with chronic lung disease recruited from 140 people approached. Five withdrew in the first month. 21 participants meeting Global Initiative for Chronic Obstructive Lung Disease criteria for COPD completed 4-month and 18 completed 1-year assessments. The mean attendance was 85%. For the prespecified primary outcome measure, total HADS score, difference between baseline and 12 months was −0.9, 95% CI −3.0 to 1.2, p=0.37. Of the secondary measures, a significant reduction was observed for HADS anxiety score after 1 year of −0.9 (95% CI −1.8 to −0.1) points, p=0.038 and an increase in the 6MWT at 1 year, of 65 (95% CI 35 to 99) m compared with baseline p<0.001. Conclusions Our findings support the feasibility of long-term participation in a community singing group for adults with COPD who have completed PR and are enrolled in a weekly community exercise group and provide evidence of improved exercise capacity and a reduction in anxiety. Trial registration number ACTRN12615000736549; Results. PMID:28119393

A lifestyle intervention supported by mobile health technologies to improve the cardiometabolic risk profile of individuals at risk for cardiovascular disease and type 2 diabetes: study rationale and protocol.

PubMed

Stuckey, Melanie I; Shapiro, Sheree; Gill, Dawn P; Petrella, Robert J

2013-11-07

Metabolic syndrome is a cluster of cardiovascular risk factors that greatly increase the risk of developing cardiovascular disease and type 2 diabetes. Regular exercise improves the risk profile, but most people do not successfully change their exercise habits to beneficially reduce risk. Tailored exercise prescribed by a family physician has shown promise as a means to increase fitness and reduce cardiometabolic risk, but optimal implementation practices remain unknown. Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes. These technologies may address the limited access to health interventions in rural and remote regions. However, the potential as a tool to support exercise-based prevention activities is not well understood. This study was undertaken to investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve metabolic syndrome and related cardiometabolic risk factors in rural community-dwelling adults at risk for cardiovascular disease and type 2 diabetes. Adults (n = 149) with at least two metabolic syndrome risk factors were recruited from rural communities and randomized to either: 1) an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application; or 2) an active control group receiving only an exercise prescription. All participants reported to the research centre at baseline, and at 12-, 24- and 52-week follow-up visits for measurement of anthropometrics and blood pressure and for a blood draw to test blood-borne markers of cardiometabolic health. Vascular and autonomic function were examined. Fitness was assessed and exercise prescribed according to the Step Test and Exercise Prescription protocol. This study tested the effects of a prescriptive exercise intervention alone, versus one supported by mobile health technology on cardiometabolic risk factors. The intervention was designed to be translated into clinical or community-based programming. Results will contribute to the current literature by investigating the utility of mobile health technology support for exercise prescription interventions to improve cardiometabolic risk status and maintain improvements over time; particularly in rural communities. NCT01944124.

Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors.

PubMed

Zhao, N-N; Zeng, K-X; Wang, Y-L; Sheng, P-J; Tang, C-Z; Xiao, P; Liu, X-W

2017-12-01

To investigate the prevalence rate of nutritional risk in high-risk stroke groups in community, analyze its influencing factors, and analyze and compare the relationship between nutritional risk or malnutrition assessed by different nutritional evaluation methods and cognitive function, so as to provide the basis and guidance for clinical nutritional assessment and support. A cross-sectional survey was performed for 1196 cases in high-risk stroke groups in community from December 2015 to January 2017. At the same time, the nutritional status of patients was evaluated using the mini nutritional assessment (MNA) and MNA-short form (MNA-SF), and the cognitive status of patients was evaluated using the mini-mental state examination (MMSE). Moreover, the relevant influencing factors of nutritional risk and MMSE score were analyzed and compared. High-risk stroke groups in community suffered from a high risk of malnutrition. MNA-SF had a higher specificity and lower false positive rate than MNA. Nutritional risk occurred more easily in high-risk stroke groups in community with a history of diabetes mellitus, less physical exercise or light manual labor, daily use of multiple drugs, and higher age. Those with a higher nutritional risk were more prone to cognitive impairment. High-risk stroke groups in community, complicated with hyperhomocysteinemia, daily use of three or more kinds of prescription drugs, and a previous history of stroke, were accompanied by cognitive impairment easily. MNA-SF can be used for the nutritional screening of high-risk stroke groups in community. For the high-risk stroke groups in community, the rational nutritional diet should be publicized, blood sugar should be controlled in a scientific manner and physical exercise should be moderately increased.

Determining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial.

PubMed

Gallo, Estelle; Stelmach, Maria; Frigeri, Fernanda; Ahn, Dong-Hyun

The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program. This was a randomized controlled trial. Sixty-nine participants who were independent community dwellers, were 65 years or older, had difficulty walking or complaints of instability, and had 1 or more risk of falls were randomly assigned into a usual care group (UCG, n = 43) or an experimental group (EG, n = 26). Both groups received PT 2 times per week for 30 minutes for 10 to 32 visits. The UCG received the usual PT delivered at Rusk. The EG was instructed in a moderate- to high-intensity home exercise program designed after completing the mini-Balance Evaluation Systems Test to assist with exercise prescription. The EG was educated on performing a recommended dosage of exercise over 6 months using a diary. The EG received 4 additional 30-minute consults every 2 to 4 weeks postdischarge to reinforce compliance. Self-report of number of falls, number of minutes of exercise per week, and performance on outcome measures (Timed Up and Go, 5-times sit-to-stand, Berg Balance Scale, and Activity Balance Confidence Scale) were monitored at evaluation, 2, 4, and 6 months. Thirty-five participants completed the study (UCG n = 22; EG n = 13). Both groups were similar at baseline on outcome measures and number of visits. Random effect model analyses demonstrated that both groups made significant reductions in fall risk over 6 months as identified by performance on outcome measures. However, the EG improved significantly more compared with the UCG over time (P < .05). Linear regression analyses showed that the EG exercised significantly more compared with the UCG at all times (P < .05). The EG exceeded the target of 115 min/wk of exercise (154 minutes, standard deviation [SD] 68.5; 170 minutes, SD 96.8; and 143 minutes, SD 68.5) at 2, 4, and 6 months, respectively. This study demonstrated that the experimental program is effective in decreasing fall risk in community-dwelling older adults and is more effective than our usual care. Moreover, it suggests that the overall experimental protocol may offer an effective strategy to foster adherence to an exercise program without the increasing number of visits. This study supports the efficacy of the experimental program in decreasing fall risk and being more effective than our usual care, as well as fostering greater compliance with an exercise regimen. It provides some preliminary evidence to support Shubert's recommendation on exercise prescription for fall prevention.

Affective Aspects of an Age-Integrated Water Exercise Program.

ERIC Educational Resources Information Center

Weiss, Caroline R.; Jamieson, Nancy B.

1987-01-01

Surveyed 88 female participants of community-based age-integrated water exercise program designed to enhance comfort and social interaction. Affective measures and observation of membership as a support group elicited few differences by age. Members endorsed having age integration in classes and there was little indication that subgroups of…

Community-based postpartum exercise program.

PubMed

Ko, Yi-Li; Yang, Chi-Li; Fang, Chin-Lung; Lee, Mei-Ying; Lin, Pi-Chu

2013-08-01

To evaluate the effectiveness of an exercise programme for postpartum women to lose weight and relieve fatigue and depression. The optimal period for weight loss is six months postpartum. However, most women cannot return to their pre-pregnancy fitness level within that period of time. A quasi-experimental one-group pretest-post-test design was carried out. A convenience sampling method was used to recruit 28 women at 2-6 months postpartum. The 'Yoga and Pilates Exercise Programme for Postpartum Woman' was designed for this study and was delivered in group sessions once a week for three months (12 times total) for 60 minutes each time by a professional coach. Of the participants, 23 completed the entire program. The participants' body composition and levels of depression and fatigue were measured before and after the programme to identify differences. Women in the high-score group showed a significant decrease of 6·71 ± 5·71 points (t = 3·113, p = 0·021) in the depression score after participating in the exercise programme. No significant difference was found for the level of fatigue before and after the exercise programme (p > 0·05). Significant reductions in the participants' body weight, body fat percentage, fat mass and basic metabolic rate were observed after the exercise programme (p < 0·001). These physical activities benefited the physical and mental health of postpartum women and enhanced their quality of life. It is worthwhile promoting a yoga and Pilates exercise programme for postpartum women in communities. © 2013 Blackwell Publishing Ltd.

The Preventing Australian Football Injuries with Exercise (PAFIX) Study: a group randomised controlled trial

PubMed Central

Finch, C; Lloyd, D; Elliott, B

2009-01-01

Background: Knee injuries are a major injury concern for Australian Football players and participants of many other sports worldwide. There is increasing evidence from laboratory and biomechanically focused studies about the likely benefit of targeted exercise programmes to prevent knee injuries. However, there have been few international studies that have evaluated the effectiveness of such programmes in the real-world context of community sport that have combined epidemiological, behavioural and biomechanical approaches. Objective: To implement a fully piloted and tested exercise training intervention to reduce the number of football-related knee injuries. In so doing, to evaluate the intervention’s effectiveness in the real-world context of community football and to determine if the underlying neural and biomechanical training adaptations are associated with decreased risk of injury. Setting: Adult players from community-level Australian Football clubs in two Australian states over the 2007–08 playing seasons. Methods: A group-clustered randomised controlled trial with teams of players randomly allocated to either a coach-delivered targeted exercise programme or usual behaviour (control). Epidemiological component: field-based injury surveillance and monitoring of training/game exposures. Behavioural component: evaluation of player and coach attitudes, knowledge, behaviours and compliance, both before and after the intervention is implemented. Biomechanical component: biomechanical, game mobility and neuromuscular parameters assessed to determine the fundamental effect of training on these factors and injury risk. Outcome measures: The rate and severity of injury in the intervention group compared with the control group. Changes, if any, in behavioural components. Process evaluation: coach delivery factors and likely sustainability. PMID:19494090

Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial.

PubMed

Kim, Hunkyung; Suzuki, Takao; Kim, Miji; Kojima, Narumi; Ota, Noriyasu; Shimotoyodome, Akira; Hase, Tadashi; Hosoi, Erika; Yoshida, Hideyo

2015-01-01

To investigate the combined and separate effects of exercise and milk fat globule membrane (MFGM) supplementation on frailty, physical function, physical activity level, and hematological parameters in community-dwelling elderly Japanese women. A total of 131 frail, elderly women over 75 years were randomly assigned to one of four groups: exercise and MFGM supplementation (Ex+MFGM), exercise and placebo (Ex+Plac), MFGM supplementation, or the placebo group. The exercise group attended a 60-minute training program twice a week for three months, and the MFGM group ingested 1g of the MFGM supplement in pill form, daily for 3 months. The primary outcome measure was change in frailty status based on Fried's frailty phenotype. Secondary outcome measures included body composition, physical function and hematological parameters, and interview survey components assessing lifestyle factors. Participants were followed for 4 months post-intervention. Significant group × time interactions were observed for usual walking speed (P = 0.005), timed up & go (P<0.001), and insulin-like growth factor-binding protein 3/insulin-like growth factor 1 ratio (P = 0.013). The frailty components revealed that weight loss, exhaustion, low physical activity, and slow walking speed were reversed, but low muscle strength did not significantly changed. Frailty reversal rate was significantly higher in the Ex+MFGM (57.6%) than in the MFGM (28.1%) or placebo (30.3%) groups at post-intervention (χ2 = 8.827, P = 0.032), and at the follow-up was also significantly greater in the Ex+MFGM (45.5%) and Ex+Plac (39.4%) groups compared with the placebo (15.2%) group (χ2 = 8.607, P = 0.035). The exercise+MFGM group had the highest odds ratio (OR) for frailty reversal at post-intervention and follow-up (OR = 3.12, 95% confidence interval (CI) = 1.13-8.60; and OR = 4.67, 95% CI = 1.45-15.08, respectively). This study suggests that interventions including exercise and nutrition can improve frailty status. Statistically significant additive effects of MFGM with exercise could not be confirmed in this population, and further investigation in larger samples is necessary. The Japan Medical Association Clinical Trial Registry (JMACCT)JMA-IIA00069.

The Effect of Diet and Exercise on Intestinal Integrity and Microbial Diversity in Mice.

PubMed

Campbell, Sara C; Wisniewski, Paul J; Noji, Michael; McGuinness, Lora R; Häggblom, Max M; Lightfoot, Stanley A; Joseph, Laurie B; Kerkhof, Lee J

2016-01-01

The gut microbiota is now known to play an important role contributing to inflammatory-based chronic diseases. This study examined intestinal integrity/inflammation and the gut microbial communities in sedentary and exercising mice presented with a normal or high-fat diet. Thirty-six, 6-week old C57BL/6NTac male mice were fed a normal or high-fat diet for 12-weeks and randomly assigned to exercise or sedentary groups. After 12 weeks animals were sacrificed and duodenum/ileum tissues were fixed for immunohistochemistry for occludin, E-cadherin, and cyclooxygenase-2 (COX-2). The bacterial communities were assayed in fecal samples using terminal restriction fragment length polymorphism (TRFLP) analysis and pyrosequencing of 16S rRNA gene amplicons. Lean sedentary (LS) mice presented normal histologic villi while obese sedentary (OS) mice had similar villi height with more than twice the width of the LS animals. Both lean (LX) and obese exercise (OX) mice duodenum and ileum were histologically normal. COX-2 expression was the greatest in the OS group, followed by LS, LX and OX. The TRFLP and pyrosequencing indicated that members of the Clostridiales order were predominant in all diet groups. Specific phylotypes were observed with exercise, including Faecalibacterium prausnitzi, Clostridium spp., and Allobaculum spp. These data suggest that exercise has a strong influence on gut integrity and host microbiome which points to the necessity for more mechanistic studies of the interactions between specific bacteria in the gut and its host.

Multidimensional exercise for people with Parkinson's disease: a case report.

PubMed

Kluding, Patricia; McGinnis, Patricia Quinn

2006-06-01

The primary impairments associated with Parkinson's disease occur in combination with the secondary, preventable effects of immobility. A community-based fitness program may help increase activity and maintain function in people in the early or middle stages of the disease. This article describes a unique program designed to reduce fall risk and promote independent exercise for people with Parkinson's disease. Two 66-year-old males, both community ambulators and in early or middle stages of Parkinson's disease, participated in 3 months of various physical activities. Group balance classes were held twice weekly during the first month, participants joined a fitness center and self-directed their exercise program during the second month, and group Tai Chi classes were held twice weekly during the third month. At conclusion of the program, participants were given suggestions for continued physical fitness activities. After the 3-month program, improvements were noted for both individuals in functional reach, Timed Up and Go, and Berg Balance scores. Both participants continued to exercise regularly for at least 8 months following the program. Two individuals with Parkinson's disease demonstrated improvement in their balance test performance over a 3-month period. Perhaps most importantly, these participants independently continued exercising after completing this program.

"We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD.

PubMed

Desveaux, Laura; Harrison, Samantha; Lee, Annemarie; Mathur, Sunita; Goldstein, Roger; Brooks, Dina

Despite well-established improvements following rehabilitation, functional gains often diminish following discharge. To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance. Semi-structured interviews were conducted with 11 individuals with HF or COPD. Deductive thematic analysis uncovered three themes: 1) transitioning to community exercise is challenging, highlighting participants' struggle with unstructured maintenance and a lack of appropriate programs; 2) a structured, group-based program tailored to functional ability facilitates adherence, describing participants views on the importance of routine, and accountability; and 3) "We are all there for the same purpose" - participant support for integrated exercise, including the benefit of multiple perspectives and sustainability. A motivating program leader and access to appropriate facilities are key features to support adherence to prescribed activity. Tailored programs can be delivered consecutively to older adults with HF and COPD. Copyright © 2017 Elsevier Inc. All rights reserved.

[Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people].

PubMed

Bae, Jeongyee; Cho, Seong Il

2014-12-01

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program. Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

Meeting stroke survivors' perceived needs: a qualitative study of a community-based exercise and education scheme.

PubMed

Reed, Mary; Harrington, Rachel; Duggan, Aine; Wood, Victorine A

2010-01-01

A qualitative study using a phenomenological approach, to explore stroke survivors' needs and their perceptions of whether a community stroke scheme met these needs. Semi-structured in-depth interviews of 12 stroke survivors, purposively selected from participants attending a new community stroke scheme. Interpretative phenomenological analysis of interviews by two researchers independently. Participants attending the community stroke scheme sought to reconstruct their lives in the aftermath of their stroke. To enable this they needed internal resources of confidence and sense of purpose to 'create their social self', and external resources of 'responsive services' and an 'informal support network', to provide direction and encouragement. Participants felt the community stroke scheme met some of these needs through exercise, goal setting and peer group interaction, which included social support and knowledge acquisition. Stroke survivors need a variety of internal and external resources so that they can rebuild their lives positively post stroke. A stroke-specific community scheme, based on exercise, life-centred goal setting, peer support and knowledge acquisition, is an external resource that can help with meeting some of the stroke survivor's needs.

"Are Your Clients Having Fun?" The Implications of Respondents' Preferences for the Delivery of Group Exercise Programs for Falls Prevention.

PubMed

McPhate, Lucy; Simek, Emily M; Haines, Terry P; Hill, Keith D; Finch, Caroline F; Day, Lesley

2016-01-01

Group exercise has been shown to be effective in preventing falls; however, adherence to these interventions is often poor. Older adults' preferences for how these programs can be delivered are unknown. To identify older people's preferences for how group exercise programs for falls prevention can be delivered. A two-wave, cross-sectional, state-wide telephone survey was undertaken. Respondents were community-dwelling men and women aged 70+ in Victoria, Australia. Open-ended questions were asked to elicit information regarding respondent preferences of the program, which were analyzed using a framework approach. Ninety-seven respondents completed the follow-up survey. The results indicate that older adults most frequently report the short-term advantages and disadvantages when describing their preferences for group exercise, such as enjoyment, social interaction, and leader qualities. Longer-term advantages such as falls prevention were described less frequently. This study indicates the importance of interpersonal skills, and that the opportunity for social interaction should not be overlooked as a positive feature of a group exercise program.

Long-term effects of cardiac rehabilitation in elderly individuals with stable coronary artery disease.

PubMed

Mandic, Sandra; Stevens, Emily; Hodge, Claire; Brown, Casey; Walker, Robert; Body, Dianne; Barclay, Leanne; Nye, Edwin R; Williams, Michael J A

2016-01-01

To compare exercise capacity and cardiovascular response to exercise in elderly individuals with coronary artery disease (CAD) who attend ongoing community-based maintenance cardiac rehabilitation (CR) versus age- and gender-matched healthy "very active" (HVA; ≥ 2000 kcal/week) and healthy "less active" (HLA; <2000 kcal/week) individuals. Sixty-three participants (age: 72.3 ± 5.1 years; 62% men; n = 21 per group) completed the following assessments: (1) symptom-limited graded exercise test with expired gas analysis and bioimpedance assessment of cardiovascular function during exercise; (2) walking tests; (3) physical function; (4) anthropometry and (5) 12-month physical activity recall. The CR group achieved 98% (range: 73-154%) of age- and gender-predicted peak oxygen consumption for healthy individuals. Peak oxygen consumption was lower in CR compared to HVA but not HLA group (VO2peak: CR: 19.0 ± 4.5, HVA: 23.7 ± 2.9, HLA: 20.7 ± 4.7 ml ·kg(-1)ċmin(-1), p = 0.001 versus HVA; p = 0.390 versus HLA). Peak heart rate was lower in CR compared to both HVA and HLA. Walking test results and cardiovascular and physical function were not different between the groups. Elderly individuals with CAD participating in maintenance CR have similar exercise capacity and cardiorespiratory response to exercise compared to their age- and gender-matched less active healthy peers. The findings support referral of elderly patients to community-based CR. Fitness benefits of long-term maintenance cardiac rehabilitation (CR) programs remain unknown. Elderly individuals with coronary artery disease participating in maintenance CR have exercise capacity and cardiorespiratory response to exercise similar to their less active healthy peers. Maintenance CR may play an important role prolonging independent living in elderly individuals.

Perceptions of the Environment for Eating and Exercise in a Rural Community

ERIC Educational Resources Information Center

Maley, Mary Maly; Warren, Barbour S.; Devine, Carol M.

2010-01-01

Objective: To understand how members of a rural community perceive the effect of the built, natural, and social environments on their food choice and physical activity behaviors. Methods: A constructivist community environmental assessment was conducted including 17 individual qualitative interviews, 2 focus groups, and photo elicitation (n = 27)…

Do older t'ai chi practitioners have better attention and memory function?

PubMed

Man, David W K; Tsang, William W N; Hui-Chan, Christina W Y

2010-12-01

Cognitive declines are common in older people and can be a major health issue in an aging world. One type of body-mind exercises, t'ai chi, can be a possible means to help maintaining older adults' cognitive abilities, in addition to beneficial effects of physical exercises. The purpose of this study was to investigate whether t'ai chi practitioners had better attention and memory functions than older people with or without regular exercises. A cross-sectional study examining the relationship between t'ai chi practice and age-, gender- and education-similar older peoples' attention and memory functions. Forty-two (42) community-dwelling elderly subjects, aged 60 or older, recruited from t'ai chi clubs in Hong Kong formed the t'ai chi group. Another 49 elderly having regular exercise habits were recruited from community centers for inclusion in the exercise group. A nonexercise group (normal healthy control) consisting of 44 subjects were also recruited by random selection and through contacting local elderly centers. They were also screened by the Modified Barthel Index, Chinese Mini-mental Status Examination, Geriatric Depression Scale, and evaluated by attention tests (Color Trail Form A-1 and 2) and memory tests (including Rivermead Behavioral Memory Test and The Hong Kong List Learning Test). The main finding was that the three groups differed in attention and memory functions, and the t'ai chi group had demonstrated better performance than the other two groups in most subtests. As a causal relationship cannot be assumed in the present cross-sectional study, future research is required to examine how t'ai chi can improve cognitive function using a randomized control trial as well as determining whether t'ai chi practice can lead to better health status among elderly people.

High- and low-intensity exercise do not improve cognitive function after stroke: A randomized controlled trial.

PubMed

Tang, Ada; Eng, Janice J; Krassioukov, Andrei V; Tsang, Teresa S M; Liu-Ambrose, Teresa

2016-11-11

To determine the effects of high versus low-intensity exercise on cognitive function following stroke. Secondary analysis from a randomized controlled trial with blinded assessors. 50-80 years old, living in the community, > 1 year post-stroke. Participants were randomized into a high-intensity Aerobic Exercise or low-intensity non-aerobic Balance/Flexibility program. Both programs were 6 months long, with 3 60-min sessions/week. Verbal item and working memory, selective attention and conflict resolution, set shifting were assessed before and after the program. Forty-seven participants completed the study (22/25 in Aerobic Exercise group, 25/25 in Balance/Flexibility group). There was an improvement in verbal item memory in both groups (time effect p = 0.04), and no between-group differences in improvement in the other outcomes (p > 0.27). There was no association between pre-exercise cognitive function and post-exercise improvement. In contrast to a small body of previous research suggesting positive benefits of exercise on cognition post-stroke, the current study found that 6 months of high or low intensity exercise was not effective in improving cognitive function, specifically executive functions. Further research in this area is warranted to establish the effectiveness of post-stroke exercise programs on cognition, and examine the mechanisms that underlie these changes.

Group-based exercise combined with dual-task training improves gait but not vascular health in active older adults without dementia.

PubMed

Gregory, Michael A; Gill, Dawn P; Zou, Guangyong; Liu-Ambrose, Teresa; Shigematsu, Ryosuke; Fitzgerald, Clara; Hachinski, Vladimir; Shoemaker, Kevin; Petrella, Robert J

2016-01-01

Gait abnormalities and vascular disease risk factors are associated with cognitive impairment in aging. To determine the impact of group-based exercise and dual-task training on gait and vascular health, in active community-dwelling older adults without dementia. Participants [n=44, mean (SD) age: 73.5 (7.2) years, 68% female] were randomized to either intervention (exercise+dual-task; EDT) or control (exercise only; EO). Each week, for 26 weeks, both groups accumulated 50 or 75 min of aerobic exercise from group-based classes and 45 min of beginner-level square stepping exercise (SSE). Participants accumulating only 50 min of aerobic exercise were instructed to participate in an additional 25 min each week outside of class. The EDT group also answered cognitively challenging questions while performing SSE (i.e., dual-task training). The effect of the interventions on gait and vascular health was compared between groups using linear mixed effects models. At 26 weeks, the EDT group demonstrated increased dual-task (DT) gait velocity [difference between groups in mean change from baseline (95% CI): 0.29 m/s (0.16-0.43), p<0.001], DT step length [5.72 cm (2.19-9.24), p =0.002], and carotid intima-media thickness [0.10mm (0.003-0.20), p=0.04], as well as reduced DT stride time variability [8.31 coefficient of variation percentage points (-12.92 to -3.70), p<0.001], when compared to the EO group. Group-based exercise combined with dual-task training can improve DT gait characteristics in active older adults without dementia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis

PubMed Central

Burton, Elissa; Cavalheri, Vinicius; Adams, Richard; Oakley Browne, Colleen; Bovery-Spencer, Petra; Fenton, Audra M; Campbell, Bruce W; Hill, Keith D

2015-01-01

Objective The objective of this systematic review and meta-analysis is to evaluate the effectiveness of exercise programs to reduce falls in older people with dementia who are living in the community. Method Peer-reviewed articles (randomized controlled trials [RCTs] and quasi-experimental trials) published in English between January 2000 and February 2014, retrieved from six electronic databases – Medline (ProQuest), CINAHL, PubMed, PsycInfo, EMBASE and Scopus – according to predefined inclusion criteria were included. Where possible, results were pooled and meta-analysis was conducted. Results Four articles (three RCT and one single-group pre- and post-test pilot study) were included. The study quality of the three RCTs was high; however, measurement outcomes, interventions, and follow-up time periods differed across studies. On completion of the intervention period, the mean number of falls was lower in the exercise group compared to the control group (mean difference [MD] [95% confidence interval {CI}] =−1.06 [−1.67 to −0.46] falls). Importantly, the exercise intervention reduced the risk of being a faller by 32% (risk ratio [95% CI] =0.68 [0.55–0.85]). Only two other outcomes were reported in two or more of the studies (step test and physiological profile assessment). No between-group differences were observed in the results of the step test (number of steps) (MD [95% CI] =0.51 [−1.77 to 2.78]) or the physiological profile assessment (MD [95% CI] =−0.10 [−0.62 to 0.42]). Conclusion Findings from this review suggest that an exercise program may potentially assist in preventing falls of older people with dementia living in the community. However, further research is needed with studies using larger sample sizes, standardized measurement outcomes, and longer follow-up periods, to inform evidence-based recommendations. PMID:25709416

Sing Your Lungs Out-a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study.

PubMed

McNaughton, Amanda; Weatherall, Mark; Williams, Mathew; McNaughton, Harry; Aldington, Sarah; Williams, Gayle; Beasley, Richard

2017-01-24

Singing group participation may benefit patients with chronic obstructive pulmonary disease (COPD). Previous studies are limited by small numbers of participants and short duration of generally hospital-based singing group intervention. This study examines the feasibility of long-term participation in a community singing group for patients with COPD who had completed pulmonary rehabilitation (PR). This was a feasibility cohort study. Patients with COPD who had completed PR and were enrolled in a weekly community exercise group were recruited to a new community-based singing group which met weekly for over 1 year. Measurements at baseline, 4 months and 1 year comprised comprehensive pulmonary function tests including lung volumes, 6 min walk test (6MWT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and hospital admission days for acute exacerbation of COPD (AECOPD) for 1 year before and after the first singing group session. There were 28 participants with chronic lung disease recruited from 140 people approached. Five withdrew in the first month. 21 participants meeting Global Initiative for Chronic Obstructive Lung Disease criteria for COPD completed 4-month and 18 completed 1-year assessments. The mean attendance was 85%. For the prespecified primary outcome measure, total HADS score, difference between baseline and 12 months was -0.9, 95% CI -3.0 to 1.2, p=0.37. Of the secondary measures, a significant reduction was observed for HADS anxiety score after 1 year of -0.9 (95% CI -1.8 to -0.1) points, p=0.038 and an increase in the 6MWT at 1 year, of 65 (95% CI 35 to 99) m compared with baseline p<0.001. Our findings support the feasibility of long-term participation in a community singing group for adults with COPD who have completed PR and are enrolled in a weekly community exercise group and provide evidence of improved exercise capacity and a reduction in anxiety. ACTRN12615000736549; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Subjective Memory Impairment and Well-Being in Community-Dwelling Older Adults

PubMed Central

Zuniga, Krystle E.; Mackenzie, Michael; Kramer, Arthur; McAuley, Edward

2015-01-01

Background The relationship between subjective memory impairment (SMI), future cognitive decline and negative health status provides an opportunity for interventions to reduce memory complaints in high risk groups. This study aimed to examine the relationship between subjective memory impairment (SMI) and indicators of well-being in older adults enrolled in an exercise trial. Additionally, the study examined whether two different modes of exercise training, aerobic walking or non-aerobic flexibility, toning, and balance, differentially influenced subjective memory across the trial. Methods Community-dwelling older adults (n=179, Mage=66.4) were randomly assigned to a walking or flexibility, toning, and balance group for 12 months. Subjective memory, happiness, perceived stress, and symptom reporting were measured at baseline, 6 months and 12 months. Results A main effect of subjective memory indicated that individuals with the fewest memory complaints had lower perceived stress (P<0.001) and physical symptom reporting (P<0.001), and higher happiness (P<0.001) across all measurement occasions. Both main and interaction effects of time and group on SMI were not significant, suggesting SMI remained stable across the intervention and was not significantly impacted by participation in exercise training. Conclusions SMI was not responsive to exercise interventions, and the relationship between subjective memory impairment (SMI) and negative well- being demonstrates a need for interventions to reduce memory complaints in high risk groups. PMID:25737426

Effects of exercise and horticultural intervention on the brain and mental health in older adults with depressive symptoms and memory problems: study protocol for a randomized controlled trial [UMIN000018547].

PubMed

Makizako, Hyuma; Tsutsumimoto, Kota; Doi, Takehiko; Hotta, Ryo; Nakakubo, Sho; Liu-Ambrose, Teresa; Shimada, Hiroyuki

2015-11-04

Depressive symptoms and memory problems are significant risk factors for dementia. Exercise can reduce depressive symptoms and improve cognitive function in older people. In addition, the benefits of horticultural activity on physical and mental well-being have been demonstrated in people with dementia. Although evidence of such non-pharmacological interventions is mounting, no studies have examined whether physical exercise and horticultural activity exert a positive impact on brain and mental health (e.g., depressive symptoms) in non-demented older adults at high risk of cognitive impairment and depression. Therefore, we propose a randomized controlled trial to assess the efficacy and efficiency of physical exercise and horticultural activity in improving brain and mental health in community-dwelling older adults with memory problems and depressive symptoms. The 20-week randomized controlled trial will include 90 community-dwelling adults aged 65 years or older with memory problems and depressive symptoms. Participants will be randomized to one of three experiments: exercise, horticultural activity, or educational control group, using a 1:1:1 allocation ratio. The combined exercise program and horticultural activity program will consist of 20 weekly 90-minute sessions. Participants in the exercise group will practice aerobic exercise, muscle strength training, postural balance retraining, and dual-task training. The horticultural activity program will include crop-related activities, such as field cultivation, growing, and harvesting. Participants in the educational control group will attend two 90-minute educational classes during the 6-month trial period. Depressive symptoms and memory performance will be measured by the Geriatric Depression Scale-15, and the Logical Memory subtests of the Wechsler Memory Scale-Revised will be used to measure depressive symptoms and memory performance as primary outcomes, at baseline (prior to randomization), immediately following intervention (6 months from baseline), and 6 months after intervention. Hippocampal volume will be measured at baseline and immediately after intervention, using magnetic resonance imaging. Secondary outcomes will comprise cognitive function, including language, attention/executive performance, and processing speed; brain-derived neurotrophic-factor serum levels; and health-related quality of life. This intervention study will determine the clinical importance and efficacy of physical exercise and horticultural activity as non-pharmacological interventions in community-dwelling older adults at high risk of poor brain and mental health. UMIN000018547 ; registered 7 August 2015.

Construction of group exercise sessions in geriatric inpatient rehabilitation.

PubMed

Wallin, Marjo; Talvitie, Ulla; Cattan, Mima; Karppi, Sirkka-Liisa

2008-01-01

There is little knowledge about the ways geriatric physiotherapy is being carried out in practice and about the situational construction of formal policies for promoting physical activity. This article examines how professional physiotherapists and frail community-dwelling older adults as their clients use talk and action to construct a group exercise session in an inpatient rehabilitation setting in Finland. The analysis of 7 group exercise sessions with a total of 52 clients and 9 professional physiotherapists revealed 3 different practitioner approaches, which served different functions in older adults' empowerment and lifestyle activity change. The highly structured approach favored taciturn physical performances completed independently and successfully by frail older adults. The guided exercise approach with individualized guidance encouraged occasional coconstruction of shared understanding of learning the exercises. The circuit training approach facilitated occasional self-regulation by the clients. The results of this study indicate that a combination of different approaches is required to address the multifaceted needs of heterogeneous frail older adults.

Effectiveness of community-based exercise intervention programme in obese adults with metabolic syndrome.

PubMed

Chang, Shu-Hung; Chen, Miao-Chuan; Chien, Nai-Hui; Lin, Hsih-Fong

2016-09-01

The objective of this study was to change the anthropometric, clinical, biochemical indicators and the rate of metabolic syndrome among obese adults in community. Obesity is an indicator of metabolic syndrome and cardiometabolic diseases. Obesity increases national health care expenditure in Taiwan. The high prevalence of obesity is not only a public health issue but also an economic problem. Changes in lifestyle can help to prevent metabolic syndrome for individuals with obesity. A randomised controlled trial was applied. In this randomised controlled trial by location, 136 metabolically abnormal obese individuals were included. The related indicators with metabolic syndrome were measured at baseline and after six months. The experimental group participated in a six-month community-based programme including provided exercise environments, exercise skills and volunteers' reminding. The control group was only provided environment and skills. One hundred and thirty-one participants completed this trail. In comparison with the baseline, the intervention group showed a significant increase in high-density lipoprotein cholesterol (2·34 mg/dl), and decrease in body weight (1·09 kg), waist circumference (3·63 cm), systolic blood pressure (10·52 mmHg), diastolic blood pressure (5·21 mmHg), fasting blood glucose (5·84 mg/dl) and body mass index (0·74 kg/m(2) ). In the control group, significant decrease in body mass index and waist circumference were discovered. Compared to the changes between the two groups, the results showed there were significant differences in waist circumference, systolic blood pressure, diastolic blood pressure and high-density lipoprotein cholesterol. The community-based intervention could help to improve high-density lipoprotein cholesterol, reduce body weight, body mass index, waist circumference, blood pressure and fasting blood glucose in metabolically abnormal obese. This community-based programme helped metabolically abnormal obese individuals become metabolically healthy. In the future, community nurses will work with village heads and volunteers. They can encourage residents in the communities to have healthy lifestyle. As a result, the goal of this programme will be successfully achieved with less time and effort. © 2016 John Wiley & Sons Ltd.

The Effect of Diet and Exercise on Intestinal Integrity and Microbial Diversity in Mice

PubMed Central

Wisniewski, Paul J.; Noji, Michael; McGuinness, Lora R.; Lightfoot, Stanley A.

2016-01-01

Background The gut microbiota is now known to play an important role contributing to inflammatory-based chronic diseases. This study examined intestinal integrity/inflammation and the gut microbial communities in sedentary and exercising mice presented with a normal or high-fat diet. Methods Thirty-six, 6-week old C57BL/6NTac male mice were fed a normal or high-fat diet for 12-weeks and randomly assigned to exercise or sedentary groups. After 12 weeks animals were sacrificed and duodenum/ileum tissues were fixed for immunohistochemistry for occludin, E-cadherin, and cyclooxygenase-2 (COX-2). The bacterial communities were assayed in fecal samples using terminal restriction fragment length polymorphism (TRFLP) analysis and pyrosequencing of 16S rRNA gene amplicons. Results Lean sedentary (LS) mice presented normal histologic villi while obese sedentary (OS) mice had similar villi height with more than twice the width of the LS animals. Both lean (LX) and obese exercise (OX) mice duodenum and ileum were histologically normal. COX-2 expression was the greatest in the OS group, followed by LS, LX and OX. The TRFLP and pyrosequencing indicated that members of the Clostridiales order were predominant in all diet groups. Specific phylotypes were observed with exercise, including Faecalibacterium prausnitzi, Clostridium spp., and Allobaculum spp. Conclusion These data suggest that exercise has a strong influence on gut integrity and host microbiome which points to the necessity for more mechanistic studies of the interactions between specific bacteria in the gut and its host. PMID:26954359

Association between demographic and socioeconomic conditions with exercise practice and physical fitness in community projects participants aged 50 years or more in Ribeirão Preto, São Paulo.

PubMed

Trapé, Átila Alexandre; Marques, Renato Francisco Rodrigues; Lizzi, Elisângela Aparecida da Silva; Yoshimura, Fernando Eidi; Franco, Laercio Joel; Zago, Anderson Saranz

2017-01-01

To investigate the association between both demographic and socioeconomic conditions with physical fitness and regular practice of physical exercises in participants of community projects, supervised by a physical education teacher. This enabled to investigate whether the adoption of an active lifestyle depends only on the personal choice or has any influence of socioeconomic factors. 213 individuals aged over 50 years joined the study, and provided information about their socioeconomic status (age, gender, education/years of study, and income); usual level of physical activity (ULPA); and physical fitness, by a physical battery tests which allowed the calculation of general functional fitness index (GFFI). The generalized linear model showed that participants ranked in the highest GFFI groups (good and very good) had more years of study and higher income (p < 0.05). The multiple linear regression model complements the previous analysis, demonstrating the magnitude of the change in the GFFI in association with the years of study (group > 15), income (all groups) and age (p < 0.05). By means of analysis of variance, a difference between the groups was verified and longer practice of exercises (> 6 months) were also associated with education and income (p < 0.05); among the groups with exercise practice whether greater than or equal to six months, that supervised showed better results in the GFFI (p < 0.05). The association between variables strengthens the hypothesis that adherence and maintenance of physical exercise might not be only dependent of individual's choice, but also the socioeconomic factors, which can influence the choice for any active lifestyle.

'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.

PubMed

Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

2011-11-24

It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge. Interventions, such as group and home based physical activity programs, have been widely reported upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact. 'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected. The planned 18 month follow-up post intervention will provide an indication of the effectiveness of the group and home based interventions in terms of adherence to physical activity, health benefits and cost. If the physiotherapy-led home based physical activity program is successful it could provide an alternative option for physical activity program delivery across a number of settings. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000890932.

A Single Bout of Aerobic Exercise Reduces Anxiety Sensitivity But Not Intolerance of Uncertainty or Distress Tolerance: A Randomized Controlled Trial.

PubMed

LeBouthillier, Daniel M; Asmundson, Gordon J G

2015-01-01

Several mechanisms have been posited for the anxiolytic effects of exercise, including reductions in anxiety sensitivity through interoceptive exposure. Studies on aerobic exercise lend support to this hypothesis; however, research investigating aerobic exercise in comparison to placebo, the dose-response relationship between aerobic exercise anxiety sensitivity, the efficacy of aerobic exercise on the spectrum of anxiety sensitivity and the effect of aerobic exercise on other related constructs (e.g. intolerance of uncertainty, distress tolerance) is lacking. We explored reductions in anxiety sensitivity and related constructs following a single session of exercise in a community sample using a randomized controlled trial design. Forty-one participants completed 30 min of aerobic exercise or a placebo stretching control. Anxiety sensitivity, intolerance of uncertainty and distress tolerance were measured at baseline, post-intervention and 3-day and 7-day follow-ups. Individuals in the aerobic exercise group, but not the control group, experienced significant reductions with moderate effect sizes in all dimensions of anxiety sensitivity. Intolerance of uncertainty and distress tolerance remained unchanged in both groups. Our trial supports the efficacy of aerobic exercise in uniquely reducing anxiety sensitivity in individuals with varying levels of the trait and highlights the importance of empirically validating the use of aerobic exercise to address specific mental health vulnerabilities. Aerobic exercise may have potential as a temporary substitute for psychotherapy aimed at reducing anxiety-related psychopathology.

Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial

PubMed Central

Barrett, Bruce; Hayney, Mary S.; Muller, Daniel; Rakel, David; Ward, Ann; Obasi, Chidi N.; Brown, Roger; Zhang, Zhengjun; Zgierska, Aleksandra; Gern, James; West, Rebecca; Ewers, Tola; Barlow, Shari; Gassman, Michele; Coe, Christopher L.

2012-01-01

PURPOSE This study was designed to evaluate potential preventive effects of meditation or exercise on incidence, duration, and severity of acute respiratory infection (ARI) illness. METHODS Community-recruited adults aged 50 years and older were randomized to 1 of 3 study groups: 8-week training in mindfulness meditation, matched 8-week training in moderate-intensity sustained exercise, or observational control. The primary outcome was area-under-the-curve global illness severity during a single cold and influenza season, using the Wisconsin Upper Respiratory Symptom Survey (WURSS-24) to assess severity. Health care visits and days of missed work were counted. Nasal wash collected during ARI illness was assayed for neutrophils, interleukin-8, and viral nucleic acid. RESULTS Of 154 adults randomized into the study, 149 completed the trial (82% female, 94% white, mean age 59.3 ± 6.6 years). There were 27 ARI episodes and 257 days of ARI illness in the meditation group (n = 51), 26 episodes and 241 illness days in the exercise group (n = 47), and 40 episodes and 453 days in the control group (n = 51). Mean global severity was 144 for meditation, 248 for exercise, and 358 for control. Compared with control, global severity was significantly lower for meditation (P = .004). Both global severity and total days of illness (duration) trended toward being lower for the exercise group (P=.16 and P=.032, respectively), as did illness duration for the meditation group (P=.034). Adjusting for covariates using zero-inflated multivariate regression models gave similar results. There were 67 ARI-related days of-work missed in the control group, 32 in the exercise group (P = .041), and 16 in the meditation group (P <.001). Health care visits did not differ significantly. Viruses were identified in 54% of samples from meditation, 42% from exercise, and 54% from control groups. Neutrophil count and interleukin-8 levels were similar among intervention groups. CONCLUSIONS Training in meditation or exercise may be effective in reducing ARI illness burden. PMID:22778122

A comparison of home-based exercise programs with and without self-manual therapy in individuals with knee osteoarthritis in community.

PubMed

Cheawthamai, Kornkamon; Vongsirinavarat, Mantana; Hiengkaew, Vimonwan; Saengrueangrob, Sasithorn

2014-07-01

The present study aimed to compare the effectiveness of the treatment programs of home-based exercise with and without self-manual therapy in individuals with knee osteoarthritis (knee OA) in community. Forty-three participants with knee OA were randomly assigned in groups. All participants received the same home-based exercise program with or without self-manual therapy over 12 weeks. Outcome measures were pain intensity, range of motions, six-minute walk test distance, the knee injury and osteoarthritis outcome score (KOOS), short-form 36 (SF-36) and satisfaction. The results showed that the self-manual therapy program significantly decreased pain at 4 weeks, increased flexion and extension at 4 and 12 weeks, and improved the KOOS in pain item and SF-36 in physical function and mental health items. The home-based exercise group showed significant increase of the six-minute walk distance at 4 and 12 weeks, improvements in the KOOS in pain and symptom items and SF-36 in the physical function and role-emotional items. Overall, the results favored a combination of self-manual therapy and home-based exercise for patients with knee OA, which apparently showed superior benefits in decreasing pain and improving active knee range of motions.

Comparison of 2 Different Exercise Approaches: Tai Chi Versus Otago, in Community-Dwelling Older Women.

PubMed

Son, Nam-Kuk; Ryu, Young Uk; Jeong, Hye-Won; Jang, Young-Hwan; Kim, Hyeong-Dong

2016-01-01

Regular exercise can delay age-related risk factors and can maintain or improve physical health and activity in older adults leading to a decrease in fall risk. The purpose of this study was to compare 2 different interventions for fall prevention, tai chi (TC) and Otago, by examining lower extremity strength, balance, and spatiotemporal gait parameters in community-dwelling older women. We performed a randomized trial in which subjects were assigned to 1 of 2 groups: the TC group (n = 21; age, 72.8 ± 4.7 years, range: 65-83 years), which participated in a modified Sun-style TC exercise program; and the Otago group (n = 24; age, 71.5 ± 3.6 years, range: 65-79 years), which participated in the Otago exercise program. The Timed Up and Go (TUG) test, functional reach (FR) test, one-leg standing (OLS) test, 5 times sit-to-stand test (5×STS), 30-second sit-to-stand (30s STS) test, and gait parameters (gait velocity, step length, step width, stride time, and cadence) were measured before and after the intervention. Both groups showed statistically significant improvements in balance (TUG and OLS tests), lower extremity strength (5×STS and 30s STS tests), and spatiotemporal gait parameters, except for step width and step length (P < .05). The Otago group showed a significantly improved FR, whereas the TC group showed a significantly improved step length after the intervention (P < .05). Furthermore, the Otago group exhibited greater improvements in the TUG (P < .001), FR (P < .001), 5×CST (P < .01), and 30-second CST (P < .01) tests: a faster cadence (P < .001) and shorter stride time (P < .001) when compared with the TC group. The TC group showed greater improvements in the OLS test, step length, and step width (P < .01) and faster gait velocity (P < .05) than the Otago group. The findings from this study support the efficacy of the TC and Otago exercise programs in improving mobility in this sample of subjects. Furthermore, the Otago group showed greater improvement in lower extremity strength, whereas the TC group showed greater improvement in balance (OLS test). Also, the TC group showed a greater improvement in gait velocity after TC training program compared with the Otago exercise program. However, this study does not elucidate which exercise program is a more effective intervention method with older women for fall prevention.

Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: a randomized controlled trial.

PubMed

Freiberger, Ellen; Häberle, Lothar; Spirduso, Waneen W; Zijlstra, G A Rixt

2012-03-01

To determine the long-term effects of three strength and balance exercise interventions on physical performance, fall-related psychological outcomes, and falls in older people. A single-blinded, four-group, randomized controlled trial. Community, Germany. Community-dwelling adults aged 70 to 90 who had fallen in the past 6 months or reported fear of falling. After baseline assessment, 280 participants were randomly assigned to the control group (CG; no intervention; n = 80) or one of three strength and balance exercise interventions (the strength and balance group (SBG; strength and balance only; n = 63), the fitness group (FG; strength and balance plus endurance training; n = 64), or the multifaceted group (MG; strength and balance plus fall risk education; n = 73). The interventions consisted of 32 one-hour group sessions in 16 weeks. Data on physical performance, fall-related psychological outcomes, and falls were collected for 24 months. Mixed-effects regression analyses showed improved short- and long-term (12 and 24 months, respectively) physical performance for the SBG and FG, particularly regarding mobility, balance, and walking speed (P < .05). The improvements in physical performance outcomes were most prominent in the FG. Fall-related psychological outcomes, number of falls, and injurious falls were not significantly different from in the control group. Training focusing on strength, balance, and endurance can enhance physical performance for up to 24 months in community-dwelling older adults. These findings did not translate to improved fall-related psychological outcomes or reduced incidence of falls. This demonstrates the need for a different approach (e.g., regarding intervention dose and components) to gain intervention benefits in the multiple domains that contribute to independence and well-being in older adults. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Exercise and Nutritional Supplementation on Community-Dwelling Elderly Japanese Women With Sarcopenic Obesity: A Randomized Controlled Trial.

PubMed

Kim, Hunkyung; Kim, Miji; Kojima, Narumi; Fujino, Ken; Hosoi, Erika; Kobayashi, Hisamine; Somekawa, Shinji; Niki, Yoshifumi; Yamashiro, Yukari; Yoshida, Hideyo

2016-11-01

To investigate the effects of exercise and/or nutritional supplementation on body composition, blood components, and physical function in community-dwelling elderly Japanese women with sarcopenic obesity. Randomized controlled trial. Urban community in Tokyo, Japan. Among 1213 community-dwelling elderly women over 70 years of age, 307 were defined with sarcopenic obesity, and 139 women participated in the study. Participants were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex + N) and exercise only (Ex) groups attended 60-minute exercise classes twice a week for 3 months. The Ex + N and nutrition only (N) groups were provided with essential amino acid supplementation and tea fortified with catechins to be taken daily for 3 months. Health education classes were provided to the control (HE) group every 2 weeks. Bioelectric impedance analysis was used to measure body composition. Skeletal muscle mass index was calculated using measures of muscle mass and height. Physical function measures included grip strength, knee extension strength, usual walking speed, and walking parameters (stride, step length, width, walking angles). Blood samples were obtained to analyze levels of albumin, triglycerides, cholesterol, hemoglobin A1c, leptin, cystatin C, vitamin D, interleukin-6, and high-sensitivity C-reactive protein. Significant between-group × time interactions were observed in usual walking speed (P = .012), stride (P = .004), right step length (P = .003), average number of steps (P = .029), and vitamin D (P < .001). Compared to the HE group, the Ex + N intervention significantly decreased total body fat mass (P = .036) and increased stride (P = .038) and vitamin D (P < .001). Significant reductions in trunk fat were observed in the Ex group compared with HE (P = .014). The Ex + N and Ex interventions were over four times as likely (odds ratio [95% confidence interval]) to reduce body fat mass than the HE group (4.42 [1.21-16.19]; 4.50 [1.13-17.9], respectively). Significant odds ratios of the Ex + N intervention improving walking speed (3.05 [1.01-9.19]), vitamin D (14.22 [1.64-123.02]), and leptin (3.86 [1.19-12.47]) were also observed. Although exercise and nutrition have beneficial effects on individual variables of body composition, blood components, and physical function, improvements in muscle mass and variable combinations such as percent fat + skeletal muscle mass index or percent fat + physical functions were not observed in this population. Further large-scale and long-term investigation is necessary. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Exercise Training and Recreational Activities to Promote Executive Functions in Chronic Stroke: A Proof-of-Concept Study

PubMed Central

Liu-Ambrose, Teresa; Eng, Janice J

2015-01-01

Background Stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. Both exercise and recreational activities are promising strategies. We assessed the effect of a six-month exercise and recreation program on executive functions in adults with chronic stroke. Methods A six-month ancillary study within a multi-centre randomized trial. Twenty-eight chronic stroke survivors (i.e., ≥ 12 months since an index stroke) were randomized to one of two experimental groups: intervention (INT; n=12) or delayed intervention (D-INT; n=16). Participants of the INT group received a six-month community-based structured program that included two sessions of exercise training and one session of recreation and leisure activities per week. Participants of the D-INT group received usual care. The primary outcome measure was the Stroop Test, a cognitive test of selective attention and conflict resolution. Secondary cognitive measures included set shifting and working memory. Mood, functional capacity, and general balance and mobility were additional secondary outcome measures. Results Compared with the D-INT group, the INT group significantly improved selective attention and conflict resolution (p=0.02), working memory (p=0.04), and functional capacity (p=0.02) at the end of the six-month intervention period. Improved selective attention and conflict resolution was significantly associated with functional capacity at six months (r=0.39; p=0.04). Conclusions This is the first randomized study to demonstrate that an exercise and recreation program can significantly benefit executive functions in community-dwelling chronic stroke survivors who are mildly cognitively impaired – a population at high-risk for dementia and functional decline. Thus, clinicians should consider prescribing exercise and recreational activities in the cognitive rehabilitation of chronic stroke survivors. Clinical Trial Registration http://clinicaltrials.gov. Unique identifier: NCT01085240. PMID:25440324

Motor imagery group practice for gait rehabilitation in individuals with post-stroke hemiparesis: a pilot study.

PubMed

Dickstein, Ruth; Levy, Sandra; Shefi, Sara; Holtzman, Sarit; Peleg, Sara; Vatine, Jean-Jacques

2014-01-01

Stroke is the leading cause of adult disability, with walking impairment being a devastating indicator of chronic post-stroke hemiparesis. Limited resources exist for individual treatments; therefore, the delivery of safe group exercise therapy is highly desired. To examine whether the application of group-based motor imagery practice to community-dwelling individuals with chronic hemiparesis improves gait. Sixteen individuals with chronic hemiparesis from two community centers participated in the study, with eight from each center. Four participants in each center received five weeks of the experimental intervention, consisting of group-based motor imagery exercises of gait tasks, followed by five weeks of control treatment of motor imagery exercises for the affected upper extremity. Four other subjects in each center received the same treatments in reverse order. Pre- and post intervention measurements included clinical and biomechanical gait parameters. Comparisons within (pre- vs. post) and between treatments (experimental vs. control) indicated no significant change in any gait variable. Nevertheless, the verbal reports of most participants alluded to satisfaction with the experimental intervention and to an increase in self-confidence. Despite the lack of evidence for the effectiveness of group-based motor imagery practice in improving gait among individuals with chronic hemiparesis, the contrast between the measured outcomes and the positive verbal reports merits further inquiry.

Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up.

PubMed

Arkkukangas, Marina; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

2017-02-27

In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency. A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization. A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups. In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

Effects of Moderate and Vigorous Exercise on Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial.

PubMed

Zhang, Hui-Jie; He, Jiang; Pan, Ling-Ling; Ma, Zhi-Min; Han, Cheng-Kun; Chen, Chung-Shiuan; Chen, Zheng; Han, Hai-Wei; Chen, Shi; Sun, Qian; Zhang, Jun-Feng; Li, Zhi-Bin; Yang, Shu-Yu; Li, Xue-Jun; Li, Xiao-Ying

2016-08-01

Nonalcoholic fatty liver disease (NAFLD) is a prevalent risk factor for chronic liver disease and cardiovascular disease. To compare the effects of moderate and vigorous exercise on intrahepatic triglyceride content and metabolic risk factors among patients with NAFLD. In this randomized clinical trial, participants with central obesity and NAFLD were recruited from community-based screening in Xiamen, China, from December 1, 2011, through December 25, 2013. Data analysis was performed from August 28, 2015, through December 15, 2015. Participants were randomly assigned to vigorous-moderate exercise (jogging 150 minutes per week at 65%-80% of maximum heart rate for 6 months and brisk walking 150 minutes per week at 45%-55% of maximum heart rate for another 6 months), moderate exercise (brisk walking 150 minutes per week for 12 months), or no exercise. Primary outcome, change in intrahepatic triglyceride content measured by proton magnetic resonance spectroscopy at 6 and 12 months; secondary outcomes, changes in body weight, waist circumference, body fat, and metabolic risk factors. A total of 220 individuals (mean [SD] age, 53.9 [7.1] years; 149 woman [67.7%]) were randomly assigned to control (n = 74), moderate exercise (n = 73), and vigorous-moderate exercise (n = 73) groups. Of them, 211 (95.9%) completed the 6-month follow-up visit; 208 (94.5%) completed the 12-month follow-up visit. Intrahepatic triglyceride content was reduced by 5.0% (95% CI, -7.2% to 2.8%; P < .001) in the vigorous-moderate exercise group and 4.2% (95% CI, -6.3% to -2.0%; P < .001) in the moderate exercise group compared with the control group at the 6-month assessment. It was reduced by 3.9% (95% CI, -6.0% to -1.7%; P < .001) in the vigorous-moderate exercise group and 3.5% (95% CI, -5.6% to -1.3%; P = .002) in the moderate exercise group compared with the control group at the 12-month assessment. Changes in intrahepatic triglyceride content were not significantly different between vigorous-moderate and moderate exercise at the 6- or 12-month assessment. Body weight, waist circumference, and blood pressure were significantly reduced in the vigorous-moderate exercise group compared with the moderate exercise and control groups at the 6-month assessment and in the vigorous-moderate and moderate exercise groups compared with the control group at the 12-month assessment. In addition, body fat was significantly reduced in the vigorous-moderate exercise group compared with the moderate exercise and control groups at the 12-month assessment. After adjusting for weight loss, the net changes in intrahepatic triglyceride content were diminished and became nonsignificant between the exercise and control groups (except for the moderate exercise group at the 6-month assessment). Vigorous and moderate exercise were equally effective in reducing intrahepatic triglyceride content; the effect appeared to be largely mediated by weight loss. clinicaltrials.gov Identifier: NCT01418027.

The Effects of an Exercise Program on Anxiety Levels and Metabolic Functions in Patients With Anxiety Disorders.

PubMed

Ma, Wei-Fen; Wu, Po-Lun; Su, Chia-Hsien; Yang, Tzu-Ching

2017-05-01

The purpose of this study was to evaluate the effects of a home-based (HB) exercise program on anxiety levels and metabolic functions in patients with anxiety disorders in Taiwan. Purposive sampling was used to recruit 86 participants for this randomized, experimental study. Participants were asked to complete a pretest before the 3-month exercise program, a posttest at 1 week, and a follow-up test at 3 months after the exercise program. Study measures included four Self-Report Scales and biophysical assessments to collect and assess personal data, lifestyle behaviors, anxiety levels, and metabolic control functions. Of the 86 study participants, 83 completed the posttest and the 3-month follow-up test, including 41 in the experimental group and 42 in the control group. Participants in the experimental group showed significant improvements in body mass index, high-density lipoprotein cholesterol levels, and the level of moderate exercise after the program relative to the control group, as analyzed by generalized estimating equations mixed-model repeated measures. State and trait anxiety levels were also significantly improved from pretest to follow-up test in the experimental group. Finally, the prevalence of metabolic syndrome declined for participants in the experimental group. The HB exercise program produced positive effects on the metabolic indicators and anxiety levels of Taiwanese adults with anxiety disorders. Health providers should consider using similar HB exercise programs to help improve the mental and physical health of patients with anxiety disorders in their communities.

Community walking programs for treatment of peripheral artery disease

PubMed Central

Mays, Ryan J.; Rogers, R. Kevin; Hiatt, William R.; Regensteiner, Judith G.

2013-01-01

Background Supervised walking programs offered at medical facilities for patients with peripheral artery disease (PAD) and intermittent claudication (IC), while effective, are often not utilized due to barriers including lack of reimbursement and the need to travel to specialized locations for the training intervention. Walking programs for PAD patients that occur in community settings, such as those outside of supervised settings, may be a viable treatment option, as they are convenient and potentially bypass the need for supervised walking. This review evaluated the various methodologies and outcomes of community walking programs for PAD. Methods A literature review using appropriate search terms was conducted within PubMed/Medline and the Cochrane databases to identify studies in the English language employing community walking programs to treat PAD patients with IC. Search results were reviewed, and relevant articles were identified that form the basis of this review. The primary outcome was peak walking performance on the treadmill. Results Randomized controlled trials (n=10) examining peak walking outcomes in 558 PAD patients demonstrated that supervised exercise programs were more effective than community walking studies that consisted of general recommendations for patients with IC to walk at home. Recent community trials that incorporated more advice and feedback for PAD patients in general resulted in similar outcomes with no differences in peak walking time compared to supervised walking exercise groups. Conclusions Unstructured recommendations for patients with symptomatic PAD to exercise in the community are not efficacious. Community walking programs with more feedback and monitoring offer improvements in walking performance for patients with claudication and may bypass some obstacles associated with facility-based exercise programs. PMID:24103409

Efficacy of the Otago Exercise Programme to reduce falls in community-dwelling adults aged 65-80 years old when delivered as group or individual training.

PubMed

Albornos-Muñoz, Laura; Moreno-Casbas, María Teresa; Sánchez-Pablo, Clara; Bays-Moneo, Ana; Fernández-Domínguez, Juan Carlos; Rich-Ruiz, Manuel; Gea-Sánchez, Montserrat

2018-04-06

This study will compare how falls can be reduced in non-institutionalized older Spanish adults aged 65-80 years by providing group or individual exercise sessions using the Otago Exercise Programme. The Otago Exercise Programme is a progressive home-based exercise programme, where trained health professionals help people engage in strength, balance and endurance exercises. Its format is based on the evidence from four clinical trials. The benefits of the Otago Exercise Programme are the same for people who have and have not suffered falls and it can also be used for visually impaired people. A multicentre, simply blinded, randomized, non-inferiority clinical trial, with two arms-group training and individual training-that started in January 2017 and will continue until December 2019. Each study group has 364 subjects, who will take part in four individual or group sessions delivered mainly by nurses over an 8-week period, with a reinforcement session 6 months later. Data will be collected at baseline and after 6 and 12 months. The fall percentage will be the most relevant clinical variable and we will also consider safety, viability, compliance, economic analysis and therapeutic value. Approval and funding was granted in December 2016 for this 3-year study by the Spanish Health Research Fund (PI16CIII/00031). Older people from 65-80 years old tend to be more isolated and tackling worries about falls can improve social activities and independence. It has been shown that group training provides better adherence to exercise than individual training and this study will test that hypothesis for the Otago Exercise Programme. © 2018 John Wiley & Sons Ltd.

What do community-dwelling Caucasian and South Asian 60-70 year olds think about exercise for fall prevention?

PubMed

Horne, Maria; Speed, Shaun; Skelton, Dawn; Todd, Chris

2009-01-01

strategies to prevent falls often recommend regular exercise. However, 40% of over 50s in the UK report less physical activity than is recommended. Even higher rates of sedentary behaviour have been reported among South Asian older adults. to identify salient beliefs that influence uptake and adherence to exercise for fall prevention among community-dwelling Caucasian and South Asian 60-70 year olds in the UK. we undertook an ethnographic study using participant observation, 15 focus groups (n = 87; mean age = 65.7 years) and 40 individual semi-structured interviews (mean age = 64.8 years). Data analysis used framework analysis. young older adults do not acknowledge their fall risk and are generally not motivated to exercise to prevent falls. Those who had fallen are more likely to acknowledge risk of future falls. Whilst many of the beliefs about falls and exercise expressed were very similar between Caucasians and South Asians, there was a tendency for South Asians to express fatalistic beliefs more often. fall prevention should not be the focus of strategies to increase uptake and adherence to exercise. The wider benefits of exercise, leading to an active healthy lifestyle should be encouraged.

Exercise addiction in CrossFit: Prevalence and psychometric properties of the Exercise Addiction Inventory.

PubMed

Lichtenstein, Mia Beck; Jensen, Tanja Tang

2016-06-01

CrossFit is a mix of aerobic and anaerobic exercise regimes with the stated goal of improving fitness and physical performance. It is growing in popularity and has a strong community known to motivate and push the participants to maximal performance. The negative consequences of these extreme exercise patterns have rarely been described. The prevalence of injuries in CrossFit is high but exercise addiction and harmful exercise attitudes have not yet been assessed. The aim of this study was to measure the prevalence of exercise addiction in CrossFit and to evaluate the reliability and validity of the Exercise Addiction Inventory (EAI) in a CrossFit population. We invited crossfitters to participate in an online survey using Facebook groups. A total of 603 regular crossfitters completed the EAI and additional questions concerning exercise amounts and negative exercise attitudes and beliefs. We used principal component analyses and structural equation models to test the psychometric properties of the EAI and to describe the characteristics of the addicted crossfitters. We found that 5% of the crossfitters were addicted to exercise and that young males had a higher risk. The EAI had good internal reliability (0.73) and construct validity. Thus we found significant positive associations between exercise addiction and the tendency to exercise in spite of injury, feelings of guilt when unable to exercise, passion turning into obsession and taking medication to be able to exercise. Exercise addiction is prevalent in CrossFit and needs further exploration. The EAI is recommended for research in CrossFit communities and applied settings.

Irish set dancing classes for people with Parkinson's disease: The needs of participants and dance teachers.

PubMed

Shanahan, Joanne; Bhriain, Orfhlaith Ní; Morris, Meg E; Volpe, Daniele; Clifford, Amanda M

2016-08-01

As the number of people diagnosed with Parkinson's disease increases, there is a need to develop initiatives that promote health and wellbeing and support self-management. Additionally, as exercise may slow physical decline, there is a need to develop methods that facilitate greater engagement with community-based exercise. The aim of this study is to examine the needs of (1) people with Parkinson's disease and (2) set dancing teachers to enable the development of participant-centred community set dance classes. A mixed methods study design was used. Two consensus group discussions using nominal group technique were held to (1) identify factors pertaining to the needs of people with Parkinson's disease from a set dance class and (2) the educational needs of set dancing teachers to enable them to teach set dancing to people with Parkinson's disease. Group discussions began with silent generation of ideas. A round-robin discussion and grouping of ideas into broader topic areas followed. Finally, participants ranked, by order of priority (1-5), the topic areas developed. Final data analysis involved summation of participants' ranking scores for each topic area. Rich information on the needs of people with Parkinson's disease from a dance class and the educational guidance sought by set dancing teachers was gathered. Topic areas developed include "teaching method" for set dances and "class environment". Accessing community exercise programmes is important for this population. The results of this study will inform the development of an educational resource on Parkinson's disease for set dancing teachers. This resource may facilitate a larger number of teachers to establish sustainable community set dancing classes for people with Parkinson's disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

Combining Photovoice and focus groups: engaging Latina teens in community assessment.

PubMed

Hannay, Jayme; Dudley, Robert; Milan, Stephanie; Leibovitz, Paula K

2013-03-01

Latino adolescents, especially girls, experience higher obesity rates and are more likely to be physically unfit than non-Latino white peers. Out-of-school programs to increase physical activity and fitness in older Latino teens are critical, but sustained engagement is challenging. This study combined a community-based participatory research methodology, Photovoice, with focus groups to engage Latina teens and their parents in identifying barriers to physical activity and initiating policy change actions to address them. The study investigates the effectiveness of applying Photovoice as both an evaluation tool and a leadership/advocacy intervention in a community-based obesity prevention program. Focus group data were collected between July 2009 and October 2010 and analyzed between November 2010 and July 2011. Five focus groups were held with adults (n = 41: 95% Latino) and four with teens (n = 36: 81% Latino, 10% non-Hispanic white, 9% African-American). All participants (19 teens, six adults) were Latino. Spanish-speaking staff of a community-based agency, program staff, high school guidance counselors, and a job development agency recruited participants. Teens aged 14-19 years enrolled in New Britain CT, high schools, and their parents were eligible. Data from Photovoice workshops (three with teens, two with parent-teen dyads) were collected and concurrently analyzed between July 2009 and August 2011. Teens criticized school-based physical exercise programs in favor of out-of-school exercise and career advice. Parental restrictions and work, transportation, and safety issues were cited as barriers to afterschool physical activity programs. Photovoice can empower teens and parents to address exercise barriers by promoting advocacy that leads to policy change (e.g., an out-of-school physical education option). Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

An effective physical fitness program for small and medium-sized enterprises.

PubMed

Tsai, Han Hui; Peng, Shu Mei; Yeh, Ching Ying; Chen, Chiou Jong; Chen, Ruey Yu

2011-01-01

The aim of this study is to develop a practicable worksite physical fitness program for small and medium-sized enterprises (SMEs). Community-based intervention consisting of a three-month exercise course was conducted, and its benefits evaluated. A self-administrated structured questionnaire and physical fitness examination were designed to compare the difference between pre and post intervention. A total of 133 SME workers completed the lifestyle/exercise course and filled out the questionnaire, but 16 were excluded from the exercise group due to health reasons. After the intervention, health indicators such as weight, blood pressure, resting heart rate, waistline, BMI, front and back trunk flexibility, abdominal muscle durability and back muscle strength were significantly improved, and improvements in musculoskeletal disorders were seen in reduced neck pain (18.8%), wrist pain (17.4%), and upper/lower back pain (8.7% and 21.7%, respectively). Cardiovascular risk factors (BMI and resting heart rate) showed a significant improvement related to frequent participation in the program (p=0.02), and the exercise group reported a significant difference in overall health (p=0.02). This study has demonstrated an effective approach to community-based fitness intervention through SMEs.

Effect of exercise on cognitive performance in community-dwelling older adults: review of intervention trials and recommendations for public health practice and research.

PubMed

Snowden, Mark; Steinman, Lesley; Mochan, Kara; Grodstein, Francine; Prohaska, Thomas R; Thurman, David J; Brown, David R; Laditka, James N; Soares, Jesus; Zweiback, Damita J; Little, Deborah; Anderson, Lynda A

2011-04-01

There is evidence from observational studies that increasing physical activity may reduce the risk of cognitive decline in older adults. Exercise intervention trials have found conflicting results. A systematic review of physical activity and exercise intervention trials on cognition in older adults was conducted. Six scientific databases and reference lists of previous reviews were searched. Thirty studies were eligible for inclusion. Articles were grouped into intervention-outcome pairings. Interventions were grouped as cardiorespiratory, strength, and multicomponent exercises. Cognitive outcomes were general cognition, executive function, memory, reaction time, attention, cognitive processing, visuospatial, and language. An eight-member multidisciplinary panel rated the quality and effectiveness of each pairing. Although there were some positive studies, the panel did not find sufficient evidence that physical activity or exercise improved cognition in older adults. Future research should report exercise adherence, use longer study durations, and determine the clinical relevance of measures used. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Effects of topical essential oil on exercise volume after a 12-week exercise program for women with fibromyalgia: a pilot study.

PubMed

Rutledge, Dana N; Jones, C Jessie

2007-12-01

We determined--in women with fibromyalgia (FM)--effects of essential oils used with a 12-week exercise program on exercise volume, pain, physical performance, and physical function. This was a randomized clinical trial comparing 024 essential oil with sham oil combined with exercise. SETTINGS included community sites in southern California. The study included 20 women randomized to 024 oil, 23 to sham oil. Women were trained in oil application before exercise, at bedtime on exercise days; the 12-week program included weekly group sessions with trained leaders guided by a prerecorded regimen (allowing choice of program level) plus 2 days of home exercise with the recorded regimen. Primary: Exercise volume (number of days exercised multiplied by exercise level--intensity and duration). Secondary: Pain (Brief Pain Inventory), measures of physical performance (30-second chair stands, 6-minute walk, multidimensional balance), and self-reported physical function (Composite Physical Function scale). The average participant was 54 years old, had some college education, was married, Caucasian, and minimally/mildly depressed. There was no significant difference in exercise volume between women using 024 as compared with those using sham oil after 12 weeks (depression as covariate). There were no significant group nor pre- to postexercise changes in pain intensity or interference. There were greater positive changes in 30-second chair stands, 6-minute walk distance, and multidimensional balance scores in the 024 group than in the sham group, but these were not significant. The counterirritant 024 oil was not different from the sham oil in its effect on exercise volume (frequency, exercise level--intensity and duration) for women with FM. It is unknown whether 024 actually decreases local pain when used with exercise. Increases in physical function found, while not significant, may be attributable to the exercise regimen or to the interaction of the oils and exercise regimen.

Effects of unipedal standing balance exercise on the prevention of falls and hip fracture among clinically defined high-risk elderly individuals: a randomized controlled trial.

PubMed

Sakamoto, Keizo; Nakamura, Toshitaka; Hagino, Hiroshi; Endo, Naoto; Mori, Satoshi; Muto, Yoshiteru; Harada, Atsushi; Nakano, Tetsuo; Itoi, Eiji; Yoshimura, Mitsuo; Norimatsu, Hiromichi; Yamamoto, Hiroshi; Ochi, Takahiro

2006-10-01

The aim of this study was to assess the effectiveness of the unipedal standing balance exercise for 1 min to prevent falls and hip fractures in high-risk elderly individuals with a randomized controlled trial. This control study was designed as a 6-month intervention trial. Subjects included 553 clinically defined high-risk adults who were living in residences or in the community. They were randomized to an exercise group and a control group. Randomization to the subjects was performed by a table of random numbers. A unipedal standing balance exercise with open eyes was performed by standing on each leg for 1 min three times per day. As a rule, subjects of the exercise group stood on one leg without holding onto any support, but unstable subjects were permitted to hold onto a bar during the exercise time. Falls and hip fractures were reported by nurses, physical therapists, or facility staff with a survey sheet every month. This survey sheet was required every month for both groups. Registered subjects were 553 persons ranging in age from 37 to 102 years (average, 81.6 years of age). Twenty-six subjects dropped out. The number of falls and hip fractures for the 6-month period after the trial for 527 of the 553 subjects for whom related data were available were assessed. The exercise group comprised 315 subjects and the control group included 212 subjects. The cumulative number of falls of the exercise group, with 1 multiple faller omitted, was 118, and the control group recorded 121 falls. A significant intergroup difference was observed. However, the cumulative number of hip fractures was only 1 case in both groups. This difference was not statistically significant. The unipedal standing balance exercise is effective to prevent falls but was not shown to be statistically significant in the prevention of hip fracture in this study.

The effect of water-based exercises on balance in persons post-stroke: a randomized controlled trial.

PubMed

Chan, Kelvin; Phadke, Chetan P; Stremler, Denise; Suter, Lynn; Pauley, Tim; Ismail, Farooq; Boulias, Chris

2017-05-01

Water-based exercises have been used in the rehabilitation of people with stroke, but little is known about the impact of this treatment on balance. This study examined the effect of water-based exercises compared to land-based exercises on the balance of people with sub-acute stroke. In this single-blind randomized controlled study, 32 patients with first-time stroke discharged from inpatient rehabilitation at West Park Healthcare Centre were recruited. Participants were randomized into W (water-based + land; n = 17) or L (land only; n = 15) exercise groups. Both groups attended therapy two times per week for six weeks. Initial and progression protocols for the water-based exercises (a combination of balance, stretching, and strengthening and endurance training) and land therapy (balance, strength, transfer, gait, and stair training) were devised. Outcomes included the Berg Balance Score, Community Balance and Mobility Score, Timed Up and Go Test, and 2 Minute Walk Test. Baseline characteristics of groups W and L were similar in age, side of stroke, time since stroke, and wait time between inpatient discharge and outpatient therapy on all four outcomes. Pooled change scores from all outcomes showed that significantly greater number of patients in the W-group showed improvement post-training compared to the L-group (p < 0.05). More patients in W-group showed change scores exceeding the published minimal detectable change scores. A combination of water- and land-based exercises has potential for improving balance. The results of this study extend the work showing benefit of water-based exercise in chronic and less-impaired stroke groups to patients with sub-acute stroke.

Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial.

PubMed

Messier, Stephen P; Callahan, Leigh F; Beavers, Daniel P; Queen, Kate; Mihalko, Shannon L; Miller, Gary D; Losina, Elena; Katz, Jeffrey N; Loeser, Richard F; Quandt, Sara A; DeVita, Paul; Hunter, David J; Lyles, Mary F; Newman, Jovita; Hackney, Betsy; Jordan, Joanne M

2017-02-22

Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA. This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m 2 ) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective. Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended by numerous OA treatment guidelines. This study will establish the effectiveness of a community program that will serve as a blueprint and exemplar for clinicians and public health officials in urban and rural communities to implement a diet-induced weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA. clinicaltrials.gov Identifier: NCT02577549 October 12, 2015.

A novel dynamic exercise initiative for older people to improve health and well-being: study protocol for a randomised controlled trial.

PubMed

Sales, Myrla Patricia Reis; Polman, Remco; Hill, Keith D; Karaharju-Huisman, Tuire; Levinger, Pazit

2015-06-24

Exercise is an important and effective approach to preventing falls in older people, but adherence to exercise participation remains a persistent problem. A unique purpose-built exercise park was designed to provide a fun but physically challenging environment to support exercise in a community setting. This project is a randomised controlled trial designed to evaluate the effectiveness of an exercise intervention using an exercise park specifically designed for older people in reducing the risk of falls. This study will be a parallel randomised control trial with pre and post intervention design. One hundred and twenty people aged between 60 and 90 years old will be recruited from Melbourne suburbs and will be randomly allocated to either an exercise park intervention group (EPIG) or a control group (CG). The CG will receive social activities and an educational booklet on falls prevention. The BOOMER balance test will be used as the primary outcome measure. Secondary outcome measures will include hand grip strength, two minute walk test, lower limb strength test, spatio-temporal walking parameters, health related quality of life, feasibility, adherence, safety, and a number of other psychosocial measures. Outcome assessment will be conducted at baseline and at 18 and 26 weeks after intervention commencement. Participants will inform their falls and physical activity history for a 12-month period via monthly calendars. Mixed linear modelling incorporating intervention and control groups at the baseline and two follow up time points (18 weeks and 26 weeks after intervention commencement) will be used to assess outcomes. This planned trial will be the first to provide evidence if the exercise park can improve functional and physiological health, psychological and well-being. In addition, this study will provide empirical evidence for effectiveness and explore the barriers to participation and the acceptability of the senior exercise park in the Australian older community. This trial is registered with the Australian New Zealand Clinical Trials Registry-Registry No. ACTRN12614000700639 registered on Jul 3rd 2014.

What older adults find useful for maintaining healthy eating and exercise habits.

PubMed

Greaney, Mary L; Lees, Faith D; Greene, Geoffrey W; Clark, Phillip G

2004-01-01

Four focus groups were conducted with a total of 29 adults 60 years of age and older enrolled in the SENIOR Project, a health promotion intervention study designed to increase fruit and vegetable consumption and exercise among community-dwelling older adults. The focus groups explored the motivations of older adults to eat five or more servings of fruits and vegetables and/or exercise and the strategies used to adopt or maintain these behaviors. Participants stated that maintaining health, remaining independent, and fearing illness provided the motivation needed to adhere to these behaviors. The strategies or the behavioral processes used to adopt or maintain these behaviors included counterconditioning, helping relationships, stimulus control, and self-liberation.

Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme.

PubMed

Foley, A; Halbert, J; Hewitt, T; Crotty, M

2003-12-01

To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Single blind, three arm, randomised controlled trial. 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Functional gains were achieved with both exercise programmes compared with the control group.

Does hydrotherapy improve strength and physical function in patients with osteoarthritis—a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme

PubMed Central

Foley, A; Halbert, J; Hewitt, T; Crotty, M

2003-01-01

Objective: To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Design: Single blind, three arm, randomised controlled trial. Subjects: 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Methods: Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). Results: In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Conclusion: Functional gains were achieved with both exercise programmes compared with the control group. PMID:14644853

Intensity and Types of Physical Exercise in Relation to Dementia Risk Reduction in Community-Living Older Adults.

PubMed

Lee, Allen T C; Richards, Marcus; Chan, Wai C; Chiu, Helen F K; Lee, Ruby S Y; Lam, Linda C W

2015-10-01

To systematically examine the amount and type of physical exercise that might reduce the future risk of dementia in community-living older people. Six-year observational study. All the Elderly Health Centers (EHCs) of the Department of Health in Hong Kong. A total of 15,589 community-living Chinese aged 65 years and older with no history of stroke, clinical dementia, or Parkinson disease when they completed health assessment at the EHCs in the first 6 months of 2005. Self-reported habitual physical exercise patterns, including the frequency, duration, and type of exercise, at baseline and Year 3 were analyzed. The study outcome was incident dementia in 6 years. Dementia was defined by presence of clinical dementia in accordance with the 10th revision of the International Statistical Classification of Diseases and Related Health Problems or Clinical Dementia Rating of 1 to 3. Both the cognitively stable and incident groups reported exercising a median of 7 days per week and 45 minutes per day at baseline and Year 3. The former practiced aerobic and mind-body exercises more at baseline and Year 3, whereas the latter practiced stretching and toning exercises more. The odds ratio for dementia remained significant for aerobic (0.81; 95% confidence interval 0.68-0.95; P = .01) and mind-body exercises (0.76; 0.63-0.92; P = .004) after excluding participants who developed dementia within 3 years after baseline and adjusting for important potential confounders, such as age, gender, educational level, and physical and psychiatric comorbidities. Although physical exercise is widely promoted as a nonpharmacological intervention for dementia prevention, not all types of exercise appear to be useful in reducing risk of dementia in older people. Our findings suggest that daily participation in aerobic and mind-body but not stretching and toning exercises might protect community-living older adults from developing dementia. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The long-term benefits of a multi-component exercise intervention to balance and mobility in healthy older adults.

PubMed

Bird, M; Hill, K D; Ball, M; Hetherington, S; Williams, A D

2011-01-01

We examined the long-term effects of a multi-component exercise program on balance, mobility and exercise behavior. The benefits of a community-based resistance and flexibility exercise intervention in a group of healthy older (60-75 years) individuals were recorded 12 months after completion of the randomized control intervention. Differences between those participants who continued to exercise and those who discontinued were investigated. Significant improvements from baseline in sit to stand (p<0.001), timed up and go (p=0.001), and sway (p<0.001) remained at follow up in the exercise intervention group, with a control group unchanged. Participants who continued exercising had significantly greater improvements in strength immediately after the intervention, compared to those who discontinued (p=0.004). Those who continued regular resistance training performed better in the step test at 12-month follow up (p=0.009) and believed that the program was of more benefit to their physical activity (p<0.001) than those who discontinued exercising. Benefits to balance and mobility persist 1 year after participation in a multi-component exercise program, due in part to some continuing participation in resistance training. Motivation to continue resistance training may be related real and perceived benefits attained from the intervention as well as the environmental context of the intervention. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Middle-aged Female Depression in Perimenopausal Period and Square Dance Intervention.

PubMed

Gao, Lei; Zhang, Linlin; Qi, Hua; Petridis, Louyis

2016-12-01

Depression is one of the most common psychiatric illnesses among perimenopausal women. Currently, drug treatments for the disorder tend to have higher risks than other forms of treatment. On the contrary, aerobic exercise can effectively relieve menopausal syndrome among perimenopausal women. Square dance, a kind of aerobic exercise favored by middle-aged women in China, could be a beneficial intervention for perimenopausal depression. A total of 321 women in perimenopause were chosen from Nangang Community, DaoLi Community, and Daowai Community in Harbin, Heilongjiang Province, from September 2015 through April 2016. Of the women with depressive symptoms, 60 did not participate in square dance. The subjects were randomly assigned to the intervention group (n=26) and control group (n=24). Intervention group patients participated in guided square dance exercise 60-90 min at least 5 times per week at a regular time for 3 months. The women in the control group received no intervention. Of the screened subjects, 72 women (22.4%) suffered mild to severe depression; younger, working married women who square danced regularly presented a low depression rate (p<0.05). The depression index score of the intervention group after three months was 0.43±0.09, a statistically significant decrease (t=5.658, p<0.001). The difference in the depression index changes of the intervention and control group was also significant (t=5.407, p<0.001). The depression rate among women in perimenopause is high. Some intervention measures, such as promoting female employment, organizing collective activities for retired or unemployed women, and stabilizing family ties can prevent or improve the depression of women in perimenopause. Square dance can effectively reduce the depression levels of women in perimenopause.

The Effects of a Diet and Exercise Program for Older Adults With Metabolic Syndrome.

PubMed

Lin, Yu-Hua; Chu, Li-Ling; Kao, Chia-Chan; Chen, Tai-Been; Lee, I; Li, Hui-Chi

2015-09-01

The prevalence of metabolic syndrome is high among older adults in Taiwan. However, few studies have studied the effect of a combined diet and exercise program on managing metabolic syndrome (MetS) in individuals 65 years and older and living in Taiwan's rural areas. This study tests the effectiveness of a diet and exercise program on the MetS biomarkers in older community residents with MetS. This study used a quasiexperimental study design. All participants were 65 years and older and were diagnosed with MetS. The outcome variables included biomarkers (blood pressure, waist circumference, hip circumference, body mass index, blood sugar, cholesterol, and triglycerides) and demographic characteristics. The participants were distributed into a diet-and-exercise group (n = 163) and a nondiet-and-nonexercise group (n = 138). The outcome variables were examined 3 months after the start of the intervention program. The participants in the diet-and-exercise group had lower values than the nondiet-and-nonexercise group for blood pressure, waist circumference, hip circumference, body mass index, blood sugar, cholesterol, and triglyceride (all ps < .001). The diet and exercise program is an effective intervention for treating older individuals with MetS. Clear and concise information concerning the effects of diet and exercise in promoting the health of older residents with MetS is helpful to improve the health of the older adults inTaiwan.

Exercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: the randomized controlled senior fitness and prevention (SEFIP) study.

PubMed

Kemmler, Wolfgang; von Stengel, Simon; Engelke, Klaus; Häberle, Lothar; Kalender, Willi A

2010-01-25

Physical exercise affects many risk factors and diseases and therefore can play a vital role in general disease prevention and treatment of elderly individuals and may reduce costs. We sought to determine whether a single exercise program affects fracture risk (bone mineral density [BMD] and falls), coronary heart disease (CHD) risk factors, and health care costs in community-dwelling elderly women. We conducted a randomized, single-blinded, controlled trial from May 1, 2005, through July 31, 2008, recruiting women 65 years or older who were living independently in the area of Erlangen-Nuremberg, Germany. In all, 246 women were randomly assigned to an 18-month exercise program (exercise group) or a wellness program (control group). The exercise group (n = 123) performed a multipurpose exercise program with special emphasis on exercise intensity; the controls (n = 123) focused on well-being with a low-intensity, low-frequency program. The main outcome measures were BMD, the number of falls, the Framingham-based 10-year CHD risk, and direct health care costs. For the 227 women who completed the 18-month study, significant exercise effects were observed for BMD of the lumbar spine (mean [95% confidence interval (CI)] percentage of change in BMD [baseline to follow-up] for the exercise group: 1.77% [1.26% to 2.28%] vs controls: 0.33% [-0.24% to 0.91%]; P < .001), femoral neck (exercise group: 1.01% [0.37% to 1.65%] vs controls: -1.05% [-1.70% to -0.40%]; P < .001), and fall rate per person during 18 months (exercise group: 1.00 [0.76 to 1.24] vs controls: 1.66 [1.33 to 1.99]; P = .002). The 10-year CHD risk was significantly affected in both subgroups (absolute change for the exercise group: -1.96% [95% CI, -2.69% to -1.23%] vs controls: -1.15% [-1.69% to -0.62%]; P = .22), with no significant difference between the groups. The direct health care costs per participant during the 18-month intervention showed nonsignificant differences between the groups (exercise group: 2255 euros[95% CI, 1791 euros-2718 euros] vs controls: 2780 euros [2187 euros-3372 euros]; P = .20). Compared with a general wellness program, our 18-month exercise program significantly improved BMD and fall risk, but not predicted CHD risk, in elderly women. This benefit occurred at no increase in direct costs. clinicaltrials.gov Identifier: NCT00267839.

Protocol for Fit Bodies, Fine Minds: a randomized controlled trial on the affect of exercise and cognitive training on cognitive functioning in older adults

PubMed Central

O'Dwyer, Siobhan T; Burton, Nicola W; Pachana, Nancy A; Brown, Wendy J

2007-01-01

Background Declines in cognitive functioning are a normal part of aging that can affect daily functioning and quality of life. This study will examine the impact of an exercise training program, and a combined exercise and cognitive training program, on the cognitive and physical functioning of older adults. Methods/Design Fit Bodies, Fine Minds is a randomized, controlled trial. Community-dwelling adults, aged between 65 and 75 years, are randomly allocated to one of three groups for 16 weeks. The exercise-only group do three 60-minute exercise sessions per week. The exercise and cognitive training group do two 60-minute exercise sessions and one 60-minute cognitive training session per week. A no-training control group is contacted every 4 weeks. Measures of cognitive functioning, physical fitness and psychological well-being are taken at baseline (0 weeks), post-test (16 weeks) and 6-month follop (40 weeks). Qualitative responses to the program are taken at post-test. Discussion With an increasingly aged population, interventions to improve the functioning and quality of life of older adults are particularly important. Exercise training, either alone or in combination with cognitive training, may be an effective means of optimizing cognitive functioning in older adults. This study will add to the growing evidence base on the effectiveness of these interventions. Trial Registration Australian Clinical Trials Register: ACTRN012607000151437 PMID:17915035

Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial.

PubMed

Emmerson, Kellie B; Harding, Katherine E; Taylor, Nicholas F

2017-08-01

To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. A community rehabilitation programme within a large metropolitan health service. Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI -12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI -0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx.

Effects of Qigong Exercise on Biomarkers and Mental and Physical Health in Adults With at Least One Risk Factor for Coronary Artery Disease.

PubMed

Hung, Hsuan-Man; Yeh, Shu-Hui; Chen, Chung-Hey

2016-05-01

Current medical technology permits the early detection of risk factors for coronary artery disease (CAD) in adults, and interventions are available to prevent CAD-related morbidity and mortality. The goal of this study was to determine the effectiveness of a Qigong exercise intervention in improving biomarker levels and mental and physical health outcomes in community-dwelling adults diagnosed with CAD risk factors, in a southern Taiwanese city. Participants were randomly assigned to an experimental (n= 84) group that participated in a 60-min Qigong group session 3 times per week for 3 months or a control (n= 61) group that did not receive the intervention. Self-perceived mental and physical health assessed with the Chinese Health Questionnaire-12, and body fat percentage were measured at baseline and 6, 12, and 16 weeks. Blood samples were collected at baseline and 12 weeks for analysis of lipid profiles, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin (HbA1c), and fasting plasma sugar. Linear mixed model analyses revealed that experimental participants had significantly improved perceived mental and physical health and body fat percentage compared to the control group at 6 and 12 weeks but not 16 weeks. The lipid profiles were significantly more improved in the Qigong group than in the control group at 12 weeks. Qigong exercise, however, had no significant effects on hs-CRP, HbA1c, or fasting plasma sugar. Findings suggest that Qigong exercise improves a limited number of CAD risk factors in community-dwelling adults aged 40 years and over. © The Author(s) 2015.

Strategies to improve recruitment and retention of older stroke survivors to a randomized clinical exercise trial.

PubMed

Taylor-Piliae, Ruth E; Boros, Daniella; Coull, Bruce M

2014-03-01

Relatively few exercise randomized clinical trials (RCTs) among stroke survivors have reported the effectiveness of recruitment and retention strategies, despite its central importance to study integrity. Our objective is to examine recruitment and retention strategies used among a group of older community-dwelling stroke survivors for an exercise RCT. Recruitment strategies were multidimensional using both paid (ie, newspaper, radio and, television) and unpaid advertisements (ie, staff visits, flyers, and brochures placed at outpatient rehabilitation centers, physician offices, and community facilities working with older adults; free media coverage of the study, presentations at stroke support groups, relatives/friends, and study Web site) to obtain referrals. Retention strategies centered on excellent communication, the study participants' needs, and having dedicated study staff. Attrition rates and adherence to the intervention were used to examine the effectiveness of these retention strategies. A total of 393 referrals were received, 233 persons were screened, and 145 stroke survivors enrolled in the study. During 3 years of study recruitment, we achieved 97% of our enrollment target. We enrolled 62% of those screened. Study enrollment from paid advertising was 21.4% (n = 31), whereas unpaid advertisements resulted in 78.6% (n = 114) of our participants. Attrition was 10% (n = 14 dropouts), and adherence to the intervention was 85%. Recruitment and retention of participants in an exercise RCT are time and labor intensive. Multiple recruitment and retention strategies are required to ensure an adequate sample of community-dwelling stroke survivors. Many of these strategies are also relevant for exercise RCTs among adults with other chronic illnesses. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study.

PubMed

Agha, Arun; Liu-Ambrose, Teresa Y L; Backman, Catherine L; Leese, Jennifer; Li, Linda C

2015-08-13

The home-based Otago Exercise Program (OEP) has been shown to reduce the occurrence of falls in community-dwelling seniors. A new OEP DVD was recently developed for people living in rural communities to be used with minimal coaching by a physical therapist. This study aimed to understand older adults' experiences using the DVD-delivered OEP and explore barriers and facilitators to implementing the DVD-delivered OEP from the participants' perspectives. Rural community-dwelling older adults (75 years and older) who participated in a six-month DVD-delivered OEP study were invited to participate in this qualitative study. Two small group interviews were initially conducted to explore the breadth of participants' experiences with the program. These were followed by semi-structured individual interviews to gain an in-depth understanding of these experiences. An inductive constant comparison analysis of the transcripts was performed. To ensure methodological rigor, field notes, journaling, and an audit trail were maintained, supplemented by peer-review. Of 32 eligible participants, five participated in group interviews and 16 in individual interviews. Three themes emerged. Theme 1, The OEP DVD-useful training tool but in need of more pep, represented participants' experiences that the DVD provided important guidance at program onset, but was too slow and low-energy for longer-term use. Theme 2, Gaining control over one's exercise regimen, but sometimes life gets in the way of staying active, described participants' appreciation of the program's flexibility, but personal health concerns and everyday lives posed challenges to adhering to the program. Theme 3, Social creatures-wanting greater human connection during exercise, described how some participants desired further social interactions for enhancing motivation and receiving guidance. Individuals should be encouraged to refer to the OEP user manual or DVD as needed and engage friends and family in exercises. The importance of exercise even when living with health problems should be raised at program onset, and participants should be supported in working through challenging issues. Health professionals should work with individuals to integrate the program with their everyday activities.

Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial.

PubMed

Delbaere, K; Valenzuela, T; Woodbury, A; Davies, T; Yeong, J; Steffens, D; Miles, L; Pickett, L; Zijlstra, G A R; Clemson, L; Close, J C T; Howard, K; Lord, S R

2015-10-22

In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people. Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective. Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. Australian New Zealand Clinical Trials Registry (ACTRN)12615000138583. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Exercise Predicts Long-Term Weight Loss in Women With Class 1 and Class 2 Obesity Through Effects on Emotional Eating and its Correlates.

PubMed

Annesi, James J

2018-01-01

The relationship between exercise and long-term weight loss is definitive. However, in deconditioned individuals, the basis of that relationship beyond minimal energy expenditures is unclear. Effects emanating from exercise's proposed association with changes in emotional eating and its psychosocial correlates were tested. Women with class 1 (n = 67) and class 2 (n = 53) obesity, participating in a new community-based weight-loss treatment based on tenets of social cognitive theory, were assessed at baseline and Months 3, 6, 12, and 24 on weight and measures of exercise outputs, emotional eating, eating self-regulation, and negative mood. An exercise-support component was provided for 2 months prior to group nutrition-change sessions. Improvements from baseline were significant on all measures but did not significantly differ by group. Although not for the initial 3 months, changes in exercise significantly predicted weight changes over 6, 12, and 24 months from baseline. However, only 26%-31% of the lost weight was directly attributable to exercise-related energy expenditures. Changes in emotional eating significantly mediated the exercise-weight-loss relationship, and changes in self-regulation and mood significantly mediated the exercise-emotional eating relationship. Findings supported exercise's role in long-term weight loss primarily through psychosocial factors.

Comparing interventions and exploring neural mechanisms of exercise in Parkinson disease: a study protocol for a randomized controlled trial.

PubMed

Earhart, Gammon M; Duncan, Ryan P; Huang, John L; Perlmutter, Joel S; Pickett, Kristen A

2015-02-05

Effective treatment of locomotor dysfunction in Parkinson disease (PD) is essential, as gait difficulty is an early and major contributor to disability. Exercise is recommended as an adjunct to traditional treatments for improving gait, balance, and quality of life. Among the exercise approaches known to improve walking, tango and treadmill training have recently emerged as two promising therapies for improving gait, disease severity and quality of life, yet these two interventions have not been directly compared to each other. Prior studies have been helpful in identifying interventions effective in improving gait function, but have done little to elucidate the neural mechanisms underlying functional improvements. The primary objective of the proposed work is to compare the effects of three community-based exercise programs, tango, treadmill training and stretching, on locomotor function in individuals with PD. In addition, we aim to determine whether and how these interventions alter functional connectivity of locomotor control networks in the brain. One hundred and twenty right-handed individuals with idiopathic PD who are at least 30 years of age will be assigned in successive waves to one of three community-based exercise groups: tango dancing, treadmill training or stretching (control). Each group will receive three months of exercise training with twice weekly one-hour group classes. Each participant will be evaluated at three time points: pre-intervention (baseline), post-intervention (3 months), and follow-up (6 months). All evaluations will include assessment of gait, balance, disease severity, and quality of life. Baseline and post-intervention evaluations will also include task-based functional magnetic resonance imaging (fMRI) and resting state functional connectivity MRI. All MRI and behavioral measures will be conducted with participants OFF anti-Parkinson medication, with behavioral measures also assessed ON medication. This study will provide important insights regarding the effects of different modes of exercise on locomotor function in PD. The protocol is innovative because it: 1) uses group exercise approaches for all conditions including treadmill training, 2) directly compares tango to treadmill training and stretching, 3) tests participants OFF medication, and 4) utilizes two distinct neuroimaging approaches to explore mechanisms of the effects of exercise on the brain. ClinicalTrials.gov NCT01768832 .

A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.

PubMed

Weerdesteyn, Vivian; Rijken, Hennie; Geurts, Alexander C H; Smits-Engelsman, Bouwien C M; Mulder, Theo; Duysens, Jacques

2006-01-01

Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people. A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores. The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores. The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments. Copyright (c) 2006 S. Karger AG, Basel.

"Four legs instead of two"--perspectives on a Nordic walking-based walking programme among people with arthritis.

PubMed

O'Donovan, Rhona; Kennedy, Norelee

2015-01-01

Nordic Walking (NW) is growing in popularity among people with arthritis. The aim of this study was to explore the perspectives of participants with arthritis on a NW-based walking programme including factors contributing to sustained participation in the programme. Three semi-structured focus groups were conducted with a total of 27 participants with various types of arthritis. The groups consisted of participants who completed a NW-based walking programme in the previous 4 years. Only participants who had sustained involvement in the walking group were included. Groups were audio-recorded, transcribed verbatim and thematic analysis was performed. Participants reported that the walking programme offered numerous benefits. Two distinct themes emerged: (1) "four legs instead of two legs" and (2) "a support group". Theme 1 incorporates the physical, psychological and educational benefits that stem from involvement in a walking group while Theme 2 incorporates the benefits of social support in group-based activity. Several benefits of a NW-based walking programme from the perspectives of individuals with arthritis who engage in group-based walking programmes were identified. The benefits may encourage sustained participation and justify the promotion of NW as an intervention for people with arthritis. Considering how to sustain exercise participation is important to ensure continued benefits from physical activity participation. A community-based Nordic walking-based walking programme for people with arthritis improved exercise knowledge and confidence to exercise. Group exercise is valuable in providing support and motivation to continue exercising.

Exercise training during rehabilitation of patients with COPD: a current perspective.

PubMed

Spruit, Martijn A; Troosters, Thierry; Trappenburg, Jacob C A; Decramer, Marc; Gosselink, Rik

2004-03-01

Patients with chronic obstructive pulmonary disease (COPD) suffer frequently from physiologic and psychological impairments, such as dyspnea, peripheral muscle weakness, exercise intolerance, decreased health-related quality of life (HRQOL) and emotional distress. Rehabilitation programmes have shown to result in significant changes in perceived dyspnea and fatigue, utilisation of healthcare resources, exercise performance and HRQOL. Exercise training, which consists of whole-body exercise training and local resistance training, is the cornerstone of these programmes. Regrettably, the positive effects of respiratory rehabilitation deteriorate over time, especially after short programmes. Hence, attention should be given to the aftercare of these patients to prevent them to revert again to a sedentary lifestyle. On empirical basis three possibilities seem to be clinically feasible: (1) continuous outpatient exercise training; (2) exercise training in a home-based or community-based setting; or (3) exercise training sessions in a group of asthma and COPD patients.

What do community-dwelling Caucasian and South Asian 60–70 year olds think about exercise for fall prevention?

PubMed Central

Horne, Maria; Speed, Shaun; Skelton, Dawn; Todd, Chris

2009-01-01

Background: strategies to prevent falls often recommend regular exercise. However, 40% of over 50s in the UK report less physical activity than is recommended. Even higher rates of sedentary behaviour have been reported among South Asian older adults. Objective: to identify salient beliefs that influence uptake and adherence to exercise for fall prevention among community-dwelling Caucasian and South Asian 60–70 year olds in the UK. Methods: we undertook an ethnographic study using participant observation, 15 focus groups (n = 87; mean age = 65.7 years) and 40 individual semi-structured interviews (mean age = 64.8 years). Data analysis used framework analysis. Results: young older adults do not acknowledge their fall risk and are generally not motivated to exercise to prevent falls. Those who had fallen are more likely to acknowledge risk of future falls. Whilst many of the beliefs about falls and exercise expressed were very similar between Caucasians and South Asians, there was a tendency for South Asians to express fatalistic beliefs more often. Conclusion: fall prevention should not be the focus of strategies to increase uptake and adherence to exercise. The wider benefits of exercise, leading to an active healthy lifestyle should be encouraged. PMID:19039019

Impact of a 12-month exercise program on the physical and psychological health of osteopenic women.

PubMed

Bravo, G; Gauthier, P; Roy, P M; Payette, H; Gaulin, P; Harvey, M; Péloquin, L; Dubois, M F

1996-07-01

To describe the effect of a supervised physical activity program on the physical and psychological health of osteopenic women. A randomized controlled trial. Sherbrooke, Quebec, Canada. A total of 124 community-living postmenopausal women, between 50 and 70 years of age, with low bone mass took part in the study. Subjects allocated to the experimental group performed weight-bearing exercises (walking, stepping up and down from benches), aerobic dancing, and flexibility exercises for 60 minutes, three times a week, over a period of 12 months. All subjects were invited to attend bi-monthly educational seminars covering topics related to osteoporosis. Spinal and femoral bone mineral density (BMD), functional fitness (flexibility, coordination, agility, strength/endurance, cardiorespiratory endurance), psychological well-being, back pain intensity, and self-perceived health. Spinal BMD stabilized in the exercisers while decreasing significantly in the controls (P = .031). No change in femoral BMD was observed in either group (P = .597). Four of the five parameters chosen to evaluate functional fitness, namely flexibility, agility, strength, and endurance, were affected positively by the exercise program (all P < .01). Adjusting for prescores by means of an analysis of covariance revealed a significant difference between the groups in psychological well-being, which favored the exercisers (P = .012). After 12 months, back pain reported by exercisers was lower than that reported by controls (P = .008). Finally, self-perceived health increased in the exercise group, whereas no difference was observed in the control group (P = .790). These results suggest that after 12 months, exercising can produce a significant increase above initial levels in the functional fitness, well-being, and self-perceived health of osteopenic women. Intensity of back pain can also be lowered by exercise. The exercise program succeeded in stabilizing spinal BMD but had no effect on femoral BMD.

Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people.

PubMed

Barker, Anna L; Talevski, Jason; Bohensky, Megan A; Brand, Caroline A; Cameron, Peter A; Morello, Renata T

2016-10-01

To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Pilot Randomized controlled trial. Community physiotherapy clinic. A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61-84). A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks. Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P < 0.05). Estimates suggest a future definitive study would require 804 participants to detect a difference in fall injury rates. A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820). © The Author(s) 2015.

Association between exercise type and quality of life in a community-dwelling older people: A cross-sectional study

PubMed Central

Oh, Sang-Ho; Kim, Don-Kyu; Lee, Shi-Uk; Jung, Se Hee

2017-01-01

Objectives This study aimed to investigate the effects of three major representative exercises (resistance, flexibility, and walking) on quality of life (QoL) in a population of community-dwelling older adults. Materials and methods This cross-sectional study used public data from the Sixth Korean National Health and Nutrition Examination Survey in 2014 (n = 1,586 older people). Demographic factors, three types of exercise, five EuroQoL subsets (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), and QoL scores (EQ-VAS) were investigated. The independent associations between each exercise and the five QoL subsets were determined using odds ratios (OR) adjusted for three demographic factors (age group, sex, and area of residence), using multivariate logistic regression analysis. Results The EQ-VAS scores of the exercisers was significantly higher than those of the non-exercisers for all exercise types. Subjects with problems in mobility dimension performed less exercise of all types of than those with normal mobility (resistance: OR, 0.687; flexibility: OR, 0.733, and walking: OR, 0.489). The self-care dimension was independently correlated with flexibility (OR, 0.558) and walking (OR, 0.485). Conclusion All types of exercisers showed higher QoL scores than non-exercisers. Among the QoL dimensions, mobility and self-care were independently associated with flexibility and walking exercise in this older people, suggesting that engaging in regular flexibility and walking exercise is important for achieving higher QoL in the older people. PMID:29216283

Long-Term Exercise Training for an Individual With Mixed Corticobasal Degeneration and Progressive Supranuclear Palsy Features: 10-Year Case Report Follow-up

PubMed Central

Boeve, Bradley F.; Petersen, Cheryl M.; Dvorak, Leah; Kantarci, Kejal

2014-01-01

Background and Purpose This case report describes the effects of long-term (10-year) participation in a community exercise program for a client with mixed features of corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP). The effects of exercise participation on both functional status and brain volume are described. Case Description A 60-year-old male dentist initially reported changes in gait and limb coordination. He received a diagnosis of atypical CBD at age 66 years; PSP was added at age 72 years. At age 70 years, the client began a therapist-led community group exercise program for people with Parkinson disease (PD). The program included trunk and lower extremity stretching and strengthening, upright balance and strengthening, and both forward and backward treadmill walking. The client participated twice weekly for 1 hour for 10 years and was reassessed in years 9 to 10. Outcomes Falls (self-reported weekly over the 10-year period of the study by the client and his wife) decreased from 1.9 falls per month in year 1 to 0.3 falls per month in year 10. Balance, walking endurance, and general mobility declined slightly. Gait speed (both comfortable and fast) declined; the client was unable to vary gait speed. Quantitative brain measurements indicated a slow rate of whole brain volume loss and ventricular expansion compared with clients with autopsy-proven CBD or PSP. Discussion This client has participated consistently in a regular group exercise program for 10 years. He has reduced fall frequency, maintained balance and endurance, and retained community ambulation using a walker. Combined with the slow rate of brain volume loss, this evidence supports the efficacy of a regular exercise program to prolong longevity and maintain function in people with CBD or PSP. PMID:24114439

[Effects of Square-Stepping Exercise inducing activation of the brain's cognitive function in community-dwelling older Japanese females--Focus on the baseline cognitive function level and age].

PubMed

Abe, Takumi; Tsuji, Taishi; Kitano, Naruki; Muraki, Toshiaki; Hotta, Kazushi; Okura, Tomohiro

2015-01-01

The purpose of this study was to investigate whether the degree of improvement in cognitive function achieved with an exercise intervention in community-dwelling older Japanese women is affected by the participant's baseline cognitive function and age. Eighty-eight women (mean age: 70.5±4.2 years) participated in a prevention program for long-term care. They completed the Square-Stepping Exercise (SSE) program once a week, 120 minutes/session, for 11 weeks. We assessed participants' cognitive function using 5 cognitive tests (5-Cog) before and after the intervention. We defined cognitive function as the 5-Cog total score and defined the change in cognitive function as the 5-cog post-score minus the pre-score. We divided participants into four groups based on age (≤69 years or ≥70 years) and baseline cognitive function level (above vs. below the median cognitive function level). We conducted two-way analysis of variance. All 4 groups improved significantly in cognitive function after the intervention. There were no baseline cognitive function level×age interactions and no significant main effects of age, although significant main effects of baseline cognitive function level (P=0.004, η(2)=0.09) were observed. Square-Stepping Exercise is an effective exercise for improving cognitive function. These results suggest that older adults with cognitive decline are more likely to improve their cognitive function with exercise than if they start the intervention with high cognitive function. Furthermore, during an exercise intervention, baseline cognitive function level may have more of an effect than a participant's age on the degree of cognitive improvement.

Increasing Awareness of Group Privilege with College Students

ERIC Educational Resources Information Center

Stark-Rose, Rose M.; Lokken, Jayne M.; Zarghami, Fatemeh

2009-01-01

A qualitative study was conducted with 850 participants in 36 different classes including Child and Family Studies, Human Relations, Aviation, and Community Studies in a university in the Midwest. The study conducted was based on a simulated discrimination exercise to increase awareness of group privilege and preferential treatment among college…

Lessons Out-of-School: Boy Scouts, Girl Scouts and 4-H Clubs as Educational Environments.

ERIC Educational Resources Information Center

Kleinfeld, Judith; Shinkwin, Anne

By providing opportunities for closer youth-adult contact, exercising responsibility, performing community service, and learning practical skills, well-functioning youth groups create important educational occasions which are often lacking in school. To point out the overlooked features of traditional youth groups, researchers interviewed and…

The effects of mindfulness eating and yoga exercise on blood sugar levels of pregnant women with gestational diabetes mellitus.

PubMed

Youngwanichsetha, Sununta; Phumdoung, Sasitorn; Ingkathawornwong, Thitiporn

2014-11-01

This randomized controlled trial was carried out to investigate the effect of mindfulness eating and yoga exercise on blood sugar levels among pregnant Thai women with GDM. Interventions promoting achievement of good glycemic control result in desired pregnancy outcomes. Little is known about the health benefits of mindfulness eating and yoga exercise on blood sugar levels among pregnant with GDM. A randomized controlled trial was carried out. Main outcome measures were capillary fasting plasma glucose, 2-h postprandial blood glucose, and hemoglobin A1c. The intervention group showed significantly reduced fasting plasma glucose, 2-h postprandial blood glucose, and glycosylated hemoglobin (HbA1c) in the intervention group (p<0.05). Mindfulness eating and yoga exercise had health benefits on glycemic control in pregnant women with GDM. It should be recommended in clinical and community health services. Copyright © 2014 Elsevier Inc. All rights reserved.

A survey of social support for exercise and its relationship to health behaviours and health status among endurance Nordic skiers.

PubMed

Anderson, Paul J; Bovard, Ralph S; Wang, Zhen; Beebe, Timothy J; Murad, Mohammad Hassan

2016-06-23

Regular exercise is a key component of obesity prevention and 48% of Americans do not meet minimum guidelines for weekly exercise. Social support has been shown to help individuals start and maintain exercise programmes. We evaluated social support among endurance athletes and explored the relationship between social support for exercise, health behaviours and health status. Survey. The largest Nordic ski race in North America. 5433 past participants responded to an online questionnaire. Social support, health behaviours and health status. The mean overall support score was 32.1 (SD=16.5; possible range=-16.0 to 88.0). The most common forms of social support were verbal such as discussing exercise, invitations to exercise and celebrating the enjoyment of exercise. We found that an increase of 10 points in the social support score was associated with a 5 min increase in weekly self-reported exercise (5.02, 95% CI 3.63 to 6.41). Physical activity recommendations should incorporate the importance of participation in group activities, especially those connected to strong fitness cultures created by community and competitive events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Does a multicomponent exercise program improve dual-task performance in amnestic mild cognitive impairment? A randomized controlled trial.

PubMed

Makizako, Hyuma; Doi, Takehiko; Shimada, Hiroyuki; Yoshida, Daisuke; Tsutsumimoto, Kota; Uemura, Kazuki; Suzuki, Takao

2012-12-01

There has been much interest in exercise interventions as a primary behavioral prevention strategy against cognitive decline. The aim of this study was to evaluate the effect of a multicomponent exercise program on physical and dual-task performances in community-dwelling older adults with amnestic mild cognitive impairment (aMCI). Fifty older adults (23 women) with aMCI (mean age, 76 years) were randomized to an intervention (n=25) or a control group (n=25). The intervention group received a multicomponent exercise program for 90 minutes/day, 2 days/week, or 40 times over six months. The multicomponent exercises included aerobic exercise, muscle strength training and postural balance retraining, which was conducted under multi-task conditions to stimulate attention and memory. Participants in the control group attended two health promotion education classes within six months. Physical and dual-task performances were measured before randomization and after six months. Dual-task performances using reaction times with balance and cognitive demands were measured. The improvement effects on dual-task performances with both balance and cognitive demands were not statistically significant: reaction time with balance demand F1,45=3.3, p=0.07, and cognitive demand F1,45=2.6, p=0.12. However, there was a significant group-by-time interaction on maximal walking speed, which decreased significantly in the control group (F1,45=5.9, p=0.02). This six-month multicomponent exercise program improved maximal walking speed in older adults with aMCI; however, it did not improve dual-task performances assessed by reaction times.

High-intensity interval training improves peak oxygen uptake and muscular exercise capacity in heart transplant recipients.

PubMed

Nytrøen, K; Rustad, L A; Aukrust, P; Ueland, T; Hallén, J; Holm, I; Rolid, K; Lekva, T; Fiane, A E; Amlie, J P; Aakhus, S; Gullestad, L

2012-11-01

Heart transplant (HTx) recipients usually have reduced exercise capacity with reported VO(2peak) levels of 50-70% predicted value. Our hypothesis was that high-intensity interval training (HIIT) is an applicable and safe form of exercise in HTx recipients and that it would markedly improve VO(2peak.) Secondarily, we wanted to evaluate central and peripheral mechanisms behind a potential VO(2peak) increase. Forty-eight clinically stable HTx recipients >18 years old and 1-8 years after HTx underwent maximal exercise testing on a treadmill and were randomized to either exercise group (a 1-year HIIT-program) or control group (usual care). The mean ± SD age was 51 ± 16 years, 71% were male and time from HTx was 4.1 ± 2.2 years. The mean VO(2peak) difference between groups at follow-up was 3.6 [2.0, 5.2] mL/kg/min (p < 0.001). The exercise group had 89.0 ± 17.5% of predicted VO(2peak) versus 82.5 ± 20.0 in the control group (p < 0.001). There were no changes in cardiac function measured by echocardiography. We have demonstrated that a long-term, partly supervised and community-based HIIT-program is an applicable, effective and safe way to improve VO(2peak) , muscular exercise capacity and general health in HTx recipients. The results indicate that HIIT should be more frequently used among stable HTx recipients in the future. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Comparison of multisensory and strength training for postural control in the elderly

PubMed Central

Alfieri, Fábio Marcon; Riberto, Marcelo; Gatz, Lucila Silveira; Ribeiro, Carla Paschoal Corsi; Lopes, José Augusto Fernandes; Battistella, Linamara Rizzo

2012-01-01

Objective The objective of this study was to analyze the efficacy of multisensory versus muscle strengthening to improve postural control in healthy community-dwelling elderly. Participants We performed a single-blinded study with 46 community-dwelling elderly allocated to strength (GS, n = 23; 70.18 ± 4.8 years 22 women and 1 man) and multisensory exercises groups (GM, n = 23; 68.8 ± 5.9 years; 22 women and 1 man) for 12 weeks. Methods We performed isokinetic evaluations of muscle groups in the ankle and foot including dorsiflexors, plantar flexors, inversion, and eversion. The oscillation of the center of pressure was assessed with a force platform. Results The GM group presented a reduction in the oscillation (66.8 ± 273.4 cm2 to 11.1 ± 11.6 cm2; P = 0.02), which was not observed in the GS group. The GM group showed better results for the peak torque and work than the GS group, but without statistical significance. Conclusion Although the GM group presented better results, it is not possible to state that one exercise regimen proved more efficacious than the other in improving balance control. PMID:22654512

Ecologically optimizing exercise maintenance in men and women post-cardiac rehabilitation: Protocol for a randomized controlled trial of efficacy with economics (ECO-PCR).

PubMed

Reid, Robert; Blanchard, Chris M; Wooding, Evyanne; Harris, Jennifer; Krahn, Murray; Pipe, Andrew; Chessex, Caroline; Grace, Sherry L

2016-09-01

Exercise-based cardiac rehabilitation (CR) participation results in increased cardio-metabolic fitness, which is associated with reduced mortality. However, many graduates fail to maintain exercise post-program. ECO-PCR investigates the efficacy and cost-effectiveness of a social ecologically-based intervention to increase long-term exercise maintenance following the completion of CR. A three-site, 2-group, parallel randomized controlled trial is underway. 412 male and 192 female (N=604) supervised CR participants are being recruited just before CR graduation. Participants are randomized (1:1 concealed allocation) to intervention or usual care. A 50-week exercise facilitator intervention has been designed to assist CR graduates in the transition from structured, supervised exercise to self-managed home- or community-based (e.g., Heart Wise Exercise programs) exercise. The intervention consists of 8 telephone contacts over the 50week period: 3 individual and 5 group. Assessments occur at CR graduation, and 26, 52 and 78weeks post-randomization. The primary outcome is change in minutes of accelerometer-measured moderate to vigorous-intensity physical activity (MVPA) from CR graduation to 52weeks post-randomization. Secondary measures include exercise capacity, quality of life, and cardiovascular risk factors. Analyses will be undertaken based on intention-to-treat. For the primary outcome, an analysis of variance will be computed to test the change in minutes of MVPA in each group between CR graduation and 52week follow-up (2 [arm]×2 [time]). Secondary objectives will be assessed using mixed-model repeated measures analyses to compare differences between groups over time. Mean costs and quality-adjusted life years for each arm will be estimated. Copyright © 2016 Elsevier Inc. All rights reserved.

Health Risk Perceptions and Exercise in Older Adulthood: An Application of Protection Motivation Theory.

PubMed

Ruthig, Joelle C

2016-09-01

Protection Motivation Theory (PMT) was applied to explore the relationship between perceived risk of acute health crises and intent to exercise. Interviews of 351 community-living older adults assessed prior physical activity (PPA), all PMT components, and exercise intent. A multi-group structural equation model revealed gender differences in PMT predictors of exercise intent. PPA, age, self-efficacy, and response efficacy directly predicted men's intent. Women's PPA and age predicted PMT components of self-efficacy and response costs, which predicted intent. Findings have implications for devising interventions to enhance physical activity in later life by targeting different PMT components for older men and women. © The Author(s) 2014.

The health promotion lifestyle of metabolic syndrome individuals with a diet and exercise programme.

PubMed

Lin, Yu-Hua; Chu, Li-Ling

2014-04-01

The purpose of this study was to explore a health promotion lifestyle (HPL) with a diet and exercise programme (DEP) in metabolic syndrome adults. The study consisted of 207 individuals who followed a DEP and 185 who did not. The subjects were rural community adults. Their HPL was evaluated using the Chinese version of the Health Promotion Lifestyle Profile Short Form (HPLP-S). The average HPLP-S score was significantly higher in the DEP group (3.28 ± 0.36) than in the group without the DEP (2.05 ± 0.65). Stepwise regression analysis revealed that group, gender, smoking, alcohol use, marital status, religion and chronic disease were predictors of an HPL and accounted for 67.0% of the variance in the HPLP-S score. This study demonstrates that a DEP has positive effects on a health promotion lifestyle. The community-based DEP targeting health promotion behaviours should be presented as a strategy for metabolic syndrome in adults. © 2013 Wiley Publishing Asia Pty Ltd.

Functional mobility and balance in community-dwelling elderly submitted to multisensory versus strength exercises

PubMed Central

Alfieri, Fábio Marcon; Riberto, Marcelo; Gatz, Lucila Silveira; Ribeiro, Carla Paschoal Corsi; Lopes, José Augusto Fernandes; Santarém, José Maria; Battistella, Linamara Rizzo

2010-01-01

It is well documented that aging impairs balance and functional mobility. The objective of this study was to compare the efficacy of multisensory versus strength exercises on these parameters. We performed a simple blinded randomized controlled trial with 46 community-dwelling elderly allocated to strength ([GST], N = 23, 70.2-years-old ± 4.8 years) or multisensory ([GMS], N = 23, 68.8-years-old ± 5.9 years) exercises twice a week for 12 weeks. Subjects were evaluated by blinded raters using the timed ‘up and go’ test (TUG), the Guralnik test battery, and a force platform. By the end of the treatment, the GMS group showed a significant improvement in TUG (9.1 ± 1.9 seconds (s) to 8.0 ± 1.0 s, P = 0.002); Guralnik test battery (10.6 ± 1.2 to 11.3 ± 0.8 P = 0.009); lateromedial (6.1 ± 11.7 cm to 3.1 ± 1.6 cm, P = 0.02) and anteroposterior displacement (4.7 ± 4.2 cm to 3.4 ± 1.0 cm, P = 0.03), which were not observed in the GST group. These results reproduce previous findings in the literature and mean that the stimulus to sensibility results in better achievements for the control of balance and dynamic activities. Multisensory exercises were shown to be more efficacious than strength exercises to improve functional mobility. PMID:20711437

Clinician-Targeted Intervention and Patient-Reported Counseling on Physical Activity

PubMed Central

Winters, Paul C.; Sanders, Mechelle R.; Decker, Francesca; Ngo, Thanh; Sciamanna, Christopher N.

2014-01-01

Introduction Limited time and lack of knowledge are barriers to physical activity counseling in primary care. The objective of this study was to examine the effectiveness of a clinician-targeted intervention that used the 5As (Ask, Advise, Agree, Assist, Arrange) approach to physical activity counseling in a medically underserved patient population. Methods Family medicine clinicians at 2 community health centers were randomized to Group 1 or Group 2 intervention. Both clinician groups participated in 4 training sessions on the 5As for physical activity counseling; Group 2 training took place 8 months after Group 1 training. Both groups were trained to refer patients to a community exercise program. We used a pre–post analysis to evaluate the effectiveness of the intervention on clinician use of 5As. Eligible patients (n = 319) rated their clinicians’ counseling skills by using a modified Physical Activity Exit Interview (PAEI) survey. Clinicians (n = 10) self-assessed their use of the 5As through a survey and interviews. Results Both patient and clinician groups had similar sociodemographic characteristics. The PAEI score for both groups combined increased from 6.9 to 8.6 (on a scale of 0–15) from baseline to immediately postintervention (P = .01) and was 8.2 (P = .09) at 6-month follow-up; most of the improvement in PAEI score was due to increased use of 5As skills by Group 2 clinicians. Group 1 reported difficulty with problem solving, whereas Group 2 reported ease of referral to the community exercise program. Conclusion A clinician training intervention showed mixed results for 5As physical activity counseling. PMID:24874781

Clinician-targeted intervention and patient-reported counseling on physical activity.

PubMed

Carroll, Jennifer K; Winters, Paul C; Sanders, Mechelle R; Decker, Francesca; Ngo, Thanh; Sciamanna, Christopher N

2014-05-29

Limited time and lack of knowledge are barriers to physical activity counseling in primary care. The objective of this study was to examine the effectiveness of a clinician-targeted intervention that used the 5As (Ask, Advise, Agree, Assist, Arrange) approach to physical activity counseling in a medically underserved patient population. Family medicine clinicians at 2 community health centers were randomized to Group 1 or Group 2 intervention. Both clinician groups participated in 4 training sessions on the 5As for physical activity counseling; Group 2 training took place 8 months after Group 1 training. Both groups were trained to refer patients to a community exercise program. We used a pre-post analysis to evaluate the effectiveness of the intervention on clinician use of 5As. Eligible patients (n = 319) rated their clinicians' counseling skills by using a modified Physical Activity Exit Interview (PAEI) survey. Clinicians (n = 10) self-assessed their use of the 5As through a survey and interviews. Both patient and clinician groups had similar sociodemographic characteristics. The PAEI score for both groups combined increased from 6.9 to 8.6 (on a scale of 0-15) from baseline to immediately postintervention (P = .01) and was 8.2 (P = .09) at 6-month follow-up; most of the improvement in PAEI score was due to increased use of 5As skills by Group 2 clinicians. Group 1 reported difficulty with problem solving, whereas Group 2 reported ease of referral to the community exercise program. A clinician training intervention showed mixed results for 5As physical activity counseling.

Intense Exercise and Aerobic Conditioning Associated with Chromium or L-Carnitine Supplementation Modified the Fecal Microbiota of Fillies.

PubMed

Almeida, Maria Luiza Mendes de; Feringer, Walter Heinz; Carvalho, Júlia Ribeiro Garcia; Rodrigues, Isadora Mestriner; Jordão, Lilian Rezende; Fonseca, Mayara Gonçalves; Carneiro de Rezende, Adalgiza Souza; de Queiroz Neto, Antonio; Weese, J Scott; Costa, Márcio Carvalho da; Lemos, Eliana Gertrudes de Macedo; Ferraz, Guilherme de Camargo

2016-01-01

Recent studies performed in humans and rats have reported that exercise can alter the intestinal microbiota. Athletic horses perform intense exercise regularly, but studies characterizing horse microbiome during aerobic conditioning programs are still limited. Evidence has indicated that this microbial community is involved in the metabolic homeostasis of the host. Research on ergogenic substances using new sequencing technologies have been limited to the intestinal microbiota and there is a considerable demand for scientific studies that verify the effectiveness of these supplements in horses. L-carnitine and chromium are potentially ergogenic substances for athletic humans and horses since they are possibly able to modify the metabolism of carbohydrates and lipids. This study aimed to assess the impact of acute exercise and aerobic conditioning, associated either with L-carnitine or chromium supplementation, on the intestinal microbiota of fillies. Twelve "Mangalarga Marchador" fillies in the incipient fitness stage were distributed into four groups: control (no exercise), exercise, L-carnitine (10g/day) and chelated chromium (10mg/day). In order to investigate the impact of acute exercise or aerobic conditioning on fecal microbiota all fillies undergoing the conditioning program were analyzed as a separate treatment. The fillies underwent two incremental exercise tests before and after training on a treadmill for 42 days at 70-80% of the lactate threshold intensity. Fecal samples were obtained before and 48 h after acute exercise (incremental exercise test). Bacterial populations were characterized by sequencing the V4 region of the 16S rRNA gene using the MiSeq Illumina platform, and 5,224,389 sequences were obtained from 48 samples. The results showed that, overall, the two most abundant phyla were Firmicutes (50.22%) followed by Verrucomicrobia (15.13%). The taxa with the highest relative abundances were unclassified Clostridiales (17.06%) and "5 genus incertae sedis" from the phylum Verrucomicrobia (12.98%). There was a decrease in the phylum Chlamydiae and in the genus Mycobacterium after the second incremental exercise test. Intense exercise changed the community's structure and aerobic conditioning was associated with changes in the composition and structure of the intestinal bacterial population of fillies. The intra-group comparison showed that chromium or L-carnitine induced moderate changes in the fecal microbiota of fillies, but the microbiota did not differ from the control group, which was exercised with no supplementation. Fecal pH correlated positively with Simpson's index, while plasma pH correlated negatively. Our results show that exercise and aerobic conditioning can change in the microbiota and provide a basis for further studies enrolling a larger number of horses at different fitness levels to better understand the effects of exercise and training on the intestinal microbiota of horses.

The Rhode Island Medical Emergency Distribution System (MEDS).

PubMed

Banner, Greg

2004-01-01

The State of Rhode Island conducted an exercise to obtain and dispense a large volume of emergency medical supplies in response to a mass casualty incident. The exercise was conducted in stages that included requesting supplies from the Strategic National Stockpile and distributing the supplies around the state. The lessons learned included how to better structure an exercise, what types of problems were encountered with requesting and distributing supplies, how to better work with members of the private medical community who are not involved in disaster planning, and how to become aware of the needs of special population groups.

The use of Metro-Apex in health administration and planning education and training.

PubMed

Washburn, A W; McGinty, R T

1977-01-01

Metro-Apex is a computerized gaming-simulation designed to give practitioners and students an understanding of the environment of health care delivery systems. The exercise allows participants to explore the interaction of health roles and the health system's interaction with the larger community system. Originally developed as an air pollution control exercise, it has evolved to be a game about communities and how they operate. In 1972, the Department of Health, Education, and Welfare funded the Center for Multidisciplinary Educational Exercises (COMEX), of the University of Southern California to modify Metro-Apex for use with health service planners, health care administrators, and students in programs leading to these positions. The game runs in several rounds of from three to eight hours for groups of from 40 to 120 persons. Used in both educational and training settings, Metro-Apex is found to be a flexible addition to the health educator's tools.

Patients' experience with nonsurgical treatment for lumbar spinal stenosis: a qualitative study.

PubMed

Bove, Allyn M; Lynch, Andrew D; Ammendolia, Carlo; Schneider, Michael

2018-04-01

Lumbar spinal stenosis (LSS) is a highly prevalent disease in older adults that causes significant limitations in walking and other daily activities. Research into optimal nonsurgical treatment approaches for LSS is lacking. The purpose of this qualitative study is to assess the opinions of participants in a randomized clinical trial of nonsurgical LSS treatments regarding the interventions they received, factors contributing to adherence to the interventions, and methods of outcomes assessment. This study used a qualitative focus group design conducted at an academic research center. Individuals participating in a randomized clinical trial (RCT) for non-surgical LSS treatment were invited to discuss their study treatments and general experiences with LSS. The three treatment arms in the study were medical care, community-based group exercise, and clinic-based manual therapy and individual exercise. Following coding of qualitative data, kappa statistic was used to calculate agreement between observers. Themes were identified and agreed upon by both coders. This study was funded by the Patient-Centered Outcomes Research Institute (PCORI). Fifty individuals (28 women, mean age 73±7.7 years) participated in a focus group. Two focus groups based on modified grounded theory were held for participants of each of the three treatment arms, for a total of six focus groups. Discussion topics included perceived effectiveness of the assigned treatment, suggestions for improvement, barriers and facilitators to completing treatment, and opinions of research outcome measures. Several themes were evident across all treatment groups. First, patients prefer individualized treatment that is tailored to their specific impairments and functional limitations. They also want to learn self-management strategies to rely less upon formal health care providers. Participants consistently stated that exercise improved their pain levels and physical function. However, they noted that these effects are temporary, so commitment to exercising long-term is important. Common barriers to completing the assigned LSS treatment included transportation issues and other comorbid health conditions. All three treatment groups cited perceived treatment benefit as a strong facilitator to continuing treatment. In addition, the ability of the health care provider to relate to the patient and listen to the patient's concerns was a common facilitator. Within the community-based group exercise treatment arm, most individuals continued group exercise after study completion, and social support was often mentioned as a facilitator to continuing treatment. Medical care was most often associated with minimal to no effect of treatment. Many individuals with LSS report barriers to accessing non-surgical treatment, but may also be willing to commit to a long-term treatment strategy that includes exercise. Social support from others with LSS and from health care providers with good communication skills may facilitate compliance with treatment recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

Perceptions of dementia and use of services in minority ethnic communities: a scoping exercise.

PubMed

Parveen, Sahdia; Peltier, Carol; Oyebode, Jan R

2017-03-01

Despite the rapidly ageing population and a predicted sevenfold increase in the prevalence of dementia in minority ethnic communities, people from these communities remain under-represented in specialist dementia services. Leventhal's Model of Self-Regulation suggests perceptions of illness facilitate help-seeking behaviours such as the use of services. This scoping exercise makes use of the model to explore perceptions of dementia in British Indian, African and Caribbean, and East and Central European communities in the United Kingdom. Between August 2013 and April 2014, culturally specific dementia awareness roadshows were attended by people living with dementia, carers and members of the public. During the roadshows, 62 British Indian, 50 African and Caribbean, and 63 East and Central European attenders participated in discussion groups and a dementia knowledge quiz. Thematic and framework analysis were conducted on the discussion group data. Three main themes are presented: Perceptions of dementia, awareness of dementia in the wider family and community, and awareness and use of services. The findings suggest that although groups attributed a biological basis for memory loss, a number of misconceptions prevailed regarding the cause of dementia. Groups also made use of religion, as opposed to medical healthcare services, as a form of personal and treatment control. Seeking help from healthcare services was hindered by lack of awareness of services, and culturally specific barriers such as language. The findings have a number of implications for policy and practice including the development of public health interventions and the need to focus further on reducing barriers to accessing services. © 2016 John Wiley & Sons Ltd.

METRO-APEX Volume 21.1: Pressure Groups' Manual. Revised.

ERIC Educational Resources Information Center

University of Southern California, Los Angeles. COMEX Research Project.

The Pressure Groups' Manual is one of a set of twenty-one manuals used in METRO-APEX 1974, a computerized college and professional level, computer-supported, role-play, simulation exercise of a community with "normal" problems. Stress is placed on environmental quality considerations. APEX 1974 is an expansion of APEX--Air Pollution…

Effects of an 1-day education program on physical functioning, activity and quality of life in community living persons with multiple sclerosis.

PubMed

Feys, Peter; Tytgat, Katrien; Gijbels, Domien; De Groote, Luc; Baert, Ilse; Van Asch, Paul

2013-01-01

Persons with MS (pwMS) in the community show reduced physical activity while studies demonstrated beneficial effects of exercise therapy in supervised settings. This study investigated, in pwMS living in the community, the effects of a 1-day education program about exercises and sports, on physical activity behavior and related outcome measures as self-efficacy, perceived walking ability, fatigue, perceived impact of MS and quality of life. PwMS attended an education day with theoretical and practical sessions that was organized by the Flemish MS Society and professional exercise experts. Forty-two participants immediately completed questionnaires as well as after three and six months. Overall disability and physical activity level were measured using PDSS (patient determined disease steps) and PASIPD (Physical Activity Scale for Individuals with Physical Disabilities) respectively. Other outcomes were the ESES, MSWS-12, MFIS, MSIS-29 and SF-36. Analyses of variance were performed in groups distinguished by self-reported disability level (PDDS ≤1; n = 24 and PDSS >1; n = 18). Groups differed significantly for perceived walking ability (PDDS,MSWS-12) and physical related-domains of MSIS-29 and SF-36, but not PASIPD. A trend towards significant group*time interaction effect was found for the PASIPD indicating, at 3 and 6 months, increased physical activity in the subgroup PDDS ≤1. For the MSIS-29, a significant time effect was found with reduced impact being largest for the more disabled group at 6 months. No changes were found in other outcome measures. An one-day education program had, depending on perceived disability level, some long-standing effects on physical activity and perceived impact of MS.

Personalized exercise for adolescents with diabetes or obesity.

PubMed

Faulkner, Melissa Spezia; Michaliszyn, Sara Fleet; Hepworth, Joseph T; Wheeler, Mark D

2014-01-01

This study examined adherence to a personalized, community-based exercise intervention by sedentary adolescents with type 1 or type 2 diabetes or those with obesity. We conducted a pretest-posttest investigation to explore the application of an individualized exercise prescription based upon current fitness level for 39 adolescents (20 with type 1 diabetes, 9 with type 2 diabetes, and 10 obese) over 16 weeks in community settings. Subjects were recruited from a university-based pediatric endocrinology clinic in the southwestern United States. Adherence to the exercise prescription was monitored using accelerometers over the entire intervention period. Moderate-to-vigorous physical activity (MVPA) levels significantly increased over sedentary baseline values (p < .001), but the average of 42.5 ± 22.1 min/day of MVPA determined at the end of the study was still less than the recommended 60 min/day. Perceptions of health were significantly increased for the total group following the intervention (p = .008). For those with type 1 diabetes, there was a significant association between MVPA duration and percentage change in HbA1c (r = -.526, p = .02). Recruitment and retention of adolescent participation in daily exercise is challenging. Personalized approaches that include adolescent choices with family support and ongoing motivation can improve individual exercise adherence and a sense of personal health.

Experiences participating in a community-based exercise programme from the perspective of people living with HIV: a qualitative study.

PubMed

Montgomery, Chantal A; Henning, Katherine J; Kantarzhi, Sarah R; Kideckel, Tamar B; Yang, Cheryl F M; O'Brien, Kelly K

2017-04-04

Our aim was to explore the experiences of engaging in a community-based exercise programme (CBEP) from the perspective of people living with HIV (PLWH). We conducted a descriptive qualitative study using semistructured interviews. We recruited adults living with HIV who participated in a 16-week CBEP in Toronto, Canada. 11 participants, the majority men (64%), with a median age of 52 years, and living with a median of 5 concurrent health conditions in addition to HIV participated in the study. We asked participants about their overall experiences: strengths, limitations and perceived benefits of the CBEP; factors influencing participation and current level of exercise after completion of the CBEP. We administered a self-reported demographic questionnaire followed by the Rapid Assessment of Physical Activity (RAPA) questionnaire. We analysed interview data using thematic analysis. We developed a framework that describes the experiences before, during and after the CBEP; and the perceived impact of the CBEP on health, which influenced the intent to, engagement in and sustainability of exercise among PLWH. Participants described the positive impact of the CBEP on their physical, mental and social health. Interviews were completed at a median of 6 months after the CBEP, when 9 participants reported ongoing engagement in exercise, but to a lesser extent than during the CBEP. Intrinsic and extrinsic factors facilitated or hindered engagement in exercise throughout all phases of the CBEP. The episodic nature of HIV and multimorbidity influenced engagement in exercise and posed challenges to re-engagement after periods of inactivity. CBEPs provide an opportunity to enhance physical activity, perceived health outcomes and knowledge about exercise for PLWH. Community-based exercise is a strategy that may be used by health providers to promote engagement in sustained physical activity for PLWH. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Survey Helps Class to See, Understand Local Standards.

ERIC Educational Resources Information Center

Pasternack, Steve

1986-01-01

Presents an exercise in which students interview various groups of citizens--church leaders, school officials, government and business leaders--in order to give students a broader understanding of the definitions of obscenity and community standards. (HTH)

Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting.

PubMed

Uc, Ergun Y; Doerschug, Kevin C; Magnotta, Vincent; Dawson, Jeffrey D; Thomsen, Teri R; Kline, Joel N; Rizzo, Matthew; Newman, Sara R; Mehta, Sonya; Grabowski, Thomas J; Bruss, Joel; Blanchette, Derek R; Anderson, Steven W; Voss, Michelle W; Kramer, Arthur F; Darling, Warren G

2014-07-29

To (1) investigate effects of aerobic walking on motor function, cognition, and quality of life in Parkinson disease (PD), and (2) compare safety, tolerability, and fitness benefits of different forms of exercise intervention: continuous/moderate intensity vs interval/alternating between low and vigorous intensity, and individual/neighborhood vs group/facility setting. Initial design was a 6-month, 2 × 2 randomized trial of different exercise regimens in independently ambulatory patients with PD. All arms were required to exercise 3 times per week, 45 minutes per session. Randomization to group/facility setting was not feasible because of logistical factors. Over the first 2 years, we randomized 43 participants to continuous or interval training. Because preliminary analyses suggested higher musculoskeletal adverse events in the interval group and lack of difference between training methods in improving fitness, the next 17 participants were allocated only to continuous training. Eighty-one percent of 60 participants completed the study with a mean attendance of 83.3% (95% confidence interval: 77.5%-89.0%), exercising at 46.8% (44.0%-49.7%) of their heart rate reserve. There were no serious adverse events. Across all completers, we observed improvements in maximum oxygen consumption, gait speed, Unified Parkinson's Disease Rating Scale sections I and III scores (particularly axial functions and rigidity), fatigue, depression, quality of life (e.g., psychological outlook), and flanker task scores (p < 0.05 to p < 0.001). Increase in maximum oxygen consumption correlated with improvements on the flanker task and quality of life (p < 0.05). Our preliminary study suggests that aerobic walking in a community setting is safe, well tolerated, and improves aerobic fitness, motor function, fatigue, mood, executive control, and quality of life in mild to moderate PD. This study provides Class IV evidence that in patients with PD, an aerobic exercise program improves aerobic fitness, motor function, fatigue, mood, and cognition. © 2014 American Academy of Neurology.

Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.

PubMed

Yamada, Minoru; Nishiguchi, Shu; Fukutani, Naoto; Aoyama, Tomoki; Arai, Hidenori

2015-08-01

The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. A cluster-randomized controlled trial. This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial.

PubMed

Binder, Ellen F; Yarasheski, Kevin E; Steger-May, Karen; Sinacore, David R; Brown, Marybeth; Schechtman, Kenneth B; Holloszy, John O

2005-11-01

Progressive resistance exercise training (PRT) has been shown to increase muscle strength and fat-free mass (FFM) in elderly persons. Limited information is available regarding the effects of PRT on lean and fat mass in frail elderly persons. Ninety-one community-dwelling sedentary men and women, 78 years and older with physical frailty (defined using standardized objective criteria) were enrolled in a 9-month trial of exercise training (ET). Physical frailty was defined as having 2 of the 3 following criteria: modified Physical Performance Test score between 18 and 32, peak aerobic power between 10 and 18 ml/kg/min, or self-report of difficulty or assistance with two instrumental activities of daily living or one basic activity of daily living. Participants were randomly assigned to either a control (CTL) group that performed a low intensity home exercise program or a supervised ET group that performed 3 months of low intensity exercise and 3 months of PRT. After completion of PRT, ET participants had greater improvements than did CTL participants in maximal voluntary force production for knee extension (mean Delta +5.3 +/- 13 ft/lb vs +1.1 +/- 11 ft/lb, p =.05), measured using isokinetic dynamometry. Total body FFM (measured using dual energy x-ray absorptiometry) increased in the ET group, but not in the CTL group (mean Delta +0.84 +/- 1.4 kg vs +0.01 +/- 1.5 kg, p =.005). Total, trunk, intra-abdominal, and subcutaneous fat mass (measured using dual energy x-ray absorptiometry and (1)H-magnetic resonance imaging) did not change in response to PRT. Three months of supervised PRT induced improvements in maximal voluntary thigh muscle strength and whole body FFM in frail, community-dwelling elderly women and men. This supervised exercise program may not be sufficient to reduce whole-body or intra-abdominal fat area in this population.

Ageing and exercise: building body capital in old age.

PubMed

Bergland, Astrid; Fougner, Marit; Lund, Anne; Debesay, Jonas

2018-01-01

Research that provides better understanding of the motivational processes in older age to maintain a healthy and active lifestyle is sought after. We apply theoretical approaches to cultural capital, active and healthy aging health to shed light on the women's experiences in maintaining physical capabilities through an active lifestyle, and thereby facilitating their own inclusion in society. Thus, the aim of this paper is to explore why older home dwelling women over the age of 70 years or more spend time in physical exercise and their experiences about the importance of participating in group exercise for their daily life.This paper reports on a qualitative study based on interviews with 16 older women aged 70 years or more and regularly attending group exercise classes in the community at an established workout center. The data were analyzed the data using an inductive content analysis approach. Three overreaching and interrelated themes emerged from the interviews: "Building body capital for independence", "Building body capital to maintain vitality and being in control" and "Building resources for social interaction". The findings suggest that group exercise is important for building body capital. The group exercise helped the women in building bodily ability to manage everyday life, maintain vitality, being in control, pursue social interaction and live independently. These body resources were important for these older women's experience of the manageability and meaningfulness of daily life. This study has provided insights into older women's understanding and experiences of the challenges of everyday life within a theoretical framework of cultural capital and health. The women acquired cultural health capital, and more specifically body capital, by participating in the group exercise classes. The women's investment in body capital through regular physical activity created resources which facilitated social participation. Therefore professionals need to be aware of this when performing group exercise.

Improved Functional Performance in Individuals With Dementia After a Moderate-Intensity Home-Based Exercise Program: A Randomized Controlled Trial.

PubMed

Dawson, Nicole; Judge, Katherine S; Gerhart, Hayden

2017-03-01

Individuals with dementia (IWDs) experience difficulties across cognitive and functional domains. Nonpharmacological interventions aimed at reducing disability are greatly needed. Exercise is a low-cost and easily implemented approach, but investigation has yielded mixed evidence to date. The purpose of the current study was to evaluate a novel and innovative moderate-intensity functional exercise intervention for IWDs, which was developed using principles from exercise science along with a Strength-Based Approach, consisting of 24 home-based sessions. A randomized, controlled intervention trial with a 2-group pretest and posttest design was used with a sample of 23 community-dwelling IWDs (intervention group: n = 13; comparison group: n = 10). Average age of participants was 73.9 years (standard deviation, 9.1) with mild to moderate cognitive impairment (Mini-Mental State Examination, Mean = 20.8; standard deviation, 5.0). A 99.0% attendance rate indicated high adherence to the moderate-intensity exercise program. Efficacy was examined using multiple linear regression. Group assignment significantly predicted performance in key outcome measures, with IWDs from the intervention group improving in lower extremity strength (B = 5.92, t = 3.26, P = .004), balance (B = 4.04, t = 4.13, P = .001), and fast gait speed (B = .32, t = 2.61, P = .02). These findings indicated IWDs are able to participate in and benefit from a moderate-intensity functional exercise program, consisting of strength and balance activities. The current intervention used a Strength-Based Approach to facilitate implementation of exercise activities that could be completed by the sample. Therefore, integration of these techniques into mainstream clinical practice and research should be feasible with this patient population. Future research directions and implications of these findings also are discussed.

Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial

PubMed Central

Delbaere, K; Valenzuela, T; Woodbury, A; Davies, T; Yeong, J; Steffens, D; Miles, L; Pickett, L; Zijlstra, G A R; Clemson, L; Close, J C T; Howard, K; Lord, S R

2015-01-01

Introduction In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people. Methods and analysis Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective. Ethics and dissemination Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN)12615000138583. PMID:26493461

Feasibility of a Self-Determination Theory-Based Exercise Program in Community-Dwelling South Korean Older Adults: Experiences from a 13-Month Trial.

PubMed

Lee, Minyoung; Kim, Min Joo; Suh, Dongwon; Kim, Jungjin; Jo, Eunkyoung; Yoon, BumChul

2016-01-01

Little is known about the effectiveness of self-determination theory (SDT), a representative motivational theory, on exercise domain in older adults. This feasibility study used quantitative and qualitative approaches to evaluate the effectiveness of a 13-month group exercise program applying SDT-based motivational strategies on exercise adherence, physical fitness, and quality of life, and to explore factors affecting exercise adherence in South Korean older adults (N = 18). Exercise attendance rate was high (82.52%). There were significant differences in aerobic endurance (p < .001), lower body strength (p < .05), dynamic balance (p < .001), and perceived social functioning (p < .05) at 13 months compared with baseline. Factors affecting exercise adherence were related to the SDT-based motivational strategies. These results support the importance of health professionals applying SDT-based motivational strategies to exercise programs to help facilitate motivation for participation and to promote physical fitness and quality of life in older adults.

The Effect of Chinese Yuanji-Dance on Dynamic Balance and the Associated Attentional Demands in Elderly Adults

PubMed Central

Wu, Wen-Lan; Wei, Ta-Sen; Chen, Shen-Kai; Chang, Jyh-Jong; Guo, Lan-Yuen; Lin, Hwai-Ting

2010-01-01

Walking performance changes with age. This has implications for the problem of falls in older adults. The aim of this study was to investigate the effects of Yuanji-Dance practice on walking balance and the associated attention demand in healthy elderly. Fifteen community-dwelling elderly (comparison group, no regular exercise habit) and fifteen Yuanji- Dance elderly (exercise group, dancing experience: 5.40 ± 1.95 years), aged 60-70 years, were included in this study. The subjects in exercise group participated in a 90-minute Yuanji-Dance practice at least three times per week and the comparison group continued their normal daily physical activity. Walking balance measures (including walking velocity, step length, step width, and percentage of time spent in double limb support, COM velocity and COM-COP inclination angles) and attentional demand tests (button reaction time and accuracy) were conducted under different conditions. Our results showed that stride lengths, walking velocities, peak A/P velocities (AP V) of the COM, medial COM-COP inclination (M angle) angles, reaction time, and accuracy decrease significantly as the dual-task (walking plus hand button pressing tasks) applied for either the comparison or exercise groups. These results demonstrated that walking performance is attenuated in our elderly participants as the cognitive tasks applied. Analysis also identified a significantly faster RT for our exercise group both in standing and walking conditions. This may indicate that physical exercise (Yuanji-Dance) may have facilitating effects on general cognitive and perceptual- motor functions. This implies that Chinese Yuanji-Dance practice for elderly adults may improve their personal safety when walking especially under the condition of multiple task demand. Key points The purpose of this study was to investigate the training effects of a Chinese traditional exercise, Yuanji-Dance, on walking balance and the associated attention demand in the healthy elderly. Walking performance is attenuated in elderly participants as the cognitive tasks applied. A significantly faster reaction time for our exercise group both in standing and walking conditions. Yuanji-Dance exercise training can improve the information processing speed of elderly people and has no influence of the dynamic walking balance. PMID:24149395

Sensory retraining: burden in daily life related to altered sensation after orthognathic surgery, a randomized clinical trial.

PubMed

Phillips, C; Kim, S H; Tucker, M; Turvey, T A

2010-08-01

Assess the long-term effect of sensory retraining exercises, age, gender, type of surgery, and pre-surgical psychological distress on patients' perception of the interference related to altered sensation 2 years after orthognathic surgery. A total of 186 subjects with a developmental dentofacial disharmony were enrolled in a multicenter randomized clinical trial: one center was a community-based practice and the other a university-based center. Subjects were randomly allocated to two groups: standard of care mouth opening exercises after BSSO or a progressive series of sensory retraining facial exercises in addition to the opening exercises. At 1, 3, 6, 12, and 24 months after surgery, subjects scored unusual feelings on the face, numbness, and loss of lip sensitivity from 'no problem (1)' to 'serious problem (7)'. A marginal proportional odds model was fit for each of the ordinal outcomes. Up to 2 years after surgery, the opening exercise only group had a higher likelihood of reporting interference in daily activities related to numbness and loss of lip sensitivity than the sensory retraining exercise group. The difference between the two groups was relatively constant. Older subjects and those with elevated psychological distress before surgery reported higher burdens related to unusual facial feelings, numbness, and loss of lip sensitivity (p < 0.02). The positive effect of sensory retraining facial exercises observed after surgery is maintained over time. Clinicians should consider the patient's age and psychological well-being prior to providing pre-surgical counseling regarding the impact on daily life of persistent altered sensation following a mandibular osteotomy.

Gym-based exercise was more costly compared with home-based exercise with telephone support when used as maintenance programs for adults with chronic health conditions: cost-effectiveness analysis of a randomised trial.

PubMed

Jansons, Paul; Robins, Lauren; O'Brien, Lisa; Haines, Terry

2018-01-01

What is the comparative cost-effectiveness of a gym-based maintenance exercise program versus a home-based maintenance program with telephone support for adults with chronic health conditions who have previously completed a short-term, supervised group exercise program? A randomised, controlled trial with blinded outcome assessment at baseline and at 3, 6, 9 and 12 months. The economic evaluation took the form of a trial-based, comparative, incremental cost-utility analysis undertaken from a societal perspective with a 12-month time horizon. People with chronic health conditions who had completed a 6-week exercise program at a community health service. One group of participants received a gym-based exercise program and health coaching for 12 months. The other group received a home-based exercise program and health coaching for 12 months with telephone follow-up for the first 10 weeks. Healthcare costs were collected from government databases and participant self-report, productivity costs from self-report, and health utility was measured using the European Quality of Life Instrument (EQ-5D-3L). Of the 105 participants included in this trial, 100 provided sufficient cost and utility measurements to enable inclusion in the economic analyses. Gym-based follow-up would cost an additional AUD491,572 from a societal perspective to gain 1 quality-adjusted life year or 1year gained in perfect health compared with the home-based approach. There was considerable uncertainty in this finding, in that there was a 37% probability that the home-based approach was both less costly and more effective than the gym-based approach. The gym-based approach was more costly than the home-based maintenance intervention with telephone support. The uncertainty of these findings suggests that if either intervention is already established in a community setting, then the other intervention is unlikely to replace it efficiently. ACTRN12610001035011. [Jansons P, Robins L, O'Brien L, Haines T (2018) Gym-based exercise was more costly compared with home-based exercise with telephone support when used as maintenance programs for adults with chronic health conditions: cost-effectiveness analysis of a randomised trial. Journal of Physiotherapy 64: 48-54]. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Jumping into the deep-end: results from a pilot impact evaluation of a community-based aquatic exercise program.

PubMed

Barker, Anna L; Talevski, Jason; Morello, Renata T; Nolan, Genevieve A; De Silva, Renee D; Briggs, Andrew M

2016-06-01

This multi-center quasi-experimental pilot study aimed to evaluate changes in pain, joint stiffness, physical function, and quality of life over 12 weeks in adults with musculoskeletal conditions attending 'Waves' aquatic exercise classes. A total of 109 adults (mean age, 65.2 years; range, 24-93 years) with musculoskeletal conditions were recruited across 18 Australian community aquatic centers. The intervention is a peer-led, 45 min, weekly aquatic exercise class including aerobic, strength, flexibility, and balance exercises (n = 67). The study also included a control group of people not participating in Waves or other formal exercise (n = 42). Outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQoL five dimensions survey (EQ-5D) at baseline and 12 weeks. Satisfaction with Waves classes was also measured at 12 weeks. Eighty two participants (43 Waves and 39 control) completed the study protocol and were included in the analysis. High levels of satisfaction with classes were reported by Waves participants. Over 90 % of participants reported Waves classes were enjoyable and would recommend classes to others. Waves participants demonstrated improvements in WOMAC and EQ-5D scores however between-group differences did not reach statistical significance. Peer-led aquatic exercise classes appear to improve pain, joint stiffness, physical function and quality of life for people with musculoskeletal conditions. The diverse study sample is likely to have limited the power to detect significant changes in outcomes. Larger studies with an adequate follow-up period are needed to confirm effects.

Training with a balance exercise assist robot is more effective than conventional training for frail older adults.

PubMed

Ozaki, Kenichi; Kondo, Izumi; Hirano, Satoshi; Kagaya, Hitoshi; Saitoh, Eiichi; Osawa, Aiko; Fujinori, Yoichi

2017-11-01

To examine the efficacy of postural strategy training using a balance exercise assist robot (BEAR) as compared with conventional balance training for frail older adults. The present study was designed as a cross-over trial without a washout term. A total of 27 community-dwelling frail or prefrail elderly residents (7 men, 20 women; age range 65-85 years) were selected from a volunteer sample. Two exercises were prepared for interventions: robotic exercise moving the center of gravity by the balance exercise assist robot system; and conventional balance training combining muscle-strengthening exercise, postural strategy training and applied motion exercise. Each exercise was carried out twice a week for 6 weeks. Participants were allocated randomly to either the robotic exercise first group or the conventional balance exercise first group. preferred and maximal gait speeds, tandem gait speeds, timed up-and-go test, functional reach test, functional base of support, center of pressure, and muscle strength of the lower extremities were assessed before and after completion of each exercise program. Robotic exercise achieved significant improvements for tandem gait speed (P = 0.012), functional reach test (P = 0.002), timed up-and-go test (P = 0.023) and muscle strength of the lower extremities (P = 0.001-0.030) compared with conventional exercise. In frail or prefrail older adults, robotic exercise was more effective for improving dynamic balance and lower extremity muscle strength than conventional exercise. These findings suggest that postural strategy training with the balance exercise assist robot is effective to improve the gait instability and muscle weakness often seen in frail older adults. Geriatr Gerontol Int 2017; 17: 1982-1990. © 2017 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

[Effects of a structured exercise programme on cardiovascular risk programmes in post-menopausal women. CLIDERICA study].

PubMed

Saucedo Rodrigo, Pedro; Abellán Alemán, José; Gómez Jara, Purificación; Leal Hernández, Mariano; Ortega Toro, Enrique; Colado, Juan Carlos; Colado Sánchez, Juan Carlos; Sáinz de Baranda Andújar, Pilar

2008-07-01

To analyse the influence of a physical exercise programme of strength/stamina on cardiovascular risk factors in low-risk post-menopausal women. Six-month randomised clinical trial with post-menopausal women. Three health centres in the autonomous community of Murcia, Spain. Sixty-three post-menopausal women aged 45 to 59 at low cardiovascular risk. INTERVENTIONS AND MAIN MEASUREMENTS: They were split into 2 groups: a) control: 23 people with no specific intervention, and b) 40 people with an intervention of strength/stamina exercise with protocol for in water and on land. At their initial and final visits, everyone in the 2 groups had anamnesis, physical examination, and general analyses, including Apo A, Apo B, insulin, serum creatinine, creatinine clearance, creatinine in urine, albuminuria, ultrasensitive PCR, and HOMA index. The insulin levels increased in the control group by 2.02 mU/L and dropped in the experimental group by 0.13 mU/L (P=.021). At the start of the study, creatinine in the control group was 0.83+/-0.12 mg/dL; and at the end, 0.91+/-0.02 mg/dL. In the intervention group it was 0.84+/-0.12 mg/dL at the start and 0.90+/-0.13 mg/dL at the end (NS). Systolic blood pressure dropped in both groups, with a bigger drop in the exercise group (11.81 vs 0.17 mm Hg) (P=.0001). HDL-C values increased in the control group by 4.97 mg/dL; and in the experimental group, by 3.46 mg/dL (NS). A controlled programme of strength/stamina physical exercise reduces the cardiovascular risk of post-menopausal women.

Eating as a cultural expression of caring among Afro-Caribbean and African American Women: Understanding the cultural dimensions of obesity

PubMed Central

Bramble, Joy; Cornelius, Llewellyn J.; Simpson, Gaynell M.

2013-01-01

Background Obesity is a growing problem in the United States that is disproportionately increasing among persons of African Americans, yet little is know about the cultural factors that relate to dietary patterns, obesity and exercise among African Americans and other groups of African descent. The purpose of this paper is to examine the cultural context under which physical activity, healthy eating and weight management is viewed among African American and Caribbean American women. Methods Four focus groups were conducted of Afro-Caribbean and African American women (age 40 and older) between May and July of 2007 to explore cultural factors related to physical activity, healthy eating and weight management. Results Cultural variation was observed among Afro-Caribbean and African American woman in terms of indigenous traditions of food and preparation. These traditions influenced how they approached eating, views of obesity and exercise. At the same time community and economic factors influence the availability of healthy eating and exercise alternatives. Conclusions In the development of interventions to improve obesity among persons of African descent it may be important not to assume that one size fits all in terms of community based interventions PMID:19711493

Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015.

PubMed

Florian, Jana; Roy, Nicole M St Omer; Quintiliani, Lisa M; Truong, Ve; Feng, Yi; Bloch, Philippe P; Russinova, Zlatka L; Lasser, Karen E

2016-08-11

Diabetes self-management takes place within a complex social and environmental context.  This study's objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes "hot spots").  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants' reports in the photovoice group. We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes.

Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial.

PubMed

José, Anderson; Dal Corso, Simone

2016-04-01

Among people who are hospitalised for community-acquired pneumonia, does an inpatient exercise-based rehabilitation program improve functional outcomes, symptoms, quality of life and length of hospital stay more than a respiratory physiotherapy regimen? Randomised trial with concealed allocation, intention-to-treat analysis and blinding of some outcomes. Forty-nine adults hospitalised for community-acquired pneumonia. The experimental group (n=32) underwent a physical training program that included warm-up, stretching, peripheral muscle strength training and walking at a controlled speed for 15 minutes. The control group (n=17) underwent a respiratory physiotherapy regimen that included percussion, vibrocompression, respiratory exercises and free walking. The intervention regimens lasted 8 days. The primary outcome was the Glittre Activities of Daily Living test, which assesses the time taken to complete a series of functional tasks (eg, rising from a chair, walking, stairs, lifting and bending). Secondary outcomes were distance walked in the incremental shuttle walk test, peripheral muscle strength, quality of life, dyspnoea, lung function, C-reactive protein and length of hospital stay. Measures were taken 1 day before and 1 day after the intervention period. There was greater improvement in the experimental group than in the control group on the Glittre Activities of Daily Living test (mean between-group difference 39 seconds, 95% CI 20 to 59) and the incremental shuttle walk test (mean between-group difference 130 m, 95% CI 77 to 182). There were also significantly greater improvements in quality of life, dyspnoea and peripheral muscle strength in the experimental group than in the control group. There were no between-group differences in lung function, C-reactive protein or length of hospital stay. The improvement in functional outcomes after an inpatient rehabilitation program was greater than the improvement after standard respiratory physiotherapy. The exercise training program led to greater benefits in functional capacity, peripheral muscle strength, dyspnoea and quality of life. ClinicalTrials.gov, NCT02103400. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Evaluation of cardiovascular risk-lowering health benefits accruing from laboratory-based, community-based and exercise-referral exercise programmes.

PubMed

Webb, R; Thompson, J E S; Ruffino, J-S; Davies, N A; Watkeys, L; Hooper, S; Jones, P M; Walters, G; Clayton, D; Thomas, A W; Morris, K; Llewellyn, D H; Ward, M; Wyatt-Williams, J; McDonnell, B J

2016-01-01

To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques. In studies 1-3, 22/28, 32/65 and 11/14 participants adhered to their respective exercise programmes, and underwent significant increases in physical activity levels. Importantly, beneficial effects similar to those seen in our previous studies (eg, modulations in expression of monocytic PPARγ target genes, decreases in blood pressure/arterial stiffness, improvements in blood lipids/insulin sensitivity) were observed (albeit to slightly differing extents) only in participants who adhered to their respective exercise programmes. While study 1 achieved more intense exercise and more pronounced beneficial effects, significant cardiovascular risk-lowering health benefits related to biomolecular markers, blood pressure, arterial stiffness and blood lipids were achieved via community/referral-based delivery modes in studies 2 and 3. Because cardiovascular health benefits were observed in all 3 studies, we conclude that the majority of benefits previously reported in laboratory-based studies can also be achieved in community-based/exercise-referral settings. These findings may be of use in guiding policymakers with regard to introduction and/or continued implementation of community/referral-based exercise programmes.

Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial).

PubMed

Zak, Marek; Swine, Christian; Grodzicki, Tomasz

2009-01-28

Consistently swelling proportion of the frail elderly within a modern society challenges the overstrained public health sector to provide both adequate medical care and comprehensive assistance in their multiple functional deficits of daily living. Easy-to-apply and task-specific ways of addressing this issue are being sought out, with a view to proposing systemic solutions for nationwide application. The present randomised, double-blind, placebo-controlled, 7-week clinical trial aimed to determine whether specifically structured, intensive exercise regimens, combined with nutritional supplementation, might improve and help sustain individual muscle strength and mobility, and possibly enhance individual functional capabilities in an on-going quest for active prevention of care-dependency. Ninety-one frail elderly (F 71 M 20; mean age 79 years) were recruited from both nursing home residents and community dwellers and randomly split into four groups: Group I - progressive resistance exercises (PRE) + functionally-oriented exercises (FOE) + nutritional supplementation (NS), Group II - PRE + FOE + placebo, Group III--standard exercises (SE) + FOE + NS, Group IV - SE + FOE + placebo. Each group pursued a 45 min. exercise session 5 times weekly. The subjects' strength with regard to four muscle groups, i.e. hip and knee extensors and flexons, was assessed at 80% (1 RM) weekly, whereas their balance and mobility at baseline and at the end of the study. The study was completed by 80 subjects. Despite its relatively short duration significant differences in muscle strength were noted both in Group I and Group II (p = 0.01; p = 0.04; respectively), although this did not translate directly into perceptible improvement in individual mobility. Notable improvements in individual mobility were reported in Group III and Group IV (p = 0.002), although without positive impact on individual muscle strength. Comprehensively structured, high-intensity regimen made up of diverse exercise types, i.e. functionally-oriented, progressive resistance and standard ones, preferably if combined with nutritional supplementation in adequate volume, demonstrates clear potential for appreciably improving overall functional status in the frail elderly in terms of individual walking capacity and muscle strength. Central Register of Clinical Trials, Poland--CEBK180/2000.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial.

PubMed

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Participants (N = 34) were generally healthy, obese, older adult women (age range 55-79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial

PubMed Central

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Background: Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Methods: Participants (N = 34) were generally healthy, obese, older adult women (age range 55–79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Results: Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Conclusion: Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments. PMID:21753869

Multiple-modality exercise and mind-motor training to improve cardiovascular health and fitness in older adults at risk for cognitive impairment: A randomized controlled trial.

PubMed

Boa Sorte Silva, Narlon C; Gregory, Michael A; Gill, Dawn P; Petrella, Robert J

The effects of multiple-modality exercise on arterial stiffening and cardiovascular fitness has not been fully explored. To explore the influence of a 24-week multiple-modality exercise program associated with a mind-motor training in cardiovascular health and fitness in community-dwelling older adults, compared to multiple-modality exercise (M2) alone. Participants (n=127, aged 67.5 [7.3] years, 71% females) were randomized to either M4 or M2 groups. Both groups received multiple-modality exercise intervention (60min/day, 3days/week for 24-weeks); however, the M4 group underwent additional 15min of mind-motor training, whereas the M2 group received 15min of balance training. Participants were assessed at 24-weeks and after a 28-week non-contact follow-up (52-weeks). at 52-weeks, the M4 group demonstrated a greater VO2max (ml/kg/min) compared to the M2 group (mean difference: 2.39, 95% CI: 0. 61 to 4.16, p=0.009). Within-group analysis indicated that the M4 group demonstrated a positive change in VO2max at 24-weeks (mean change: 1.93, 95% CI: 0.82 to 3.05, p=0.001) and 52-weeks (4.02, 95% CI: 2.71 to 5.32, p=0.001). Similarly, the M2 group increased VO2max at 24-weeks (2.28, 95% CI: 1.23 to 3.32, p<0.001) and 52-weeks (1.63, 95% CI: 0.43 to 2.83, p=0.008). Additionally, the M2 group decreased 24h SBP (mmHg) at 24-weeks (-2.31, 95% CI: -4.61 to -0.01, p=0.049); whereas the M4 group improved 24h DBP (-1.6, 95% CI: -3.03 to -0.17, p=0.028) at 52-weeks. Mind-motor training associated with multiple-modality exercise can positively impact cardiovascular fitness to the same extent as multiple-modality exercise alone. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of WiiActive exercises on fear of falling and functional outcomes in community-dwelling older adults: a randomised control trial.

PubMed

Kwok, Boon Chong; Pua, Yong Hao

2016-09-01

the study compares the effects of a Nintendo Wii exercise programme and a standard Gym-based exercise intervention on fear of falling, knee strength, physical function and falls rate in older adults. eighty community-dwelling adults aged 60 years and above with short physical performance battery score of 5-9 points and modified falls efficacy scale (MFES) score of ≤9 points participated in the parallel-group randomised trial. Each intervention arm involved an hour of intervention per week, totalling 12 sessions over 12 weeks. Besides 1-year fall incidence, the participants were evaluated on MFES, knee extensor strength (KES), timed-up-and-go test, gait speed, 6-minute walk test and narrow corridor walk test at weeks 13 and 24. at week 13, between interventions, the effect of MFES changes did not reach statistical significance (difference = -0.07 point, 95% CI -0.56 to 0.42, P = 0.78); at week 24, the Wii group showed statistically significant effects over the Gym group (difference = 0.8 point, 95% CI 0.27 to 1.29, P < 0.01). For KES, the two groups did not differ statistically at week 13 (difference = -2.0%, 95% CI -5.6 to -1.7, P = 0.29); at week 24, the Gym group had greater strength gains than the Wii group (difference = -5.1%, 95% CI -8.7 to -1.5, P < 0.01). No between-group differences were observed for other outcome measures. on completion of a 12-week Nintendo Wii exercise programme, there was no significant benefit seen on fear of falling when compared to a standard Gym-based exercise intervention; however, post-intervention there was an apparent reduction in fear of falling in the group allocated to Wii training, despite knee strength apparently improving more in those allocated to the Gym. It is possible that long-term gains after using the Wii might be due to a carry-over effect. Australian New Zealand Clinical Trials Registry, ACTRN12610000576022. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Wii-hab for pre-frail older adults.

PubMed

Daniel, Kathryn

2012-01-01

To examine the effectiveness of a novel intervention aimed at decreasing indices related to frailty through systematic, Progressive Functional Rehabilitation (PFR). Pre-frail volunteers were recruited to participate in a 15 week exercise intervention or control group. Those who met study criteria and consented were randomized into one of three groups: control, seated exercise, or Wii(®) -fit. Test measures were completed before and after the 15 week intervention period on all participants. Measures included: Senior Fitness Test, Body Weight, Balance Efficacy Scale, CHAMPS, Late-Life Function and Disability Index, MOS SF-36. Attendance was also recorded. There were improvements on several of the measures included in the Senior Fitness Test including chair stands, arm curls, step 2, six minute walk, sit and reach, and the timed up and go. A few participants did lose weight. All of the differences reflected improved physical functional status in the seated exercise or Wii-fit groups compared with the control group. Increased physical activity was beneficial for all who participated. There were improvements in physical performance scores on several of the measures on the senior fitness test in both the seated exercise and Wii-fit groups. Participants in the Wii-fit group also showed improvement in their reported caloric expenditure and balance confidence. This pilot study suggests a rehabilitation effect that was similar to the effect of community based senior fitness classes. A home video game console system with weight vest could be an effective alternative for pre-frail senior adults to group exercise classes. © 2012 Association of Rehabilitation Nurses.

Evaluating the effectiveness of home exercise programmes using an online exercise prescription tool in children with cerebral palsy: protocol for a randomised controlled trial

PubMed Central

Williams, Sian A; Gucciardi, Daniel F; Bear, Natasha; Gibson, Noula

2018-01-01

Introduction Children with cerebral palsy (CP) and other neurodevelopmental disabilities often receive a home programme of exercises to assist in reaching their therapy goals. Adherence to exercise programmes is necessary to attain the level of practice required to achieve goals; however, adherence can be difficult to accomplish. In this paper, we describe the protocol for a randomised controlled trial to evaluate the effectiveness of delivering a home exercise programme to school-age children with disabilities using Physitrack, an online exercise prescription tool with a website or app interface. Methods and analysis Participants aged 6–17 years, with CP or other neurodevelopmental disabilities, receiving community physiotherapy services in Western Australia, will be recruited. Participants will be stratified by age and functional mobility and randomised to either the intervention group, who will complete an 8-week home exercise programme using Physitrack, or the control group, who will complete an 8-week exercise programme without Physitrack. Researcher blinding to group allocation, and participant blinding to outcome, will be maintained. The primary outcome measures are adherence to the home exercise programme with weekly collection of home exercise logs; achievement of individualised goals by phone interview before and after intervention; and correctness of exercise performance by collection and analysis of videos of participants performing home exercises. Secondary outcome measures include enjoyment of physical activity, confidence to complete exercise programme, preferred method of delivery of programme and usability of Physitrack. A sample size of 58 participants will be necessary to see an effect on home programme adherence. Data will be analysed using the intention-to-treat principle. Ethics and dissemination Ethical approval was obtained from Curtin University Human Research Ethics Committee in July 2016 (10391). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences. Trial registration number ACTRN12616000743460; Pre-results. PMID:29362255

The effect of low and moderate intensity aerobic exercises on sleep quality in men older adults.

PubMed

Akbari Kamrani, Ahmad Ali; Shams, Amir; Shamsipour Dehkordi, Parvaneh; Mohajeri, Robabeh

2014-03-01

Sleep is an active and complex rhythmic state that may be affected by the aging process. The purpose of present research was to investigate the effect of low and moderate intensity aerobic exercises on sleep quality in older adults. The research method is quasi-experimental with pre-test and post-test design. The statistical sample included 45 volunteer elderly men with age range of 60-70 years-old that divided randomly in two experimental groups (aerobic exercise with low and moderate intensity) and one control group. In each group selected 15 older adults based on inclusion and exclusion criteria (such as, without sleep apnea, not smoking, and no taking hypnotic drugs). First, all subjects were evaluated by a doctor to confirm their physical and mental health. Also, the maximum heart rate (MaxHR) of subjects was obtained by subtracting one's age from 220. Furthermore, based on aerobic exercise type (40-50% MaxHR for low intensity group and 60-70% MaxHR for moderate intensity group) the target MaxHR was calculated for each subject. The exercise protocol consisted of 8 weeks aerobic exercises (2 sessions in per-week) based on Rockport one-mile walking/running test and the control group continued their daily activities. All subjects in per-test and post-test stages completed the Petersburg Sleep Quality Index (PSQI). In pre-test stage, results showed that there were no significant differences between control and experimental groups in sleep quality and its components (P>0.05). On the other hand, results in post-test stage showed that there were significant differences between control and experimental groups in these variables (P<0.05). Also, the Tukey Post Hoc showed that the moderate intensity group scores in total sleep quality and its components were better than other groups (P<0.05). Finally, the low intensity group scores in total sleep quality and its components were better than control group (P<0.05). Generally, the present research showed that the aerobic exercises with moderate intensity (60-70% MaxHR) have a positive and significant effect on sleep quality and its components. Thus, based on these findings, the aerobic exercises with moderate intensity is a useful to improve the sleep quality and its components among community older adults were recommended.

Student construction of small molecule models using Spartan Model to explore polarity

NASA Astrophysics Data System (ADS)

Dale, Glenn Lamar

2006-12-01

This study compared the attitudes and the gains of knowledge concerning Lewis structures and polarity of molecules. The students performed a lab exercise in which they drew Lewis structures, constructed models of the molecules, determined the geometry of the molecules, and determined the polarity of the molecules. The control group students constructed models using physical ball-and-stick models. The treatment group students used Spartan Model to construct models. Students from a university and a community college participated in this study. Four lab classes at each school made up the treatment group. Five lab classes at the university and three lab classes at the community college made up the control group. The treatment group classes were selected based on available computer resources. All students in the study were given the Lab Pre Test, Lab Post Test, and the Lecture Post Test to assess the student's ability to answer questions pertaining to Lewis structures and polarity of molecules. An Attitudinal Survey assessed the attitudes of the students who participated in the study. Student interviews were performed to assess the student's attitudes towards the lab exercise. The interviews investigated attitudes about the modeling exercise, Lewis structures, and polarity of molecules. There were no significant differences in the performance of the treatment group when compared to the control group on the performance assessment instruments at the university or the community college. The treatment group students at the university had a more positive attitude about the lab activity. They believed that the lab activity helped them better understand the concepts of Lewis structure and molecular polarity. At the community college, the control group students had a more positive attitude about the lab activity. The students involved in the study believed that the lab activity helped them to understand the concepts of molecular geometry and polarity. The interviews of the treatment group students indicated that they strongly believed that the lab activity helped them better understand the concept of Lewis structures and of molecular polarity. As reflected in the interviews of the treatment group and the control group, the lab activity did not help the students be able to look at a Lewis structure and build a mental image of the molecule. The students believed the electrostatic potential plots generated by Spartan Model were very insightful into the concept of polarity. It gave them a visual representation of a difficult topic.

Effects of short-term step aerobics exercise on bone metabolism and functional fitness in postmenopausal women with low bone mass.

PubMed

Wen, H J; Huang, T H; Li, T L; Chong, P N; Ang, B S

2017-02-01

Measurement of bone turnover markers is an alternative way to determine the effects of exercise on bone health. A 10-week group-based step aerobics exercise significantly improved functional fitness in postmenopausal women with low bone mass, and showed a positive trend in reducing resorption activity via bone turnover markers. The major goal of this study was to determine the effects of short-term group-based step aerobics (GBSA) exercise on the bone metabolism, bone mineral density (BMD), and functional fitness of postmenopausal women (PMW) with low bone mass. Forty-eight PMW (aged 58.2 ± 3.5 years) with low bone mass (lumbar spine BMD T-score of -2.00 ± 0.67) were recruited and randomly assigned to an exercise group (EG) or to a control group (CG). Participants from the EG attended a progressive 10-week GBSA exercise at an intensity of 75-85 % of heart rate reserve, 90 min per session, and three sessions per week. Serum bone metabolic markers (C-terminal telopeptide of type 1 collagen [CTX] and osteocalcin), BMD, and functional fitness components were measured before and after the training program. Mixed-models repeated measures method was used to compare differences between the groups (α = 0.05). After the 10-week intervention period, there was no significant exercise program by time interaction for CTX; however, the percent change for CTX was significantly different between the groups (EG = -13.1 ± 24.4 % vs. CG = 11.0 ± 51.5 %, P < 0.05). While there was no significant change of osteocalcin in both groups. As expected, there was no significant change of BMD in both groups. In addition, the functional fitness components in the EG were significantly improved, as demonstrated by substantial enhancement in both lower- and upper-limb muscular strength and cardiovascular endurance (P < 0.05). The current short-term GBSA exercise benefited to bone metabolism and general health by significantly reduced bone resorption activity and improved functional fitness in PMW with low bone mass. This suggested GBSA could be adopted as a form of group-based exercise for senior community.

A prehabilitation program for physically frail community-living older persons.

PubMed

Gill, Thomas M; Baker, Dorothy I; Gottschalk, Margaret; Gahbauer, Evelyne A; Charpentier, Peter A; de Regt, Paul T; Wallace, Sarah J

2003-03-01

To describe the development and implementation of a preventive, home-based physical therapy program (PREHAB) and to provide evidence for the safety and interrater reliability of the PREHAB protocol. Demonstration study. General community. Ninety-four physically frail, community-living persons, aged 75 years or older, who were randomized to the PREHAB program in a clinical trial. The PREHAB program built on the physical therapy component of 2 previous home-based protocols. A total of 223 assessment items were linked to 28 possible interventions, including progressive balance and conditioning exercises, by using detailed algorithms and decisions rules that were automated on notebook computers. The percentages of participants who were eligible for and who completed each intervention, the extent of progress noted in the balance and conditioning exercises, adherence to the training program, and adverse events. Participants who completed the PREHAB program and those who ended it prematurely received an average of 9.7 and 7.2 interventions during an average of 14.9 and 9.5 home visits, respectively. With few exceptions, the completion rate and interrater reliability for the specific interventions were high. Despite high self-reported adherence to the training program, the majority of participants did not advance beyond the initial Thera-Band level for the upper- and lower-extremity conditioning exercises, and only about a third advanced to the highest 2 levels of the balance exercises. Adverse events were no more common in the PREHAB group than in the educational control group. Our results support the feasibility and safety of the PREHAB program, but also show the special challenges and pitfalls of such a strategy when it is implemented among persons of advanced age and physical frailty. Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

The effects of health counseling and exercise training on self-rated health and well-being in middle-aged men: a randomized trial.

PubMed

Engberg, Elina; Liira, Helena; Kukkonen-Harjula, Katriina; From, Svetlana; Kautiainen, Hannu; Pitkälä, Kaisu; Tikkanen, Heikki O

2017-06-01

Few community-based lifestyle interventions have examined subjective well-being. We examined the effects of health counseling and exercise training on self-rated health (SRH), self-rated well-being (SRW) and depressive symptoms in middle-aged men at increased risk for cardiovascular disease (CVD) in a randomized controlled trial. Men (N.=168) with at least two CVD risk factors engaging in leisure-time physical activity less than three times/week were randomized into: A) a group receiving single-session health counseling; B) a group receiving single-session health counseling and three months of weekly structured group exercise training; or C) a control group. We assessed SRH and SRW using visual analogue scales and depressive symptoms using a brief depression screener (the Patient Health Questionnaire-2, PHQ-2). Generalized estimating equation (GEE) models showed that, after 3 and 12 months, SRH (P=0.024) and SRW (P=0.014) improved across all groups. We found no differences between the groups (group by time effect, P=0.44 and P=0.80). The proportion of men with PHQ-2 scores ≥3 (positive depression screen) decreased in groups A (from 27% to 13%) and B (from 34% to 18%), but increased among controls (from 26% to 31%) (group by time effect, P=0.078). We found improvements in SRH and SRW, with a diminishing proportion of men screening positive for depression one year after a single health counseling session and a three-month exercise-training program. We detected, however, no statistically significant differences when comparing men who received health counseling or health counseling combined with exercise training to controls.

Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962

PubMed Central

2009-01-01

Background Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted. Methods The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs. Conclusion A new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme. Trial registration Current Controlled Trials ISRCTN58562962. PMID:19686587

Motives for physical exercise participation as a basis for the development of patient-oriented exercise interventions in osteoarthritis: a cross-sectional study.

PubMed

Krauss, Inga; Katzmarek, Uwe; Rieger, Monika A; Sudeck, Gorden

2017-08-01

Physical exercises are effective in the treatment of osteoarthritis (OA). There is consensus that exercise interventions should take into account the patient's preferences and needs in order to improve compliance to exercise regimes. One important personal factor is the patient's motivation for physical exercise. Health improvement is a relevant motive for exercise participation. Accordingly, exercise interventions primarily focus on health related needs such as strengthening and pain reduction. However exercising provides further many-faceted incentives that may foster exercise adherence. The present study aimed to characterize target groups for person-tailored exercise interventions in OA according to the International Classification of Functioning and Disability and Health (ICF). Target groups should be classified by similar individual exercise participation motive profiles and further described by their disease-related symptoms, limitations and psychological determinants of exercise behavior. Observational study via self-administered questionnaires. Community. We enrolled 292 adults with hip/knee OA living independently of assistance. Participants completed the Bernese Motive and Goal Inventory in Leisure and Health Sports (BMZI), the Hannover Functional Ability Questionnaire for Osteoarthritis, the WOMAC-Index (pain/stiffness), the General Self-efficacy Scale and a questionnaire on perceived barriers to exercise participation. The BMZI-scales served as active variables for cluster analysis (Ward's method), other scales were used as passive variables to further describe the identified clusters. Four clusters were defined using five exercise participation motives: health, body/appearance, esthetics, nature, and contact. Based on the identified motive profiles the target groups are labelled health-focused sports people; sporty, nature-oriented individualists; functionalists primarily motivated by maintaining or improving health through exercise; and nature-oriented, health-conscious exercisers. This study contributes to the development of person-oriented exercise recommendations with a special regard to motives for exercise participation. This study delineates four phenotypes with distinctive profiles of facilitators and barriers to exercise behavior. Key aspects of person-oriented exercise interventions could be defined according to each phenotype. Incentives related to physical exercise such as enjoyment, contact, or natural environment may encourage compliance to an exercise intervention. Goal setting in the context of OA rehabilitation should therefore not only refer to health-oriented reasons but also reconsider individual motives for exercise participation.

"Left to my own devices, I don't know": using theory and patient-reported barriers to move from physical activity recommendations to practice.

PubMed

Ziebart, C; McArthur, C; Lee, L; Papaioannou, A; Laprade, J; Cheung, A M; Jain, R; Giangregorio, L

2018-05-01

Knowledge exchange with community-dwelling individuals across Ontario revealed barriers to implementation of physical activity recommendations that reflected capability, opportunity, and motivation; barriers unique to individuals with osteoporosis include fear of fracturing, trust in providers, and knowledge of exercise terminology. Using the Behaviour Change Wheel, we identified interventions (training, education, modeling) and policy categories (communication/marketing, guidelines, service provision). Physical activity recommendations exist for individuals with osteoporosis; however, to change behavior, we must address barriers and facilitators to their implementation. The purposes of this project are (1) to identify barriers to and facilitators of uptake of disease-specific physical activity recommendations (2) to use the findings to identify behavior change strategies using the Behaviour Change Wheel (BCW). Focus groups and semi-structured interviews were conducted with community-dwelling individuals attending osteoporosis-related programs or education sessions in Ontario. They were stratified by geographic area, urban/rural, and gender, and transcribed verbatim. Two researchers coded data and identified emerging themes. Using the Behaviour Change Wheel framework, themes were categorized into capability, opportunity, and motivation, and interventions were identified. Two hundred forty community-dwelling individuals across Ontario participated (mean ± SD age = 72 ± 8.28). Barriers were as follows: capability: disease-related symptoms hinder exercise and physical activity participation, lack of exercise-related knowledge, low exercise self-efficacy; opportunity: access to exercise programs that meet needs and preferences, limited resources and time, physical activity norms and preferences; motivation: incentives to exercise, fear of fracturing, trust in exercise providers. Interventions selected were training, education, and modeling. Policy categories selected were communication/marketing, guidelines, and service provision. Barriers unique to individuals with osteoporosis included the following: lack of knowledge on key exercise concepts, fear of fracturing, and trust in providers. Behavior change techniques may need tailoring to gender, age, or presence of comorbid conditions.

Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial.

PubMed

Brandão, Glauber Sá; Gomes, Glaucia Sá Brandão Freitas; Brandão, Glaudson Sá; Callou Sampaio, Antônia A; Donner, Claudio F; Oliveira, Luis V F; Camelier, Aquiles Assunção

2018-01-01

Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n  = 65) and a control group - CG (sleep hygiene only, n  = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI ( p  < 0.01) and in all its 7 components of evaluation ( p  < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01). Our results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders. Ensaiosclinicos.gov.br process number: RBR-3cqzfy.

Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

PubMed

Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

2011-03-28

Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P < .002) under dual-task condition in the intervention group, compared with the delayed intervention control group. Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

Sports and exercise cardiology in the United States: cardiovascular specialists as members of the athlete healthcare team.

PubMed

Lawless, Christine E; Olshansky, Brian; Washington, Reginald L; Baggish, Aaron L; Daniels, Curt J; Lawrence, Silvana M; Sullivan, Renee M; Kovacs, Richard J; Bove, Alfred A

2014-04-22

In recent years, athletic participation has more than doubled in all major demographic groups, while simultaneously, children and adults with established heart disease desire participation in sports and exercise. Despite conferring favorable long-term effects on well-being and survival, exercise can be associated with risk of adverse events in the short term. Complex individual cardiovascular (CV) demands and adaptations imposed by exercise present distinct challenges to the cardiologist asked to evaluate athletes. Here, we describe the evolution of sports and exercise cardiology as a unique discipline within the continuum of CV specialties, provide the rationale for tailoring of CV care to athletes and exercising individuals, define the role of the CV specialist within the athlete care team, and lay the foundation for the development of Sports and Exercise Cardiology in the United States. In 2011, the American College of Cardiology launched the Section of Sports and Exercise Cardiology. Membership has grown from 150 to over 4,000 members in just 2 short years, indicating marked interest from the CV community to advance the integration of sports and exercise cardiology into mainstream CV care. Although the current athlete CV care model has distinct limitations, here, we have outlined a new paradigm of care for the American athlete and exercising individual. By practicing and promoting this new paradigm, we believe we will enhance the CV care of athletes of all ages, and serve the greater athletic community and our nation as a whole, by allowing safest participation in sports and physical activity for all individuals who seek this lifestyle. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Changes in Exercise Data Management

NASA Technical Reports Server (NTRS)

Buxton, R. E.; Kalogera, K. L.; Hanson, A. M.

2018-01-01

The suite of exercise hardware aboard the International Space Station (ISS) generates an immense amount of data. The data collected from the treadmill, cycle ergometer, and resistance strength training hardware are basic exercise parameters (time, heart rate, speed, load, etc.). The raw data are post processed in the laboratory and more detailed parameters are calculated from each exercise data file. Updates have recently been made to how this valuable data are stored, adding an additional level of data security, increasing data accessibility, and resulting in overall increased efficiency of medical report delivery. Questions regarding exercise performance or how exercise may influence other variables of crew health frequently arise within the crew health care community. Inquiries over the health of the exercise hardware often need quick analysis and response to ensure the exercise system is operable on a continuous basis. Consolidating all of the exercise system data in a single repository enables a quick response to both the medical and engineering communities. A SQL server database is currently in use, and provides a secure location for all of the exercise data starting at ISS Expedition 1 - current day. The database has been structured to update derived metrics automatically, making analysis and reporting available within minutes of dropping the inflight data it into the database. Commercial tools were evaluated to help aggregate and visualize data from the SQL database. The Tableau software provides manageable interface, which has improved the laboratory's output time of crew reports by 67%. Expansion of the SQL database to be inclusive of additional medical requirement metrics, addition of 'app-like' tools for mobile visualization, and collaborative use (e.g. operational support teams, research groups, and International Partners) of the data system is currently being explored.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial.

PubMed

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline; Dargent-Molina, Patricia

2015-07-22

To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Pragmatic multicentre, two arm, parallel group, randomised controlled trial. 20 study sites in 16 medium to large cities throughout France. 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a "shared frailty" model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls related to the intervention were recorded. A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling.Trial registration ClinicalTrials.gov (NCT00545350). © El-Khoury et al 2015.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial

PubMed Central

El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline

2015-01-01

Objective To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Design Pragmatic multicentre, two arm, parallel group, randomised controlled trial. Setting 20 study sites in 16 medium to large cities throughout France. Participants 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Intervention Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. Outcome measures A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a “shared frailty” model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. Results There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls related to the intervention were recorded. Conclusion A two year progressive balance retraining programme combining weekly group and individual sessions was effective in reducing injurious falls and in improving measured and perceived physical function in women aged 75-85 at risk of falling. Trial registration ClinicalTrials.gov (NCT00545350). PMID:26201510

The association between physical activity and social isolation in community-dwelling older adults.

PubMed

Robins, Lauren M; Hill, Keith D; Finch, Caroline F; Clemson, Lindy; Haines, Terry

2018-02-01

Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01-1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R 2 = 0.104). Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Trends in ice sheet mass balance, 1992 to 2017

NASA Astrophysics Data System (ADS)

Shepherd, A.; Ivins, E. R.; Smith, B.; Velicogna, I.; Whitehouse, P. L.; Rignot, E. J.; van den Broeke, M. R.; Briggs, K.; Hogg, A.; Krinner, G.; Joughin, I. R.; Nowicki, S.; Payne, A. J.; Scambos, T.; Schlegel, N.; Moyano, G.; Konrad, H.

2017-12-01

The Ice Sheet Mass Balance Inter-Comparison Exercise (IMBIE) is a community effort, jointly supported by ESA and NASA, that aims to provide a consensus estimate of ice sheet mass balance from satellite gravimetry, altimetry and mass budget assessments, on an annual basis. The project has five experiment groups, one for each of the satellite techniques and two others to analyse surface mass balance (SMB) and glacial isostatic adjustment (GIA). The basic premise for the exercise is that individual ice sheet mass balance datasets are generated by project participants using common spatial and temporal domains to allow meaningful inter-comparison, and this controlled comparison in turn supports aggregation of the individual datasets over their full period. Participation is open to the full community, and the quality and consistency of submissions is regulated through a series of data standards and documentation requirements. The second phase of IMBIE commenced in 2015, with participant data submitted in 2016 and a combined estimate due for public release in 2017. Data from 48 participant groups were submitted to one of the three satellite mass balance technique groups or to the ancillary dataset groups. The individual mass balance estimates and ancillary datasets have been compared and combined within the respective groups. Following this, estimates of ice sheet mass balance derived from the individual techniques were then compared and combined. The result is single estimates of ice sheet mass balance for Greenland, East Antarctica, West Antarctica, and the Antarctic Peninsula. The participants, methodology and results of the exercise will be presented in this paper.

Physical Activity Differentially Affects the Cecal Microbiota of Ovariectomized Female Rats Selectively Bred for High and Low Aerobic Capacity

PubMed Central

Liu, Tzu-Wen; Park, Young-Min; Holscher, Hannah D.; Padilla, Jaume; Scroggins, Rebecca J.; Welly, Rebecca; Britton, Steven L.; Koch, Lauren G.; Vieira-Potter, Victoria J.; Swanson, Kelly S.

2015-01-01

The gut microbiota is considered a relevant factor in obesity and associated metabolic diseases, for which postmenopausal women are particularly at risk. Increasing physical activity has been recognized as an efficacious approach to prevent or treat obesity, yet the impact of physical activity on the microbiota remains under-investigated. We examined the impacts of voluntary exercise on host metabolism and gut microbiota in ovariectomized (OVX) high capacity (HCR) and low capacity running (LCR) rats. HCR and LCR rats (age = 27wk) were OVX and fed a high-fat diet (45% kcal fat) ad libitum and housed in cages equipped with (exercise, EX) or without (sedentary, SED) running wheels for 11wk (n = 7-8/group). We hypothesized that increased physical activity would hinder weight gain, increase metabolic health and shift the microbiota of LCR rats, resulting in populations more similar to that of HCR rats. Animals were compared for characteristic metabolic parameters including body composition, lipid profile and energy expenditure; whereas cecal digesta were collected for DNA extraction. 16S rRNA gene-based amplicon Illumina MiSeq sequencing was performed, followed by analysis using QIIME 1.8.0 to assess cecal microbiota. Voluntary exercise decreased body and fat mass, and normalized fasting NEFA concentrations of LCR rats, despite only running one-third the distance of HCR rats. Exercise, however, increased food intake, weight gain and fat mass of HCR rats. Exercise clustered the gut microbial community of LCR rats, which separated them from the other groups. Assessments of specific taxa revealed significant (p<0.05) line by exercise interactions including shifts in the abundances of Firmicutes, Proteobacteria, and Cyanobacteria. Relative abundance of Christensenellaceae family was higher (p = 0.026) in HCR than LCR rats, and positively correlated (p<0.05) with food intake, body weight and running distance. These findings demonstrate that exercise differentially impacts host metabolism and gut microbial communities of female HCR and LCR rats without ovarian function. PMID:26301712

Effects of a dance-based aquatic exercise program in obese postmenopausal women with knee osteoarthritis: a randomized controlled trial.

PubMed

Casilda-López, Jesús; Valenza, Marie Carmen; Cabrera-Martos, Irene; Díaz-Pelegrina, Ana; Moreno-Ramírez, Maria Paz; Valenza-Demet, Gerald

2017-07-01

To evaluate the effects of a dance-based aquatic exercise program on functionality, cardiorespiratory capacity, postexercise heart rate, and fatigue in obese postmenopausal women with knee osteoarthritis. A randomized controlled trial was performed. In all, 34 obese women diagnosed with knee osteoarthritis participated. Women were randomly allocated to an experimental group (n = 17) or a control group (n = 17). Participants in the experimental group were included in an 8-week dance-based aquatic exercise program conducted in community swimming pools. Those in the control group underwent a global aquatic exercise program. The primary outcome measure was functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were cardiorespiratory capacity evaluated with the 6-minute walk test, and postexercise heart rate and fatigue assessed using a visual analog scale. Variables were measured at baseline, after the intervention, and at 3-month follow-up. A between-group analysis showed significant postintervention differences in functionality (aggregate postintervention WOMAC score of 37.30 ± 16.61 vs 41.83 ± 13.69; P = 0.048) in favor of the experimental group. In addition, significant between-group differences were found after the 8 weeks in cardiorespiratory capacity, postexercise heart rate, and fatigue. Follow-up continued to show significant differences between groups in function (aggregate WOMAC score of 38.60 ± 13.61 vs 42.60 ± 9.05; P = 0.038), postexercise heart rate, and fatigue. An 8-week dance-based exercise program significantly improved function and cardiorespiratory capacity, and decreased postexercise heart rate and fatigue. Most of these improvements were maintained at 3-month follow-up in obese postmenopausal women.

Multiple-modality exercise and mind-motor training to improve mobility in older adults: A randomized controlled trial.

PubMed

Boa Sorte Silva, Narlon C; Gill, Dawn P; Gregory, Michael A; Bocti, John; Petrella, Robert J

2018-03-01

To investigate the effects of multiple-modality exercise with or without additional mind-motor training on mobility outcomes in older adults with subjective cognitive complaints. This was a 24-week randomized controlled trial with a 28-week no-contact follow-up. Community-dwelling older adults underwent a thrice -weekly, Multiple-Modality exercise and Mind-Motor (M4) training or Multiple-Modality (M2) exercise with an active control intervention (balance, range of motion and breathing exercises). Study outcomes included differences between groups at 24weeks and after the no-contact follow-up (i.e., 52weeks) in usual and dual-task (DT, i.e., serial sevens [S7] and phonemic verbal fluency [VF] tasks) gait velocity, step length and cycle time variability, as well as DT cognitive accuracy. 127 participants (mean age 67.5 [7.3] years, 71% women) were randomized to either M2 (n=64) or M4 (n=63) groups. Participants were assessed at baseline, intervention endpoint (24weeks), and study endpoint (52weeks). At 24weeks, the M2 group demonstrated greater improvements in usual gait velocity, usual step length, and DT gait velocity (VF) compared to the M4 group, and no between- or within-group changes in DT accuracy were observed. At 52weeks, the M2 group retained the gains in gait velocity and step length, whereas the M4 group demonstrated trends for improvement (p=0.052) in DT cognitive accuracy (VF). Our results suggest that additional mind-motor training was not effective to improve mobility outcomes. In fact, participants in the active control group experienced greater benefits as a result of the intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

C-Reactive Protein and Resistance Exercise in Community Dwelling Old Adults.

PubMed

Ramel, A; Geirsdottir, O G; Jonsson, P V; Thorsdottiri, I

2015-08-01

C-reactive protein (CRP), an acute phase reactant, has been associated with atherosclerosis and has also been discussed as a target for intervention. The effects of resistance exercise on CRP are currently not clear. The present analysis investigated the response of CRP to resistance exercise in old adults. Intervention study. Community. Old Icelandic adults (N = 235, 73.7 ± 5.7 years, 58.2% female). Twelve-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80% of the 1-repetition maximum) designed to increase strength and muscle mass of major muscle groups. C-reactive protein (CRP). Mean CRP levels were 7.1 ± 4.6 mg/dL at baseline, thirty-six (15.6%) subjects had abnormally high CRP (>10 mg/L) values at baseline. After the resistance exercise program the overall changes in CRP were minor and not significant. However, CRP decreased considerably in participants with high CRP at baseline (-4.28 ± 9.41 mg/L; P = 0.015) but increased slightly in participants with normal CRP (0.81 ± 4.58 mg/L, P = 0.021). Our study shows that the concentrations of circulating CRP decreased considerably after a 12-week resistance exercise program in participants with abnormally high CRP at baseline, possibly reducing thus risk for future disease. CRP changed little in participants with normal CRP at the start of the study.

The influence of primary health care professionals in encouraging exercise and physical activity uptake among White and South Asian older adults: experiences of young older adults.

PubMed

Horne, Maria; Skelton, Dawn; Speed, Shaun; Todd, Chris

2010-01-01

To explore the influence of primary health care professionals in increasing exercise and physical activity among 60-70-year-old White and South Asian community dwellers. Fifteen focus groups and 40 in-depth interviews with community dwelling White and South Asian 60-70-year olds. The sample was selected to include people with very different experiences of participation and non-participation in exercise and physical activity. Data were analysed using framework analysis. Primary health care professionals' advice and support was found to be a motivator to the initiation of exercise and physical activity. However, this was usually in relation to advice on weight reduction, cardiac conditions and mobility issues, but not generally to improve or increase activity levels. An underlying attitude of genuine interest and empathy was valued and shaped decisions about initiating and/or increasing activity levels. Primary health care professionals should be encouraged to show interest and empathy with older people about the positive benefits of exercise and physical activity to them individually. This advice needs to be tailored to the older adult's symptoms. Primary health care professionals need to be able to provide specific advice as to the quantity (frequency, duration, intensity and type) of exercise or physical activity to undertake. Practitioners need to listen to their patients' needs, show empathy and avoid ageism during consultations.

Sensory retraining: burden in daily life related to altered sensation after orthognathic surgery, a randomized clinical trial

PubMed Central

Phillips, C; Kim, S H; Tucker, M; Turvey, T A

2010-01-01

Objective Assess the long-term effect of sensory re-training exercises, age, gender, type of surgery, and pre-surgical psychological distress on patients' perception of the interference related to altered sensation two years after orthognathic surgery. Setting and Sample Population 186 subjects with a developmental dentofacial disharmony were enrolled in a multicenter randomized clinical trial: one center was a community based practice and the other a university-based center. Methods and Materials Subjects were randomly allocated to two groups: standard of care mouth opening exercises after BSSO or a progressive series of sensory retraining facial exercises in addition to the opening exercises. At 1, 3, 6, 12, and 24 months after surgery, subjects scored unusual feelings on the face, numbness, and loss of lip sensitivity from “no problem(1)” to “serious problem(7)”. A marginal proportional odds model was fit for each of the ordinal outcomes. Results Up to two years after surgery, the opening exercise only group had a higher likelihood of reporting interference in daily activities related to numbness and loss of lip sensitivity than the sensory retraining exercise group. The difference between the two groups was relatively constant. Older subjects and those with elevated psychological distress before surgery reported higher burdens related to unusual facial feelings, numbness, and loss of lip sensitivity (P<0.02). Conclusion The positive effect of sensory retraining facial exercises observed after surgery is maintained over time. Clinicians should consider the patient's age and psychological well-being prior to providing pre-surgical counseling regarding the impact on daily life of persistent altered sensation following a mandibular osteotomy. PMID:20618719

Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial.

PubMed

Schenkman, Margaret; Moore, Charity G; Kohrt, Wendy M; Hall, Deborah A; Delitto, Anthony; Comella, Cynthia L; Josbeno, Deborah A; Christiansen, Cory L; Berman, Brian D; Kluger, Benzi M; Melanson, Edward L; Jain, Samay; Robichaud, Julie A; Poon, Cynthia; Corcos, Daniel M

2018-02-01

Parkinson disease is a progressive neurologic disorder. Limited evidence suggests endurance exercise modifies disease severity, particularly high-intensity exercise. To examine the feasibility and safety of high-intensity treadmill exercise in patients with de novo Parkinson disease who are not taking medication and whether the effect on motor symptoms warrants a phase 3 trial. The Study in Parkinson Disease of Exercise (SPARX) was a phase 2, multicenter randomized clinical trial with 3 groups and masked assessors. Individuals from outpatient and community-based clinics were enrolled from May 1, 2012, through November 30, 2015, with the primary end point at 6 months. Individuals with idiopathic Parkinson disease (Hoehn and Yahr stages 1 or 2) aged 40 to 80 years within 5 years of diagnosis who were not exercising at moderate intensity greater than 3 times per week and not expected to need dopaminergic medication within 6 months participated in this study. A total of 384 volunteers were screened by telephone; 128 were randomly assigned to 1 of 3 groups (high-intensity exercise, moderate-intensity exercise, or control). High-intensity treadmill exercise (4 days per week, 80%-85% maximum heart rate [n = 43]), moderate-intensity treadmill exercise (4 days per week, 60%-65% maximum heart rate [n = 45]), or wait-list control (n = 40) for 6 months. Feasibility measures were adherence to prescribed heart rate and exercise frequency of 3 days per week and safety. The clinical outcome was 6-month change in Unified Parkinson's Disease Rating Scale motor score. A total of 128 patients were included in the study (mean [SD] age, 64 [9] years; age range, 40-80 years; 73 [57.0%] male; and 108 [84.4%] non-Hispanic white). Exercise rates were 2.8 (95% CI, 2.4-3.2) days per week at 80.2% (95% CI, 78.8%-81.7%) maximum heart rate in the high-intensity group and 3.2 (95% CI, 2.8-3.6; P = .13) days per week at 65.9% (95% CI, 64.2%-67.7%) maximum heart rate in the moderate-intensity group (P < .001). The mean change in Unified Parkinson's Disease Rating Scale motor score in the high-intensity group was 0.3 (95% CI, -1.7 to 2.3) compared with 3.2 (95% CI, 1.4 to 5.1) in the usual care group (P = .03). The high-intensity group, but not the moderate-intensity group, reached the predefined nonfutility threshold compared with the control group. Anticipated adverse musculoskeletal events were not severe. High-intensity treadmill exercise may be feasible and prescribed safely for patients with Parkinson disease. An efficacy trial is warranted to determine whether high-intensity treadmill exercise produces meaningful clinical benefits in de novo Parkinson disease. clinicaltrials.gov Identifier: NCT01506479.

Action seniors! - secondary falls prevention in community-dwelling senior fallers: study protocol for a randomized controlled trial.

PubMed

Liu-Ambrose, Teresa; Davis, Jennifer C; Hsu, Chun Liang; Gomez, Caitlin; Vertes, Kelly; Marra, Carlo; Brasher, Penelope M; Dao, Elizabeth; Khan, Karim M; Cook, Wendy; Donaldson, Meghan G; Rhodes, Ryan; Dian, Larry

2015-04-10

Falls are a 'geriatric giant' and are the third leading cause of chronic disability worldwide. About 30% of community-dwellers over the age of 65 experience one or more falls every year leading to significant risk for hospitalization, institutionalization, and even death. As the proportion of older adults increases, falls will place an increasing demand and cost on the health care system. Exercise can effectively and efficiently reduce falls. Specifically, the Otago Exercise Program has demonstrated benefit and cost-effectiveness for the primary prevention of falls in four randomized trials of community-dwelling seniors. Although evidence is mounting, few studies have evaluated exercise for secondary falls prevention (that is, preventing falls among those with a significant history of falls). Hence, we propose a randomized controlled trial powered for falls that will, for the first time, assess the efficacy and efficiency of the Otago Exercise Program for secondary falls prevention. A randomized controlled trial among 344 community-dwelling seniors aged 70 years and older who attend a falls prevention clinic to assess the efficacy and the cost-effectiveness of a 12-month Otago Exercise Program intervention as a secondary falls prevention strategy. Participants randomized to the control group will continue to behave as they did prior to study enrolment. The economic evaluation will examine the incremental costs and benefits generated by using the Otago Exercise Program intervention versus the control. The burden of falls is significant. The challenge is to make a difference - to discover effective, ideally cost-effective, interventions that prevent injurious falls that can be readily translated to the population. Our proposal is very practical - the exercise program requires minimal equipment, the physical therapist expertise is widely available, and seniors in Canada and elsewhere have adopted the program and complied with it. Our innovation includes applying the intervention to a targeted high-risk population, aiming to provide the best value for money. Given society's limited financial resources and the known and increasing burden of falls, there is an urgent need to test this feasible intervention which would be eminently ready for roll out. ClinicalTrials.gov Protocol Registration System: NCT01029171; registered 7 December 2009.

Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study.

PubMed

Dunleavy, K; Kava, K; Goldberg, A; Malek, M H; Talley, S A; Tutag-Lehr, V; Hildreth, J

2016-09-01

To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). Quasi-randomised parallel controlled study. Community, university and private practice settings in four locations. Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=17, Pilates n=20, yoga n=19). Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist. The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18). NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference -4.3 (95% confidence interval -1.64 to -6.7); P<0.001} and yoga groups [baseline: 12.8 (SD 7.4) vs Week 12: 8.1 (SD 5.6); mean difference -4.7 (95% confidence interval -2.1 to -7.4); P<0.00], with no change in the control group. Pain ratings also improved significantly. Moderate-to-large effect sizes (0.7 to 1.8) and low numbers needed to treat were found. There were no differences in outcomes between the exercise groups or associated adverse effects. No improvements in range of movement or posture were found. Pilates and yoga group exercise interventions with appropriate modifications and supervision were safe and equally effective for decreasing disability and pain compared with the control group for individuals with mild-to-moderate CNP. Physiotherapists may consider including these approaches in a plan of care. ClinicalTrials.gov NCT01999283. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Considerations for expanding community exercise programs incorporating a healthcare-recreation partnership for people with balance and mobility limitations: a mixed methods evaluation.

PubMed

Salbach, Nancy M; Howe, Jo-Anne; Baldry, Diem; Merali, Saira; Munce, Sarah E P

2018-04-02

To increase access to safe and appropriate exercise for people with balance and mobility limitations, community organizations have partnered with healthcare providers to deliver an evidence-based, task-oriented group exercise program in community centers in Canada. We aimed to understand challenges and solutions to implementing this program model to inform plans for expansion. At a 1-day meeting, 53 stakeholders (healthcare/recreation personnel, program participants/caregivers, researchers) identified challenges to program implementation that were captured by seven themes: Resources to deliver the exercise class (e.g., difficulty finding instructors with the skills to work with people with mobility limitations); Program marketing (e.g., to foster healthcare referrals); Transportation (e.g., particularly from rural areas); Program access (e.g., program full); Maintaining program integrity; Sustaining partnerships (i.e., with healthcare partners); and Funding (e.g., to deliver program or register). Stakeholders prioritized solutions to form an action plan. A survey of individuals supervising 28 programs revealed that people with stroke, acquired brain injury, multiple sclerosis, and Parkinson's disease register at 95-100% of centers. The most prevalent issues with program fidelity across centers were not requiring a minimum level of walking ability (32%), class sizes exceeding 12 (21%), and instructor-to-participant ratios exceeding 1:4 (19%). Findings provide considerations for program expansion.

Relation among 25(OH)D, Aquatic Exercises, and Multifunctional Fitness on Functional Performance of Elderly Women from the Community.

PubMed

Nascimento, N A Perigo; Moreira, P F P; Marin, R V; Moreira, L D F; Castro, M Lazaretti; Santos, C A F; Filho, C M A; Cendoroglo, M Seabra

2016-04-01

The aim of this study was to investigate if there is a relation among 25(OH)D, aquatic training, and multifunctional fitness on functional performance of elderly woman from the community. Cross-sectional study. Community. We evaluated elderly women aged ≥ 60 years (67±5 years old). One-hundred eighty were engaged in aquatic training (AT), 119 in multifunctional fitness (MF) for at least one year, and sedentary group (SED) with 162 independent elderly women from the community centers who had not practicing any regular physical exercise at least one year before. Timed up-and-go (TUG), 2-minute step test (2MST), 30-second chair stand (CS), arm curl (AC), functional reach test (FRT), unipedal balance test (UB) with visual control, handgrip right (HR) and handgrip left (HL) portable dynamometer for strength hip flexors (Hip strength) and knee extensors (Knee strength), serum 25(OH)D, intact parathyroid hormone (PTH), and creatinine clearance. Physical and functional tests showed differences among the three groups (ST; TUG, CS, AC, FR and USB = p <0.001). The PTH and the TUG test correlated inversely with 25(OH)D (r = -0.29 - p <0.001/ r = - 0.16 - p <0.001), also between 25(OH)D and BMI for AT and MF groups respectively (r= -0,15; p=0,04/ r= - 0,19; p=0,036). The AC test showed positive correlation (r = 0, 1 - p <0.001). The age and 25(OH)D were controlled and assumed to be a covariates in the statistical analysis that employed ANCOVA. There was difference on the performance of TUG test (p= 0.049). TUG performance was associated with age, exercise type and serum levels of 25(OH)D. The 25(OH)D insufficiency was common in elderly women from subtropical areas.

Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

PubMed Central

2012-01-01

Background Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods/design The Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial registration Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291 PMID:22640372

Barriers to diabetes awareness and self-help are influenced by people's demographics: perspectives of South Asians with type 2 diabetes.

PubMed

Pardhan, Shahina; Nakafero, Georgina; Raman, Rajiv; Sapkota, Raju

2018-03-26

To determine whether barriers to diabetes awareness and self-help differ in South Asian participants of different demographic characteristics (age, gender, and literacy) with type 2 diabetes living in the United Kingdom. Six focus group discussions (FGDs) were carried out in patients who were categorized according to age (30-60 years, ≥60 years), gender (male, female) and literacy status (literate, illiterate). Data were analysed following the iterative process of thematic analysis techniques. Barriers were demographic-specific. The illiterate groups reported language as the major barrier to improved diabetes awareness and self-help. The literate groups reported that information provided by healthcare providers was general, and not specific to their diet/culture. Major barriers to adherence to the recommended diet for diabetes included: insufficient knowledge/awareness about nutritional content of food (all groups); lack of self-will to resist eating sweets, especially during weddings/festivals (literate older groups/literate younger females/illiterate older males); difficulty cooking separate meals for diabetic and non-diabetic family members (illiterate/literate older females). Other barriers to seeking advice/help ranged from not wanting to disclose their diabetes as it may affect employment/work (literate groups) to fear of being singled out at social gatherings (illiterate groups). General lack of motivation to exercise was reported by all groups. Time constraints and not knowing what/how to exercise was reported by literate younger groups whilst the illiterate older groups reported to not having suitable exercising facilities at local communities. Different barriers were also reported when accessing healthcare; language barriers (illiterate groups), restricted access to doctors' appointments/difficulty attending specific appointment slots offered by General Practitioners (literate females). Different barriers exist to improved awareness about diabetes and self-help in different patient demographics. Lack of culturally appropriate diabetes educational/awareness programs in the community appeared to be a major barrier in most older and illiterate participants while younger participants reported time constraint.

How adolescents perceive that community-based exercise improves their well-being.

PubMed

Rourke, Kevin; Wilson, Coralie J

2017-10-01

To determine if adolescents perceive community-based exercise as beneficial to their well-being and in what ways. A New South Wales Police Citizens Youth Club ran a four-week fitness course. The classes involved: 1) sports including basketball and soccer, 2) non-contact boxing drills, and 3) games, both team games such as dodgeball and non-team games such as line tag. Parental consent to offer a survey at the completion of the course was requested during registration. The survey was the Warwick Edinburgh Mental Well-being Scale; it was minimally modified to measure perceived benefit to mental well-being instead of actual benefit. Thirty-one high school adolescents, ages 13-18, completed the survey. As a group, participants reported that they believed their well-being had improved after the course. The mean score for each survey item showed an improvement in every area of mental well-being for this sample of adolescents. Thirty-two per cent of adolescents reported having less energy. Survey scores indicated a statistically significant improvement in perceived well-being ( p<0.0001). The results of this study suggest that four weeks of community-based exercise improves perceived mental well-being in adolescent participants.

Improving aerobic fitness in older adults

PubMed Central

Petrella, Robert J.; Lattanzio, Chastity N.; Shapiro, Sheree; Overend, Tom

2010-01-01

ABSTRACT OBJECTIVE To determine the effects of adding stages of change–based counseling to an exercise prescription for older, sedentary adults in family practice. DESIGN The Step Test Exercise Prescription Stages of change counseling study was a 12-month cluster randomized trial. SETTING Forty family practices in 4 regions of Canada. PARTICIPANTS Healthy, community-dwelling men (48%) and women (52%) with a mean (SD) age of 64.9 (7.1) years (range 55 to 85 years). There were a total of 193 participants in the intervention group and 167 in the control group. INTERVENTION Intervention physicians were trained to deliver a tailored exercise prescription and a transtheoretical behaviour change counseling program. Control physicians were trained to deliver the exercise prescription alone. MAIN OUTCOME MEASURES Predicted cardiorespiratory fitness, measured by predicted maximal oxygen consumption (pVO2max), and energy expenditure, measured by 7-day physical activity recall. RESULTS Mean increase in pVO2max was significant for both the intervention (3.02 [95% confidence interval 2.40 to 3.65] mL/kg/min) and control (2.21 [95% confidence interval 1.27 to 3.15] mL/kg/min) groups at 12 months (P < .001); however, there was no difference between groups. Women in the intervention group improved their fitness significantly more than women in the control group did (3.20 vs 1.23 mL/kg/min). The intervention group had a 4–mm Hg reduction in systolic blood pressure, while the control group’s mean reduction was 0.4 mm Hg (P < .001). The mean (SD) energy expended significantly increased and was higher in the intervention group than in the control group (69.06 [169.87] kcal/d vs −6.96 [157.06] kcal/d, P < .006). Practice setting characteristics did not significantly affect the primary outcomes. CONCLUSION The Step Test Exercise Prescription Stages of change exercise and behavioural intervention improved fitness and activity and lowered systolic blood pressure across a range of Canadian practices, but this was not significantly different from the control group, which received only the exercise prescription. Women in the intervention group showed higher levels of fitness than women in the control group did; men in both groups showed similar improvement. PMID:20463260

Exercise response in Parkinson’s disease: insights from a cross-sectional comparison with sedentary controls and a per-protocol analysis of a randomised controlled trial

PubMed Central

Collett, Johnny; Franssen, Marloes; Meaney, Andy; Sexton, Claire; Dennis-West, Andrea; Betts, Jill F; Izadi, Hooshang; Bogdanovic, Marko; Tims, Martin; Farmer, Andrew; Dawes, Helen

2017-01-01

Objectives To investigate the acute and adaptation cardiovascular and metabolic training responses in people with Parkinson’s disease (pwP). Design (1) A cross-sectional study of exercise response of pwP compared with sedentary controls and (2) an interventional study of exercise training in pwP. Setting Community leisure facilities. Participants pwP (n=83) and sedentary controls (n=55). Interventions Study 1 included participants from a two-arm-parallel single-blind phase II randomised controlled trial (RCT), that undertook a baseline maximal incremental exercise test and study 2 included those randomised to the exercise group in the RCT, who completed a 6-month weekly exercise programme (n=37). The intervention study 2 was a prescribed exercise program consisting of sessions lasting 60 min, two times a week over a 6-month period. The control group followed the same protocol which derived the same cardiorespiratory parameters, except that they were instructed to aim for a cadence of ~60 revolutions per minute and the unloaded phase lasted 3 min with an initial step of 25 W. Primary and secondary outcome measures Stepwise incremental exercise test to volitional exhaustion was the primary outcome measure. Results Study 1 showed higher maximum values for heart rate (HR), VO2 L/min, VCO2 L/min and ventilation L/min for the control group; respiratory exchange ratio (RER), perceived exertion and O2 pulse (VO2 L/min/HR) did not differ between groups. In study 2, for pwP who adhered to training (n=37), RER increased significantly and although there was no significant change in aerobic capacity or HR response, reduced blood pressure was found. Conclusions An abnormal cardiovascular response to exercise was observed in pwP compared to controls. After the exercise programme, metabolic deficiencies remained for pwP. These observations add to the pathogenic understanding of PD, acknowledge an underling metabolic contribution and support that certain cardiovascular symptoms may improve as a result of this type of exercise. PMID:29282259

Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015

PubMed Central

Roy, Nicole M. St. Omer; Quintiliani, Lisa M.; Truong, Ve; Feng, Yi; Bloch, Philippe P.; Russinova, Zlatka L.; Lasser, Karen E.

2016-01-01

Introduction Diabetes self-management takes place within a complex social and environmental context.  This study’s objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. Methods We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes “hot spots”).  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Results Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants’ reports in the photovoice group. Conclusion We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes. PMID:27513998

Benefits of exercise for older adults. A review of existing evidence and current recommendations for the general population.

PubMed

Elward, K; Larson, E B

1992-02-01

Currently available data are of variable rigor and from a variety of sources, yet they do support several conclusions about the potential value of exercise for whole groups of elderly persons. (1) Exercise of moderate intensity may benefit many elderly persons in numerous and complementary ways (e.g., cardiovascular status, fracture risk, functional ability, and mental processing). (2) There are few complications associated with such increases in activity. Indeed, a remarkable aspect of research on exercise in the elderly has been the virtual absence of reports of serious cardiovascular or musculoskeletal complications in any published trials. Cardiac rehabilitation programs, enrolling many persons over 65 years of age with known coronary artery disease, also report few major cardiovascular complications. Thus, exercise should be viewed as safe for most older adults. (3) Exercise in the elderly probably needs to be tailored, and when possible, individualized, with the specific objectives of the person or group in mind. Some benefits are probably related to the intensity of exercise (e.g., cardiovascular disease), others due to the type of exercise (weight-bearing versus nonweight-bearing for osteoporosis, or racket sports for hand-eye coordination), and still others possibly relate to the setting in which exercise occurs (social-psychological benefits). (4) The authors believe the known physiologic effects of exercise on age-related changes and existing clinical research support the general notion that vigorous weight-bearing exercises such as walking are the safest, cheapest, easiest, and most widely beneficial for the average senior. (5) Research has yet to define good ways by which to stimulate large numbers of sedentary elderly persons to exercise regularly. The potential and complementary benefits appear to be great enough to justify widespread efforts at the community and individual level, however.

A long-term self-managed handwriting intervention for people with Parkinson's disease: results from the control group of a phase II randomized controlled trial.

PubMed

Collett, Johnny; Franssen, Marloes; Winward, Charlotte; Izadi, Hooshang; Meaney, Andy; Mahmoud, Wala; Bogdanovic, Marko; Tims, Martin; Wade, Derick; Dawes, Helen

2017-12-01

To report on the control group of a trial primarily designed to investigate exercise for improving mobility in people with Parkinson's disease (pwP). The control group undertook a handwriting intervention to control for attention and time spent practising a specific activity. Secondary analysis of a two-arm parallel phase II randomized controlled trial with blind assessment. Community. PwP able to walk ⩾100 m and with no contraindication to exercise were recruited from the Thames Valley, UK, and randomized (1:1) to exercise or handwriting, via a concealed computer-generated list. Handwriting was undertaken at home and exercise in community facilities; both were delivered through workbooks with monthly support visits and involved practice for 1 hour, twice weekly, over a period of six months. Handwriting was assessed, at baseline, 3, 6 and 12 months, using a pangram giving writing speed, amplitude (area) and progressive reduction in amplitude (ratio). The Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale (UPDRS) item 2.7 measured self-reported handwriting deficits. In all, 105 pwP were recruited (analysed: n  = 51 handwriting, n  = 54 exercise). A total of 40 pwP adhered to the handwriting programme, most completing ⩾1 session/week. Moderate effects were found for amplitude (total area: d = 0.32; 95% confidence interval (CI): -0.11 to 0.7; P = 0.13) in favour of handwriting over a period of12 months; effects for writing speed and ratio parameters were small ≤0.11. Self-reported handwriting difficulties also favoured handwriting (UPDRS 2.7: odds ratio (OR) = 0.55; 95% CI: 0.34 to 0.91; P = 0.02). No adverse effects were reported. PwP generally adhere to self-directed home handwriting which may provide benefit with minimal risk. Encouraging effects were found in writing amplitude and, moreover, perceived ability.

Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders

PubMed Central

Bustamante, Eduardo E.; Davis, Catherine L.; Frazier, Stacy L.; Rusch, Dana; Fogg, Louis F.; Atkins, Marc S.; Marquez, David X.

2016-01-01

Purpose To test feasibility and impact of a 10-week after-school exercise program for children with ADHD and/or disruptive behavior disorders (DBD) living in an urban poor community. Methods Children were randomized to exercise (n=19) or a comparable but sedentary attention control program (n=16). Cognitive and behavioral outcomes were collected pre-post. Intent-to-treat mixed models tested group × time and group × time × attendance interactions. Effect sizes were calculated within and between groups. Results Feasibility was evidenced by 86% retention, 60% attendance, and average 75% maximum heart rate. Group × time results were null on the primary outcome, parent-reported executive function. Among secondary outcomes, between-group effect sizes favored exercise on hyperactive symptoms (d=0.47) and verbal working memory (d=0.26), and controls on visuospatial working memory (d=-0.21) and oppositional defiant symptoms (d=-0.37). In each group, within-group effect sizes were moderate-large on most outcomes (d=0.67 to 1.60). A group × time × attendance interaction emerged on visuospatial working memory (F[1,33]=7.42, p<.05), such that attendance to the control program was related to greater improvements (r=.72, p<.01) while attendance to the exercise program was not (r=.25, p=.34). Conclusions While between-group findings on the primary outcome, parent-reported executive function, were null, between-group effect sizes on hyperactivity and visuospatial working memory may reflect adaptations to the specific challenges presented by distinct formats. Both groups demonstrated substantial within-group improvements on clinically relevant outcomes. Findings underscore the importance of programmatic features such as routines, engaging activities, behavior management strategies, and adult attention; and highlight the potential for after-school programs to benefit children with ADHD and DBD living in urban poverty where health needs are high and services resources few. PMID:26829000

Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders.

PubMed

Bustamante, Eduardo Esteban; Davis, Catherine Lucy; Frazier, Stacy Lynn; Rusch, Dana; Fogg, Louis F; Atkins, Marc S; Marquez, David Xavier

2016-07-01

The objective of this study is to test the feasibility and impact of a 10-wk after-school exercise program for children with attention deficit hyperactivity disorder and/or disruptive behavior disorders living in an urban poor community. Children were randomized to an exercise program (n = 19) or a comparable but sedentary attention control program (n = 16). Cognitive and behavioral outcomes were collected pre-/posttest. Intent-to-treat mixed models tested group-time and group-time-attendance interactions. Effect sizes were calculated within and between groups. Feasibility was evidenced by 86% retention, 60% attendance, and average 75% maximum HR. Group-time results were null on the primary outcome, parent-reported executive function. Among secondary outcomes, between-group effect sizes favored exercise on hyperactive symptoms (d = 0.47) and verbal working memory (d = 0.26), and controls on visuospatial working memory (d = -0.21) and oppositional defiant symptoms (d = -0.37). In each group, within-group effect sizes were moderate to large on most outcomes (d = 0.67 to 1.60). A group-time-attendance interaction emerged on visuospatial working memory (F[1,33] = 7.42, P < 0.05), such that attendance to the control program was related to greater improvements (r = 0.72, P < 0.01), whereas attendance to the exercise program was not (r = 0.25, P = 0.34). Although between-group findings on the primary outcome, parent-reported executive function, were null, between-group effect sizes on hyperactivity and visuospatial working memory may reflect adaptations to the specific challenges presented by distinct formats. Both groups demonstrated substantial within-group improvements on clinically relevant outcomes. Findings underscore the importance of programmatic features, such as routines, engaging activities, behavior management strategies, and adult attention, and highlight the potential for after-school programs to benefit children with attention deficit hyperactivity disorder and disruptive behavior disorder living in urban poverty where health needs are high and services resources few.

Primary and secondary exercise dependence in a community-based sample of road race runners.

PubMed

Cook, Brian; Karr, Trisha M; Zunker, Christie; Mitchell, James E; Thompson, Ron; Sherman, Roberta; Crosby, Ross D; Cao, Li; Erickson, Ann; Wonderlich, Stephen A

2013-10-01

The purpose of our study was to examine exercise dependence (EXD) in a large community-based sample of runners. The secondary purpose of this study was to examine differences in EXD symptoms between primary and secondary EXD. Our sample included 2660 runners recruited from a local road race (M age = 38.78 years, SD = 10.80; 66.39% women; 91.62% Caucasian) who completed all study measures online within 3 weeks of the race. In this study, EXD prevalence was lower than most previously reported rates (gamma = .248, p < .001) and individuals in the at-risk for EXD category participated in longer distance races, F(8,1) = 14.13, p = .01, partial eta squared = .05. Group differences were found for gender, F(1,1921) 8.08, p = .01, partial eta squared = .004, and primary or secondary group status, F(1,1921) 159.53, p = .01, partial eta squared = .077. Implications of primary and secondary EXD differences and future research are discussed.

An exercise trial for wheelchair users: Project Workout on Wheels

PubMed Central

Froehlich-Grobe, Katherine; Aaronson, Lauren S.; Washburn, Richard A.; Little, Todd D.; Lee, Jaehoon; Nary, Dorothy E.; VanSciver, Angela; Nesbitt, Jill; Norman, Sarah E.

2011-01-01

There is growing interest in promoting health for people with disabilities, yet evidence regarding community-based interventions is sparse. This paper describes the design details of a randomized controlled trial (RCT) that will test the effectiveness of a multi-component behaviorally-based, intervention to promote exercise adoption (over 6 months) and maintenance (up to one year) among wheelchair users and includes descriptive data on participant characteristics at baseline. Participants were randomly assigned to either a staff-supported intervention group or a self-guided comparison group. The primary study aim is to assess the effectiveness of the multi-component behaviorally-based intervention for promoting physical activity adoption and maintenance. The RCT will also assess the physical and psychosocial effects of the intervention and the complex interplay of factors that influence the effectiveness of the intervention. Therefore, the primary outcome derives from participant reports of weekly exercise (type, frequency, duration) over 52 weeks. Secondary outcomes collected on four occasions (baseline, 3 months, 6 months, 12 months) included physiological outcomes (VO2 peak, strength), disability-related outcomes (pain, fatigue, participation), and psychosocial outcomes (exercise self-efficacy, exercise barriers, quality of life, depression, mood). This study will provide evidence regarding the effectiveness of a multi-component behaviorally-based intervention for promoting exercise adoption among people with mobility impairments that necessitate wheelchair use. PMID:22101206

Training Mixtec Promotores to Assess Health Concerns in their Community: A CBPR Pilot Study

PubMed Central

Maxwell, Annette E.; Young, Sandra; Vega, Roena Rabelo; Herrmann, Alison K.; See, Cha; Glenn, Beth A.; Mistry, Ritesh; Bastani, Roshan

2012-01-01

Background An academic institution and a community organization partnered for one of the first studies assessing health needs of Mixtecs, indigenous immigrants from Southern Mexico, residing in Ventura County, California. Methods Ten bilingual Spanish- and Mixteco- speaking promotores received a one-day focus group training, participated in a focus group themselves and conducted 5 focus groups with 42 Mixtec community members. Results The focus group training is described. Health concerns discussed in the focus groups include outdoor exercise among women viewed as flirtatious; reluctance to ask for governmental assistance due to fear that children will have to pay back later; soda consumption perceived as a symbol of socio-economic status; and unwillingness to obtain mammograms or pap smears because private body parts are to be touched by husbands only. Discussion Training promotores to conduct focus groups can increase organizational capacity to identify pressing health needs in under-represented and hard-to-reach population groups. PMID:22940912

Exercise frequency, health risk factors, and diseases of the elderly.

PubMed

Kemmler, Wolfgang; von Stengel, Simon

2013-11-01

To determine the effect of exercise frequency on various diseases and risk factors of the elderly. Retrospective analysis of a randomized controlled 18-month exercise trial. University ambulatory group setting. Community-dwelling women aged ≥65 years (N=162) in the area of Northern Bavaria. Mixed, intense aerobic, resistance, and balance protocol for 18 months. Subjects were retrospectively subdivided into 2 groups according to their effective attendance over 18 months (>1-<2 vs ≥2-4 sessions/wk). Bone mineral density (BMD), lean body mass, appendicular skeletal muscle mass by dual-energy x-ray absorptiometry, Framingham study-based 10-year coronary heart disease (CHD) risk, and number of falls by calendar method. Significant differences between the low-frequency exercise group (LF-EG) and the high-frequency exercise group (HF-EG) were observed for lumbar spine BMD (HF-EG, 2.4%±2.8% vs LF-EG, 0.3%±2.2%; P<.001) and proximal femur BMD (HF-EG, 2.4%±2.8% vs LF-EG, -0.5%±1.6%; P=.014), lean body mass (1.6%±3.4% vs 0.3%±2.6%, P=.053), and appendicular skeletal muscle mass (0.9%±4.5% vs -1.3%±3.2%, P=.011). No differences between both exercise groups were observed for 10-year CHD risk (-1.94%±4.14% vs -2.00%±3.13%; P=.943) and number of falls (0.95±1.36 vs 1.03±1.21 falls/person). Comparing the LF-EG with the less active control group (n=47), only nonsignificant effects for fall number (P=.065) and 10-year CHD risk (P=.178) were evaluated. Although this result might not be generalizable across all exercise types and cohorts, it indicates that an overall exercise frequency of at least 2 sessions/wk may be crucial for impacting bone and muscle mass of elderly subjects. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Intensive exercise reduces the fear of additional falls in elderly people: findings from the Korea falls prevention study.

PubMed

Oh, Dong Hyun; Park, Ji Eun; Lee, Eon Sook; Oh, Sang Woo; Cho, Sung Il; Jang, Soong Nang; Baik, Hyun Wook

2012-12-01

Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded "not at all" or "a little." The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.

Effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults with risk of falls.

PubMed

Lee, Hsuei-Chen; Chang, Ku-Chou; Tsauo, Jau-Yih; Hung, Jen-Wen; Huang, Yu-Ching; Lin, Sang-I

2013-04-01

To evaluate effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults. Multicenter randomized controlled trial. Three medical centers and adjacent community health centers. Community-dwelling older adults (N=616) who have fallen in the previous year or are at risk of falling. After baseline assessment, eligible subjects were randomly allocated into the intervention group (IG) or the control group (CG), stratified by the Physiological Profile Assessment (PPA) fall risk level. The IG received a 3-month multifactorial intervention program including 8 weeks of exercise training, health education, home hazards evaluation/modification, along with medication review and ophthalmology/other specialty consults. The CG received health education brochures, referrals, and recommendations without direct exercise intervention. Primary outcome was fall incidence within 1 year. Secondary outcomes were PPA battery (overall fall risk index, vision, muscular strength, reaction time, balance, and proprioception), Timed Up & Go (TUG) test, Taiwan version of the International Physical Activity Questionnaire, EuroQol-5D, Geriatric Depression Scale (GDS), and the Falls Efficacy Scale-International at 3 months after randomization. Participants were 76±7 years old and included low risk 25.6%, moderate risk 25.6%, and marked risk 48.7%. The cumulative 1-year fall incidence was 25.2% in the IG and 27.6% in the CG (hazard ratio=.90; 95% confidence interval, .66-1.23). The IG improved more favorably than the CG on overall PPA fall risk index, reaction time, postural sway with eyes open, TUG test, and GDS, especially for those with marked fall risk. The multifactorial fall prevention program with exercise intervention improved functional performance at 3 months for community-dwelling older adults with risk of falls, but did not reduce falls at 1-year follow-up. Fall incidence might have been decreased simultaneously in both groups by heightened awareness engendered during assessments, education, referrals, and recommendations. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Potential of a Sports Club-Based Exercise Program for Improving Physical Activity in Type 2 Diabetes Mellitus.

PubMed

Lackinger, Christian; Haider, Sandra; Kosi, Lana; Harreiter, Juergen; Winhofer, Yvonne; Kautzky-Willer, Alexandra

2015-09-01

Although the infrastructure of Austrians' sports clubs is well developed, exercise classes for people suffering from type II diabetes mellitus (T2DM) do not exist. This feasibility study evaluates factors for participating in target group specific exercise courses (TGSEC) and changes in physical activity. This intervention study was performed in 22 communities of Austria. Initial TGSEC were offered to T2DM patients over 2 months. Participants were surveyed at 4 time points with a questionnaire: before the program, 2, 6 and 12 months after the initial questionnaire. 881 patients aged 59.0 (SD: 9.6) years took part in TGSEC. At baseline a lack of suitable exercise groups prevented 51% from being active. 58% were encouraged by the medical sector. After 12 months the weekly time spent on exercise training was increased from 1.40 (SD: 2.55) hours to 2.15 (SD: 3.00) hours (P < .001). The dropout rate during the first 2 months was 12.9%. The rate of return for the 12 months questionnaire was 42%. TGSEC provided by sports clubs attract people suffering from T2DM and effectively enhance physical activity.

Aerobic and Cognitive Exercise (ACE) Pilot Study for Older Adults: Executive Function Improves with Cognitive Challenge While Exergaming.

PubMed

Barcelos, Nicole; Shah, Nikita; Cohen, Katherine; Hogan, Michael J; Mulkerrin, Eamon; Arciero, Paul J; Cohen, Brian D; Kramer, Arthur F; Anderson-Hanley, Cay

2015-11-01

Dementia cases are increasing worldwide; thus, investigators seek to identify interventions that might prevent or ameliorate cognitive decline in later life. Extensive research confirms the benefits of physical exercise for brain health, yet only a fraction of older adults exercise regularly. Interactive mental and physical exercise, as in aerobic exergaming, not only motivates, but has also been found to yield cognitive benefit above and beyond traditional exercise. This pilot study sought to investigate whether greater cognitive challenge while exergaming would yield differential outcomes in executive function and generalize to everyday functioning. Sixty-four community based older adults (mean age=82) were randomly assigned to pedal a stationary bike, while interactively engaging on-screen with: (1) a low cognitive demand task (bike tour), or (2) a high cognitive demand task (video game). Executive function (indices from Trails, Stroop and Digit Span) was assessed before and after a single-bout and 3-month exercise intervention. Significant group × time interactions were found after a single-bout (Color Trails) and after 3 months of exergaming (Stroop; among 20 adherents). Those in the high cognitive demand group performed better than those in the low cognitive dose condition. Everyday function improved across both exercise conditions. Pilot data indicate that for older adults, cognitive benefit while exergaming increased concomitantly with higher doses of interactive mental challenge.

An exploratory study of physical activity and perceived barriers to exercise in ambulant people with neuromuscular disease compared with unaffected controls.

PubMed

Phillips, Margaret; Flemming, Nicola; Tsintzas, Kostas

2009-08-01

To determine activity patterns and perceived barriers to exercise in ambulant people with neuromuscular disease compared with ambulatory controls. Prospective controlled parallel group design. Outpatient clinic and community. Thirteen ambulatory people with neuromuscular disease and 18 ambulatory controls. Heart rates were recorded during sedentary activity and treadmill walking at various speeds to indicate activity threshold (flex heart rate), followed by ambulatory heart rate monitoring over two weekdays and one weekend day. The EPIC-Norfolk Physical Activity Questionnaire-2 and Barriers to Physical Activity and Disability Survey were completed. Participants with neuromuscular disease were less active than controls as estimated by both the EPIC-Norfolk Physical Activity Questionnaire-2, P<0.004, and the flex heart rate method, P<0.05. The number of perceived barriers was greater in the neuromuscular group, a mean of 7 (SD 4.2) barriers, compared with mean 3 (SD 2.1) barriers for controls, P<0.05. Specific barriers differed, with the barriers of 'pain', 'lack of energy' and 'exercise is too difficult' showing the greatest discrepancy and being higher in the neuromuscular disease group. Physical activity, as determined by two different methods, was less and barriers to exercise greater in people with neuromuscular disease compared with healthy controls. Specific barriers were different in the two groups. This information could assist in the design of achievable and effective exercise programmes for people with neuromuscular disease.

A corrective emotional experience - or just a bit of exercise? The relevance of interpersonal learning in Exercise on prescription.

PubMed

Roessler, Kirsten Kaya

2011-08-01

The objective of the present study was to examine psychological aspects of intra- and interpersonal learning for patients with Type 2 diabetes, hypertension and dyslipidemia treated with Exercise on prescription. The research design consists of a qualitative investigation of 30 patients in Denmark undergoing a community-based exercise treatment at baseline, a post-intervention investigation after four months and a follow-up one year after the start of intervention. The results demonstrated that, for the majority of the participants, interaction under group conditions contributes to maintaining the commitment to exercise. For a corrective emotional experience- a correction of an emotional situation a person could not handle in the past - to occur requires two conditions: the group and the environment must be experienced as sufficiently safe, and there must be feedback to permit reality-testing. However, existential psychological aspects such as fear of dying or the universality of suffering triggered, but could not sustain, a change in health behavior. The article concludes that behavioral change is strengthened by interaction with health personnel and with the training group. These new insights likewise demand an increased focus on the human resources of general practitioners or physiotherapists who handle the training. They should learn about their supportive role for the participants, the regressive urges of the participants and the benefits of promoting group relations. © 2011 The Author. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Physiotherapy and physical functioning post-stroke: exercise habits and functioning 4 years later? Long-term follow-up after a 1-year long-term intervention period: a randomized controlled trial.

PubMed

Langhammer, Birgitta; Lindmark, Birgitta; Stanghelle, Johan K

2014-01-01

Physical activity is mandatory if patients are to remain healthy and independent after stroke. Maintenance of motor function, tone, grip strength, balance, mobility, gait, independence in personal and instrumental activities of daily living, health-related quality-of-life and an active lifestyle 4 years post-stroke. A prospective randomized controlled trial. Four years post-stroke, 37 of the 75 participating persons were eligible for follow-up; 19 (54.3%) from the intensive exercise group and 18 (45%) from the regular exercise group. Both groups were performing equally well with no significant differences in total scores on the BI (p = 0.3), MAS (p = 0.4), BBS (p = 0.1), TUG (p = 0.08), 6MWT (p = 0.1), bilateral grip strength (affected hand, p = 0.8; non-affected hand, p = 0.9) nor in the items of NHP (p > 0.005). Independence in performing the IADL was 40%, while 60% had help from relatives or community-based services. This longitudinal study shows that persons with stroke in two groups with different exercise regimes during the first year after stroke did not differ in long-term outcomes. Both groups maintained function and had a relatively active life style 4 years after the acute incident. The results underline the importance of follow-up testing and encouragement to exercise, to motivate and sustain physical activity patterns, to maintain physical function, not only in the acute but also in the chronic phase of stroke.

Promoting Optimal Physical Exercise for Life (PROPEL): aerobic exercise and self-management early after stroke to increase daily physical activity—study protocol for a stepped-wedge randomised trial

PubMed Central

Mansfield, Avril; Brooks, Dina; Tang, Ada; Taylor, Denise; Inness, Elizabeth L; Kiss, Alex; Middleton, Laura; Biasin, Louis; Fleck, Rebecca; French, Esmé; LeBlanc, Kathryn; Aqui, Anthony; Danells, Cynthia

2017-01-01

Introduction Physical exercise after stroke is essential for improving recovery and general health, and reducing future stroke risk. However, people with stroke are not sufficiently active on return to the community after rehabilitation. We developed the Promoting Optimal Physical Exercise for Life (PROPEL) programme, which combines exercise with self-management strategies within rehabilitation to promote ongoing physical activity in the community after rehabilitation. This study aims to evaluate the effect of PROPEL on long-term participation in exercise after discharge from stroke rehabilitation. We hypothesise that individuals who complete PROPEL will be more likely to meet recommended frequency, duration and intensity of exercise compared with individuals who do not complete the programme up to 6 months post discharge from stroke rehabilitation. Methods and analysis Individuals undergoing outpatient stroke rehabilitation at one of six hospitals will be recruited (target n=192 total). A stepped-wedge design will be employed; that is, the PROPEL intervention (group exercise plus self-management) will be ‘rolled out’ to each site at a random time within the study period. Prior to roll-out of the PROPEL intervention, sites will complete the control intervention (group aerobic exercise only). Participation in physical activity for 6 months post discharge will be measured via activity and heart rate monitors, and standardised physical activity questionnaire. Adherence to exercise guidelines will be evaluated by (1) number of ‘active minutes’ per week (from the activity monitor), (2) amount of time per week when heart rate is within a target range (ie, 55%–80% of age-predicted maximum) and (3) amount of time per week completing ‘moderate’ or ‘strenuous’ physical activities (from the questionnaire). We will compare the proportion of active and inactive individuals at 6 months post intervention using mixed-model logistic regression, with fixed effects of time and phase and random effect of cluster (site). Ethics and dissemination To date, research ethics approval has been received from five of the six sites, with conditional approval granted by the sixth site. Results will be disseminated directly to study participants at the end of the trial, and to other stake holders via publication in a peer-reviewed journal. Trial registration number NCT02951338; Pre-results. PMID:28667222

Facilitating Self-Transcendence: An Intervention to Enhance Well-Being in Late Life.

PubMed

McCarthy, Valerie Lander; Hall, Lynne A; Crawford, Timothy N; Connelly, Jennifer

2018-06-01

This randomized controlled pilot study evaluated the effects of the Psychoeducational Approach to Transcendence and Health (PATH) Program, an 8-week intervention hypothesized to increase self-transcendence and improve well-being in community-dwelling women aged 60 years and older ( N = 20). The PATH combined mindfulness exercises, group processes, creative activities, and at-home practice using community engaged research methods. Findings provided some support for the effectiveness of PATH. Although there was no significant Group × Time interaction, self-transcendence, psychological well-being, and life satisfaction differed significantly pre- and postintervention in the wait-listed control group, which received a revised version of the program. Further study is needed with a larger sample to determine the effectiveness of PATH. Potentially, PATH may be a convenient and affordable activity to support personal development and improve well-being among older adults at senior centers, retirement communities, nursing homes, church groups, and other places where older adults gather.

Exercise rehabilitation on home-dwelling patients with Alzheimer's disease--a randomized, controlled trial. Study protocol.

PubMed

Pitkala, Kaisu H; Raivio, Minna M; Laakkonen, Marja-Liisa; Tilvis, Reijo S; Kautiainen, Hannu; Strandberg, Timo E

2010-10-06

Besides cognitive decline, Alzheimer's disease (AD) leads to physical disability, need for help and permanent institutional care. The trials investigating effects of exercise rehabilitation on physical functioning of home-dwelling older dementia patients are still scarce. The aim of this study is to investigate the effectiveness of intensive exercise rehabilitation lasting for one year on mobility and physical functioning of home-dwelling patients with AD. During years 2008-2010, patients with AD (n = 210) living with their spousal caregiver in community are recruited using central AD registers in Finland, and they are offered exercise rehabilitation lasting for one year. The patients are randomized into three arms: 1) tailored home-based exercise twice weekly 2) group-based exercise twice weekly in rehabilitation center 3) control group with usual care and information of exercise and nutrition. Main outcome measures will be Guralnik's mobility and balance tests and FIM-test to assess physical functioning. Secondary measures will be cognition, neuropsychiatric symptoms according to the Neuropsychiatric Inventory, caregivers' burden, depression and health-related quality of life (RAND-36). Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two year follow-up. To our knowledge this is the first large scale trial exploring whether home-dwelling patients with AD will benefit from intense and long-lasting exercise rehabilitation in respect to their mobility and physical functioning. It will also provide data on cost-effectiveness of the intervention. ACTRN12608000037303.

A community-based approach to trials of aerobic exercise in aging and Alzheimer’s disease

PubMed Central

Vidoni, Eric D.; Van Sciver, Angela; Johnson, David K.; He, Jinghua; Honea, Robyn; Haines, Brian; Goodwin, Jami; Laubinger, M. Pat; Anderson, Heather S.; Kluding, Patricia M.; Donnelly, Joseph E.; Billinger, Sandra A.; Burns, Jeffrey M.

2012-01-01

The benefits of exercise for aging have received considerable attention in both the popular and academic press. The putative benefits of exercise for maximizing cognitive function and supporting brain health have great potential for combating Alzheimer’s disease (AD). Aerobic exercise offers a low-cost, low-risk intervention that is widely available and may have disease modifying effects. Demonstrating aerobic exercise alters the AD process would have enormous public health implications. The purpose of this paper is to a report the protocol of a current, community-based pilot study of aerobic exercise for AD to guide future investigation. This manuscript provides 1) an overview of possible benefits of exercise in those with dementia, 2) a rationale and recommendations for implementation of a community-based approach, 3) recommendation for implementation of similar study protocols, 4) unique challenges in conducting an exercise trial in AD. PMID:22903151

Changes in self-efficacy for exercise and improved nutrition fostered by increased self-regulation among adults with obesity.

PubMed

Annesi, James J; Johnson, Ping H; McEwen, Kristin L

2015-10-01

Behavioral theory suggests that treatments that increase participants' use of self-regulatory skills and/or their feelings of ability (self-efficacy) will improve exercise and nutrition behaviors. In addition, psychosocial factors associated with increased exercise may carry over to improved eating. Self-regulation might enhance self-efficacy through feelings of ability to manage barriers to maintaining weight-loss behaviors. Sedentary adults with severe or morbid obesity (M age = 43 years; M BMI = 40.1 kg/m(2)) participated in a 6-month study within a community-based YMCA center. We randomly assigned participants to one of the two groups that incorporated the same cognitive-behavioral support of exercise paired with methods for controlled, healthy eating emphasizing either (a) self-efficacy (n = 138), or (b) self-regulation (n = 136) methods. Mixed model repeated measures ANOVAs indicated significant improvements in exercise- and eating-related self-regulation over 3 months, and exercise- and eating-related self-efficacy over 6 months. The Self-Regulation Treatment Group demonstrated greater improvements in self-regulation for eating and fruit and vegetable intake than the Self-Efficacy Group. Regression analyses indicated that for both exercise and eating, self-regulation change significantly predicted self-efficacy change. In separate equations, changes in exercise and fruit and vegetable intake mediated those relationships, and change in self-efficacy and the corresponding behavioral changes demonstrated reciprocal, mutually reinforcing, relationships. There was evidence of carry-over, or generalization, of both self-regulation and self-efficacy changes from an exercise context to an eating context. We discussed findings in terms of leveraging self-regulation to improve self-efficacy, and provide a rationale for why exercise is the strongest predictor of success with weight loss. Results may be used to inform future behavioral weight-management treatments through improved knowledge of relationships among theoretically derived psychosocial factors.

Home-based exercise and support programme for people with dementia and their caregivers: study protocol of a randomised controlled trial

PubMed Central

2011-01-01

Background Dementia affects the mood of people with dementia but also of their caregivers. In the coming years, the number of people with dementia will increase worldwide and most of them will continue to live in the community as long as possible. Home-based psychosocial interventions reducing the depressive symptoms of both people with dementia and their caregivers in their own home are highly needed. Methods/Design This manuscript describes the design of a Randomised Controlled Trial (RCT) of the effects of a home-based exercise and support programme for people with dementia and their caregivers. The aim is to randomly assign 156 dyads (caregiver and dementia diagnosed person) to an intervention group or a comparison group. The experimental group receives a home programme in which exercise and support for the people with dementia and their caregivers are combined and integrated. The comparison group receives a minimal intervention. Primary outcomes are physical health (people with dementia) and mood (people with dementia and caregivers). In addition, to get more insight in the working components of the intervention and the impact of the intervention on the relationship of the dyads a qualitative sub-study is carried out. Discussion This study aims to contribute to an evidence-based treatment to reduce depressive symptoms among people with dementia and their caregivers independently living in the community. Trial Registration The study has been registered at the Netherlands National Trial Register (NTR), which is connected to the International Clinical Trials Registry Platform of the WHO. Trial number: NTR1802. PMID:22117691

Toward the Style of the Community Change Educator.

ERIC Educational Resources Information Center

Franklin, Richard

Variations and implications of change agents' patterns or styles of interaction with client systems (individuals, groups, or multigroups) are discussed. Five styles are defined: (1) the instructor, who imparts information to clients and interacts only with his agency; (2) the paterfamilias, who exercises personal, paternalistic influence and…

Exergaming and older adult cognition: a cluster randomized clinical trial.

PubMed

Anderson-Hanley, Cay; Arciero, Paul J; Brickman, Adam M; Nimon, Joseph P; Okuma, Naoko; Westen, Sarah C; Merz, Molly E; Pence, Brandt D; Woods, Jeffrey A; Kramer, Arthur F; Zimmerman, Earl A

2012-02-01

Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or "exergames" may elicit greater participation. To test the following hypotheses: (1) stationary cycling with virtual reality tours ("cybercycle") will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase. Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function in older adults. Data were collected in 2008-2010; analyses were conducted in 2010-2011. 102 older adults from eight retirement communities enrolled; 79 were randomized and 63 completed. A recumbent stationary ergometer was utilized; virtual reality tours and competitors were enabled on the cybercycle. Executive function (Color Trails Difference, Stroop C, Digits Backward); clinical status (mild cognitive impairment; MCI); exercise effort/fitness; and plasma BDNF. Intent-to-treat analyses, controlling for age, education, and cluster randomization, revealed a significant group X time interaction for composite executive function (p=0.002). Cybercycling yielded a medium effect over traditional exercise (d=0.50). Cybercyclists had a 23% relative risk reduction in clinical progression to MCI. Exercise effort and fitness were comparable, suggesting another underlying mechanism. A significant group X time interaction for BDNF (p=0.05) indicated enhanced neuroplasticity among cybercyclists. Cybercycling older adults achieved better cognitive function than traditional exercisers, for the same effort, suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline. This study is registered at Clinicaltrials.gov NCT01167400. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland.

PubMed

Buttery, Amanda K; Husk, Janet; Lowe, Derek; Treml, Jonathan; Vasilakis, Naomi; Riglin, Jackie

2014-05-01

falling, and fear of falling, significantly affect older people and their lifestyle resulting in loss of confidence, restriction of activity and deteriorating quality of life. Multi-factorial assessment and active participation in an evidence-based exercise programme are key interventions to prevent and manage falls. to examine older people's experiences of therapeutic exercise as part of a falls prevention service in NHS Trusts in England, Wales and Northern Ireland. a cross-sectional survey targeted patients and staff members delivering exercise interventions for reducing falls. A multi-disciplinary group including patient and staff representatives developed a 20-item patient questionnaire and a 12-item staff questionnaire that were distributed to 94 NHS Trusts (113 participating sites within the NHS Trusts) in October 2011. response was 57% for the patient sample and 88% for the staff sample. The median (IQR) age of patients was 82 (77-86) years. 72% were women. Two-thirds reported attending group-based therapeutic exercise classes generally of short duration (80% <12 weeks) and low intensity (85% one class per week) at hospitals and community venues. Balance and strength exercises were prescribed; 68% reported using resistance equipment such as ankle weights and/or exercise band. Only 52% reported exercises were made more difficult as they improved. However, patient satisfaction levels were high (95% satisfied or very satisfied). Patients and staff reported limited availability of strength and balance follow-up classes. despite high levels of patient satisfaction therapeutic exercise provision was limited and implementation of evidence-based exercise interventions by healthcare providers is incomplete and varies widely. Patients and staff wanted greater availability of long-term exercise services for falls prevention.

Aquatic Exercise Therapy for People With Parkinson Disease: A Randomized Controlled Trial.

PubMed

Carroll, Louise M; Volpe, Daniele; Morris, Meg E; Saunders, Jean; Clifford, Amanda M

2017-04-01

To evaluate the effects of aquatic exercise therapy on gait variability and disability compared with usual care for people with Parkinson disease (PD). Single-blind randomized controlled trial. Community-based hydrotherapy pool. Individuals with PD (Hoehn-Yahr stages I-III) (N=21). Participants were randomly assigned to either an aquatic exercise therapy group (45min, twice a week for 6wk) or a group that received usual care. The primary outcome measure was gait variability as measured using a motion capture system. Secondary outcomes were quality of life measured on the Parkinson's Disease Questionnaire-39 and freezing of gait and motor disability quantified by the Unified Parkinson's Disease Rating Scale. Feasibility was evaluated by measuring safety, adverse events, and participant satisfaction. People in the aquatic therapy group and usual care group showed similar small improvements in gait variability. The aquatic therapy group showed greater improvements in disability than the usual care group (P<.01). No differences between groups or over time were identified for freezing of gait or quality of life. Aquatic therapy sessions were safe and enjoyable with no adverse events. Aquatic therapy appears feasible and safe for some people in the early stages of PD. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Reduction in trunk fat predicts cardiovascular exercise training-related reductions in C-reactive protein.

PubMed

Vieira, V J; Hu, L; Valentine, R J; McAuley, E; Evans, E M; Baynard, T; Woods, J A

2009-05-01

C-reactive protein (CRP) is an independent risk factor for cardiovascular disease. We sought to determine (1) if 10 months of cardiovascular exercise training (Cardio) reduces CRP in a group of older adults, (2) if such a reduction is related to improvements in trunk fat, fitness, and/or psychosocial variables, and (3) if the effect of Cardio on CRP differs between men and women. Community-dwelling residents (n=127; 60-83 yrs) were randomized to a Flex group (n=61) where they participated in 2-75 min supervised sessions per wk during which they performed non-cardiovascular flexibility and balance exercises or a Cardio group (n=66) where they participated in three supervised sessions per wk during which they performed cardiovascular exercises for approximately 45-60 min at 60-70% maximal oxygen uptake. The main outcome measures were serum CRP, cardiovascular fitness, total and central adiposity, and self-reported psychosocial function. Cardio experienced a reduction in CRP (-0.5mg/L), as well as improvements in fitness (+7%) and total (-1.5%) and central (i.e., trunk) (-2.5%) adiposity. These relationships were not modified by sex. Regression analyses indicated that only the reduction in trunk fat was significantly related to the reduction in CRP. Ten months of cardiovascular exercise training reduced CRP in previously sedentary older adults and this effect was partially mediated by a reduction in trunk fat.

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study.

PubMed

Li, Fuzhong; Harmer, Peter

2014-05-26

Falls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in community practice. Thus, there is a pressing need to translate and disseminate evidence-based exercise programs to community providers that serve older adults at increased risk of falling. The current study addresses this public health need by disseminating the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program through community senior centers. The study uses a single-group design in which the TJQMBB program is being delivered to community-dwelling older adults through collaboration with senior centers in selected counties in Oregon, USA, for 48 weeks, followed by a 24-week post-intervention follow-up. Study process and outcome measures will be evaluated in accordance with the components of the RE-AIM framework that focus on Reach, Effectiveness, Adoption, Implementation and Maintenance. This study will determine whether the evidence-based TJQMBB fall prevention program can be disseminated through a broad spectrum of community-based senior centers that often cater to low-income, underserved community-dwelling older adults at risk of falling. If shown to be both practically implementable and sustainable, the TJQMBB program will provide an effective, potentially low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults. ClinicalTrials.gov Identifier: NCT01854931.

Cost-effectiveness of vitamin D supplementation and exercise in preventing injurious falls among older home-dwelling women: findings from an RCT.

PubMed

Patil, R; Kolu, P; Raitanen, J; Valvanne, J; Kannus, P; Karinkanta, S; Sievänen, H; Uusi-Rasi, K

2016-01-01

This study assessed the cost-effectiveness of vitamin D supplementation and exercise, separately and combined, in preventing medically attended injurious falls among older home-dwelling Finnish women. Given a willingness to pay of €3,000 per injurious fall prevented, the exercise intervention had an 86 % probability of being cost-effective in this population. The costs of falling in older persons are high, both to the individual and to society. Both vitamin D and exercise have been suggested to reduce the risk of falls. This study assessed the cost-effectiveness of vitamin D supplementation and exercise, separately and combined, in preventing medically attended injurious falls among older Finnish women. Economic evaluation was based on the results of a previously published 2-year randomized controlled trial (RCT) where 409 community-dwelling women aged 70 to 80 years were recruited into four groups: (1) no exercise + placebo (D-Ex-), (2) no exercise + vitamin D 800 IU/day (D+Ex-), (3) exercise + placebo (D-Ex+), and (4) exercise + vitamin D 800 IU/day (D+Ex+). The outcomes were medically attended injurious falls and fall-related health care utilization costs over the intervention period, the latter evaluated from a societal perspective based on 2011 unit costs. Incremental cost-effectiveness ratios (ICER) were calculated for the number of injurious falls per person-year prevented and uncertainty estimated using bootstrapping. Incidence rate ratios (95 % CI) for medically attended injurious falls were lower in both Ex+ groups compared with D-Ex-: 0.46 (0.22 to 0.95) for D-Ex+, 0.38 (0.17 to 0.81) for D+Ex+. Step-wise calculation of ICERs resulted in exclusion of D+Ex- as more expensive and less effective. Recalculated ICERs were €221 for D-Ex-, €708 for D-Ex+, and €3,820 for D+Ex+; bootstrapping indicated 93 % probability that each injurious fall avoided by D-Ex+ per person year costs €708. At a willingness to pay €3,000 per injurious fall prevented, there was an 85.6 % chance of the exercise intervention being cost-effective in this population. Exercise was effective in reducing fall-related injuries among community-dwelling older women at a moderate cost. Vitamin D supplementation had marginal additional benefit. The results provide a firm basis for initiating feasible and cost-effective exercise interventions in this population.

Effects of Relaxation Exercises and Music Therapy on the Psychological Symptoms and Depression Levels of Patients with Schizophrenia.

PubMed

Kavak, Funda; Ünal, Süheyla; Yılmaz, Emine

2016-10-01

This study aims to identify the effects of relaxation exercises and music therapy on the psychological symptoms and depression levels of patients with chronic schizophrenia. This semi-experimental study was conducted using pre- and post-tests with a control group. The study population consists of patients with schizophrenia who regularly attended community mental health centers in the Malatya and Elazığ provinces of Turkey between May 2015 and September 2015. The study's sample consists of 70 patients with schizophrenia (n=35 in the control group; n=35 in the experimental group) who were selected randomly based on power analysis. The "Patient Information Form," the "Brief Psychiatric Rating Scale (BPRS)" and the "Calgary Depression Scale for Schizophrenia (CDSS)" were used for data collection. Patients in the experimental group participated in relaxation exercises and music therapy 5 times a week for 4 weeks. The experimental group of 35 persons was divided into three groups of approximately 10-12 individuals in order to enable all participants to attend the program. No intervention was applied to the patients in the control group. The data were evaluated using percentage distribution, arithmetic means, standard deviations, Chi-square and independent samples t-tests. The study found that patients in the experimental group showed a decrease in total mean scores on the BPRS and CDSS; the difference between the post-test scores of the experimental group and the post-test scores of the control group was statistically significant (p<0.05). The practice of relaxation exercises and music therapy was proven to be effective in reducing schizophrenic patients' psychological symptoms and levels of depression. Relaxation exercises and music therapy can be used as a complementary therapy in the medical treatment of patients with chronic schizophrenia. Copyright © 2016 Elsevier Inc. All rights reserved.

Attitude toward the out-patient cardiac rehabilitation program and facilitators for maintenance of exercise behavior.

PubMed

Wong, Eliza M L; Zhong, Xue Bing; Sit, Janet W H; Chair, Sek Ying; Leung, Doris Y P; Leung, Carmen; Leung, K C

2016-09-01

This study examined the attitudes of Chinese patients with coronary heart disease (CHD) toward the outpatient cardiac rehabilitation program (OCRP), as well as their exercise behavior, intention, maintenance and related factors. A qualitative descriptive study design was used, and 22 CHD patients were recruited in Hong Kong in 2014. In-depth interviews and content analyses were conducted. The tripartite model of attitudes was adopted as research framework. Two themes were identified: (1) informant attitude (perception, affection, and practice) toward the OCRP and (2) Exercise Behavior - intention, maintenance and its related factors. Most informants showed positive perception and affection regarding the outpatient rehabilitation program, leading to regular practice of exercise in the program and at home. Peer, group dynamic, social support and Chinese culture influences on exercise behavior may serve as major facilitators to maintain exercise behavior. Positive attitude toward the OCRP enhanced the participation rate, whereas peer and social support from the family and workplace were useful to improve the maintenance of exercise behavior. Overall, this study provides insights into strategic planning for the OCRP and continual support for CHD patients in the community.

Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy.

PubMed

Going, Scott; Lohman, Timothy; Houtkooper, Linda; Metcalfe, Lauve; Flint-Wagner, Hilary; Blew, Robert; Stanford, Vanessa; Cussler, Ellen; Martin, Jane; Teixeira, Pedro; Harris, Margaret; Milliken, Laura; Figueroa-Galvez, Arturo; Weber, Judith

2003-08-01

Osteoporosis is a major public health concern. The combination of exercise, hormone replacement therapy, and calcium supplementation may have added benefits for improving bone mineral density compared to a single intervention. To test this notion, 320 healthy, non-smoking postmenopausal women, who did or did not use hormone replacement therapy (HRT), were randomized within groups to exercise or no exercise and followed for 12 months. All women received 800 mg calcium citrate supplements daily. Women who exercised performed supervised aerobic, weight-bearing and weight-lifting exercise, three times per week in community-based exercise facilities. Regional bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry. Women who used HRT, calcium, and exercised increased femoral neck, trochanteric and lumbar spine bone mineral density by approximately 1-2%. Trochanteric BMD was also significantly increased by approximately 1.0% in women who exercised and used calcium without HRT compared to a negligible change in women who used HRT and did not exercise. The results demonstrate that regional BMD can be improved with aerobic, weight-bearing activity combined with weight lifting at clinically relevant sites in postmenopausal women. The response was significant at more sites in women who used HRT, suggesting a greater benefit with hormone replacement and exercise compared to HRT alone.

Feasibility of a Virtual Exercise Coach to Promote Walking in Community-Dwelling Persons with Parkinson Disease

PubMed Central

Ellis, Terry; Latham, Nancy K.; DeAngelis, Tamara R.; Thomas, Cathi A.; Saint-Hilaire, Marie; Bickmore, Timothy W.

2013-01-01

Objective The short-term benefits of exercise for persons with Parkinson Disease (PD) are well-established, but long-term adherence is limited. The aim of this study was to explore the feasibility, acceptability and preliminary evidence of effectiveness of a virtual exercise coach to promote daily walking in community dwelling persons with PD. Design Twenty subjects with PD participated in this Phase I single group, non-randomized clinical trial. Subjects were instructed to interact with the virtual exercise coach for 5 minutes, wear a pedometer and walk daily for one month. Retention rate, satisfaction and interaction history were assessed at 1-month. Six-minute walk and gait speed were assessed at baseline and post intervention. Results Participants were 55% female, mean age 65.6. At study completion, there was a 100% retention rate. Subjects had an average satisfaction score of 5.6/7 (with seven indicating maximal satisfaction) with the virtual exercise coach. Interaction history revealed that participants logged-in an average of 25.4 days (SD 7) out of the recommended 30 days. Mean adherence to daily walking was 85%. Both gait speed and the 6-minute walk test significantly improved (p<0.05). No adverse events were reported. Conclusions Sedentary persons with PD successfully used a computer and interacted with a virtual exercise coach. Retention, satisfaction and adherence to daily walking were high over one-month and significant improvements were seen in mobility. PMID:23552335

Nuclear Forensics International Technical Working Group (ITWG): a collaboration of scientists, law enforcement officials, and regulators working to combat nuclear terrorism and proliferation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwantes, Jon M.

Founded in 1996 upon the initiative of the “Group of 8” governments (G8), the Nuclear Forensics International Technical Working Group (ITWG) is an ad hoc organization of official Nuclear Forensics practitioners (scientists, law enforcement, and regulators) that can be called upon to provide technical assistance to the global community in the event of a seizure of nuclear or radiological materials. The ITWG is supported by and is affiliated with nearly 40 countries and international partner organizations including the International Atomic Energy Agency (IAEA), EURATOM, INTERPOL, EUROPOL, and the United Nations Interregional Crime and Justice Research Institute (UNICRI) (Figure 1). Besidesmore » providing a network of nuclear forensics laboratories that are able to assist the global community during a nuclear smuggling event, the ITWG is also committed to the advancement of the science of nuclear forensic analysis, largely through participation in periodic table top and Collaborative Materials Exercises (CMXs). Exercise scenarios use “real world” samples with realistic forensics investigation time constraints and reporting requirements. These exercises are designed to promote best practices in the field and test, evaluate, and improve new technical capabilities, methods and techniques in order to advance the science of nuclear forensics. Past efforts to advance nuclear forensic science have also included scenarios that asked laboratories to adapt conventional forensics methods (e.g. DNA, fingerprints, tool marks, and document comparisons) for collecting and preserving evidence comingled with radioactive materials.« less

Does self-efficacy mediate functional change in older adults participating in an exercise program after hip fracture? A randomized control trial

PubMed Central

Latham, Nancy K.; Ni, Pengsheng; Jette, Alan M.

2015-01-01

Objectives This study examined whether self-efficacy mediated the effect of the HIP Rehab exercise program on activity limitations in older adults after hip fracture, and whether the mediation effect was different between different gender and age groups. Design Randomized controlled trial (RCT) Setting Community Participants Two hundred and thirty two participants aged 79±9.4 years with hip fracture were randomly assigned to intervention (n=120) or attention control (n=112) groups. Interventions The 6-month intervention, the HIP Rehab, is a functionally-oriented, home-based exercise program. Data was collected at baseline, post-intervention (6 months), and follow-up (9 months). Main outcome measure Activity Measure for Post-Acute Care (AM-PAC) Results The mediation effect of the HIP Rehab exercise program on Basic Mobility function through self-efficacy for exercise was significant at 9 months (βindirect=0.21). Similarly, the mediation effect of the intervention on Daily Activity function through self-efficacy for exercise was significant at 9 months (βindirect=0.49). In subgroup analyses, the mediation effect was significant at 9 months in the younger group (≤79 years old) in comparison to the older group, and was significant in females in comparison to males. Conclusion Self-efficacy may play a partial mediating role for the effect on some longer-term functional outcomes in the HIP Rehab intervention. The results suggest that program components that target self-efficacy should be incorporated in the future hip fracture rehabilitation interventions. Age and gender of the targeted participants may also need to be considered when developing interventions. PMID:25701101

Nonparetic Knee Extensor Strength Is the Determinant of Exercise Capacity of Community-Dwelling Stroke Survivors

PubMed Central

Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

2014-01-01

Objective. To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. Design. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. Results. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO2 peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Conclusions. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living. PMID:25197712

Nonparetic knee extensor strength is the determinant of exercise capacity of community-dwelling stroke survivors.

PubMed

Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

2014-01-01

To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO₂ peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living.

Insurance Benefit Preferences of the Low-income Uninsured

PubMed Central

Danis, Marion; Biddle, Andrea K; Goold, Susan Dorr

2002-01-01

OBJECTIVE A frequently cited obstacle to universal insurance is the lack of consensus about what benefits to offer in an affordable insurance package. This study was conducted to assess the feasibility of providing uninsured patients the opportunity to define their own benefit package within cost constraints. DESIGN Structured group exercises SETTING Community setting PARTICIPANTS Uninsured individuals recruited from clinical and community settings in central North Carolina. MEASUREMENTS Insurance choices were measured using a simulation exercise, CHAT (Choosing Healthplans All Together). Participants designed managed care plans, individually and as groups, by selecting from 15 service categories having varied levels of restriction (e.g., formulary, copayments) within the constraints of a fixed monthly premium comparable to the typical per member/per month managed care premium paid by U.S. employers. MAIN RESULTS Two hundred thirty-four individuals who were predominantly male (70%), African American (55%), and socioeconomically disadvantaged (53% earned <$15,000 annually) participated in 22 groups and were able to design health benefit packages individually and in groups. All 22 groups chose to cover hospitalization, pharmacy, dental, and specialty care, and 21 groups chose primary care and mental health. Although individuals' choices differed from their groups' selections, 86% of participants were willing to abide by group choices. CONCLUSIONS Groups of low-income uninsured individuals are able to identify acceptable benefit packages that are comparable in cost but differ in benefit design from managed care contracts offered to many U.S. employees today. PMID:11841528

Changes in cardiovascular disease knowledge and behavior in a low-education population of African-American and white adults.

PubMed

Smith, N L; Croft, J B; Heath, G W; Cokkinides, V

1996-01-01

Racial differences in secular changes in cardiovascular disease risk factor knowledge and behaviors were assessed among adults with low levels of education throughout a community-wide cardiovascular disease prevention program. Four independent cross-sectional telephone surveys were conducted with the random-digit-dialing technique in 1987, 1988, 1989, and 1991 in a biracial South Carolina community. Community-wide cardiovascular disease intervention programs were initiated in 1988 and continued through 1990. Changes in the prevalence of cardiovascular risk factor knowledge, dietary fat intake, leisure-time physical activity, smoking, and cholesterol screening behavior were compared between African-American and white respondents in a population subset with less than 12 years of education using analysis of covariance regression techniques. Mean intake of high fat foods was lower in 1991 than in 1987 among both white and African-American respondents; the trend for lower mean intake began in 1989 among African-American adults. Prevalence of the correct exercise knowledge was higher in 1988 than in 1987 for both groups, but this trend was maintained only among white respondents. However, prevalence of leisure-time physical activity did not change significantly between 1987 and 1991. Prevalence of cholesterol level knowledge and screening behavior increased over time among both groups; however, greater increasing trends between 1987 and 1991 were observed among white adults. Favorable secular changes in fat intake, exercise knowledge, cholesterol level knowledge, and cholesterol screening behavior were observed among both race groups during a time period that coincided with community-wide intervention efforts and messages. Greater changes in most of these behaviors and knowledge were observed among white adults suggesting that health behavior messages may not have reached all segments of this community.

Sustained economic benefits of resistance training in community-dwelling senior women.

PubMed

Davis, Jennifer C; Marra, Carlo A; Robertson, M Clare; Najafzadeh, Mehdi; Liu-Ambrose, Teresa

2011-07-01

To determine whether the health and cost benefits of resistance training were sustained 12 months after formal cessation of the intervention. Cost-utility analysis conducted alongside a randomized controlled trial. Community-dwelling women aged 65 to 75 living in Vancouver, British Columbia. One hundred twenty-three of the 155 community-dwelling women aged 65 to 75 years who originally were randomly allocated to once-weekly resistance training (n=54), twice-weekly resistance training (n=52), or twice-weekly balance and tone exercises (control group; n=49) participated in the 12-month follow-up study. Of these, 98 took part in the economic evaluation (twice-weekly balance and tone exercises, n=28; once-weekly resistance training, n=35; twice-weekly resistance training, n=35). The primary outcome measure was incremental cost per quality-adjusted life year (QALY) gained. Healthcare resource utilization was assessed over 21 months (2009 prices); health status was assessed using the EuroQol-5D to calculate QALYs using a 21-month time horizon. Once- and twice-weekly resistance training were less costly than balance and tone classes, with incremental mean healthcare costs of Canadian dollars (CAD$)1,857 and CAD$1,077, respectively. The incremental QALYs for once- and twice-weekly resistance training were -0.051 and -0.081, respectively, compared with balance and tone exercises. The cost benefits of participating in a 12-month resistance training intervention were sustained for the once- and twice-weekly resistance training group, whereas the health benefits were not. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Cancer survivors' experiences of a community-based cancer-specific exercise programme: results of an exploratory survey.

PubMed

Catt, Susan; Sheward, J; Sheward, E; Harder, H

2018-04-05

Exercise levels often decline following cancer diagnosis despite growing evidence of its benefits. Treatment side effects, older age, lack of confidence and opportunity to exercise with others in similar circumstances influence this. Our study explored the experiences of people attending a cancer-specific community-based exercise programme (CU Fitter™). A survey distributed to those attending the programme gathered demographic/clinical information, self-reported exercise levels, information provision and barriers to/benefits of exercise. Sixty surveys were evaluable from 65/100 returned (62% female, 68% > 60 years, 66% breast/prostate cancer). Most (68%) were receiving treatment. Sixty-eight percent attended classes once or twice weekly. Fifty-five percent received exercise advice after diagnosis, usually from their hospital doctor/nurse. More (73%) had read about exercising, but less used the Internet to source information (32%). Self-reported exercise levels were higher currently than before diagnosis (p = 0.05). Forty-eight percent said their primary barrier to exercising was the physical impact of cancer/treatment. Improving fitness/health (40%) and social support (16%) were the most important gains from the programme. Many (67%) had made other lifestyle changes and intented to keep (50%) or increase (30%) exercising. This community-based cancer-specific exercise approach engaged people with cancer and showed physical, psychological, and social benefits. Community-grown exercise initiatives bring cancer survivors together creating their own supportive environment. Combining this with instructors familiar with the population and providing an open-ended service may prove particularly motivating and beneficial. Further work is required to provide evidence for this.

Cost-effectiveness of a preferred intensity exercise programme for young people with depression compared with treatment as usual: an economic evaluation alongside a clinical trial in the UK.

PubMed

Turner, David; Carter, Tim; Sach, Tracey; Guo, Boliang; Callaghan, Patrick

2017-11-26

To assess the cost-effectiveness of preferred intensity exercise programme for young people with depression compared with a treatment as usual control group. A 'within trial' cost-effectiveness and cost-utility analysis conducted alongside a randomised controlled trial. The perspective of the analysis was the UK National Health Service and social services. The intervention was provided in a community leisure centre setting. 86 young people aged 14-17 years attending Tier 2 and Tier 3 CAMHS (Child and Adolescent Mental Health Services) outpatient services presenting with depression. The intervention comprised 12 separate sessions of circuit training over a 6-week period. Sessions were supervised by a qualified exercise therapist. Participants also received treatment as usual. The comparator group received treatment as usual. We found improvements in the Children's Depression Inventory-2 (CDI-2) and estimated cost-effectiveness at £61 per point improvement in CDI-2 for the exercise group compared with control. We found no evidence that the exercise intervention led to differences in quality-adjusted life years (QALY). QALYs were estimated using the EQ-5D-5L (5-level version of EuroQol-5 dimension). There is evidence that exercise can be an effective intervention for adolescents with depression and the current study shows that preferred intensity exercise could also represent a cost-effective intervention in terms of the CDI-2. NCT01474837. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Association between healthy diet and exercise and greater muscle mass in older adults.

PubMed

Kim, Jinhee; Lee, Yunhwan; Kye, Seunghee; Chung, Yoon-Sok; Kim, Kwang-Min

2015-05-01

To examine the association between healthy diet and exercise, individually and combined, and low muscle mass in older Korean adults. Population-based cross-sectional study from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys from 2008 to 2011. Community. Nationally representative sample aged 65 and older (1,486 men, 1,799 women) in the Republic of Korea. A food frequency questionnaire was used to determine frequency of food group consumption (meat, fish, eggs, legumes; vegetables; fruits). Participation in exercise (aerobic and resistance) was based on self-report. Combined healthy lifestyle factors were calculated as the number of recommendations met regarding consumption of food groups and exercise performed. Appendicular skeletal muscle mass (ASM) was measured using dual-energy X-ray absorptiometry, and low muscle mass was defined using the variable of ASM adjusted for weight. Logistic regression analysis was performed to examine the association between healthy lifestyle factors and low muscle mass, adjusting for sociodemographic characteristics and health-related variables. In women, after controlling for covariates, vegetable consumption (odds ratio (OR)=0.52, 95% confidence interval (CI)=0.30-0.89) and aerobic exercise (OR=0.62, 95% CI=0.39-1.00) were inversely associated with low muscle mass. Also, the odds of low muscle mass was lower in women with three or more healthy lifestyle factors versus none (OR=0.45, 95% CI=0.23-0.87). In men, there were no associations between food group consumption and exercise and low muscle mass. Older women who exercise and consume a healthy diet have lower odds of low muscle mass. Engaging in multiple healthy behaviors may be important in preventing low muscle mass in late life. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Economic evaluation of a group-based exercise program for falls prevention among the older community-dwelling population.

PubMed

McLean, Kendra; Day, Lesley; Dalton, Andrew

2015-03-26

Falls among older people are of growing concern globally. Implementing cost-effective strategies for their prevention is of utmost importance given the ageing population and associated potential for increased costs of fall-related injury over the next decades. The purpose of this study was to undertake a cost-utility analysis and secondary cost-effectiveness analysis from a healthcare system perspective, of a group-based exercise program compared to routine care for falls prevention in an older community-dwelling population. A decision analysis using a decision tree model was based on the results of a previously published randomised controlled trial with a community-dwelling population aged over 70. Measures of falls, fall-related injuries and resource use were directly obtained from trial data and supplemented by literature-based utility measures. A sub-group analysis was performed of women only. Cost estimates are reported in 2010 British Pound Sterling (GBP). The ICER of GBP£51,483 per QALY for the base case analysis was well above the accepted cost-effectiveness threshold of GBP£20,000 to £30,000 per QALY, but in a sensitivity analysis with minimised program implementation the incremental cost reached GBP£25,678 per QALY. The ICER value at 95% confidence in the base case analysis was GBP£99,664 per QALY and GBP£50,549 per QALY in the lower cost analysis. Males had a 44% lower injury rate if they fell, compared to females resulting in a more favourable ICER for the women only analysis. For women only the ICER was GBP£22,986 per QALY in the base case and was below the cost-effectiveness threshold for all other variations of program implementation. The ICER value at 95% confidence was GBP£48,212 in the women only base case analysis and GBP£23,645 in the lower cost analysis. The base case incremental cost per fall averted was GBP£652 (GBP£616 for women only). A threshold analysis indicates that this exercise program cannot realistically break even. The results suggest that this exercise program is cost-effective for women only. There is no evidence to support its cost-effectiveness in a group of mixed gender unless the costs of program implementation are minimal. Conservative assumptions may have underestimated the true cost-effectiveness of the program.

The Los Angeles County Community Disaster Resilience Project - a community-level, public health initiative to build community disaster resilience.

PubMed

Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

2014-08-19

Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest-posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

PubMed Central

Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

2014-01-01

Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports. PMID:25153472

Exercise and Fall Prevention: Narrowing the Research-to-Practice Gap and Enhancing Integration of Clinical and Community Practice.

PubMed

Li, Fuzhong; Eckstrom, Elizabeth; Harmer, Peter; Fitzgerald, Kathleen; Voit, Jan; Cameron, Kathleen A

2016-02-01

Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence-based, exercise-focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practice, including lack of evidence of the transferability of efficacy trial results to clinical and community settings, insufficient local expertise to roll out community exercise programs, and inadequate infrastructure to integrate evidence-based programs into clinical and community practice. The practical solutions highlighted in this article can be used to address these evidence-to-practice challenges. Falls and their associated healthcare costs can be reduced by better integrating research on exercise intervention into clinical practice and community programs. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial.

PubMed

Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean

2013-08-01

To compare the effectiveness of supervised Tai Chi exercises versus the conventional physical therapy exercises in a personalized rehabilitation program in terms of the incidence and severity of falls in a frail older population. The participants were frail older adults living in the community, admitted to the day hospital program in Sherbrooke, Quebec, Canada (n = 152). They were randomized to receive a 15-week intervention, either by supervised Tai Chi exercises (n = 76) or conventional physical therapy (n = 76). Fall incidence and severity were assessed using both the calendar technique and phone interviews once a month during 12 months following the end of the intervention. Other variables were collected at baseline to compare the two groups: age, comorbidity, balance, sensory interaction on balance, and self-rated health. Both interventions demonstrated a protective effect on falls but Tai Chi showed a greater one (RR = 0.74; 95% CI = 0.56-0.98) as compared to conventional physical therapy exercises. Supervised Tai Chi exercises as part of a rehabilitation program seem to be a more effective alternative to the conventional physical therapy exercises for this specific population.

Can a tailored exercise and home hazard reduction program reduce the rate of falls in community dwelling older people with cognitive impairment: protocol paper for the i-FOCIS randomised controlled trial.

PubMed

Close, Jacqueline C T; Wesson, Jacqueline; Sherrington, Catherine; Hill, Keith D; Kurrle, Sue; Lord, Stephen R; Brodaty, Henry; Howard, Kirsten; Gitlin, Laura N; O'Rourke, Sandra D; Clemson, Lindy

2014-08-15

The rate of falls in community dwelling older people with cognitive impairment (CI) is twice that of a cognitively intact population, with almost two thirds of people with CI falling annually. Studies indicate that exercise involving balance and/or a home hazard reduction program are effective in preventing falls in cognitively intact older people. However the potential benefit of these interventions in reducing falls in people with CI has not been established.This randomised controlled trial will determine whether a tailored exercise and home hazard reduction program can reduce the rate of falls in community dwelling older people with CI. We will determine whether the intervention has beneficial effects on a range of physical and psychological outcome measures as well as quality of life of participants and their carers. A health economic analysis examining the cost and potential benefits of the program will also be undertaken. Three hundred and sixty people aged 65 years or older living in the community with CI will be recruited to participate in the trial. Each will have an identifiable carer with a minimum of 3.5 hours of face to face contact each week.Participants will undergo an assessment at baseline with retests at 6 and 12 months. Participants allocated to the intervention group will participate in an exercise and home hazard reduction program tailored to their cognitive and physical abilities.The primary outcome measure will be the rate of falls which will be measured using monthly falls calendars. Secondary outcome measures will include the risk of falling, quality of life, measures of physical and cognitive function, fear of falling and planned and unplanned use of health services. Carers will be followed up to determine carer burden, coping strategies and quality of life. The study will determine the impact of this tailored intervention in reducing the rate of falls in community dwelling older people with CI as well as the cost-effectiveness and adherence to the program. The results will have direct implications for the design and implementation of interventions for this high-risk group of older people. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry - ACTRN12614000603617.

Health education programs may be as effective as exercise intervention on improving health-related quality of life among Japanese people over 65 years.

PubMed

Tamari, Kotaro; Kawamura, Kenji; Sato, Mitsuya; Harada, Kazuhiro

2012-09-01

The current study was aimed to examine the short-term effects of a 3-month health education program on health-related quality of life using the Short-Form 36. Twenty-five Japanese older people aged 65 and older in the health education program were compared with two historical control groups (n = 25 each) undertaking group and resistance exercise interventions and matched by age, sex and body mass index. A series of split-design two-way analyses of variance were conducted for data analysis. Significant improvements were observed in general health and vitality subscales of the Short-Form 36 in the educational program group. Multivariate analyses, adjusted for several confounding factors, revealed that the effects of the three programs were comparable. The findings suggest that a structured 3-month educational program may be as effective as exercise interventions in improving general health and vitality in a community-dwelling Japanese older population. © 2011 The Authors. Australasian Journal on Ageing © 2011 ACOTA.

The effects of a life goal-setting technique in a preventive care program for frail community-dwelling older people: a cluster nonrandomized controlled trial.

PubMed

Yuri, Yoshimi; Takabatake, Shinichi; Nishikawa, Tomoko; Oka, Mari; Fujiwara, Taro

2016-05-12

Frailty among older people is associated with an increased risk of needing care. There have been many reports on preventive care programs for frail older people, but few have shown positive effects on disability prevention. Physical exercise programs for frail older people affect elements such as physical fitness and balance, but are less effective for disability outcomes and are not followed up in the longer term. We developed a life goal-setting technique (LGST). Our objective was to determine the effect of a LGST plus standard preventive care program for community-dwelling frail older people. We used a cluster nonrandomized controlled trial with seven intervention and nine matched control groups, with baseline assessment and follow-up at 3, 6, and 9 months. Participants were 176 frail older people, aged 65 years or over, living in the community in Izumi, Osaka, Japan. All participants attended regular 120 min preventive care exercise classes each week, over 3 months. They also received oral care and nutrition education. The intervention groups alone received life goal-setting support. We assessed outcomes longitudinally, comparing pre-intervention with follow-up. The primary outcome measure was health improvement according to the Japanese Ministry of Health, Labour and Welfare's "Kihon Checklist" for assessment of frailty and quality of life (QOL), analyzed with a two-way ANOVA and post-test comparison. Secondary outcomes included physical functions and assessment of life goals. The improvement on the Kihon Checklist for the intervention group was approximately 60 % from baseline to 9-months follow-up; the control group improved by approximately 40 %. The difference between groups was significant at 3-month (p = 0.043) and 6-month (p = 0.015) follow-ups but not at 9-month (p = 0.098) follow-up. Analysis of QOL yielded a significant time × group interaction effect (p = 0.022). The effect was significant at 3 months in the intervention group, but at no time in the control group. A 3-month exercise program helped to decrease frailty and improve QOL in frail older people, and the addition of LGST increased its effectiveness. The LGST is a feasible and promising intervention for reducing risk of needing care. UMIN000021485 . Registered 15 March 2016.

The Art of Space Flight Exercise Hardware: Design and Implementation

NASA Technical Reports Server (NTRS)

Beyene, Nahom M.

2004-01-01

The design of space flight exercise hardware depends on experience with crew health maintenance in a microgravity environment, history in development of flight-quality exercise hardware, and a foundation for certifying proper project management and design methodology. Developed over the past 40 years, the expertise in designing exercise countermeasures hardware at the Johnson Space Center stems from these three aspects of design. The medical community has steadily pursued an understanding of physiological changes in humans in a weightless environment and methods of counteracting negative effects on the cardiovascular and musculoskeletal system. The effects of weightlessness extend to the pulmonary and neurovestibular system as well with conditions ranging from motion sickness to loss of bone density. Results have shown losses in water weight and muscle mass in antigravity muscle groups. With the support of university-based research groups and partner space agencies, NASA has identified exercise to be the primary countermeasure for long-duration space flight. The history of exercise hardware began during the Apollo Era and leads directly to the present hardware on the International Space Station. Under the classifications of aerobic and resistive exercise, there is a clear line of development from the early devices to the countermeasures hardware used today. In support of all engineering projects, the engineering directorate has created a structured framework for project management. Engineers have identified standards and "best practices" to promote efficient and elegant design of space exercise hardware. The quality of space exercise hardware depends on how well hardware requirements are justified by exercise performance guidelines and crew health indicators. When considering the microgravity environment of the device, designers must consider performance of hardware separately from the combined human-in-hardware system. Astronauts are the caretakers of the hardware while it is deployed and conduct all sanitization, calibration, and maintenance for the devices. Thus, hardware designs must account for these issues with a goal of minimizing crew time on orbit required to complete these tasks. In the future, humans will venture to Mars and exercise countermeasures will play a critical role in allowing us to continue in our spirit of exploration. NASA will benefit from further experimentation on Earth, through the International Space Station, and with advanced biomechanical models to quantify how each device counteracts specific symptoms of weightlessness. With the continued support of international space agencies and the academic research community, we will usher the next frontier in human space exploration.

Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial

PubMed Central

Sheehan, Bart; Atherton, Nicky; Nichols, Vivien; Collins, Helen; Mistry, Dipesh; Dosanjh, Sukhdeep; Slowther, Anne Marie; Khan, Iftekhar; Petrou, Stavros; Lall, Ranjit

2018-01-01

Abstract Objective To estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate dementia. Design Multicentre, pragmatic, investigator masked, randomised controlled trial. Setting National Health Service primary care, community and memory services, dementia research registers, and voluntary sector providers in 15 English regions. Participants 494 people with dementia: 329 were assigned to an aerobic and strength exercise programme and 165 were assigned to usual care. Random allocation was 2:1 in favour of the exercise arm. Interventions Usual care plus four months of supervised exercise and support for ongoing physical activity, or usual care only. Interventions were delivered in community gym facilities and NHS premises. Main outcome measures The primary outcome was score on the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) at 12 months. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, health related quality of life, and carer quality of life and burden. Physical fitness (including the six minute walk test) was measured in the exercise arm during the intervention. Results The average age of participants was 77 (SD 7.9) years and 301/494 (61%) were men. By 12 months the mean ADAS-cog score had increased to 25.2 (SD 12.3) in the exercise arm and 23.8 (SD 10.4) in the usual care arm (adjusted between group difference −1.4, 95% confidence interval −2.6 to −0.2, P=0.03). This indicates greater cognitive impairment in the exercise group, although the average difference is small and clinical relevance uncertain. No differences were found in secondary outcomes or preplanned subgroup analyses by dementia type (Alzheimer’s disease or other), severity of cognitive impairment, sex, and mobility. Compliance with exercise was good. Over 65% of participants (214/329) attended more than three quarters of scheduled sessions. Six minute walking distance improved over six weeks (mean change 18.1 m, 95% confidence interval 11.6 m to 24.6 m). Conclusion A moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes. Trial registration Current Controlled Trials ISRCTN10416500. PMID:29769247

Stroll your way to well-being: a survey of the perceived benefits, barriers, community support, and stigma associated with pram walking groups designed for new mothers, Sydney, Australia.

PubMed

Currie, Janet L; Develin, Elizabeth

2002-12-01

In our survey of 500 mothers with children 0-5 years involving telephone interviews (n = 450) and focus groups (n = 50), we showed that 87% of mothers telephone surveyed used a pram for incidental activities, whilst 47% used the pram specifically for exercise. Factors preventing mothers exercising more included poor weather, lack of time, and poor quality paths. Ninety-two percent of mothers believed that pram walking would increase mental well-being, and 87% felt that it would help to reduce postnatal depression (PND). However, feedback from focus groups expressed less confidence in the program's ability to potentially benefit mothers with PND. Programs will have to be marketed carefully to avoid the stigma associated with PND and successfully target mothers at risk.

Show me the money! An analysis of underserved stakeholders' funding priorities in Patient Centered Outcomes Research domains.

PubMed

Cargill, Stephanie Solomon; Baker, Lauren Lyn; Goold, Susan Dorr

2017-07-01

Develop an accessible exercise to engage underserved populations about research funding priorities; analyze the criteria they use to prioritize research; contrast these criteria to those currently used by Patient Centered Outcomes Research Institute (PCORI). Academic and community partners collaborated to develop an Ipad exercise to facilitate group deliberation about PCOR funding priorities. 16 groups (n = 183) of underserved individuals in both urban and rural areas participated. Recordings were qualitatively analyzed for prioritization criteria. Analysis yielded ten codes, many of which were similar to PCORI criteria, but all of which challenged or illuminated these criteria. Directly involving underserved populations in determining funding criteria is both feasible and important, and can better fulfill PCORI's goal of incorporating patient priorities.

Achievement of exercise objectives and satisfaction with the walk with ease program-group and self-directed participants.

PubMed

Nyrop, Kirsten A; Cleveland, Rebecca; Callahan, Leigh F

2014-01-01

This study presents group (instructor-led) and self-directed (nongroup) participant achievement of exercise objectives and satisfaction with the Arthritis Foundation's Walk With Ease (WWE) program at 6 weeks postintervention and 1-year follow-up. Secondary data analysis. Rural and urban counties in North Carolina. Four hundred sixty-two adults with self-reported joint pain/stiffness or physician-diagnosed arthritis, age ≥18 years, no serious medical condition, no cognitive impairments, English speaking. Intervention. WWE is a 6-week community-based walking program offered in two formats-group and self-directed. Self-report measures collected at baseline, 6 weeks, and 1 year. Descriptive statistics, χ (2) and t-tests. Individuals self-selected either group (n = 192) or self-directed (n = 270) format. On average, participants were age 67, Caucasian (70%), and female (88%). Mean minutes per walk increased from 16.7 at baseline to 34.2 minutes at 1 year among group participants, and from 16.5 to 33.7 minutes among self-directed. At 1 year, 59.6% of group and 69.3% of self-directed participants reported continued walking (p = .06). Group participants were more likely than self-directed to do recommended stretching (p < .02) and warm-up/cool-down exercises (p < .01). Group and self-directed participants have similar self-reported walking outcomes but have some differences in their utilization of WWE recommendations.

BounceBack capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study.

PubMed

Udani, Jay K; Singh, Betsy B; Singh, Vijay J; Sandoval, Elizabeth

2009-06-05

Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack, to alleviate the severity of DOMS after standardized eccentric exercise. The study was a randomized, double-blind, placebo-controlled, crossover study. Ten healthy community-dwelling untrained subjects, ranging in age from 18-45 years, were enrolled. Mean differences within and between groups were assessed inferentially at each data collection time-point using t-tests for all outcome measures. In this controlled pilot study, intake of BounceBack capsules for 30 days resulted in a significant reduction in standardized measures of pain and tenderness post-eccentric exercise compared to the placebo group. There were trends towards reductions in plasma indicators of inflammation (high sensitivity C-reactive protein) and muscle damage (creatine phosphokinase and myoglobin). BounceBack capsules were able to significantly reduce standardized measures of pain and tenderness at several post-eccentric exercise time points in comparison to placebo. The differences in the serological markers of DOMS, while not statistically significant, appear to support the clinical findings. The product appears to have a good safety profile and further study with a larger sample size is warranted based on the current results.

BounceBack™ capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study

PubMed Central

Udani, Jay K; Singh, Betsy B; Singh, Vijay J; Sandoval, Elizabeth

2009-01-01

Background Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack™, to alleviate the severity of DOMS after standardized eccentric exercise. Methods The study was a randomized, double-blind, placebo-controlled, crossover study. Ten healthy community-dwelling untrained subjects, ranging in age from 18–45 years, were enrolled. Mean differences within and between groups were assessed inferentially at each data collection time-point using t-tests for all outcome measures. Results In this controlled pilot study, intake of BounceBack™ capsules for 30 days resulted in a significant reduction in standardized measures of pain and tenderness post-eccentric exercise compared to the placebo group. There were trends towards reductions in plasma indicators of inflammation (high sensitivity C-reactive protein) and muscle damage (creatine phosphokinase and myoglobin). Conclusion BounceBack™ capsules were able to significantly reduce standardized measures of pain and tenderness at several post-eccentric exercise time points in comparison to placebo. The differences in the serological markers of DOMS, while not statistically significant, appear to support the clinical findings. The product appears to have a good safety profile and further study with a larger sample size is warranted based on the current results. PMID:19500355

Effects of the Finnish Alzheimer disease exercise trial (FINALEX): a randomized controlled trial.

PubMed

Pitkälä, Kaisu H; Pöysti, Minna M; Laakkonen, Marja-Liisa; Tilvis, Reijo S; Savikko, Niina; Kautiainen, Hannu; Strandberg, Timo E

2013-05-27

Few rigorous clinical trials have investigated the effectiveness of exercise on the physical functioning of patients with Alzheimer disease (AD). To investigate the effects of intense and long-term exercise on the physical functioning and mobility of home-dwelling patients with AD and to explore its effects on the use and costs of health and social services. A randomized controlled trial. A total of 210 home-dwelling patients with AD living with their spousal caregiver. The 3 trial arms included (1) group-based exercise (GE; 4-hour sessions with approximately 1-hour training) and (2) tailored home-based exercise (HE; 1-hour training), both twice a week for 1 year, and (3) a control group (CG) receiving the usual community care. The Functional Independence Measure (FIM), the Short Physical Performance Battery, and information on the use and costs of social and health care services. All groups deteriorated in functioning during the year after randomization, but deterioration was significantly faster in the CG than in the HE or GE group at 6 (P = .003) and 12 (P = .015) months. The FIM changes at 12 months were -7.1 (95% CI, -3.7 to -10.5), -10.3 (95% CI, -6.7 to -13.9), and -14.4 (95% CI, -10.9 to -18.0) in the HE group, GE group, and CG, respectively. The HE and GE groups had significantly fewer falls than the CG during the follow-up year. The total costs of health and social services for the HE patient-caregiver dyads (in US dollars per dyad per year) were $25,112 (95% CI, $17,642 to $32,581) (P = .13 for comparison with the CG), $22,066 in the GE group ($15,931 to $28,199; P = .03 vs CG), and $34,121 ($24,559 to $43,681) in the CG. An intensive and long-term exercise program had beneficial effects on the physical functioning of patients with AD without increasing the total costs of health and social services or causing any significant adverse effects. anzctr.org.au Identifier: ACTRN12608000037303.

Time perspective and smoking, obesity, and exercise in a community sample.

PubMed

Guthrie, Lori C; Lessl, Kristen; Ochi, Onyinyechukwu; Ward, Michael M

2013-03-01

To examine associations between time perspective and smoking, body mass index, and exercise. In this community-based survey, adults reported smoking and exercise habits and weight and height and completed the Zimbardo Time Perspective Inventory. Subjects (N=265) who were more future oriented reported more frequent exercise, but were more likely to smoke. Fatalistic and hedonistic present orientations were not associated with smoking, obesity, or exercise. Time perspective is not consistently associated with common health behaviors in adults.

Australasian College of Sports Physicians-position statement: the place of mesenchymal stem/stromal cell therapies in sport and exercise medicine.

PubMed

Osborne, Hamish; Anderson, Lynley; Burt, Peter; Young, Mark; Gerrard, David

2016-10-01

This Position Statement has been written expressly for members of the Australasian College of Sports Physicians (ACSP); however, it may also be of interest to the wider medical community, sporting organisations, athletes and the general community. It has been informed by a comprehensive review of the scientific literature and the opinions of kindred organisations. This statement outlines the use of mesenchymal stem cell (MSC) therapies in the broad context of Sport and Exercise Medicine, recognising that every medical practitioner should respect: (1) the evidence for the therapeutic use of MSCs and (2) the priority for patient health and welfare. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impact of 6-month aerobic exercise on Alzheimer's symptoms.

PubMed

Yu, Fang; Thomas, William; Nelson, Nathaniel W; Bronas, Ulf G; Dysken, Maurice; Wyman, Jean F

2015-06-01

Little is known about how aerobic exercise affects Alzheimer's disease (AD). The purpose of this pilot study was to test the impact of 6-month cycling on AD symptoms in community-dwelling older adults with mild-to-moderate AD, using a single-group, repeated-measures design (n = 26). AD symptoms were measured with the AD Assessment Scale-Cognitive (ADAS-Cog), Disability in AD (DAD), and Neuropsychiatric Inventory-Caregiver (NPI-Q) scales at baseline, 3 and 6 months. Data were analyzed using mixed linear models. The ADAS-Cog, DAD, and NPI-Q severity scores remained unchanged over the 6-month period, while caregiver distress decreased 40% (p < .05). We conclude that aerobic exercise may reduce AD symptoms and appears effective in decreasing caregiver distress. Further randomized controlled trials are needed to examine the effects of aerobic exercise in AD. © The Author(s) 2013.

Effects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study.

PubMed

He, L I; Wei, Wang Ren; Can, Zhao

2018-01-24

Essential hypertension (EP) is characterized by blood pressure (BP) elevations, which often lead to target organ damage and cardiovascular illness. The following study investigates whether aerobic exercise programs with different intensities could reduce the magnitude of BP rise. Patients with essential hypertension were recruited from the Baoshan Community Health Service Center. A total of 46 patients were finally selected and randomly assigned into two groups: control group (CON) included patients who did not participate in exercise intervention training; treatment group (TRG) included patients who participated in 12-week brisk walking training (60-min of brisk walking, three times a week for a total of 12 weeks). 3-minute step tests of low and high intensity were conducted pre- and post-intervention. To compare the effects of exercise intervention, 23 subjects with normal blood pressure (NBP) who did not participate in 12-week brisk walking training, were recruited. After 12 weeks of brisk walking, SBP of TRG during resting, low and high-intensity exercise was significantly reduced by 8.3mmHg, 15.6mmHg, and 22.6mmHg, respectively; while HR of TRG's during resting, low and high intensity was significantly reduced by 3.6beats/minute, 8.7beats/minute and 11.3beats/minute, respectively. Meanwhile, after 12 weeks of brisk walking, TRG's steps per day, [Formula: see text]o 2max , moderate physical activity time and physical activity energy expenditure significantly increased by 6000 steps, 2.4 ml/kg/m, 40 minutes and 113 kcal, respectively. At the same time, TRG's body fat rate and sedentary time significantly reduced by 2% and 60 minutes per day. Brisk walking can reduce the magnitude of BP rise during exercise of different intensities and may be reduced the risk of acute cardiovascular incidents in elderly patients with essential hypertension. EP: Essential hypertension; BP: blood pressure; CON: control group; TRG: treatment group; NBP: normal blood pressure; PA: physical activity.

Virtual reality exercise improves mobility after stroke: an inpatient randomized controlled trial.

PubMed

McEwen, Daniel; Taillon-Hobson, Anne; Bilodeau, Martin; Sveistrup, Heidi; Finestone, Hillel

2014-06-01

Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and gait in stroke rehabilitation inpatients. A blinded randomized controlled trial studying 59 stroke survivors on an inpatient stroke rehabilitation unit was performed. The treatment group (n=30) received standard stroke rehabilitation therapy plus a program of VR exercises that challenged balance (eg, soccer goaltending, snowboarding) performed while standing. The control group (n=29) received standard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance (performed in sitting). VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period. Objective outcome measures of balance and mobility were assessed before, immediately after, and 1 month after training. Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test, with both groups meeting minimal clinical important differences after training. More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain (P=0.04) immediately after training. This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes. Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR. http://www.ANZCTR.org.au/. Unique identifier: ACTRN12613000710729. © 2014 American Heart Association, Inc.

OA17 Compassionate communities: engaging with communities to support patients at end of life: a birmingham st. mary's hospice lived experience.

PubMed

Murungu, Diana; Woolf, Tina Swani Sarah

2015-04-01

Researchers carrying out a rebranding exercise for us in 2006 found that people from Black Asian and other Minority Ethnic (BAME) communities did not respond to their survey. This appeared to support anecdotal evidence from staff suggesting that the number of BAME patients accessing our services did not reflect the real need. To increase access to Hospice Care services for people from BAME communities. From April to July 2007 we used qualitative methods to carry out an exploratory study, to identify barriers to hospice care for patients from BAME communities. Currently we use community development methods to raise awareness of hospice services among BAME communities in Birmingham and Sandwell; while offering training and cultural/spiritual broker services to clinicians increasing their understanding of patients and families from these communities. There was no information about Hospice care services among people from BAME communities. Many people from BAME communities belong to cultural or spiritual groups whose members support each other during times of celebration, illness, death and bereavement. They refer to this support as 'our way of life'. Death, dying, and cancer are taboo subjects. In 2009 we set up the Compassionate Communities Project (CCP) within our Reaching People Programme (RPP) to increase access to our services for people from BAME communities. CCP enables community groups and service providers to work together in end of life. Representatives from BAME communities help train clinicians on supporting people from their communities in end of life. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Fall Prevention in a Primary Care Setting.

PubMed

Siegrist, Monika; Freiberger, Ellen; Geilhof, Barbara; Salb, Johannes; Hentschke, Christian; Landendoerfer, Peter; Linde, Klause; Halle, Martin; Blank, Wolfgang A

2016-05-27

Falls and fall-related injuries are common in community-dwelling elderly people. Effective multifactorial fall prevention programs in the primary care setting may be a promising approach to reduce the incidence rate of falls. In a cluster randomized trial in 33 general practices 378 people living independently and at high risk of falling (65 to 94 years old; 285 women) were allocated to either a 16 week exercise-based fall prevention program including muscle strengthening and challenging balance training exercises, combined with a 12 week home-based exercise program (222 participants), or to usual care (156 participants). The main outcome was number of falls over a period of 12 months. Secondary outcomes were the number of fall-related injuries, physical function (Timed-Up-and-Go-Test, TUG, Chair-Stand-Test, CST, modified Romberg Test), and fear of falling. In the intervention group (n=222 patients in 17 general practices) 291 falls occurred, compared to 367 falls in the usual care group (n=156 patients in 16 general practices). We observed a lower incidence rate for falls in the intervention group (incidence rate ratio/IRR: 0.54; 95% confidence interval (CI): [0.35; 0.84], p=0.007) and for fall-related injuries (IRR: 0.66; [0.42; 0.94], p=0.033). Additionally, patients in the intervention group showed significant improvements in secondary endpoints (TUG: -2.39 s, [-3.91; -0.87], p=0.014; mRomberg: 1.70 s, [0.35; 3.04], p=0.037; fear of falling: -2.28 points, [-3.87; -0.69], p=0.022) compared to usual care. A complex falls prevention program in a primary care setting was effective in reducing falls and fall-related injuries in community dwelling older adults at risk.

Creative Health for Elders through Psychology and Art: A Pilot Study.

ERIC Educational Resources Information Center

Fling, Sheila; And Others

Twelve community residents (10 women, 2 men; average age = 67) registered for a continuing education class in "creative living for elders." In 10 weekly, 2-hour sessions, a clinical psychologist and two artists led the group in exercise, muscle relaxation, regulated breathing, guided imagery, affirmations, and sensory awareness integrated with art…

Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative.

ERIC Educational Resources Information Center

Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.

2002-01-01

In a culturally competent diabetes self-management intervention in Starr County, Texas, bilingual Mexican American nurses, dieticians, and community workers provided weekly instruction on nutrition, self-monitoring, exercise and other self-care topics. A biweekly support group promoted behavior change. Interviews and examinations with 256 Mexican…

Attempts to Prevent Falls and Injury: A Prospective Community Study.

ERIC Educational Resources Information Center

Reinsch, Sibylle; And Others

1992-01-01

At 16 senior centers, studied effectiveness of exercise and cognitive-behavioral programs, compared to discussion control program, in reducing falls and injuries among 230 older adults. After one year of programs, observed no significant difference in time to first fall among groups. Secondary outcome measures such as strength, balance, fear of…

Life Styling for the Promotion of Health While Aging.

ERIC Educational Resources Information Center

Perry, Gloria R.

Classes on lifestyling for the promotion of health for the elderly were offered to a senior citizens' group in a community center setting. The objectives of the sessions were: (1) to teach the importance of health maintenance and primary prevention throughout the aging process; (2) to disseminate information relative to diet, exercise, and stress…

Twelve-Week Exercise Influences Memory Complaint but not Memory Performance in Older Adults: A Randomized Controlled Study.

PubMed

Iuliano, Enzo; Fiorilli, Giovanni; Aquino, Giovanna; Di Costanzo, Alfonso; Calcagno, Giuseppe; di Cagno, Alessandra

2017-10-01

This study aimed to evaluate the effects of different types of exercise on memory performance and memory complaint after a 12-week intervention. Eighty community-dwelling volunteers, aged 66.96 ± 11.73 years, were randomly divided into four groups: resistance, cardiovascular, postural, and control groups (20 participants for each group). All participants were tested for their cognitive functions before and after their respective 12-week intervention using Rey memory words test, Prose memory test, and Memory Complaint Questionnaire (MAC-Q). Statistical analysis showed that the three experimental groups significantly improved MAC-Q scores in comparison with the control group (p < .05). The variation of MAC-Q scores and the variations of Rey and Prose memory tests scores were not correlated. These results indicate that the 12-week interventions exclusively influenced memory complaint but not memory performance. Further investigations are needed to understand the relation between memory complaint and memory performance, and the factors that can influence this relationship.

A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype

PubMed Central

Dalleck, Lance C; Van Guilder, Gary P; Richardson, Tara B; Bredle, Donald L; Janot, Jeffrey M

2014-01-01

Background Lower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness. Methods and results Metabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (P<0.05) transitioned to metabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; P<0.05) and 7.5 (95% confidence interval: 1.5–37.5; P<0.05) times more likely to transition from MAO to MHO, respectively. Conclusion Community-based exercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease. PMID:25120373

What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes

PubMed Central

Finch, Caroline F; Doyle, Tim LA; Dempsey, Alasdair R; Elliott, Bruce C; Twomey, Dara M; White, Peta E; Diamantopoulou, Kathy; Young, Warren; Lloyd, David G

2014-01-01

Background Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future. PMID:24047571

Promoting Optimal Physical Exercise for Life (PROPEL): aerobic exercise and self-management early after stroke to increase daily physical activity-study protocol for a stepped-wedge randomised trial.

PubMed

Mansfield, Avril; Brooks, Dina; Tang, Ada; Taylor, Denise; Inness, Elizabeth L; Kiss, Alex; Middleton, Laura; Biasin, Louis; Fleck, Rebecca; French, Esmé; LeBlanc, Kathryn; Aqui, Anthony; Danells, Cynthia

2017-06-30

Physical exercise after stroke is essential for improving recovery and general health, and reducing future stroke risk. However, people with stroke are not sufficiently active on return to the community after rehabilitation. We developed the Promoting Optimal Physical Exercise for Life (PROPEL) programme, which combines exercise with self-management strategies within rehabilitation to promote ongoing physical activity in the community after rehabilitation. This study aims to evaluate the effect of PROPEL on long-term participation in exercise after discharge from stroke rehabilitation. We hypothesise that individuals who complete PROPEL will be more likely to meet recommended frequency, duration and intensity of exercise compared with individuals who do not complete the programme up to 6 months post discharge from stroke rehabilitation. Individuals undergoing outpatient stroke rehabilitation at one of six hospitals will be recruited (target n=192 total). A stepped-wedge design will be employed; that is, the PROPEL intervention (group exercise plus self-management) will be 'rolled out' to each site at a random time within the study period. Prior to roll-out of the PROPEL intervention, sites will complete the control intervention (group aerobic exercise only). Participation in physical activity for 6 months post discharge will be measured via activity and heart rate monitors, and standardised physical activity questionnaire. Adherence to exercise guidelines will be evaluated by (1) number of 'active minutes' per week (from the activity monitor), (2) amount of time per week when heart rate is within a target range (ie, 55%-80% of age-predicted maximum) and (3) amount of time per week completing 'moderate' or 'strenuous' physical activities (from the questionnaire). We will compare the proportion of active and inactive individuals at 6 months post intervention using mixed-model logistic regression, with fixed effects of time and phase and random effect of cluster (site). To date, research ethics approval has been received from five of the six sites, with conditional approval granted by the sixth site. Results will be disseminated directly to study participants at the end of the trial, and to other stake holders via publication in a peer-reviewed journal. NCT02951338; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation.

PubMed

McNamara, Renae J; McKeough, Zoe J; Mo, Laura R; Dallimore, Jamie T; Dennis, Sarah M

2016-01-01

Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation. Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program. Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years) commenced the community-based exercise training program. Twenty-two (71%) completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers. The convenience and accessibility of a community venue for rehabilitation contributed to high levels of satisfaction and a positive experience for people with chronic respiratory and chronic cardiac disease and physiotherapists.

Developing a Tabletop Exercise to Test Community Resilience: Lessons from the Los Angeles County Community Disaster Resilience Project.

PubMed

Chandra, Anita; Williams, Malcolm V; Lopez, Christian; Tang, Jennifer; Eisenman, David; Magana, Aizita

2015-10-01

We aimed to develop and test a community resilience tabletop exercise to assess progress in community resilience and to provide an opportunity for quality improvement and capacity building. A tabletop exercise was developed for the Los Angeles County Community Disaster Resilience (LACCDR) project by using an extended heat wave scenario with health and infrastructure consequences. The tabletop was administered to preparedness only (control) and resilience (intervention) coalitions during the summer of 2014. Each exercise lasted approximately 2 hours. The coalitions and LACCDR study team members independently rated each exercise to assess 4 resilience levers (partnership, engagement, self-sufficiency, and education). Resilience coalitions received more detailed feedback in the form of recommendations for improvement. The resilience coalitions performed the same or better than the preparedness coalitions on the partnership and self-sufficiency levers. Most coalitions did not have enough (both quantity and type) of the partner organizations needed for an escalating heat wave or changing conditions or enough engagement of organizations representing at-risk populations. Coalitions also lacked educational materials to cover topics as far ranging as heat to power outages to psychological impacts of disaster. A tabletop exercise can be used to stress and test resilience-based capacities, with particular attention to a community's ability to leverage a range of partnerships and other assets to confront a slowly evolving but multifactorial emergency.

Yoga Is as Good as Stretching–Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial

PubMed Central

McAuley, Edward

2016-01-01

Abstract Background. Despite yoga’s popularity, few clinical trials have employed rigorous methodology to systematically explore its functional benefits compared with more established forms of exercise. The objective of this study was to compare the functional benefits of yoga with the conventional stretching–strengthening exercises recommended for adults. Methods. Sedentary healthy adults ( N = 118; Mage = 62.0) participated in an 8-week (three times a week for 1 hour) randomized controlled trial, which consisted of a Hatha yoga group ( n = 61) and a stretching–strengthening exercise group ( n = 57). Standardized functional fitness tests assessing balance, strength, flexibility, and mobility were administered at baseline and postintervention. Results. A repeated measures multivariate analysis of variance showed a significant time effect for measures of balance [ F (3,18) = 4.88, p < .01, partial η 2 = .45], strength [ F (2,19) = 15.37, p < .001, partial η 2 = .62], flexibility [ F (4,17) = 8.86, p < .001, partial η 2 = .68], and mobility [ F (2,19) = 8.54, p < .002, partial η 2 = .47]. Both groups showed significant improvements on measures of balance (left–right leg and four square step); strength (chair stands and arm curls); flexibility (back scratch and sit-and-reach); and mobility (gait speed and 8-feet up and go), with partial η 2 ranging from .05 to .47. Conclusions. These data suggest that regular yoga practice is just as effective as stretching–strengthening exercises in improving functional fitness. To our knowledge, this is the first study to examine functional benefits of yoga in comparison with stretching–strengthening exercises in sedentary, healthy, community-dwelling older adults. These findings have clinical implications as yoga is a more amenable form of exercise than strengthening exercises as it requires minimal equipment and can be adapted for individuals with lower levels of functioning or disabilities. PMID:26297940

Psychosocial benefits of workplace physical exercise: cluster randomized controlled trial.

PubMed

Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Andersen, Lars L

2017-10-10

While benefits of workplace physical exercise on physical health is well known, little is known about the psychosocial effects of such initiatives. This study evaluates the effect of workplace versus home-based physical exercise on psychosocial factors among healthcare workers. A total of 200 female healthcare workers (Age: 42.0, BMI: 24.1) from 18 departments at three hospitals were cluster-randomized to 10 weeks of: 1) home-based physical exercise (HOME) performed alone during leisure time for 10 min 5 days per week or 2) workplace physical exercise (WORK) performed in groups during working hours for 10 min 5 days per week and up to 5 group-based coaching sessions on motivation for regular physical exercise. Vitality and mental health (SF-36, scale 0-100), psychosocial work environment (COPSOQ, scale 0-100), work- and leisure disability (DASH, 0-100), control- (Bournemouth, scale 0-10) and concern about pain (Pain Catastrophizing Scale, scale 0-10) were assessed at baseline and at 10-week follow-up. Vitality as well as control and concern about pain improved more following WORK than HOME (all p < 0.05) in spite of increased work pace (p < 0.05). Work- and leisure disability, emotional demands, influence at work, sense of community, social support and mental health remained unchanged. Between-group differences at follow-up (WORK vs. HOME) were 7 [95% confidence interval (95% CI) 3 to 10] for vitality, -0.8 [95% CI -1.3 to -0.3] for control of pain and -0.9 [95% CI -1.4 to -0.5] for concern about pain, respectively. Performing physical exercise together with colleagues during working hours was more effective than home-based exercise in improving vitality and concern and control of pain among healthcare workers. These benefits occurred in spite of increased work pace. NCT01921764 at ClinicalTrials.gov . Registered 10 August 2013.

Yoga Is as Good as Stretching-Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial.

PubMed

Gothe, Neha P; McAuley, Edward

2016-03-01

Despite yoga's popularity, few clinical trials have employed rigorous methodology to systematically explore its functional benefits compared with more established forms of exercise. The objective of this study was to compare the functional benefits of yoga with the conventional stretching-strengthening exercises recommended for adults. Sedentary healthy adults (N = 118; M age = 62.0) participated in an 8-week (three times a week for 1 hour) randomized controlled trial, which consisted of a Hatha yoga group (n = 61) and a stretching-strengthening exercise group (n = 57). Standardized functional fitness tests assessing balance, strength, flexibility, and mobility were administered at baseline and postintervention. A repeated measures multivariate analysis of variance showed a significant time effect for measures of balance [F(3,18) = 4.88, p < .01, partial η(2) = .45], strength [F(2,19) = 15.37, p < .001, partial η(2) = .62], flexibility [F(4,17) = 8.86, p < .001, partial η(2) = .68], and mobility [F(2,19) = 8.54, p < .002, partial η(2) = .47]. Both groups showed significant improvements on measures of balance (left-right leg and four square step); strength (chair stands and arm curls); flexibility (back scratch and sit-and-reach); and mobility (gait speed and 8-feet up and go), with partial η(2) ranging from .05 to .47. These data suggest that regular yoga practice is just as effective as stretching-strengthening exercises in improving functional fitness. To our knowledge, this is the first study to examine functional benefits of yoga in comparison with stretching-strengthening exercises in sedentary, healthy, community-dwelling older adults. These findings have clinical implications as yoga is a more amenable form of exercise than strengthening exercises as it requires minimal equipment and can be adapted for individuals with lower levels of functioning or disabilities. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Pilot Study of Determinants of Ongoing Participation in EnhanceFitness: A Community-Based Group Exercise Program for Older Adults.

PubMed

Gillette, David B; Petrescu-Prahova, Miruna; Herting, Jerald R; Belza, Basia

2015-01-01

Physical activity has many benefits for older adults, but adherence is often low. The purposes of this study were to (1) identify motivators and barriers for participation in EnhanceFitness (EF), a group-based exercise program; and (2) quantitatively examine the association between motivators, barriers and individual characteristics, and ongoing participation in the program. This was a prospective, cross-sectional study. We mailed a pilot, investigator-developed survey to assess motivators and barriers to exercising to 340 adults who started a new EF class, regardless of their attendance rate. We precoded surveys on the basis of class attendance, with former participants defined as having no attendance a month or more before a 4-month fitness check. Of the 241 respondents (71% response rate), 61 (25%) were precoded as former participants and 180 (75%) as current participants. The mean age of respondents was 71 years and they were predominately female (89%). More than half of respondents were whites (58%), and almost half were married (46%). Former participants reported lower total motivation scores than current participants (P < .01) and had a significantly higher mean total barrier score (P < .001). The effects of 5 barriers ("Class was too hard," "Class was too easy," "I don't like to exercise," "Personal illness," and "Exercise caused pain") and 2 motivators ("I want to exercise" and "I plan exercise as part of my day") were significantly different between current and former participants. Discrete event history models show that dropout was related positively to ethnicity (whites were more likely to drop out) and health-related barriers. In newly formed EF classes, participants who drop out report more program, psychosocial, and health barriers, and fewer program and psychosocial motivators. Total barrier score and health barriers significantly predict a participant's dropping out, and white ethnicity is associated with a higher likelihood of dropping out. Employing strategies that address health barriers to participation could improve attendance rates for group-based exercise programs.

Cognitive health benefits of strengthening exercise for community-dwelling older adults.

PubMed

Anderson-Hanley, Cay; Nimon, Joseph P; Westen, Sarah C

2010-11-01

While aerobic exercise has been linked to improved performance on cognitive tasks of executive functioning among older adults, not all older adults can avail themselves of such exercise due to physical limitations. In this study, community-dwelling older adults were evaluated on tasks of executive functioning before and after a month-long strengthening, nonaerobic exercise program. A total of 16 participants who engaged in such exercise showed significantly improved scores on Digits Backward and Stroop C tasks when compared to 16 participants who were on an exercise waiting list. Positive benefits of strengthening exercise on cognition are supported. Additional research is needed to clarify the generalizability of these findings.

Environmental influences on physical activity in rural Midwestern adults: a qualitative approach.

PubMed

Chrisman, Matthew; Nothwehr, Faryle; Yang, Ginger; Oleson, Jacob

2015-01-01

Qualitative research can be used to examine multiple factors associated with physical activity and help practitioners identify language used by the rural adult population when discussing this behavior. Three focus groups were conducted among 19 residents of multiple towns in a rural Midwestern county to examine the language and influences on rural physical activity. Focus group members were asked to define physical activity, exercise, community, and neighborhood. They were asked about the activities they engaged in and facilitators and barriers to those activities. A guidebook was developed to capture major themes and common patterns that emerged in the responses to the topics discussed. The data were reviewed for repeated statements and points that were agreed on by multiple participants. Important factors associated with physical activity include the importance of social support and modeling physical activity behavior. Also, the influence of pets and children was important for engaging these adults in physical activity. The focus group members engaged in walking and bicycling in their neighborhood streets and community trails, and desired to see community buildings be open to the public for exercise. This study revealed contextual issues and culturally relevant language for practitioners to use in tailoring physical activity measurement tools or designing interventions for a rural adult population. Social support (specifically, seeing others being active and using pets as motivators for being active) and policy attitudes may be targeted for interventions to increase physical activity in rural adults. © 2014 Society for Public Health Education.

Environmental Influences on Physical Activity in Rural Midwestern Adults: A Qualitative Approach

PubMed Central

Chrisman, Matthew; Nothwehr, Faryle; Yang, Ginger; Oleson, Jacob

2014-01-01

Qualitative research can be used to examine multiple factors associated with physical activity and help practitioners identify language used by the rural adult population when discussing this behavior. Three focus groups were conducted among 19 residents of multiple towns in a rural Midwestern county to examine the language and influences on rural physical activity. Focus group members were asked to define physical activity, exercise, community, and neighborhood. They were asked about the activities they engaged in and facilitators and barriers to those activities. A guidebook was developed to capture major themes and common patterns that emerged in the responses to the topics discussed. The data were reviewed for repeated statements and points that were agreed on by multiple participants. Important factors associated with physical activity include the importance of social support and modeling physical activity behavior. Also, the influence of pets and children was important for engaging these adults in physical activity. The focus group members engaged in walking and bicycling in their neighborhood streets and community trails, and desired to see community buildings be open to the public for exercise. This study revealed contextual issues and culturally relevant language for practitioners to use in tailoring physical activity measurement tools or designing interventions for a rural adult population. Social support (specifically, seeing others being active and using pets as motivators for being active) and policy attitudes may be targeted for interventions to increase physical activity in rural adults. PMID:24662894

The Effect of Aerobic Exercise on Quantity and Quality of Sleep Among Elderly People Referring to Health Centers of Lar City, Southern of Iran; A Randomized Controlled Clinical Trial.

PubMed

Sharif, Farkhondeh; Seddigh, Maryam; Jahanbin, Iran; Keshavarzi, Sareh

2015-01-01

Aging is associated with reduced quality and quantity of sleep. 50% of senior citizens living in the community and 70% of those living in nursing homes suffer from sleep disorders. Moreover, insomnia increases the risk of mortality and morbidity in older adults. We aimed to investigate the effect of aerobic exercise on quantity and quality of sleep among the elderly people referring to health centers of Lar city, southern Iran. We enrolled 60 elderly people whose age range was 60-75 years and (mean ±SD) age was (64.8±5.2). Participants were randomly assigned into two groups of 30 each (case group= 30 and control group=30). The patients in the case group participated in exercise trainings consisted of three one-hour sessions per week for 12 consecutive weeks. Sleep quantity and quantity in the participants was evaluated before and after intervention using Pittsburgh Sleep Quality Index (PSQI). Independent t-test showed that sleep quality score was improved by 44.46% in the case group (p<0.0001). Furthermore, sleep duration was improved by 98/16% (p=0.038) and sleep latency was improved by 76/6% in the case group; while, the difference between the two groups regarding the changes in the sleep latency was not statistically significant (p=0.089). Aerobic exercise program could improve the sleep quality and quantity in the elderly. It could also be used as a cost effective and long lasting method of therapy with no side effect which could be used for the treatment of insomnia in older people.

Efficacy of a Student-Led, Community-Based, Multifactorial Fall Prevention Program: Stay in Balance.

PubMed

Der Ananian, Cheryl A; Mitros, Melanie; Buman, Matthew Paul

2017-01-01

Falls are a major public health concern in older adults. Recent fall prevention guidelines recommend the use of multifactorial fall prevention programs (FPPs) that include exercise for community-dwelling older adults; however, the availability of sustainable, community-based FPPs is limited. We conducted a 24-week quasi-experimental study to evaluate the efficacy of a community-based, multifactorial FPP [Stay in Balance (SIB)] on dynamic and functional balance and muscular strength. The SIB program was delivered by allied health students and included a health education program focused on fall risk factors and a progressive exercise program emphasizing lower-extremity strength and balance. All participants initially received the 12-week SIB program, and participants were non-randomly assigned at baseline to either continue the SIB exercise program at home or as a center-based program for an additional 12 weeks. Adults aged 60 and older ( n  = 69) who were at-risk of falling (fall history or 2+ fall risk factors) were recruited to participate. Mixed effects repeated measures using Statistical Application Software Proc Mixed were used to examine group, time, and group-by-time effects on dynamic balance (8-Foot Up and Go), functional balance (Berg Balance Scale), and muscular strength (30 s chair stands and 30 s arm curls). Non-normally distributed outcome variables were log-transformed. After adjusting for age, gender, and body mass index, 8-Foot Up and Go scores, improved significantly over time [ F (2,173)  = 8.92, p  = 0.0; T0 - T2 diff = 1.2 (1.0)]. Berg Balance Scores [ F (2,173)  = 29.0, p  < 0.0001; T0 - T2 diff = 4.96 (0.72)], chair stands [ F (2,171)  = 10.17, p  < 0.0001; T0 - T2 diff = 3.1 (0.7)], and arm curls [ F (2,171)  = 12.7, p  < 0.02; T0 - T2 diff = 2.7 (0.6)] also all improved significantly over time. There were no significant group-by-time effects observed for any of the outcomes. The SIB program improved dynamic and functional balance and muscular strength in older adults at-risk for falling. Our findings indicate continuing home-based strength and balance exercises at home after completion of a center-based FPP program may be an effective and feasible way to maintain improvements in balance and strength parameters.

Effects of a tailor-made exercise program on exercise adherence and health outcomes in patients with knee osteoarthritis: a mixed-methods pilot study.

PubMed

Lee, Fung-Kam Iris; Lee, Tze-Fan Diana; So, Winnie Kwok-Wei

2016-01-01

Previous studies showed that exercise intervention was effective in symptoms control of knee osteoarthritis (OA) but poor intervention adherence reduced the exercise effect. It has been suspected that the design of exercise intervention mainly from the health care professionals' perspective could not address the patients' barriers to exercise. Therefore, a tailor-made exercise program which incorporated the patient's perspective in the design was developed and ready for evaluation. This pilot study estimated the effects of a tailor-made exercise program on exercise adherence and health outcomes, and explored the participants' perception and experience of the program. The intervention of this study was a 4-week community-based group exercise program, which required the participants to attend a 1-hour session each week. Thirty-four older people with knee OA were recruited to the program. Mixed-methods study design was used to estimate the effects of this program and explore the participants' perception and experience of the program. Exercise adherence and performance in return-demonstration of the exercise were assessed at 12 weeks after the program. Disease-specific health status (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (12-item Short Form of the Medical Outcome Study Questionnaire), knee range of motion, muscle strength, and endurance of the lower extremities (Timed-Stands Test) were measured at the beginning of the program and 12 weeks after. Six participants were interviewed individually on the 12th week. Thirty-three participants (75.0±7.3 years) completed the one-group pretest and post-test study. The participants' exercise adherence was 91.4%±14.54%, and their correct performance in return-demonstration was 76.7%±21.75%. Most of the participants' health outcomes significantly improved at posttests except the 12-item Short Form of the Medical Outcome Study Questionnaire physical health summary score. The qualitative findings provided rich information to explain and support the quantitative results. The results of this study showed that a tailor-made exercise program could improve exercise adherence and health outcomes in older people with knee OA.

Effects of a tailor-made exercise program on exercise adherence and health outcomes in patients with knee osteoarthritis: a mixed-methods pilot study

PubMed Central

Lee, Fung-Kam Iris; Lee, Tze-Fan Diana; So, Winnie Kwok-Wei

2016-01-01

Introduction Previous studies showed that exercise intervention was effective in symptoms control of knee osteoarthritis (OA) but poor intervention adherence reduced the exercise effect. It has been suspected that the design of exercise intervention mainly from the health care professionals’ perspective could not address the patients’ barriers to exercise. Therefore, a tailor-made exercise program which incorporated the patient’s perspective in the design was developed and ready for evaluation. Objectives This pilot study estimated the effects of a tailor-made exercise program on exercise adherence and health outcomes, and explored the participants’ perception and experience of the program. Methods The intervention of this study was a 4-week community-based group exercise program, which required the participants to attend a 1-hour session each week. Thirty-four older people with knee OA were recruited to the program. Mixed-methods study design was used to estimate the effects of this program and explore the participants’ perception and experience of the program. Exercise adherence and performance in return-demonstration of the exercise were assessed at 12 weeks after the program. Disease-specific health status (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (12-item Short Form of the Medical Outcome Study Questionnaire), knee range of motion, muscle strength, and endurance of the lower extremities (Timed-Stands Test) were measured at the beginning of the program and 12 weeks after. Six participants were interviewed individually on the 12th week. Results Thirty-three participants (75.0±7.3 years) completed the one-group pretest and post-test study. The participants’ exercise adherence was 91.4%±14.54%, and their correct performance in return-demonstration was 76.7%±21.75%. Most of the participants’ health outcomes significantly improved at posttests except the 12-item Short Form of the Medical Outcome Study Questionnaire physical health summary score. The qualitative findings provided rich information to explain and support the quantitative results. Conclusion The results of this study showed that a tailor-made exercise program could improve exercise adherence and health outcomes in older people with knee OA. PMID:27785001

The role of exercise in modifying outcomes for people with multiple sclerosis: a randomized trial

PubMed Central

2013-01-01

Background Despite the commonly known benefits of exercise and physical activity evidence shows that persons Multiple Sclerosis (MS) are relatively inactive yet physical activity may be even more important in a population facing functional deterioration. No exercise is effective if it is not done and people with MS face unique barriers to exercise engagement which need to be overcome. We have developed and pilot tested a Multiple Sclerosis Tailored Exercise Program (MSTEP) and it is ready to be tested against general guidelines for superiority and ultimately for its impact on MS relevant outcomes. The primary research question is to what extent does an MS Tailored Exercise Program (MSTEP) result in greater improvements in exercise capacity and related outcomes over a one year period in comparison to a program based on general guidelines for exercise among people with MS who are sedentary and wish to engage in exercise as part of MS self-management. Methods/Design The proposed study is an assessor-blind, parallel-group, randomized controlled trial (RCT). The duration of the intervention will be one year with follow-up to year two. The targeted outcomes are exercise capacity, functional ambulation, strength, and components of quality of life including frequency and intensity of fatigue symptoms, mood, global physical function, health perception, and objective measures of activity level. Logistic regression will be used to test the main hypothesis related to the superiority of the MSTEP program based on a greater proportion of people making a clinically relevant gain in exercise capacity at 1 year and at 2 years, using an intention-to-treat approach. Sample size will be 240 (120 per group). Discussion The MS community is clearly looking for interventions to help alleviate the disabling sequelae of MS and promote health. Exercise is a well-known intervention which has known benefits to all, yet few exercise regularly. For people with MS, the role of exercise in MS management needs to be rigorously assessed to inform people as to how best to use exercise to reduce disability and promote health. Trial registration Clinical Trials.gov: NCT01611987 PMID:23809312

Daily Life Physical Activity Modulates the Effects of an Exercise Program on Lower-Extremity Physical Function in Japanese Older Adults.

PubMed

Jindo, Takashi; Kitano, Naruki; Tsunoda, Kenji; Kusuda, Mikiko; Hotta, Kazushi; Okura, Tomohiro

Decreasing daily life physical activity (PA) outside an exercise program might hinder the benefit of that program on lower-extremity physical function (LEPF) in older adults. The purpose of this study was to investigate how daily life PA modulates the effects of an exercise program on LEPF. The participants were 46 community-dwelling older adults (mean age, 70.1 ± 3.5 years) in Kasama City, a rural area in Japan. All participated in a fall-prevention program called square-stepping exercise once a week for 11 weeks. We evaluated their daily life PA outside the exercise program with pedometers and calculated the average daily step counts during the early and late periods of the program. We divided participants into 2 groups on the basis of whether or not they decreased PA by more than 1000 steps per day between the early and late periods. To ascertain the LEPF benefits induced by participating in the exercise program, we measured 5 physical performance tests before and after the intervention: 1-leg stand, 5-time sit-to-stand, Timed Up and Go (TUG), habitual walking speed, and choice-stepping reaction time (CSRT). We used a 2-way analysis of variance to confirm the interaction between the 2 groups and the time effect before and after the intervention. During the exercise program, 8 participants decreased their daily life PA (early period, 6971 ± 2771; late period, 5175 ± 2132) and 38 participants maintained PA (early period, 6326 ± 2477; late period, 6628 ± 2636). Both groups significantly improved their performance in TUG and CSRT at the posttest compared with the baseline. A significant group-by-time interaction on the walking speed (P = .038) was observed: participants who maintained PA improved their performance more than those who decreased their PA. Square-stepping exercise requires and strengthens dynamic balance and agility, which contributed to the improved time effects that occurred in TUG and CSRT. On the contrary, because PA is positively associated with walking speed, maintaining daily life PA outside an exercise program may have a stronger influence on walking speed. To enhance the effectiveness of an exercise program for young-old adults, researchers and instructors should try to maintain the participant's daily life PA outside the program. Regardless of decreasing or maintaining daily life PA, the square-stepping exercise program could improve aspects of LEPF that require complex physical performance. However, a greater effect can be expected when participants maintain their daily life PA outside the exercise program.

Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.

PubMed

Bogaerts, An; Verschueren, Sabine; Delecluse, Christophe; Claessens, Albrecht L; Boonen, Steven

2007-07-01

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n=94), a fitness group (n=60) or a control group (n=66). The whole body vibration and fitness groups trained three times a week for 1 year. The vibration group performed exercises on a vibration platform and the fitness group performed cardiovascular, strength, balance and stretching exercises. Balance was measured using dynamic computerized posturography at baseline and after 6 and 12 months. Whole body vibration training was associated with reduced falls frequency on a moving platform when vision was disturbed and improvements in the response to toes down rotations at the ankle induced by the moving platform. The fitness group showed reduced falls frequency on the moving surface when vision was disturbed. Thus, whole body vibration training may improve some aspects of postural control in community dwelling older individuals.

FIT for FUNCTION: study protocol for a randomized controlled trial.

PubMed

Richardson, Julie; Tang, Ada; Guyatt, Gordon; Thabane, Lehana; Xie, Feng; Sahlas, Demetrios; Hart, Robert; Fleck, Rebecca; Hladysh, Genevieve; Macrae, Louise

2018-01-15

The current state of evidence suggests that community-based exercise programs are beneficial in improving impairment, function, and health status, and are greatly needed for persons with stroke. However, limitations of these studies include risk of bias, feasibility, and cost issues. This single-blinded, randomized controlled trial (RCT) of 216 participants with stroke will compare the effectiveness of a 12-week YMCA community-based wellness program (FIT for FUNCTION) specifically designed for community-dwelling persons with stroke to persons who receive a standard YMCA membership. The primary outcome will be community reintegration using the Reintegration to Normal Living Index at 12 and 24 weeks. Secondary outcomes include measurement of physical activity level using the Rapid Assessment of Physical Activity and accelerometry; balance using the Berg Balance Scale; lower extremity function using the Short Physical Performance Battery; exercise capacity using the 6-min walk test; grip strength and isometric knee extension strength using hand held dynamometry; and health-related quality of life using the European Quality of Life 5-Dimension Questionnaire. We are also assessing cardiovascular health and lipids; glucose and inflammatory markers will be collected following 12-h fast for total cholesterol, insulin, glucose, and glycated hemoglobin. Self-efficacy for physical activity will be assessed with a single question and self-efficacy for managing chronic disease will be assessed using the Stanford 6-item Scale. The Patient Activation Measure will be used to assess the patient's level of knowledge, skill, and confidence for self-management. Healthcare utilization and costs will be evaluated. Group, time, and group × time interaction effects will be estimated using generalized linear models for continuous variables, including relevant baseline variables as covariates in the analysis that differ appreciably between groups at baseline. Cost data will be treated as non-parametric and analyzed using a Mann-Whitney U test. This is a RCT with broad study eligibility criteria intended to recruit a wide spectrum of individuals living in the community with stroke. If positive benefits are demonstrated, results will provide strong research evidence to support the implementation of structured, community-based exercise and education/self-management programs for a broad range of people living in the community with stroke. ClinicalTrials.gov, NCT02703805 . Registered on 14 October 2014.

The role of social capital and community belongingness for exercise adherence: An exploratory study of the CrossFit gym model.

PubMed

Whiteman-Sandland, Jessica; Hawkins, Jemma; Clayton, Debbie

2016-08-01

This is the first study to measure the 'sense of community' reportedly offered by the CrossFit gym model. A cross-sectional study adapted Social Capital and General Belongingness scales to compare perceptions of a CrossFit gym and a traditional gym. CrossFit gym members reported significantly higher levels of social capital (both bridging and bonding) and community belongingness compared with traditional gym members. However, regression analysis showed neither social capital, community belongingness, nor gym type was an independent predictor of gym attendance. Exercise and health professionals may benefit from evaluating further the 'sense of community' offered by gym-based exercise programmes.

Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada.

PubMed

Wasfi, Rania; Steinmetz-Wood, Madeleine; Kestens, Yan

2017-01-01

This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20-1.67) and older adults (OR: 2.09; 95%CI: 1.51-2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15-2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking.

Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada

PubMed Central

Steinmetz-Wood, Madeleine; Kestens, Yan

2017-01-01

This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20–1.67) and older adults (OR: 2.09; 95%CI: 1.51–2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15–2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking. PMID:29261706

Exercise Mode Moderates the Relationship Between Mobility and Basal Ganglia Volume in Healthy Older Adults.

PubMed

Nagamatsu, Lindsay S; Weinstein, Andrea M; Erickson, Kirk I; Fanning, Jason; Awick, Elizabeth A; Kramer, Arthur F; McAuley, Edward

2016-01-01

To examine whether 12 months of aerobic training (AT) moderated the relationship between change in mobility and change in basal ganglia volume than balance and toning (BAT) exercises in older adults. Secondary analysis of a randomized controlled trial. Champaign-Urbana, Illinois. Community-dwelling older adults (N=101; mean age 66.4). Twelve-month exercise trial with two groups: AT and BAT. Mobility was assessed using the Timed Up and Go test. Basal ganglia (putamen, caudate nucleus, pallidum) was segmented from T1-weighted magnetic resonance images using the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain Software Library Integrated Registration and Segmentation Tool. Measurements were obtained at baseline and trial completion. Hierarchical multiple regression was conducted to examine whether exercise mode moderates the relationship between change in mobility and change in basal ganglia volume over 12 months. Age, sex, and education were included as covariates. Exercise significantly moderated the relationship between change in mobility and change in left putamen volume. Specifically, for the AT group, volume of the left putamen did not change, regardless of change in mobility. Similarly, in the BAT group, those who improved their mobility most over 12 months had no change in left putamen volume, although left putamen volume of those who declined in mobility levels decreased significantly. The primary finding that older adults who engaged in 12 months of BAT training and improved mobility exhibited maintenance of brain volume in an important region responsible for motor control provides compelling evidence that such exercises can contribute to the promotion of functional independence and healthy aging. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Exercise Mode Moderates the Relationship Between Mobility and Basal Ganglia Volume in Healthy Older Adults

PubMed Central

Nagamatsu, Lindsay S.; Weinstein, Andrea M.; Erickson, Kirk I.; Fanning, Jason; Awick, Elizabeth A.; Kramer, Arthur F.; McAuley, Edward

2015-01-01

Background Identifying effective intervention strategies to combat age-related decline in mobility and brain health is a priority. The primary aim of our study was to examine whether 12 months of aerobic training (AT) versus balance and toning (BAT) exercises moderates the relationship between change in mobility and change in basal ganglia volume in older adults. Design Secondary analysis of a randomized controlled trial. Setting Champaign-Urbana, Illinois. Participants Community-dwelling older adults (N = 101; mean age = 66.41 years) Intervention 12-month exercise trial with two groups: AT and BAT. Measurements Mobility was assessed by the Timed Up and Go (TUG) test. Basal ganglia (putamen, caudate nucleus, pallidum) was segmented from T1-weighted MR images using FIRST. Measurements were obtained at baseline and trial completion. Hierarchical multiple regression was conducted to examine whether exercise mode moderates the relationship between change in mobility and change in basal ganglia volume over 12 months. Age, sex, and education were included as covariates. Results Exercise mode significantly moderated the relationship between change in mobility and change in left putamen volume. Specifically, for the AT group, volume of the left putamen did not change, regardless of change in mobility. Similarly, in the BAT group, those who improved their mobility most over 12 months had no change in left putamen volume; however, those who declined in mobility levels significantly decreased in left putamen volume. Conclusion Our primary finding that older adults who engage in 12 months of balance and tone training and improve mobility exhibit maintenance of brain volume in a key region responsible for motor control provides compelling evidence that such exercises can contribute to the promotion of functional independence and healthy aging. PMID:26782858

Balance Confidence Improves with Resistance or Agility training: Increase is not Correlated with Objective Changes in Fall Risk and Physical Abilities

PubMed Central

Liu-Ambrose, Teresa; Khan, Karim M; Eng, Janice J; Lord, SR; McKay, HA

2012-01-01

Background While the fear of falling is a common psychological consequence of falling, older adults who have not fallen also frequently report this fear. Fear of falling can lead to activity restriction that is self-imposed rather than due to actual physical impairments. Evidence suggests that exercise can significantly improve balance confidence, as measured by falls-related self-efficacy scales. However, there are no prospective reports that correlate change in balance confidence with changes in fall risk and physical abilities as induced by participating in a group-based exercise program. Objective The primary purpose of this prospective study was to examine the relationship between the change in balance confidence and the changes in fall risk and physical abilities in older women with confirmed low bone mass after 13 weeks of exercise participation. The secondary purpose of this study was to examine the relationship between the change in balance confidence and the change in physical activity level. Methods The sample comprised 98 women aged 75 to 85 years old women with low bone mass. Participants were randomly assigned to one of three groups: Resistance Training (n=32), Agility Training (n=34), and Stretching (sham) exercises (n=32). The 50-minute exercise classes for each study arm were held twice weekly at a local YMCA community centre. Results Both resistance training and agility training significantly improved balance confidence by 6% from baseline after 13 weeks. However, the change in balance confidence was only weakly correlated with improved general physical function and not significantly correlated with the changes in fall risk score, postural stability, gait speed, or physical activity level. As well, we observed balance confidence enhancement in the presence of increased fall risk or deterioration in physical abilities. Conclusions Two different types of exercise training improved balance confidence in older women with low bone mass. This change in balance confidence was significantly correlated with change in general physical function. Because of the observation of discordance between balance confidence change and changes in fall risk and physical abilities, those who design group-based exercise programs for community-dwelling older adults may wish to consider including an education component on factors that influence fear of falling. Objective changes in fall risk factors cannot be assumed to mirror change of fear of falling and physical abilities in older adults in the short-term. PMID:15477698

Effects of an Aerobic Exercise Program on Community-Based Adults with Mental Retardation.

ERIC Educational Resources Information Center

Pommering, Thomas L.; And Others

1994-01-01

Evaluation of a 10-week aerobic exercise program on 14 community-based adults with mental retardation found a 91.3% attendance rate and significant increases in maximal oxygen consumption, oxygen pulse, maximum ventilation, exercise stress test duration, and flexibility. However, no significant changes were observed in weight or body composition.…

Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial.

PubMed

D'Amico, Francesco; Rehill, Amritpal; Knapp, Martin; Lowery, David; Cerga-Pashoja, Arlinda; Griffin, Mark; Iliffe, Steve; Warner, James

2016-06-01

Although available evidence is modest, exercise could be beneficial in reducing behavioural and psychological symptoms of dementia. We aim to evaluate the cost-effectiveness of a dyadic exercise regimen for individuals with dementia and their main carer as therapy for behavioural and psychological symptoms of dementia. Cost-effectiveness analysis within a two-arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored, for 20-30 min at least five times per week). The study randomised 131 community-dwelling individuals with dementia and clinically significant behavioural and psychological symptoms with a carer willing and able to participate in the exercise regimen; 52 dyads provided sufficient cost data for analyses. Mean intervention cost was £284 per dyad. For the subsample of 52 dyads, the intervention group had significantly higher mean cost from a societal perspective (mean difference £2728.60, p = 0.05), but costs were not significantly different from a health and social care perspective. The exercise intervention was more cost-effective than treatment as usual from both societal and health and social care perspectives for the measure of behavioural and psychological symptoms (Neuropsychiatric Inventory). It does not appear cost-effective in terms of cost per quality-adjusted life year gain. The exercise intervention has the potential to be seen as cost-effective when considering behavioural and psychological symptoms but did not appear cost-effective when considering quality-adjusted life year gains. Copyright © 2015 John Wiley & Sons, Ltd.

[Perceived quality of life in the "healthy people" municipal community health promotion program in Ciudad Lineal-Madrid].

PubMed

Esteban-Peña, M; Gerechter-Fernández, S; Martínez-Simancas, A M; Zancada-González, J; Hernandez-Barrera, V; Jiménez-García, R

The measurement of the health-related quality of life (HRQoL) is a comprehensive way to estimate the health of both the individual and the community. The aim of this study was to assess changes in health and HRQoL using the intervention strategies «healthy people» and «health promotion programs» of the City Council of Madrid-Madrid Health. The study was conducted in the Municipal Health Centre of Ciudad Lineal, in 2014, and included promotion of exercise, healthy eating, smoking cessation, psycho-hygiene, memory training, and health education for the elderly, with group interventions. A before and after community trial, with the administration of questionnaire with COOP/WONCA HRQoL charts to 200 participants. The study population (n=87), included those who completed the first and second questionnaire. Positive changes were seen in the overall before and after COOP/WONCA scores, with a mean change from 23.16 to 21.94, with statistical significance, p≤0.002. In the psychology groups, it changed from 28.14 to 23.57 with a p≤0.05, and healthy eating from 22.81 to 20.85, with p≤0.03. In the health education groups it changed from 21 to 20.81 points, and in memory training from 23.31 to 22.45 points (both without significance). The significant improvement in scores reflects a positive change in self-perceived health of this community after the intervention and proper operation of programs. The areas directly related to health and interventions in psychology and nutrition-exercise, are those with the most significant changes. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain.

PubMed

Jessep, Sally A; Walsh, Nicola E; Ratcliffe, Julie; Hurley, Michael V

2009-06-01

Chronic knee pain is a major cause of disability in the elderly. Management guidelines recommend exercise and self-management interventions as effective treatments. The authors previously described a rehabilitation programme integrating exercise and self-management [Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain)] that produced short-term improvements in pain and physical function, but sustaining these improvements is difficult. Moreover, the programme is untried in clinical environments, where it would ultimately be delivered. To establish the feasibility of ESCAPE-knee pain and compare its clinical effectiveness and costs with outpatient physiotherapy. Pragmatic, randomised controlled trial. Outpatient physiotherapy department and community centre. Sixty-four people with chronic knee pain. Outpatient physiotherapy compared with ESCAPE-knee pain. The primary outcome was physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcomes included pain, objective functional performance, anxiety, depression, exercise-related health beliefs and healthcare utilisation. All outcomes were assessed at baseline and 12 months after completing the interventions (primary endpoint). ANCOVA investigated between-group differences. Both groups demonstrated similar improvements in clinical outcomes. Outpatient physiotherapy cost pound 130 per person and the healthcare utilisation costs of participants over 1 year were pound 583. The ESCAPE-knee pain programme cost pound 64 per person and the healthcare utilisation costs of participants over 1 year were pound 320. ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective.

Balance circuit classes to improve balance among rehabilitation inpatients: a protocol for a randomised controlled trial.

PubMed

Treacy, Daniel; Schurr, Karl; Sherrington, Catherine

2013-07-20

Impaired balance and mobility are common among rehabilitation inpatients. Poor balance and mobility lead to an increased risk of falling. Specific balance exercise has been shown to improve balance and reduce falls within the community setting. However few studies have measured the effects of balance exercises on balance within the inpatient setting. A single centre, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. One hundred and sixty two patients admitted to the general rehabilitation ward at Bankstown-Lidcombe Hospital will be recruited. Eligible participants will have no medical contraindications to exercise and will be able to: fully weight bear; stand unaided independently for at least 30 seconds; and participate in group therapy sessions with minimal supervision. Participants will be randomly allocated to an intervention group or usual-care control group. Both groups will receive standard rehabilitation intervention that includes physiotherapy mobility training and exercise for at least two hours on each week day. The intervention group will also receive six 1-hour circuit classes of supervised balance exercises designed to maximise the ability to make postural adjustments in standing, stepping and walking. The primary outcome is balance. Balance will be assessed by measuring the total time the participant can stand unsupported in five different positions; feet apart, feet together, semi-tandem, tandem and single-leg-stance. Secondary outcomes include mobility, self reported physical functioning, falls and hospital readmissions. Performance on the outcome measures will be assessed before randomisation and at two-weeks and three-months after randomisation by physiotherapists unaware of intervention group allocation. This study will determine the impact of additional balance circuit classes on balance among rehabilitation inpatients. The results will provide essential information to guide evidence-based physiotherapy at the study site as well as across other rehabilitation inpatient settings. The protocol for this study is registered with the Australian New Zealand, Clinical Trials Registry: ACTRN=12611000412932.

Effectiveness of Senior Dance on risk factors for falls in older adults (DanSE): a study protocol for a randomised controlled trial

PubMed Central

Franco, Marcia R; Sherrington, Catherine; Tiedemann, Anne; Pereira, Leani S; Perracini, Monica R; Faria, Claudia R S; Pinto, Rafael Z; Pastre, Carlos M

2016-01-01

Introduction Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. Methods and analysis This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. Ethics and dissemination Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences. Trial registration number NCT02603523, Pre-results. PMID:28039296

Long-Term Exercise in Older Adults: 4-Year Outcomes of Music-Based Multitask Training

PubMed Central

Herrmann, François R.; Fielding, Roger A.; Reid, Kieran F.; Rizzoli, René; Trombetti, Andrea

2016-01-01

Prospective controlled evidence supporting the efficacy of long-term exercise to prevent physical decline and reduce falls in old age is lacking. The present study aimed to assess the effects of long-term music-based multitask exercise (i.e., Jaques-Dalcroze eurhythmics) on physical function and fall risk in older adults. A 3-year follow-up extension of a 1-year randomized controlled trial (NCT01107288) was conducted in Geneva (Switzerland), in which 134 community-dwellers aged ≥65 years at increased risk of falls received a 6-month music-based multitask exercise program. Four years following original trial enrolment, 52 subjects (baseline mean ± SD age, 75 ± 8 years) who (i) have maintained exercise program participation through the 4-year follow-up visit (“long-term intervention group”, n = 23) or (ii) have discontinued participation following original trial completion (“control group”, n = 29) were studied. They were reassessed in a blind fashion, using the same procedures as at baseline. At 4 years, linear mixed-effects models showed significant gait (gait speed, P = 0.006) and balance (one-legged stance time, P = 0.015) improvements in the long-term intervention group, compared with the control group. Also, long-term intervention subjects did better on Timed Up & Go, Five-Times-Sit-to-Stand and handgrip strength tests, than controls (P < 0.05, for all comparisons). Furthermore, the exercise program reduced the risk of falling (relative risk, 0.69; 95 % confidence interval, 0.5–0.9; P = 0.008). These findings suggest that long-term maintenance of a music-based multitask exercise program is a promising strategy to prevent age-related physical decline in older adults. They also highlight the efficacy of sustained long-term adherence to exercise for falls prevention. PMID:25148876

Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial.

PubMed

Baker, Michael K; Kennedy, David J; Bohle, Philip L; Campbell, Deena S; Knapman, Leona; Grady, Jodie; Wiltshire, James; McNamara, Maria; Evans, William J; Atlantis, Evan; Fiatarone Singh, Maria A

2007-01-01

To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults. Randomized, controlled trial. Retirement village. Thirty-eight subjects (14 men and 24 women) aged 76.6 +/- 6.1. A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week. Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level. Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39+/-31% in exercise, versus 21+/-24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3+/-15%, P=.002) and chair stand time (-7.1+/-15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=-0.568, P=.009, PRT progression in loading r=-0.587, P=.02, and total volume of aerobic training r=-0.541, P=.01), as well as improvements in muscle strength (r=-0.498, P=.002). Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults.

Calorie Restriction in Overweight SeniorS: Response of Older Adults to a Dieting Study: The CROSSROADS Randomized Controlled Clinical Trial

PubMed Central

Haas, Marilyn C.; Bodner, Eric V.; Brown, Cynthia J.; Bryan, David; Buys, David R.; Keita, Akilah Dulin; Flagg, Lee Anne; Goss, Amy; Gower, Barbara; Hovater, Martha; Hunter, Gary; Ritchie, Christine S.; Roth, David L.; Wingo, Brooks C.; Ard, Jamy; Locher, Julie L.

2014-01-01

We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling, obese, older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue (VAT)), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article. PMID:25424512

Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.

PubMed

Haas, Marilyn C; Bodner, Eric V; Brown, Cynthia J; Bryan, David; Buys, David R; Keita, Akilah Dulin; Flagg, Lee Anne; Goss, Amy; Gower, Barbara; Hovater, Martha; Hunter, Gary; Ritchie, Christine S; Roth, David L; Wingo, Brooks C; Ard, Jamy; Locher, Julie L

2014-01-01

We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), and functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article.

The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community.

PubMed

Yang, Jong-Eun; Lee, Tac-Young; Kim, Jin-Kyung

2017-12-01

[Purpose] The purpose of this study is to explore the effect of a VR exercise program on falls and depression in the elderly with mild depression who reside in the local community. [Subjects and Methods] This study was performed by targeting 15 elderly subjects with mild depression who resided in the local community. The targeted subjects voluntarily selected 3 VR exercise programs (each lasting 10 minutes) among 4 activities, and a resting time of 5 minutes was given for an interval after each activity. The VR exercise program was performed for total 12 weeks (36 times), 3 times a week, 45 minutes per session. [Results] After exercise, scores of static balance test (anteroposterior), Falls Efficacy Scale, and the Activities-specific Balance Confidence Scale in the test subjects were improved and depression and internal stress scores were significantly decreased after the intervention. [Conclusion] It can be concluded that the VR exercise program exerts a positive effect not only on the physical factor but also on the mental factor of the elderly subjects with mild depression who reside in the local community. It is expected that based on the VR exercise program, diversified home programs for the elderly should be developed in the future.

Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial.

PubMed

Katzman, W B; Vittinghoff, E; Lin, F; Schafer, A; Long, R K; Wong, S; Gladin, A; Fan, B; Allaire, B; Kado, D M; Lane, N E

2017-10-01

A 6-month randomized controlled trial of spine-strengthening exercise and posture training reduced both radiographic and clinical measures of kyphosis. Participants receiving the intervention improved self-image and satisfaction with their appearance. Results suggest that spine-strengthening exercise and postural training may be an effective treatment option for older adults with hyperkyphosis. The purpose of the present study is to determine in a randomized controlled trial whether spine-strengthening exercises improve Cobb angle of kyphosis in community-dwelling older adults. We recruited adults ≥60 years with kyphosis ≥40° and enrolled 99 participants (71 women, 28 men), mean age 70.6 ± 0.6 years, range 60-88, with baseline Cobb angle 57.4 ± 12.5°. The intervention included group spine-strengthening exercise and postural training, delivered by a physical therapist, 1-h, three times weekly for 6 months. Controls received four group health education meetings. The primary outcome was change in the gold standard Cobb angle of kyphosis measured from standing lateral spine radiographs. Secondary outcomes included change in kyphometer-measured kyphosis, physical function (modified Physical Performance Test, gait speed, Timed Up and Go, Timed Loaded Standing, 6-Min Walk), and health-related quality of life (HRQoL) (PROMIS global health and physical function indexes, SRS-30 self-image domain). ANCOVA was used to assess treatment effects on change from baseline to 6 months in all outcomes. There was a -3.0° (95% CI -5.2, -0.8) between-group difference in change in Cobb angle, p = 0.009, favoring the intervention and approximating the magnitude of change from an incident vertebral fracture. Kyphometer-measured kyphosis (p = 0.03) and SRS-30 self-esteem (p < 0.001) showed favorable between-group differences in change, with no group differences in physical function or additional HRQoL outcomes, p > 0.05. Spine-strengthening exercise and posture training over 6 months reduced kyphosis compared to control. Our randomized controlled trial results suggest that a targeted kyphosis-specific exercise program may be an effective treatment option for older adults with hyperkyphosis. ClinicalTrials.gov; identifier NCT01751685.

Qualitative Investigation of Exercise Perceptions and Experiences in People With Multiple Sclerosis Before, During, and After Participation in a Personally Tailored Exercise Program.

PubMed

Crank, Helen; Carter, Anouska; Humphreys, Liam; Snowdon, Nicky; Daley, Amanda; Woodroofe, Nicola; Sharrack, Basil; Petty, Jane; Saxton, John M

2017-12-01

To undertake a qualitative investigation of exercise perceptions and experiences in people with multiple sclerosis (PwMS) before, during, and after participation in a personally tailored program designed to promote long-term maintenance of self-directed exercise. Focus groups and semistructured telephone interviews. University exercise science department close to the recruiting hospital. PwMS (N=33; mean age ± SD, 47.6±7.9y). Participants were recruited after participation in a randomized controlled exercise trial; all had been allocated to a 12-week exercise program comprising supervised and self-directed exercise sessions. Exercise perceptions and experiences before, during, and after participation in the program. Four themes emerged from the analysis: (1) the transition to inactivity; (2) lack of knowledge and confidence; (3) positive exercise experiences; and (4) perspectives on exercise adherence. Lack of confidence and exercise knowledge, coupled with negative perceptions about physical capabilities after an MS diagnosis, are clear barriers to exercise participation in PwMS. These issues are not being adequately addressed as part of the health care pathway or in community settings. Perceptions of improved posture, ability to overcome everyday difficulties, acute mood enhancements during and after exercise, and increased opportunities for social interaction were among the reported benefits of exercise participation. Despite the provision of a personally tailored exercise plan and use of cognitive behavioral strategies, self-directed exercise continued to present challenges to PwMS, and the importance of seeking cost-effective ways to maintain motivational support was implicit in participant responses. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Barriers to healthy-lifestyle participation in stroke: consumer participation in secondary prevention design.

PubMed

Lennon, Olive C; Doody, Catherine; Ni Choisdealbh, Cliodhna; Blake, Catherine

2013-12-01

The aim of the study was to explore community-dwelling stroke patients' perceived barriers to healthy-lifestyle participation for secondary disease prevention, as well as their preferred means for risk-reduction information dissemination and motivators to participation in healthy-lifestyle interventions. Four focus groups (5-6 stroke survivors per group) were defined from community support groups. Key questions addressed barriers to healthy-lifestyle adoption, preferred methods for receiving information and factors that would engage participants in a risk-reduction programme. Groups were audiotaped, transcribed verbatim and analysed for thematic content using a framework approach. Twenty-two participants, 12 men, 10 women, mean age 71.4 (53-87) years, were included in the study. Three overarching themes emerged as barriers to healthy-lifestyle participation: physical, mental and environmental. Exercise participation difficulties spread across all three themes; healthy eating and smoking cessation concentrated in environmental and mental dimensions. Talks (discussions) were noted as participants' preferred method of information provision. Risk-reduction programmes considered attractive were stroke specific, convenient and delivered by healthcare professionals and involved both social and exercise components. Many stroke patients appear unable to adopt healthy-lifestyle changes through advice alone because of physical, mental and environmental barriers. Risk-reduction programmes including interactive education should be specifically tailored to address barriers currently experienced and extend beyond the stroke survivor to others in their environment who influence lifestyle choices.

Community-based exercise for chronic disease management: an Italian design for the United States?

PubMed

Weinrich, Michael; Stuart, Mary; Benvenuti, Francesco

2014-10-01

Although only a small proportion of older adults in the United States engage in recommended amounts of physical exercise, the health benefits of exercise for this population and the potential for lowering health care costs are substantial. However, access to regular exercise programs for the frail elderly and individuals with disabilities remains limited. In the context of health reform and emerging opportunities in developing integrated systems of care, the experience in Tuscany in implementing a community-based program of exercise for the elderly should be of interest. © The Author(s) 2014.

A Post-Hospital Home Exercise Program Improved Mobility but Increased Falls in Older People: A Randomised Controlled Trial

PubMed Central

Sherrington, Catherine; Lord, Stephen R.; Vogler, Constance M.; Close, Jacqueline C. T.; Howard, Kirsten; Dean, Catherine M.; Heller, Gillian Z.; Clemson, Lindy; O'Rourke, Sandra D.; Ramsay, Elisabeth; Barraclough, Elizabeth; Herbert, Robert D.; Cumming, Robert G.

2014-01-01

Background Home exercise can prevent falls in the general older community but its impact in people recently discharged from hospital is not known. The study aimed to investigate the effects of a home-based exercise program on falls and mobility among people recently discharged from hospital. Methods and Findings This randomised controlled trial (ACTRN12607000563460) was conducted among 340 older people. Intervention group participants (n = 171) were asked to exercise at home for 15–20 minutes up to 6 times weekly for 12 months. The control group (n = 169) received usual care. Primary outcomes were rate of falls (assessed over 12 months using monthly calendars), performance-based mobility (Lower Extremity Summary Performance Score, range 0–3, at baseline and 12 months, assessor unaware of group allocation) and self-reported ease of mobility task performance (range 0–40, assessed with 12 monthly questionaries). Participants had an average age of 81.2 years (SD 8.0) and 70% had fallen in the past year. Complete primary outcome data were obtained for at least 92% of randomised participants. Participants in the intervention group reported more falls than the control group (177 falls versus 123 falls) during the 12-month study period and this difference was statistically significant (incidence rate ratio 1.43, 95% CI 1.07 to 1.93, p = 0.017). At 12-months, performance-based mobility had improved significantly more in the intervention group than in the control group (between-group difference adjusted for baseline performance 0.13, 95% CI 0.04 to 0.21, p = 0.004). Self-reported ease in undertaking mobility tasks over the 12-month period was not significantly different between the groups (0.49, 95% CI −0.91 to 1.90, p = 0.488). Conclusions An individualised home exercise prescription significantly improved performance-based mobility but significantly increased the rate of falls in older people recently discharged from hospital. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12607000563460 PMID:25180702

Not sending the message: A low prevalence of strength-based exercise participation in rural and regional Central Queensland.

PubMed

Dalbo, Vincent J; Czerepusko, James B; Tucker, Patrick S; Kingsley, Michael I; Moon, Jordan R; Young, Kaelin; Scanlan, Aaron T

2015-10-01

The primary aim of this study was to determine the prevalence of current strength-based exercise in rural and regional populations of Central Queensland. The secondary aim was to examine the proportion of residents from various demographic groups who currently partake in strength-based exercise to allow for targeted strength training campaigns. A cross-sectional, survey-based experimental design was followed. Rural and regional Australia. Rural and regional community-dwelling individuals living in Central Queensland and aged 18 years and older. Survey data was collected in October and November 2010 as part of the Central Queensland University Social Survey. Strength-based exercise participation, gender, age, income, years of education, self-reported physical activity and perception of health. Participation in strength-based exercise was 13.2%. Women were less likely to partake in strength-based exercise than male, and ≥55 year old adults were less likely to partake in strength-based exercise than 18-34 year old adults. Participation in strength-based exercise was found to increase with years of education, self-reported physical activity and self-rated health. The prevalence of adults in rural and regional Central Queensland engaging in strength-based exercise is low. Exercise physiologists, clinicians and government officials must work together to ensure that this form of exercise is acknowledged as a vital component of health in rural and regional areas. © 2015 National Rural Health Alliance Inc.

ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial.

PubMed

Gschwind, Yves J; Eichberg, Sabine; Ejupi, Andreas; de Rosario, Helios; Kroll, Michael; Marston, Hannah R; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Aal, Konstantin; Vaziri, Daryoush; Woodbury, Ashley; Fink, Dennis; Delbaere, Kim

2015-01-01

Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people's homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors. A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes. The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052). The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function. Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651 International Standard Randomised Controlled Trial Number: ISRCTN15932647.

Physical Activity among Somali Men in Minnesota: Barriers, Facilitators and Recommendations

PubMed Central

Mohamed, Ahmed A.; Hassan, Abdullahi M.; Weis, Jennifer A.; Sia, Irene G.; Wieland, Mark L.

2014-01-01

Immigrants and refugees arrive to the US healthier than the general population, but this advantage declines with increasing duration of residence. One factor contributing to this decline is sub-optimal physical activity, but reasons for this are poorly understood. Persons from Somalia represent the largest African refugee population to the United States, yet little is known about perceptions of physical activity among Somali men. Somali members of a community-based participatory research partnership implemented three age-stratified focus groups and three semi-structured interviews among 20 Somali men in Rochester, MN. Team-based inductive analysis generated themes for barriers and facilitators to physical activity. Barriers to physical activity included less walking opportunities in the US, embarrassment about exercise clothing and lack of familiarity with exercise equipment/modalities, fear of harassment, competing priorities, facility costs, transportation, and winter weather. Facilitators to physical activity included high knowledge about how to be active, success stories from others in their community as inspiration, and community cohesion. Findings may be used to derive interventions aimed to promote physical activity among Somali men in the US. PMID:23697961

Your Community: Government, Laws and Courts, Community Services, Transportation.

ERIC Educational Resources Information Center

Wright, Melinda

Information and accompanying exercises in this learning module are provided to reinforce functional reading skills and, at the same time, introduce Columbia College (CA) students to area community services. The module first describes the components of government at the local, state, and federal levels, and provides exercises to help the student…

Primary prevention of metabolic syndrome in the community using an evidence-based exercise program.

PubMed

Dalleck, Lance C; Van Guilder, Gary P; Quinn, Esther M; Bredle, Don L

2013-10-01

The purpose of the present study was to examine the effectiveness of a community-based exercise program to lower metabolic syndrome (MetS) risk factors. MetS components were retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program between January 2007 and May 2012 at the University of Wisconsin-Eau Claire. Except for total cholesterol, all health outcome variables, including the 5 MetS components, improved following community exercise. Individuals having MetS decreased from 22.3% before participation to 13.5% at end (p<0.05), while prevalence of participants with no MetS components increased 56% (from 65 to 102; p<0.05). Compared to the lowest quartile of relative energy expenditure, participants with the highest quartile were 6.4 (95% CI 1.8-23.2; p<0.05), 7 (95% CI 2.5-20.0; p<0.05) and 9.3 (95% CI 2.6-34.0; p<0.05) times more likely to eliminate low-HDL cholesterol, impaired fasting glucose, and low cardiorespiratory fitness as MetS risk factors, respectively. A community exercise program is an effective method to reduce cardiovascular risk in adults by substantially decreasing the prevalence of MetS and its components. Greater volumes of exercise may increase the likelihood of MetS risk factor elimination. Copyright © 2013 Elsevier Inc. All rights reserved.

Comparison of whole-body vibration exercise and plyometric exercise to improve isokinetic muscular strength, jumping performance and balance of female volleyball players

PubMed Central

Kim, Yong-Youn; Park, Si-Eun

2016-01-01

[Purpose] The purpose of this study was to assess the effect of whole-body vibration exercise and plyometric exercise on female volleyball players. [Subjects and Methods] Subjects were randomly allocated to two exercise groups (whole-body vibration exercise group and plyometric exercise group). The exercise was conducted three times each week for 8 weeks. Isokinetic muscular strength, jumping performance, and balance were measured before starting the exercise and after finishing the 8 weeks of exercise. [Results] Measurements of isokinetic muscular strength revealed that the whole-body vibration exercise group showed significant increase after the exercise. However, the plyometric exercise group had no significant increase in lumbar flexion, extension, and knee flexion. Measurements of vertical jumping revealed that, the whole-body vibration exercise group had no significant increase after the exercise. However, the plyometric exercise group showed significant increase. Measurements of balance revealed that, the whole-body vibration exercise group showed significant increase. However, the plyometric exercise group showed no significant increase. [Conclusion] Although both whole-body vibration and plyometric exercises are effective intervention methods, the two methods have different effects on the improvement of isokinetic muscular strength, jumping performance, and balance of female volleyball players. PMID:27942136

Comparison of whole-body vibration exercise and plyometric exercise to improve isokinetic muscular strength, jumping performance and balance of female volleyball players.

PubMed

Kim, Yong-Youn; Park, Si-Eun

2016-11-01

[Purpose] The purpose of this study was to assess the effect of whole-body vibration exercise and plyometric exercise on female volleyball players. [Subjects and Methods] Subjects were randomly allocated to two exercise groups (whole-body vibration exercise group and plyometric exercise group). The exercise was conducted three times each week for 8 weeks. Isokinetic muscular strength, jumping performance, and balance were measured before starting the exercise and after finishing the 8 weeks of exercise. [Results] Measurements of isokinetic muscular strength revealed that the whole-body vibration exercise group showed significant increase after the exercise. However, the plyometric exercise group had no significant increase in lumbar flexion, extension, and knee flexion. Measurements of vertical jumping revealed that, the whole-body vibration exercise group had no significant increase after the exercise. However, the plyometric exercise group showed significant increase. Measurements of balance revealed that, the whole-body vibration exercise group showed significant increase. However, the plyometric exercise group showed no significant increase. [Conclusion] Although both whole-body vibration and plyometric exercises are effective intervention methods, the two methods have different effects on the improvement of isokinetic muscular strength, jumping performance, and balance of female volleyball players.

Balance disorders in the elderly and the benefit of balance exercise.

PubMed

Prasansuk, Suchitra; Siriyananda, Chana; Nakorn, Apinan Na; Atipas, Suvajana; Chongvisal, Samut

2004-10-01

Symptoms of balance disorders including 'unsteadiness', 'dizziness and vertigo' are common in the elderly and commonly found in general practice in medicine. There are many causes of balance disorders and vary from one person to another. Disorder of the internal ear or vestibular end-organ type is one cause. Unsteadiness of somato-sensory or proprioception is common in the elderly so is degenerative disorder of central control in brain. The elderly are prone to many chronic illnesses or disorders which are causes of balance disorder or give rise to more rapid degeneration of the central nervous system i.e. high blood pressure, diabetes mellitus, heart disease, proprioception and joint problems, arthritis and muscular weakness due to lack of good health and exercise. The objectives of this research study were to find the etiologies of balance disorders and how Balance Exercises and the 'National Health Service' can be of benefit in helping to prevent them. 1565 elderly inhabitants (age > or = 60 years) of 20 communities adjacent to Siriraj Hospital were selected for study. Among these, 625 persons had a history of balance disorders. Among those, 256 had symptoms during the week selected for examination. The average age was 66 years old, women outnumbered men with a ratio of 2.4:1. The common underlying causes were hypertension in 32.4%, diabetes mellitus 13.8%, arthritis 8.1%, and heart disease 4.4% respectively. All are still taking one or more types of drug. The subjects were randomly divided into two groups for the study purpose of effectiveness of balance exercise. Group 1 did not perform the head balance exercise and Group 2 performed the head balance exercise. Audiometric testing showed impaired hearing in 90% of the subjects. The majority slowed hearing loss in high frequencies. Testing of middle ear function found 75% of Group 1 to have normal middle ear function 77% of Group 2. Brainstem Electrical Response Audiometry (BERA) showed normal response latencies of in 96% of group 1 and 94% of Group 2. Poor morphology of waveform was found in 12% of Group 1 and 16% of Group 2. Doppler sonography for intra-cranial blood flow measurement showed abnormal flow of the ICA in 17.6% of group 1 and 20.16% of group 2. Basilar arterial abnormal flow was found in 77.6% of Group 1 and 80.6% of Group 2 respectively. The flow of ICA was improved after 8 weeks in both groups. The measurement of balance by Posturography showed 86.7% abnormality in Group 1 and 83.5% abnormality in Group 2 (and the majority due to inner ear problems but many cases had a mixture of joints and CNS problems too). Results of the self-evaluation (by questionaires) showed the elderly to have symptoms of light headedness in 51% and loss of balance in 29%, Vertigo with rotation occurred in 23.6%. 49% of the symptoms were intermittent, 56.4% experienced a 'fall". On questioning about the benefit and performance of Head and Neck Exercises, 82.8% found the exercises were easy to perform, 56.4% said the results were very beneficial.

Muscle function in aged women in response to a water-based exercises program and progressive resistance training.

PubMed

Bento, Paulo Cesar Barauce; Rodacki, André Luiz Felix

2015-11-01

The purpose of the present study was to determine the effects of a water-based exercise program on muscle function compared with regular high-intensity resistance training. Older women (n = 87) were recruited from the local community. The inclusion criteria were, to be aged 60 years or older, able to walk and able to carry out daily living activities independently. Participants were randomly assigned to one of the following groups: water-based exercises (WBG), resistance training (RTG) or control (CG). The experimental groups carried out 12 weeks of an excise program performed on water or on land. The dynamic strength, the isometric peak, and rate of torque development for the lower limbs were assessed before and after interventions. The water-based program provided a similar improvement in dynamic strength in comparison with resistance training. The isometric peak torque increased around the hip and ankle joints in the water-based group, and around the knee joint in the resistance-training group (P < 0.05). The rate of torque development increased only in the water-based group around the hip extensors muscles (P < 0.05). Water-based programs constitute an attractive alternative to promote relevant strength gains using moderate loads and fast speed movements, which were also effective to improve the capacity to generate fast torques. © 2014 Japan Geriatrics Society.

Leader behaviors, group cohesion, and participation in a walking group program

PubMed Central

Izumi, Betty T.; Schulz, Amy J.; Mentz, Graciela; Israel, Barbara A.; Sand, Sharon L.; Reyes, Angela G.; Hoston, Bernadine; Richardson, Dawn; Gamboa, Cindy; Rowe, Zachary; Diaz, Goya

2015-01-01

Background Fewer than half of all U.S. adults meet the 2008 Physical Activity Guidelines. Leader behaviors and group cohesion have been associated with increased participation or adherence in sports team and exercise class settings. Physical activity interventions in community settings that encompass these factors may enhance intervention adherence. Purpose To examine the impact of Community Health Promoter leader behaviors and group cohesion on participation in a walking group intervention among racially/ethnically diverse adults in low-to-moderate income communities in Detroit, Mich. Design Data for the current study were drawn from the Walk Your Heart to Health (WYHH) data set. WYHH was a multi-site cluster randomized controlled study with a lagged intervention and outcome measurements at baseline, four, eight, and 32 weeks. Pooled survey data from both intervention arms is used for the current study. Data were analyzed between August 2013 and October 2014. Setting/participants A total of 603 non-Hispanic Black, non-Hispanic White, and Hispanic adults across five cohorts that began the 32-week WYHH intervention between March 2009 and October 2011. Intervention A 32-week long walking group program hosted by community- and faith-based organizations and facilitated by Community Health Promoters. Walking groups met three times per week for 90-minutes per session. To promote participation in or adherence to WYHH, Community Health Promoters used evidence-based strategies to facilitate group cohesion. Group members assumed increasing leadership responsibility for facilitating sessions over time. Main outcome measures Participation in WYHH as measured by consistency of attendance. Results Community Health Promoter leader behaviors were positively associated with participation in WYHH. Social but not task cohesion was significantly associated with consistent participation. Social cohesion may mediate the relationship between leader behaviors and walking group participation. Conclusions Providing leaders with training to build socially cohesive groups may help motivate individuals to continue participation in community-based physical activity programs. PMID:26094226

Drinking policies and exercise-associated hyponatraemia: is anyone still promoting overdrinking?

PubMed

Beltrami, F G; Hew-Butler, T; Noakes, T D

2008-10-01

The purpose of this review is to describe the evolution of hydration research and advice on drinking during exercise from published scientific papers, books and non-scientific material (advertisements and magazine contents) and detail how erroneous advice is likely propagated throughout the global sports medicine community. Hydration advice from sports-linked entities, the scientific community, exercise physiology textbooks and non-scientific sources was analysed historically and compared with the most recent scientific evidence. Drinking policies during exercise have changed substantially throughout history. Since the mid-1990s, however, there has been an increase in the promotion of overdrinking by athletes. While the scientific community is slowly moving away from "blanket" hydration advice in which one form of advice fits all and towards more modest, individualised, hydration guidelines in which thirst is recognised as the best physiological indicator of each subject's fluid needs during exercise, marketing departments of the global sports drink industry continue to promote overdrinking.

Psychometric evaluation of the Korean Version of the Self-Efficacy for Exercise Scale for older adults.

PubMed

Choi, Mona; Ahn, Sangwoo; Jung, Dukyoo

2015-01-01

We evaluated the psychometric properties of the Korean version of the Self-Efficacy for Exercise Scale (SEE-K). The SEE-K consists of nine items and was translated into Korean using the forward-backward translation method. We administered it to 212 community-dwelling older adults along with measures of outcome expectation for exercise, quality of life, and physical activity. The validity was determined using confirmatory factor analysis and Rasch analysis with INFIT and OUTFIT statistics, which showed acceptable model fit. The concurrent validity was confirmed according to positive correlations between the SEE-K, outcome expectation for exercise, and quality of life. Furthermore, the high physical activity group had higher SEE-K scores. Finally, the reliability of the SEE-K was deemed acceptable based on Cronbach's alpha, coefficients of determination, and person and item separation indices with reliability. Thus, the SEE-K appears to have satisfactory validity and reliability among older adults in South Korea. Copyright © 2015 Elsevier Inc. All rights reserved.

Consumer preferences in format and type of community-based weight control programs.

PubMed

Sherwood, N E; Morton, N; Jeffery, R W; French, S A; Neumark-Sztainer, D; Falkner, N H

1998-01-01

The purpose of this study was to provide further information about preferences for types and formats (e.g., correspondence vs. face to face) of eating and exercise programs, actual participation rates in a variety of offered programs, and characteristics of program participants vs. nonparticipants. Over a 3-year period, a large sample of community volunteers was given the opportunity to participate in various forms of diet and exercise programs as part of a weight gain prevention study. The study was conducted at a university and three local health department sites. Subjects in the study were 616 individuals participating in the Pound of Prevention study (POP), a 3-year randomized evaluation of an intervention for preventing weight gain. The primary outcomes assessed were participation rates for each program offering. Program participants were also compared to those who did not participate on demographic characteristics, smoking, diet behavior, exercise behavior, and weight concern. Survey results indicated that correspondence formats for delivery of health education programs were rated as more desirable than face-to-face formats. Participation for program offering ranged from 0 to 16% of the study population. Participation data were consistent with survey results and showed participants' preference for correspondence formats even more strongly. Program offering attracted health-conscious participants with higher education and income levels. These data suggest that some community members will get interested and take part in low-cost, minimal contact programs for exercise and weight control. Future research efforts should focus on investigating ways to increase participation in brief or minimal contact programs, particularly among groups that may be difficult to reach and at high risk for the development of obesity.

A one-year proprioceptive exercise programme reduces the incidence of falls in community-dwelling elderly people: A before-after non-randomised intervention study.

PubMed

Pérez-Ros, Pilar; Martinez-Arnau, Francisco M; Malafarina, Vincenzo; Tarazona-Santabalbina, Francisco J

2016-12-01

The risk of falls increases with age. Balance alteration and polypharmacy are independent contributors to an increased risk of falls. The primary aim was to assess whether a proprioceptive exercise programme reduces the incidence of falls. A secondary aim was to assess the association between drugs and falls. This was a before-after non-randomised intervention study. The study recruited independent and cognitively intact community-dwelling people aged over 69 years, from December 2012 to May 2014. The intervention was done by a nurse and consisted of a monthly supervised group session of proprioceptive training for 1 year, supplemented by a home diary exercise. Daily medication was reviewed. We included 572 subjects (63.3% women), mean age 76.1±3.9 years. The mean number of drugs prescribed at the start of the study was 4.7±3.0and 353 of the participants (61.7%) were taking four or more drugs a day. The elderly who fell were more dependent in their activities of daily living (Barthel index), and their balance was worse (determined using the Tinetti scale), as were their results on a cognitive scale (the MEC). After the intervention, an increase in self-perceived quality of life (EQ5D) was reported. The incidence of falls was reduced from 37.5% in the 12 months prior to the intervention to 25.7% in the 12 months after the intervention. During the follow-up, beta-blocker use was associated with an increased incidence of falls (OR=2.05; 95%IC: 1.24-3.39; p=0.005). In contrast, antiplatelet/anticoagulation drugs were associated with a lower risk of falls (OR=0.7; 95%IC: 0.55-0.88; p=0.003). The proprioceptive exercise programme reduced the incidence of falls in community-dwelling older people. Multiple drug use was an independent predictor of an increased risk of falls, and specific drug groups were associated with falls. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT).

PubMed

Bruce, Julie; Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-18

Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver 'active' interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to 'active' intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. ISRCTN 71002650; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study.

PubMed

O'Brien, Kelly K; Bayoumi, Ahmed M; Solomon, Patricia; Tang, Ada; Murzin, Kate; Chan Carusone, Soo; Zobeiry, Mehdi; Nayar, Ayesha; Davis, Aileen M

2016-10-20

Our aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH). We will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0-8 months), participants will be monitored bimonthly. In the intervention phase (8-14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14-22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically. Protocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals. NCT02794415; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

From Food to Fuel: Perceptions of Exercise and Food in a Community of Food Bloggers

ERIC Educational Resources Information Center

Lynch, Meghan

2012-01-01

Objective: An investigation of the discussion surrounding the relationship between food and exercise in one community of photography-based food blogs that past research has identified as exhibiting characteristics of dietary restraint. Design: Forty-five blogs written by young adult women belonging to a food-blogging community were selected for…

Comparison of the effect of different modalities of physical exercise on functionality and anthropometric measurements in community-dwelling older women.

PubMed

Vasconcelos, Ana Paula Sena Lomba; Cardozo, Diogo Correia; Lucchetti, Alessandra Lamas Granero; Lucchetti, Giancarlo

2016-10-01

The present study aims to assess the effect of different modalities of physical exercises ("Functional Gymnastics"-FG, "Resistance Training"-RT and "Pilates combined with Hydrogymnastics"-PCH) on functional capacity and anthropometric measurements of 148 older women (60 years old or more). A comparative observational study was conducted. Functional and anthropometric measurements were assessed at baseline and after 16 weeks. All groups assessed showed significant changes between baseline and post-training. On the comparison of pre and post-training, differences in anthropometric measurements but not in functional test performance were found. The PCH had greater weight loss compared to the FG and RT, reduction in BMI compared to the FG and RT; reduction in waist compared to the FG and RT, and in hip compared to the RT. Although all groups improved, Pilates/Hydrogymnastics combination was more strongly associated with reductions in weight, BMI, waist and hip measurements but not functionality, than other modalities. These results highlight the role of combination physical exercise training in older women. Copyright © 2016 Elsevier Ltd. All rights reserved.

Taiji for individuals with Parkinson disease and their support partners: a program evaluation.

PubMed

Klein, Penelope J; Rivers, Lynn

2006-03-01

Exercise is advocated in the management of Parkinson disease (PD), however, little is known regarding the potential benefits of complementary mind/body exercise for this clinical population. The purpose of this pilot program evaluation was to gain insight into participant and instructor perceptions of the perceived benefits and potential utility of a taiji exercise program. Program participants (N=15) included 8 individuals with PD and 7 support partners with no history of PD. Group taiji instruction was offered in 45-minute weekly sessions, for 12 weeks at a community facility. Post-program evaluation included administration of a survey questionnaire, thematic analysis of a focus group discussion, instructor reflections, and review of attendance records. Benefits were perceived by participants in physical, psychological, and social domains. Thirteen of the survey respondents, including 6 of the 8 respondents with PD reported perceiving a physical benefit attributed to taiji practice. Improved balance was reported most frequently. Instructor observations and participant testimony suggest movement capability for individuals with Parkinsons may also be improved by performing taiji. This preliminary research provides support for further Taiji Buddy program examination and application.

Bending the Arc of Exercise and Recreation Technology Toward People With Disabilities.

PubMed

Rimmer, James H; Lai, Byron; Young, Hui-Ju

2016-09-01

Most of the published research on exercise and disability has focused on short-term efficacy studies targeting specific disability groups. These studies often use grant-related or other financial resources to temporarily remove the many barriers that people with physical/mobility disability experience when attempting to become physically active. In this commentary, we explore how technology can be used to promote more sustainable physical activity outcomes in the home and community using a set of 4 overlapping domains: Access, Usability, Adherence, and Health and Function. In addition, we describe how the order in which these domains should be addressed will vary depending on the needs of the target group and the context of their environment. Finally, we provide examples of various types of technologies (eg, hardware and software) that can support the "afterlife" of successful short-term exercise and rehabilitation trials in people with physical/mobility disability who desire to self-manage their own health and maintain a regular and sustainable pattern of physical activity across their life span. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The role of exercise in fall prevention for older adults.

PubMed

Rose, Debra J; Hernandez, Danielle

2010-11-01

This article reviews the evidence for the effectiveness of stand-alone exercise interventions and multifactorial intervention strategies that include exercise in lowering fall incidence rates and/or fall risk among older adults residing in the community, acute, subacute, and long-term care settings. Stand-alone exercise programs that emphasize multiple exercise categories are effective in reducing fall rates and fall risk in community-residing older adults, and may also be effective when conducted for a sufficient duration with older adult patients in subacute settings. In contrast, multifactorial fall risk reduction programs that include exercise as a component and are delivered by a multidisciplinary team are more effective in lowering fall rates in long-term care settings. Copyright © 2010 Elsevier Inc. All rights reserved.

A Field and Classroom Exercise for Measuring the Species Diversity of Freshwater Plankton Communities.

ERIC Educational Resources Information Center

Kirby, John M.; Reinking, Larry N.

1994-01-01

Utilizing the vast diversity of planktonic communities that exist in local, temperate ponds and lakes, the authors describe a simple exercise that gives students both a field and classroom experience in biodiversity. (ZWH)

Combining Motivational and Physical Intervention Components to Promote Fall-Reducing Physical Activity Among Community-Dwelling Older Adults: A Feasibility Study.

PubMed

McMahon, Siobhan Kathleen; Wyman, Jean F; Belyea, Michael J; Shearer, Nelma; Hekler, Eric B; Fleury, Julie

2016-11-01

To assess the feasibility of a new intervention, Ready~Steady, in terms of demand, acceptability, implementation, and limited efficacy. Randomized controlled trial; repeated measures. Two rural communities in Itasca County, Minnesota. Thirty participants were randomized to an intervention (n = 16) or attention-control (n = 14) group. Ready~Steady combined two components: (1) motivational (motivational support, social network support, empowering education), and (2) fall-reducing physical activities (PAs; guidance to practice leg-strengthening, balance, and flexibility activities and walking). Acceptability questionnaire and Indices of Procedural Consistency (investigator developed), Community Health Activity Model Program for Seniors Questionnaire (confirmed with accelerometry), Short Physical Performance Battery, Perceived Environmental Support Scale, Social Support for Exercise Questionnaire, Goal Attainment Scale, Index of Readiness, and Index of Self-Regulation. Descriptive statistics and a marginal approach to repeated-measures analysis of variance, using mixed-model procedures. Attrition was 7% and mean attendance was 7.2 of 8 sessions, participants evaluated Ready~Steady as acceptable, and implementation fidelity was good. The intervention group improved significantly more than the attention-control group in PA behavior, F 1,27 = 11.92, p = .002; fall risk (functional balance and strength), F 1,27 = 14.89, p = .001; support for exercise from friends, F 1,27 = 11.44, p = .002; and self-regulation, F 1,26 = 38.82, p < .005. The Ready~Steady intervention was feasible as evidenced by low attrition and good attendance and implementation, as well as positive effects on targeted outcomes and theoretical mechanisms of change. © 2016 by American Journal of Health Promotion, Inc.

Effects of Carbohydrate and Glutamine Supplementation on Oral Mucosa Immunity after Strenuous Exercise at High Altitude: A Double-Blind Randomized Trial.

PubMed

Caris, Aline Venticinque; Da Silva, Edgar Tavares; Dos Santos, Samile Amorim; Tufik, Sergio; Dos Santos, Ronaldo Vagner Thomatieli

2017-07-03

This study analyzed the effects of carbohydrate and glutamine supplementation on salivary immunity after exercise at a simulated altitude of 4500 m. Fifteen volunteers performed exercise of 70% of VO 2peak until exhaustion and were divided into three groups: hypoxia placebo, hypoxia 8% maltodextrin (200 mL/20 min), and hypoxia after six days glutamine (20 g/day) and 8% maltodextrin (200 mL/20 min). All procedures were randomized and double-blind. Saliva was collected at rest (basal), before exercise (pre-exercise), immediately after exercise (post-exercise), and two hours after exercise. Analysis of Variance (ANOVA) for repeated measures and Tukey post hoc test were performed. Statistical significance was set at p < 0.05. SaO₂% reduced when comparing baseline vs. pre-exercise, post-exercise, and after recovery for all three groups. There was also a reduction of SaO₂% in pre-exercise vs. post-exercise for the hypoxia group and an increase was observed in pre-exercise vs. recovery for both supplementation groups, and between post-exercise and for the three groups studied. There was an increase of salivary flow in post-exercise vs. recovery in Hypoxia + Carbohydrate group. Immunoglobulin A (IgA) decreased from baseline vs. post-exercise for Hypoxia + Glutamine group. Interleukin 10 (IL-10) increased from post-exercise vs. after recovery in Hypoxia + Carbohydrate group. Reduction of tumor necrosis factor alpha (TNF-α) was observed from baseline vs. post-exercise and after recovery for the Hypoxia + Carbohydrate group; a lower concentration was observed in pre-exercise vs. post-exercise and recovery. TNF-α had a reduction from baseline vs. post-exercise for both supplementation groups, and a lower secretion between baseline vs. recovery, and pre-exercise vs. post-exercise for Hypoxia + Carbohydrate group. Five hours of hypoxia and exercise did not change IgA. Carbohydrates, with greater efficiency than glutamine, induced anti-inflammatory responses.

Effects of Carbohydrate and Glutamine Supplementation on Oral Mucosa Immunity after Strenuous Exercise at High Altitude: A Double-Blind Randomized Trial

PubMed Central

Caris, Aline Venticinque; Da Silva, Edgar Tavares; Dos Santos, Samile Amorim; Tufik, Sergio

2017-01-01

This study analyzed the effects of carbohydrate and glutamine supplementation on salivary immunity after exercise at a simulated altitude of 4500 m. Fifteen volunteers performed exercise of 70% of VO2peak until exhaustion and were divided into three groups: hypoxia placebo, hypoxia 8% maltodextrin (200 mL/20 min), and hypoxia after six days glutamine (20 g/day) and 8% maltodextrin (200 mL/20 min). All procedures were randomized and double-blind. Saliva was collected at rest (basal), before exercise (pre-exercise), immediately after exercise (post-exercise), and two hours after exercise. Analysis of Variance (ANOVA) for repeated measures and Tukey post hoc test were performed. Statistical significance was set at p < 0.05. SaO2% reduced when comparing baseline vs. pre-exercise, post-exercise, and after recovery for all three groups. There was also a reduction of SaO2% in pre-exercise vs. post-exercise for the hypoxia group and an increase was observed in pre-exercise vs. recovery for both supplementation groups, and between post-exercise and for the three groups studied. There was an increase of salivary flow in post-exercise vs. recovery in Hypoxia + Carbohydrate group. Immunoglobulin A (IgA) decreased from baseline vs. post-exercise for Hypoxia + Glutamine group. Interleukin 10 (IL-10) increased from post-exercise vs. after recovery in Hypoxia + Carbohydrate group. Reduction of tumor necrosis factor alpha (TNF-α) was observed from baseline vs. post-exercise and after recovery for the Hypoxia + Carbohydrate group; a lower concentration was observed in pre-exercise vs. post-exercise and recovery. TNF-α had a reduction from baseline vs. post-exercise for both supplementation groups, and a lower secretion between baseline vs. recovery, and pre-exercise vs. post-exercise for Hypoxia + Carbohydrate group. Five hours of hypoxia and exercise did not change IgA. Carbohydrates, with greater efficiency than glutamine, induced anti-inflammatory responses. PMID:28671626

Differential Effects of Tango Versus Dance for PD in Parkinson Disease

PubMed Central

McNeely, Marie E.; Mai, Marina M.; Duncan, Ryan P.; Earhart, Gammon M.

2015-01-01

Over half of the general population does not achieve recommended daily levels of physical activity, and activity levels in people with Parkinson disease (PD) are lower than in healthy older adults. Dance can serve as an adjunct to traditional treatments to improve gait, balance, and quality of life in people with PD. This study directly compares a tango dance intervention and a dance intervention based on the Dance for PD model, which integrates multiple dance styles. Eleven people with PD participated in a community-based mixed styles dance intervention called Dance for Parkinson’s (D4PD). Participants in the D4PD group were matched to participants in an ongoing community-based exercise study who participated in tango dance. The groups received 12 weeks of intervention, attending 1-h group classes twice a week. Participants were evaluated off anti-PD medication before and after intervention. Measures of balance, repeated sit-to-stand performance and endurance (mini-balance evaluation systems test, four square step test, five times sit to stand, 6-min walk time) improved from pre to post similarly in both groups. Motor sign severity (movement disorders society unified Parkinson disease rating scale motor subsection) and functional mobility (timed up and go) improved in the tango group and worsened in the D4PD group. Gait velocity was not affected by either intervention. Direct comparisons of different interventions are ­critical for developing optimal exercise interventions designed to specifically target motor impairments in PD. Tango dance interventions may preferentially improve mobility and motor signs in people with PD, compared to D4PD. PMID:26733865

Managing mobility outcomes in vulnerable seniors ( MMOVeS): a randomized controlled pilot study.

PubMed

Figueiredo, Sabrina; Morais, Jose A; Mayo, Nancy

2017-12-01

To estimate feasibility and potential for efficacy of an individualized, exercise-focused, self-management program (i.e. Managing Mobility Outcomes In Vulnerable Seniors ( MMOVeS)), in comparison to exercise information in improving mobility after six months among seniors recently discharged from hospital. Randomized pilot study. Two McGill University-teaching hospitals. Community dwelling seniors, aged 70 years and older, recently discharged from either participating hospitals. The physiotherapy-facilitated intervention consisted of (1) evaluation of mobility capacity, (2) setting short- and long-term goals, (3) delineation of an exercise treatment plan, (4) an educational booklet to enhance mobility self-management skills, and (5) six monthly telephone calls. Control group received a booklet with information on exercises targeting mobility limitations in seniors. Mobility, pain, and health status were assessed at baseline and at six months using multiple indicators drawn from Disabilities of the Arm, Shoulder, and Hand (DASH) Score, Lower Extremity Functional Scale (LEFS) and Short-Form (SF)-36. In all, 26 people were randomized to the intervention (mean age: 81 ± 8; 39% women), and 23 were randomized to the control (mean age: 79 ± 7; 33% women). The odds ratio for the mobility outcomes combined was 3.08 and the 95% confidence interval excluded 1 (1.65-5.77). The odds ratio for pain and health perception favored the MMOVeS group, but the 95% confidence interval included the null value. This feasibility study highlights the potential for efficacy of an individualized, exercise-focused, self-management program in comparison to exercise information in improving mobility outcome for seniors. Furthermore, a home-program combining self-management skills and exercise taught with minimal supervision prove to be feasible. Finally, data from this study can be used to estimate sample size for a confirmatory trial.

The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial.

PubMed

Voukelatos, Alexander; Merom, Dafna; Sherrington, Catherine; Rissel, Chris; Cumming, Robert G; Lord, Stephen R

2015-05-01

walking is the most popular form of exercise in older people but the impact of walking on falls is unclear. This study investigated the impact of a 48-week walking programme on falls in older people. three hundred and eighty-six physically inactive people aged 65+ years living in the community were randomised into an intervention or control group. The intervention group received a self-paced, 48-week walking programme that involved three mailed printed manuals and telephone coaching. Coinciding with the walking programme manual control group participants received health information unrelated to falls. Monthly falls calendars were used to monitor falls (primary outcome) over 48 weeks. Secondary outcomes were self-reported quality of life, falls efficacy, exercise and walking levels. Mobility, leg strength and choice stepping reaction time were measured in a sub-sample (n = 178) of participants. there was no difference in fall rates between the intervention and control groups in the follow-up period (IRR = 0.88, 95% CI: 0.60-1.29). By the end of the study, intervention group participants spent significantly more time exercising in general, and specifically walking for exercise (median 1.69 versus 0.75 h/week, P < 0.001). our finding that a walking programme is ineffective in preventing falls supports previous research and questions the suitability of recommending walking as a fall prevention strategy for older people. Walking, however, increases physical activity levels in previously inactive older people. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Lower limb power rehabilitation (LLPR) using interactive video game for improvement of balance function in older people.

PubMed

Chen, Po-Yin; Wei, Shun-Hwa; Hsieh, Wan-Ling; Cheen, Jang-Rong; Chen, Liang-Kung; Kao, Chung-Lan

2012-01-01

Declined balance functions have adverse effects on elderly population. Lower limbs muscle power training is currently an emerging concept in rehabilitation on individuals with decreased balance and mobility. In this prospective, controlled study, we used a human-computer interactive video-game-based rehabilitation device (LLPR) for training of lower limb muscle power in the elderly. Forty (aged >65 years) individuals were recruited from the community. Twenty participants in the exercise group received 30-min training, twice a week, using the LLPR system. The LLPR system allows participants to perform fast speed sit-to-stand (STS) movements. Twenty age-matched participants in the control group performed slow speed STS movements, as well as strengthening and balance exercises, with the same frequency and duration. The results were compared after 12 sessions (6 weeks) of training. The mechanical and time parameters during STS movement were measured using the LLPR system. Modified falls efficacy scale (MFES), Tinetti Performance-Oriented Mobility Assessment (POMA), function reach test, five times sit to stand (FTSS) and Timed Up and Go (TUG) were administered to participants as clinical assessments. Results showed that in the exercise group, all the mechanical and time parameters showed significant improvement. In control group, only the maximal vertical ground reaction force (MVGRF) improved significantly. For clinical assessments (balance, mobility, and self-confidence), exercise group showed significantly better scores. The STS movements in video-game-based training mimic real life situations which may help to transfer the training effects into daily activities. The effectiveness of lower limb muscle training is worthy of further investigation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Motivational characteristics and resistance training in older adults: a randomized controlled trial and 1-year follow-up.

PubMed

Kekäläinen, Tiia; Kokko, Katja; Tammelin, Tuija; Sipilä, Sarianna; Walker, Simon

2018-06-07

The aim of this study was to investigate the effects of a nine-month supervised resistance training intervention on motivational and volitional characteristics related to exercise, and whether the absolute level and/or intervention-induced change in these characteristics predict self-directed continuation of resistance training one year after the intervention. Community-dwelling older adults aged 65-75, who did not fulfill physical activity recommendations, were randomized into resistance training intervention groups: training once- (n=26), twice- (n=27), three-times-a-week (n=28) or non-training control group (n=25). Training groups participated in supervised resistance training for nine months: during months 1-3 all groups trained twice-a-week and then with allocated frequencies during months 4-9. Exercise-related motivation, self-efficacy and planning were measured with questionnaires at baseline, month-3 and month-9. The continuance of resistance training was determined by interviews six and twelve months after the end of the intervention. The intervention improved action and coping planning as well as intrinsic motivation (group×time p<.05). During one-year follow-up, 54% of participants did not continue self-directed regular resistance training, 22% continued regular resistance training once-a-week and 24% twice-a-week. Increases in exercise self-efficacy and intrinsic motivation related to training during the intervention predicted continuation of resistance training twice-a-week. Resistance training improved exercise-related motivational and volitional characteristics in older adults. These improvements were linked to continuing resistance training one year after the supervised intervention. The role of these characteristics should be taken into account when promoting long-term resistance training participation among older adults. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach.

PubMed

Saligheh, Maryam; McNamara, Beverley; Rooney, Rosanna

2016-06-02

Postpartum women's recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA. This study sought to explore women's beliefs about and experiences of PA and exercise during the 6 weeks to 12 months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation agreed to take part in interview sessions to provide an in-depth understanding of the women's perceptions of the postpartum period and their physical activity during this time. Findings are presented with reference to the social ecological framework and indicate postpartum women face substantial personal and environmental barriers to PA and exercise participation: fatigue, a lack of motivation and confidence, substantial time constraints, lack of access to affordable and appropriate activities and poor access to public transport. In contrast, enablers such as possessing greater social support, in particular partner support, improved PA and exercise participation. The findings encourage facilitation of exercise through mothers' groups, mothers' exercise clubs or postnatal classes suggesting behavioral and social change is needed. Interaction between individuals, community, organizations and policy makers is required. In addition, the provision of specifically tailored and appropriate exercise programs could potentially enable increased PA in postpartum women, thereby improving their health.

[A study of factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas].

PubMed

Takai, Itsushi

2012-01-01

It is important to promote self-efficacy for exercise for developing exercise habit. The purpose of this study was to investigate factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas. The subjects were 69 elderly men (mean age of 74.2±2.0 SD) who had given approval for participation in the study. We examined the following factors: family situation, history of falls, frequency of going out, stage model of a change, self-efficacy for exercise, fall efficacy scale (FES), geriatric depression scale (GDS), subjective health, functional ability and motor function (5 m walking time, chair stand test-5times). Analysis of variance was used to assess a stage model of a change differences in self-efficacy for exercise and other measures. Correlation analysis and multiple regression analysis were performed to determine the relationships between self-efficacy for exercise and other measures. We found that self-efficacy of exercise, FES, GDS (p<0.01) and CST (p<0.05) vary depending on the stage model of change. Self-efficacy for exercise was found to correlate with psychological factors and functional ability (|r|=0.47-0.67). Multiple regression analysis revealed that the independent factors related to self-efficacy for exercise were FES and GDS. FES and GDS were found to be significant and independent predictors of self-efficacy for exercise in community-dwelling elderly men in urban areas. We should consider not only the approach based on behavioral science but also mental support for depression and fear of falling to promote exercise self-efficacy.

Effects of a Social Welfare Program for Health Promotion on Cardiovascular Risk Factors.

PubMed

Choi, Seong-Jin; Chang, Jae Seung; Kong, In Deok

2015-09-01

Socioeconomic status is closely associated with an individual's health status. However, there are few studies examining the role of exercise-training as part of a community-based social welfare program in socially vulnerable groups. Given this, our aim was to measure whether long-term exercise training as a social welfare program affects the prevalence of depressive symptoms, metabolic syndrome and peripheral blood vessel condition among participants with low household income. Twenty-nine adults and twenty-two older adults were recruited into this study with non-radomized, pre/post-test design. The subjects underwent a combined training consisting of aerobic and muscle strengthening exercises for 6 months or more. Depressive symptoms were evaluated using the Beck Depression Inventory and the Korean version of Geriatric Depression Scale. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Blood vessel condition was assessed using non-invasive accelerated photoplethysmograph. Mean skeletal muscle mass increased after exercise-training, but body mass index and percent body fat were unchanged. Overall age-specific physical fitness and performance increased markedly among both adult and elderly subjects, respectively. The proportion of depressive symptoms was significantly reduced by 33% after exercise-training among all participants. The prevalence of individuals having metabolic syndrome was significantly reduced by 19.6% and the number of individual components of metabolic syndrome decreased after the exercise intervention. Among components of metabolic syndrome, waist circumference, HDL cholesterol and systolic blood pressure significantly improved. In addition, the proportions of moderate and severe arteriosclerotic progression significantly decreased. Long-term exercise-training as a social welfare program is beneficial for health promotion and effective in simultaneously improving psychological and physiological health status in a low income population. This suggests that the development and expansion of an exercise intervention as a health-promoting welfare program are needed to address the inequality of exercise participation among socially vulnerable groups.

Exercise for reducing fear of falling in older people living in the community.

PubMed

Kendrick, Denise; Kumar, Arun; Carpenter, Hannah; Zijlstra, G A Rixt; Skelton, Dawn A; Cook, Juliette R; Stevens, Zoe; Belcher, Carolyn M; Haworth, Deborah; Gawler, Sheena J; Gage, Heather; Masud, Tahir; Bowling, Ann; Pearl, Mirilee; Morris, Richard W; Iliffe, Steve; Delbaere, Kim

2014-11-28

Fear of falling is common in older people and associated with serious physical and psychosocial consequences. Exercise (planned, structured, repetitive and purposive physical activity aimed at improving physical fitness) may reduce fear of falling by improving strength, gait, balance and mood, and reducing the occurrence of falls. To assess the effects (benefits, harms and costs) of exercise interventions for reducing fear of falling in older people living in the community. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (July 2013), the Central Register of Controlled Trials (CENTRAL 2013, Issue 7), MEDLINE (1946 to July Week 3 2013), EMBASE (1980 to 2013 Week 30), CINAHL (1982 to July 2013), PsycINFO (1967 to August 2013), AMED (1985 to August 2013), the World Health Organization International Clinical Trials Registry Platform (accessed 7 August 2013) and Current Controlled Trials (accessed 7 August 2013). We applied no language restrictions. We handsearched reference lists and consulted experts. We included randomised and quasi-randomised trials that recruited community-dwelling people (where the majority were aged 65 and over) and were not restricted to specific medical conditions (e.g. stroke, hip fracture). We included trials that evaluated exercise interventions compared with no intervention or a non-exercise intervention (e.g. social visits), and that measured fear of falling. Exercise interventions were varied; for example, they could be 'prescriptions' or recommendations, group-based or individual, supervised or unsupervised. Pairs of review authors independently assessed studies for inclusion, assessed the risk of bias in the studies and extracted data. We combined effect sizes across studies using the fixed-effect model, with the random-effect model used where significant statistical heterogeneity was present. We estimated risk ratios (RR) for dichotomous outcomes and incidence rate ratios (IRR) for rate outcomes. We estimated mean differences (MD) where studies used the same continuous measures and standardised mean differences (SMD) where different measures or different formats of the same measure were used. Where possible, we performed various, usually prespecified, sensitivity and subgroup analyses. We included 30 studies, which evaluated 3D exercise (Tai Chi and yoga), balance training or strength and resistance training. Two of these were cluster-randomised trials, two were cross-over trials and one was quasi-randomised. The studies included a total of 2878 participants with a mean age ranging from 68 to 85 years. Most studies included more women than men, with four studies recruiting women only. Twelve studies recruited participants at increased risk of falls; three of these recruited participants who also had fear of falling.Poor reporting of the allocation methods in the trials made it difficult to assess the risk of selection bias in most studies. All of the studies were at high risk of performance and detection biases as there was no blinding of participants and outcome assessors and the outcomes were self reported. Twelve studies were at high risk of attrition bias. Using GRADE criteria, we judged the quality of evidence to be 'low' for fear of falling immediately post intervention and 'very low' for fear of falling at short or long-term follow-up and all other outcomes.Exercise interventions were associated with a small to moderate reduction in fear of falling immediately post intervention (SMD 0.37 favouring exercise, 95% confidence interval (CI) 0.18 to 0.56; 24 studies; 1692 participants, low quality evidence). Pooled effect sizes did not differ significantly between the different scales used to measure fear of falling. Although none of the sensitivity analyses changed the direction of effect, the greatest reduction in the size of the effect was on removal of an extreme outlier study with 73 participants (SMD 0.24 favouring exercise, 95% CI 0.12 to 0.36). None of our subgroup analyses provided robust evidence of differences in effect in terms of either the study primary aim (reduction of fear of falling or other aim), the study population (recruitment on the basis of increased falls risk or not), the characteristics of the study exercise intervention or the study control intervention (no treatment or alternative intervention). However, there was some weak evidence of a smaller effect, which included no reduction, of exercise when compared with an alternative control.There was very low quality evidence that exercise interventions may be associated with a small reduction in fear of falling up to six months post intervention (SMD 0.17, 95% CI -0.05 to 0.38; four studies, 356 participants) and more than six months post intervention (SMD 0.20, 95% CI -0.01 to 0.41; three studies, 386 participants).Very low quality evidence suggests exercise interventions in these studies that also reported on fear of falling reduced the risk of falling measured either as participants incurring at least one fall during follow-up or the number of falls during follow-up. Very low quality evidence from four studies indicated that exercise interventions did not appear to reduce symptoms of depression or increase physical activity. The only study reporting the effects of exercise interventions on anxiety found no difference between groups. No studies reported the effects of exercise interventions on activity avoidance or costs. It is important to remember that our included studies do not represent the totality of the evidence of the effect of exercise interventions on falls, depression, anxiety or physical activity as our review only includes studies that reported fear of falling. Exercise interventions in community-dwelling older people probably reduce fear of falling to a limited extent immediately after the intervention, without increasing the risk or frequency of falls. There is insufficient evidence to determine whether exercise interventions reduce fear of falling beyond the end of the intervention or their effect on other outcomes. Although further evidence from well-designed randomised trials is required, priority should be given to establishing a core set of outcomes that includes fear of falling for all trials examining the effects of exercise interventions in older people living in the community.

[Effects of shadow boxing training on exercise endurance and quality of life of patients with chronic obstructive pulmonary disease].

PubMed

Gu, Gang; Zhou, Yu-min; Wang, Da-li; Chen, Lian; Zhong, Nan-shan; Ran, Pi-xin

2012-04-10

To evaluate the effects of shadow boxing training on the exercise endurance and quality of life of Chinese patients with COPD (chronic obstructive pulmonary disease). From May 2010 to March 2011, a total of 70 COPD patients in stable phases were recruited from Liwan, Yuexiu and Haizhu districts of Guangzhou. There were 35 patients in the shadow boxing exercise group and 35 patients in the control group. And they were matched by gender and age. The patients in the shadow boxing group exercised for 3 months while those in the control group received the conventional out-hospital management only. Their demographic, medical history, smoking status, medicinal use, spirometric data, clinical COPD questionnaire (CCQ) scores, 6-minute walking distance and Borg scores were collected before and after trial. A total of 63 COPD patients (33 in shadow boxing group vs. 30 in control group) completed the study. There was an average dropout rate of 5.7% (2/35) in shadow boxing group and 14.3% (5/35) in control group. No differences existed between two groups in age (67 ± 8 vs 69 ± 9 yr), male proportion (84.8% vs 86.7%), body mass index (22.8 ± 2.6 vs 22.7 ± 3.0), usage proportion of medicine (42.4% vs 33.3%), duration of disease (4.0 ± 7.5 vs 5.5 ± 7.3), percentage of smokers (78.8% vs 80.0%), 6-minute walking distance (447 ± 94 vs 414 ± 100), CCQ total score (15.0 ± 9.4 vs 14.1 ± 8.8), CCQ symptom score (9.2 ± 5.6 vs 8.3 ± 5.0) and activity score (5.8 ± 4.5 vs 5.8 ± 4.4) at baseline (all P > 0.05). At the end of study, the 6-minute walking distance of patients had statistical differences between two groups (P < 0.01). The shadow boxing group increased by (51 ± 55) m while the control dropped by (19 ± 58) m. The total score, symptom score and activity score of clinical COPD questionnaire had statistical differences between two groups. They decreased significantly in the shadow boxing group as compared with the baseline data while there was no significant change in the control group. No statistical differences existed between two groups in the changes of forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), FEV(1)% pred, Borg score and dyspnea scales. Capable of improving the exercise endurance and life quality of COPD patients, shadow boxing exercise may become one of effective rehabilitation programs for COPD patients in stable phases in communities.

Effect of a dual-task net-step exercise on cognitive and gait function in older adults.

PubMed

Kitazawa, Kazutoshi; Showa, Satoko; Hiraoka, Akira; Fushiki, Yasuhiro; Sakauchi, Humio; Mori, Mitsuru

2015-01-01

Participation in generally recommended aerobics or strength exercises may be challenging for older adults. Therefore, it is necessary to consider the types and levels of physical activities suited for them to improve their cognitive and gait function and adherence to exercise programs. This has prompted efforts to identify exercises that require less physical strength and frequency of performance, while still offering cognitive and health benefits. Here, we aimed to assess the effect of a novel dual-task net-step exercise (NSE) performed once a week for 8 consecutive weeks on improvements in cognitive performance and gait function in an older population. In this pretest/posttest experimental case control study, 60 healthy older adults (mean age 76.4 years) were recruited from community-dwelling people and separated randomly into 2 groups: a dual-task NSE group and a control group. The NSE group was asked to walk across a net without stepping on the ropes or being caught in the net. Two computer panel-type cognitive functional assessments, the Touch-M and Touch Panel-Type Dementia Assessment Scale, were administered at baseline and after 8 weeks of intervention to determine the effects of NSE. Improvements in gait function were also evaluated using Timed Up and Go test scores. Mixed-effect models with repeated measures (group × time) (analysis of variance, F test) were used to test the effects of NSE. Adjustments were made for covariates including age and sex (analysis of covariance). The NSE group showed significant improvement in cognitive performance (6.8% change; total Touch-M score 5.4 points; P = .04) and gait performance (11.5% change; Timed Up and Go time -0.98 second; P < .001) over the 8-week period. In the control group, there was no significant improvement. This study shows that dual-task NSE is capable of improving cognitive and gait performance in healthy older adults. Our results indicate that NSE offers an option for a large segment of the older population who need an easier way to maintain their cognitive health and gait function.

The effectiveness of physical exercise training in pain, mobility, and psychological well-being of older persons living in nursing homes.

PubMed

Tse, Mimi M Y; Tang, Shuk Kwan; Wan, Vanessa T C; Vong, Sinfia K S

2014-12-01

Pain is common in the aging population, particularly among older residents of nursing homes. It has been found that 50% of older people living in the community have been experiencing chronic pain, and the number increased to 80% for older residents of nursing homes. Exercise is an effective non-pharmacological intervention that can reduce pain and improve physical and psychological functions. A quasi-experimental study with a pretest-posttest control group designed was conducted to evaluate the effects of a physical exercise program (PEP) on older residents of nursing homes who have chronic pain. Three-hundred-ninety-six older residents with chronic pain were recruited from 10 nursing homes run by non-governmental organizations in Hong Kong. The average age of the older residents was 85.44 ± 6.29. Five nursing homes were randomized to the experimental group with PEP (n = 225, age = 85.45 ± 6.25); the other five nursing homes were randomized to the control group without the PEP (n = 171, age = 85.44 ± 6.35). PEP was an eight-week training program given by a physiotherapist and nurses once a week. It consisted of warm-up exercises, muscle strengthening, stretching, balancing, and self-administered massage to acupressure points. At the end of each PEP session, pamphlets with pictures illustrating the "exercise of the day" were given to the older residents of nursing homes as a tool to enhance their self-management skills. The control group received no training during the eight weeks. Upon completion of the PEP, the experimental group experienced a significantly greater reduction in pain intensity from 4.19 ± 2.25 (on an 11 point scale) to 2.67 ± 2.08, as compared to the control group (p < .05). In addition, the psychological well-being (happiness, loneliness, life satisfaction, and depression) of the experimental group was significantly improved (p < .05). Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Effectiveness of Senior Dance on risk factors for falls in older adults (DanSE): a study protocol for a randomised controlled trial.

PubMed

Franco, Marcia R; Sherrington, Catherine; Tiedemann, Anne; Pereira, Leani S; Perracini, Monica R; Faria, Claudia R S; Pinto, Rafael Z; Pastre, Carlos M

2016-12-30

Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences. NCT02603523, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Basic Psychological Needs in Exercise Scale: Measurement Invariance over Gender

ERIC Educational Resources Information Center

Vlachopoulos, Symeon P.

2008-01-01

This study examined the extent of measurement invariance of the Basic Psychological Needs in Exercise Scale responses (BPNES; Vlachopoulos & Michailidou, 2006) across male (n = 716) and female (n = 1,147) exercise participants. BPNES responses from exercise participants attending private fitness centers (n = 1,012) and community exercise programs…

Effects of the weight management program based self-efficacy for body composition, blood lipid profile, weight self-efficacy lifestyles, depression in middle-aged obese women.

PubMed

Park, Nam Hee; An, Hye Gyung

2006-12-01

This study was done to determine the effects of weight management program using self-efficacy in middle-aged obese women. The study also attempted to measure the effects of the program on the weight efficacy lifestyle, body composition, and depression. The research design of this study was a nonequivalent control group pretest-posttest design. The experimental group consisted of 21 middle-aged obese women and another 21 middle-aged obese women in the control group. The women in the experimental group participated in the weight management program for 12 weeks using self-efficacy. The weight management program using self-efficacy included education on effects of exercise for weight control, aerobic exercise program, muscle training and counseling through the telephone. After 12 weeks of participation in the program, BMI (p<.0001), body fat % (p<.0001), abdominal fat (p<.0001), in the experimental group were significantly decreased compared to the control group. Weight self-efficacy lifestyle (p<.0001) and depression (p=.006) in the experimental group were significantly improved after the program compared to the control group. According to these findings, weight management program self-efficacy for middle-aged obese women could increase weight efficacy lifestyle, and decrease depression, BMI, body fat, and abdominal fat. The result also suggested that the increasing weight efficacy and lifestyle help the obese women to perform and continue exercise. This program could be used in the community such as public health center for weight care and mental health promotion of middle-aged obese women.

The effectiveness of isometric exercises as compared to general exercises in the management of chronic non-specific neck pain.

PubMed

Khan, Muhammad; Soomro, Rabail Rani; Ali, Syed Shahzad

2014-09-01

To evaluate the effectiveness of isometric exercises as compared to general exercises in chronic non-specific neck pain. For this randomised controlled trial total 68 patients (34 each group) with chronic non-specific neck pain were recruited from Alain Poly Clinic and Institute of Physical Medicine & Rehabilitation Dow University of Health Sciences, Karachi between May, 2012 and August, 2012. Simple randomisation method was used to assign participants into isometric exercise group and general exercise groups. The isometric exercise group performed exercises for neck muscle groups with a rubber band and general exercises group performed active range of movement exercises for all neck movements. Patients in both groups received 3 supervised treatment sessions per week for 12 weeks. Visual Analogue Scale (VAS), North wick Park Neck Pain Questionnaire and goniometer were used to assess pain, disability and neck range of movements at baseline and after 12 weeks. Both interventions showed statistically significant improvements in pain, function and range of movement p = 0.001f or isometric exercise group, p = 0.04 for general exercises group and p = 0.001 for range of movement. However, mean improvements in post intervention VAS score and North wick Park Neck Pain Questionnaire score was better in isometric exercises group as compared to general exercise group. In conclusion, both interventions are effective in the treatment of chronic non-specific neck pain however; isometric exercises are clinically more effective than general exercises.

Research to Encourage Exercise for Fibromyalgia (REEF): Use of Motivational Interviewing Design and Method

PubMed Central

Ang, Dennis C.; Kaleth, Anthony S.; Bigatti, Silvia; Mazzuca, Steve; Saha, Chandan; Hilligoss, Janna; Lengerich, Mimi; Bandy, Robert

2010-01-01

Fibromyalgia (FM), defined as the presence of both chronic widespread pain and the finding of 11/18 tender points on examination, is an illness associated with major personal and societal burden. Supervised aerobic exercise is an important treatment modality to improve patient symptoms. Unfortunately, adherence to an exercise regimen after a structured supervised program is disappointingly low. Since FM is a chronic illness, studies are needed to test strategies that would enhance exercise adherence in these individuals. Individuals who are able to adhere to exercise almost always maintain the symptomatic benefits of exercise. The objective of this paper was to describe the protocol of the Research to Encourage Exercise for Fibromyalgia (REEF). REEF is a randomized attention-controlled trial that seeks to test the efficacy of 6 sessions of telephone delivered motivational interviewing (MI) that targets exercise adherence to improve FM-relevant clinical outcomes (i.e., physical function and pain severity). The trial has recently completed enrolling 216 subjects, and randomization has resulted in well balanced groups. Details on the study design, MI program, and treatment fidelity are provided in the paper. Outcome assessments at week 12, week 24 and week 36 will test the immediate, intermediate and long term effects of exercise-based MI on adherence (as measured by the Community Health Activities Model Program for Seniors/CHAMPS and accelerometer) and clinical outcomes. When completed, REEF will determine whether exercise-based MI could be utilized as a management strategy to sustain the clinical benefits of exercise for FM. PMID:20828634

Research to Encourage Exercise for Fibromyalgia (REEF): use of motivational interviewing design and method.

PubMed

Ang, Dennis C; Kaleth, Anthony S; Bigatti, Silvia; Mazzuca, Steve; Saha, Chandan; Hilligoss, Janna; Lengerich, Mimi; Bandy, Robert

2011-01-01

Fibromyalgia (FM), defined as the presence of both chronic widespread pain and the finding of 11/18 tender points on examination, is an illness associated with major personal and societal burden. Supervised aerobic exercise is an important treatment modality to improve patient symptoms. Unfortunately, adherence to an exercise regimen after a structured supervised program is disappointingly low. Since FM is a chronic illness, studies are needed to test strategies that would enhance exercise adherence in these individuals. Individuals who are able to adhere to exercise almost always maintain the symptomatic benefits of exercise. The objective of this paper was to describe the protocol of the Research to Encourage Exercise for Fibromyalgia (REEF). REEF is a randomized attention-controlled trial that seeks to test the efficacy of 6 sessions of telephone delivered motivational interviewing (MI) that targets exercise adherence to improve FM-relevant clinical outcomes (i.e., physical function and pain severity). The trial has recently completed enrolling 216 subjects, and randomization has resulted in well-balanced groups. Details on the study design, MI program, and treatment fidelity are provided in the paper. Outcome assessments at week 12, week 24 and week 36 will test the immediate, intermediate and long-term effects of exercise-based MI on adherence (as measured by the Community Health Activities Model Program for Seniors/CHAMPS and accelerometer) and clinical outcomes. When completed, REEF will determine whether exercise-based MI could be utilized as a management strategy to sustain the clinical benefits of exercise for FM. Copyright © 2010 Elsevier Inc. All rights reserved.

Developing the Stroke Exercise Preference Inventory (SEPI)

PubMed Central

Bonner, Nicholas S.; O’Halloran, Paul D.; Bernhardt, Julie; Cumming, Toby B.

2016-01-01

Background Physical inactivity is highly prevalent after stroke, increasing the risk of poor health outcomes including recurrent stroke. Tailoring of exercise programs to individual preferences can improve adherence, but no tools exist for this purpose in stroke. Methods We identified potential questionnaire items for establishing exercise preferences via: (i) our preliminary Exercise Preference Questionnaire in stroke, (ii) similar tools used in other conditions, and (iii) expert panel consultations. The resulting 35-item questionnaire (SEPI-35) was administered to stroke survivors, along with measures of disability, depression, anxiety, fatigue and self-reported physical activity. Exploratory factor analysis was used to identify a factor structure in exercise preferences, providing a framework for item reduction. Associations between exercise preferences and personal characteristics were analysed using multivariable regression. Results A group of 134 community-dwelling stroke survivors (mean age 64.0, SD 13.3) participated. Analysis of the SEPI-35 identified 7 exercise preference factors (Supervision-support, Confidence-challenge, Health-wellbeing, Exercise context, Home-alone, Similar others, Music-TV). Item reduction processes yielded a 13-item version (SEPI-13); in analysis of this version, the original factor structure was maintained. Lower scores on Confidence-challenge were significantly associated with disability (p = 0.002), depression (p = 0.001) and fatigue (p = 0.001). Self-reported barriers to exercise were particularly prevalent in those experiencing fatigue and anxiety. Conclusions The SEPI-13 is a brief instrument that allows assessment of exercise preferences and barriers in the stroke population. This new tool can be employed by health professionals to inform the development of individually tailored exercise interventions. PMID:27711242

Detection of Inter- and Intra-Specific Competition in the Insect Communities of British Trees: A Practical Exercise in Community Ecology.

ERIC Educational Resources Information Center

Putman, R. J.

1984-01-01

Describes an activity (suitable for high school or college) in which the effects of competition in the structuring of ecological communities are examined. The exercise also offers an introduction into species diversity; more advanced classes may be encouraged to seek reasons for differences in insect diversity on different trees. (Author/JN)

Attitudes to apps for continence

PubMed Central

Stephen, Kate; Rodger, Gaener; Cumming, Grant

2012-01-01

Background Urinary incontinence (UI) is a common condition in women which can be caused by the weakening or dysfunction of pelvic floor muscles as a result of ageing, pregnancy or obesity. Prevalence of UI is higher in women than that of diabetes, depression and hypertension but rates are difficult to establish because there is evidence of a reluctance to seek help and assumptions that symptoms are normal and untreatable. Women can become increasingly depressed and isolated. The first line of treatment for UI is pelvic floor muscle training (PFMT) and effectiveness has been shown in over 50 randomised controlled trials. However, there are gaps in research about motivation and adherence to exercise. Research about mobile participatory healthcare has identified the role of technology in addressing problems with adherence. There has been an increase in the use of smart phones to access the internet and in the number of health related applications but there is a lack of research about how individuals interact with this new technology and a lack of understanding about effectiveness of different elements of the technology. Mobile phone apps have been developed to support women in PFMT. The approaches used to promote exercise include; improving incontinence symptoms, strengthening muscles after pregnancy and increasing sexual sensation. The apps have features such as; reminders, counts and graphs to show progress, and timers for contractions. Research will be undertaken in Moray, North East Scotland to increase understanding of the experience of community dwelling women in using apps for PFMT. This study forms part of doctoral research which will also include an explanatory randomised controlled trial and post-trial interviews. Aims and objectives The study aims to increase understanding of the motivation and adherence of women in undertaking PFMT. The attitudes and views of health professionals and community dwelling women toward mobile phone apps for PFMT will be investigated. Design elements of at least three apps will be reviewed in terms of their potential usefulness in promoting and prompting behaviour change and in the development of exercise habit formation. The acceptability of apps to support PFMT and the different approaches used will also be examined. Methods Focus groups will be conducted with health professionals and community dwelling women from Moray, North East Scotland. The health professionals will be asked to review the quality of health information and to consider implications for potential use by patients. The community dwelling women will be asked for their views on usability and acceptability and for their responses to the different elements and approaches of the apps. The groups will include; mothers of young children, perimenopausal women and older women to represent different age groups. Results Data from focus groups around attitudes to, and acceptability of, PFMT apps will be presented at the Congress. Conclusions Results from this study will increase understanding about motivation for PFMT and the role of apps in encouraging women to exercise to prevent and improve incontinence symptoms and will be used to design future research.

Intense Exercise and Aerobic Conditioning Associated with Chromium or L-Carnitine Supplementation Modified the Fecal Microbiota of Fillies

PubMed Central

Feringer, Walter Heinz; Carvalho, Júlia Ribeiro Garcia; Rodrigues, Isadora Mestriner; Jordão, Lilian Rezende; Fonseca, Mayara Gonçalves; Carneiro de Rezende, Adalgiza Souza; de Queiroz Neto, Antonio; Weese, J. Scott; da Costa, Márcio Carvalho

2016-01-01

Recent studies performed in humans and rats have reported that exercise can alter the intestinal microbiota. Athletic horses perform intense exercise regularly, but studies characterizing horse microbiome during aerobic conditioning programs are still limited. Evidence has indicated that this microbial community is involved in the metabolic homeostasis of the host. Research on ergogenic substances using new sequencing technologies have been limited to the intestinal microbiota and there is a considerable demand for scientific studies that verify the effectiveness of these supplements in horses. L-carnitine and chromium are potentially ergogenic substances for athletic humans and horses since they are possibly able to modify the metabolism of carbohydrates and lipids. This study aimed to assess the impact of acute exercise and aerobic conditioning, associated either with L-carnitine or chromium supplementation, on the intestinal microbiota of fillies. Twelve “Mangalarga Marchador” fillies in the incipient fitness stage were distributed into four groups: control (no exercise), exercise, L-carnitine (10g/day) and chelated chromium (10mg/day). In order to investigate the impact of acute exercise or aerobic conditioning on fecal microbiota all fillies undergoing the conditioning program were analyzed as a separate treatment. The fillies underwent two incremental exercise tests before and after training on a treadmill for 42 days at 70–80% of the lactate threshold intensity. Fecal samples were obtained before and 48 h after acute exercise (incremental exercise test). Bacterial populations were characterized by sequencing the V4 region of the 16S rRNA gene using the MiSeq Illumina platform, and 5,224,389 sequences were obtained from 48 samples. The results showed that, overall, the two most abundant phyla were Firmicutes (50.22%) followed by Verrucomicrobia (15.13%). The taxa with the highest relative abundances were unclassified Clostridiales (17.06%) and "5 genus incertae sedis" from the phylum Verrucomicrobia (12.98%). There was a decrease in the phylum Chlamydiae and in the genus Mycobacterium after the second incremental exercise test. Intense exercise changed the community’s structure and aerobic conditioning was associated with changes in the composition and structure of the intestinal bacterial population of fillies. The intra-group comparison showed that chromium or L-carnitine induced moderate changes in the fecal microbiota of fillies, but the microbiota did not differ from the control group, which was exercised with no supplementation. Fecal pH correlated positively with Simpson’s index, while plasma pH correlated negatively. Our results show that exercise and aerobic conditioning can change in the microbiota and provide a basis for further studies enrolling a larger number of horses at different fitness levels to better understand the effects of exercise and training on the intestinal microbiota of horses. PMID:27935992

The Arab American Experience with Diabetes: Perceptions, Myths and Implications for Culturally-Specific Interventions

PubMed Central

Bertran, Elizabeth A; Pinelli, Nicole R; Sills, Stephen J; Jaber, Linda A

2016-01-01

Aims Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans’ knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. Methods Sixty-nine self-identified Arab or Arab Americans ≥ 30 years of age and without diabetes participated in 8 focus groups. Results Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma. The main barrier to healthcare was lack of health insurance and/or cost of care. Intervention preferences included gender-specific exercise, group-delivered education featuring religious ideology, inclusion of the family, and utilization of community facilities. Conclusion Lifestyle interventions for Arab Americans need to address cultural preferences, diabetes myths, and folk remedies. Interventions should incorporate Arabic cultural content and gender-specific group education and exercise. Utilization of family support and religious centers will enable culturally-acceptable and cost-effective interventions. PMID:27460886

Satisfaction of Basic Psychological Needs, Self-Determined Exercise Motivation, and Psychological Well-Being in Mothers Exercising in Group-Based Versus Individual-Based Contexts.

PubMed

Lovell, Geoff P; Gordon, James A R; Mueller, Marcus B; Mulgrew, Kate; Sharman, Rachael

2016-01-01

We compared mothers who exercised predominantly in group settings, those who exercised predominantly in individual settings, and those who exercised equally in group and individual contexts among the following: (a) satisfaction of basic psychological needs (autonomy, competence, and relatedness); (b) self-determined exercise motivation; and (c) psychological well-being. With clear implications for mothers' exercise interventions we found that exercising either predominantly in group contexts or in mixed group and individual settings was associated with mothers having significantly higher satisfaction of basic psychological needs and self-determined exercise motivation than those exercising predominantly alone.

Dual-energy x-ray absorptiometry to measure the effects of a thirteen-week moderate to vigorous aquatic exercise and nutritional education intervention on percent body fat in adults with intellectual disabilities from group home settings.

PubMed

Casey, Amanda; Boyd, Colin; Mackenzie, Sasho; Rasmussen, Roy

2012-05-01

People with intellectual disability are more likely to be obese and extremely obese than people without intellectual disability with rates remaining elevated among adults, women and individuals living in community settings. Dual-energy X-ray absorptiometry measured the effects of a 13-week aquatic exercise and nutrition intervention on percent body fat in eight adults with intellectual disabilities (aged 41.0 ± 13.7 yrs) of varying fat levels (15%-39%) from two group homes. A moderate to vigorous aquatic exercise program lasted for the duration of 13 weeks with three, one-hour sessions held at a 25m pool each week. Nutritional assistants educated participants as to the importance of food choice and portion size. A two-tailed Wilcoxon matched-pairs signed-ranks test determined the impact of the combined intervention on body fat percentage and BMI at pre and post test. Median body fat percentage (0.8 %) and BMI (0.3 kg/m(2)) decreased following the exercise intervention, but neither were statistically significant, p = .11 and p = .55, respectively. The combined intervention was ineffective at reducing percent body fat in adults with intellectual disability according to dual-energy X-ray absorptiometry. These results are in agreement with findings from exercise alone interventions and suggest that more stringent nutritional guidelines are needed for this population and especially for individuals living in group home settings. The study did show that adults with intellectual disability may participate in moderate to vigorous physical activity when given the opportunity.

Pilot study comparing changes in postural control after training using a video game balance board program and 2 standard activity-based balance intervention programs.

PubMed

Pluchino, Alessandra; Lee, Sae Yong; Asfour, Shihab; Roos, Bernard A; Signorile, Joseph F

2012-07-01

To compare the impacts of Tai Chi, a standard balance exercise program, and a video game balance board program on postural control and perceived falls risk. Randomized controlled trial. Research laboratory. Independent seniors (N=40; 72.5±8.40) began the training, 27 completed. Tai Chi, a standard balance exercise program, and a video game balance board program. The following were used as measures: Timed Up & Go, One-Leg Stance, functional reach, Tinetti Performance Oriented Mobility Assessment, force plate center of pressure (COP) and time to boundary, dynamic posturography (DP), Falls Risk for Older People-Community Setting, and Falls Efficacy Scale. No significant differences were seen between groups for any outcome measures at baseline, nor were significant time or group × time differences for any field test or questionnaire. No group × time differences were seen for any COP measures; however, significant time differences were seen for total COP, 3 of 4 anterior/posterior displacement and both velocity, and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample. For DP, significant improvements in the overall score (dynamic movement analysis score), and in 2 of the 3 linear and angular measures were seen for the sample. The video game balance board program, which can be performed at home, was as effective as Tai Chi and the standard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures. This finding may have implications for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Congregating to create for social change: Urban youth media production and sense of community

PubMed Central

Charmaraman, Linda

2011-01-01

This case study explored how adolescents were empowered through after school media production activities and, in the process, re-imagined themselves as active and engaged citizens within their community. Through analyzing interviews, participant observations, and media artifacts of 14 participants (aged 15-19) over a period of 18 months, three main themes emerged from the triangulation of data: (1) sociocultural capital through group ownership; (2) safe space for creative expression; and (3) developing a sense of community with diverse voices. These young people exercised their collective voice toward pro-social actions by writing and producing their stories and showcasing their works at community screenings. They hoped that their videos would promote individual and community transformations. Building on youth development, community psychology, and media literacy frameworks, this article discusses educational implications like advocating for the power of youth media production to bridge participants’ personal and private artistry to public and political statements. PMID:23459677

Congregating to create for social change: Urban youth media production and sense of community.

PubMed

Charmaraman, Linda

2013-03-01

This case study explored how adolescents were empowered through after school media production activities and, in the process, re-imagined themselves as active and engaged citizens within their community. Through analyzing interviews, participant observations, and media artifacts of 14 participants (aged 15-19) over a period of 18 months, three main themes emerged from the triangulation of data: (1) sociocultural capital through group ownership; (2) safe space for creative expression; and (3) developing a sense of community with diverse voices. These young people exercised their collective voice toward pro-social actions by writing and producing their stories and showcasing their works at community screenings. They hoped that their videos would promote individual and community transformations. Building on youth development, community psychology, and media literacy frameworks, this article discusses educational implications like advocating for the power of youth media production to bridge participants' personal and private artistry to public and political statements.

Simulating Social and Political Influences on Hazard Analysis through a Classroom Role Playing Exercise

NASA Astrophysics Data System (ADS)

Hales, T. C.; Cashman, K. V.

2006-12-01

Geological hazard mitigation is a complicated process that involves both detailed scientific research and negotiations between community members with competing interests in the solution. Geological hazards classes based around traditional lecture methods have difficulty conveying the decision-making processes that go into these negotiations. To address this deficiency, we have spent five years developing and testing a role- playing exercise based on mitigation of a dam outburst hazard on Ruapehu volcano, New Zealand. In our exercise, students are asked to undertake one of five different roles and decide the best way to mitigate the hazard. Over the course of their discussion students are challenged to reach a consensus decision despite the presence of strongly opposed positions. Key to the success of the exercise are (1) the presence of a facilitator and recorder for each meeting, (2) the provision of unique information for each interested party, and (3) the division of the class into multiple meeting groups, such that everyone is required to participate and individual groups can evolve to different conclusions. The exercise can be completed in a single hour and twenty minute classroom session that is divided into four parts: an introduction, a meeting between members of the same interested party to discuss strategy, a meeting between different interested parties, and a debriefing session. This framework can be readily translated to any classroom hazard problem. In our experience, students have responded positively to the use of role-playing to supplement lectures.

Case Studies in Exercise and Sport Sciences: A Powerful Tool to Bridge the Science-Practice Gap.

PubMed

Halperin, Israel

2018-03-27

Despite the progress made by the scientific exercise community in collaborating and communicating with non-scientist coaches, there is room for improvement. Coaches find research difficult to understand, feel that their interests are not being addressed by exercise research, and rely on peer-discussion to further their coaching knowledge base while consuming little peer-reviewed articles. One useful strategy to bridge the science-practice gap is with case-studies. In addition to furthering our understanding of the physiology, psychology, and training schedules of elite athletes, case studies can serve 1) as a useful communication channel with coaches if presented as narratives and 2) to establish and strengthen relationships between scientists and coaches leading to fruitful research collaborations. The purpose of this invited commentary is to discuss these two less-recognized benefits of case-studies, and propose a way to incorporate case-studies more frequently alongside group-based studies.

Case Studies in Exercise and Sport Sciences: A Powerful Tool to Bridge the Science-Practice Gap.

PubMed

Halperin, Israel

2018-06-21

Despite the progress made by the scientific exercise community in collaborating and communicating with nonscientist coaches, there is room for improvement. Coaches find research difficult to understand, feel that their interests are not being addressed by exercise research, and rely on peer discussion to further their coaching knowledge base while consuming few peer-reviewed articles. One useful strategy to bridge the science-practice gap is with case studies. In addition to furthering our understanding of the physiology, psychology, and training schedules of elite athletes, case studies can serve (1) as a useful communication channel with coaches if presented as narratives and (2) to establish and strengthen relationships between scientists and coaches, leading to fruitful research collaborations. The purpose of this invited commentary is to discuss these 2 less-recognized benefits of case studies and propose a way to incorporate case studies more frequently alongside group-based studies.

Emergency Exercise Participation and Evaluation

ERIC Educational Resources Information Center

Smith, Julie; Black, Lynette; Williams, Linda

2012-01-01

Extension is uniquely positioned to participate in emergency exercises, formally or informally, with the goal of engaging community members in emergency and disaster preparedness. With their knowledge of community needs, Extension personnel are valuable resources and can assist emergency managers in the process of identifying local risks and…

Adoption of a Tai Chi Intervention, Tai Ji Quan: Moving for Better Balance, for Fall Prevention by Rural Faith-Based Organizations, 2013-2014.

PubMed

Jones, Dina L; Starcher, Rachael W; Eicher, Jennifer L; Wilcox, Sara

2016-07-14

Translating evidence-based, community-delivered, fall-prevention exercise programs into new settings is a public health priority. Older adults (aged ≥65 y) are at high risk for falls. We conducted a community engagement project in West Virginia to evaluate the adoption of a tai chi exercise program, Tai Ji Quan: Moving for Better Balance, by rural faith-based organizations (FBOs) and exercise instructors by recruiting 20 FBOs and 20 or more exercise instructors and by obtaining input from key stakeholders (representatives of FBOs, community representatives, exercise instructors) regarding potential barriers and facilitators to program adoption. We used both multistage, purposeful random sampling and snowball sampling to recruit FBOs and exercise instructors in 7 West Virginia counties. Two forums were held with stakeholders to identify barriers and facilitators to program adoption. We calculated separate adoption rates for organizations and exercise instructors. It took up to 3 months to recruit each FBO with an adoption rate of 94%. We made 289 telephone calls, sent 193 emails and 215 letters, distributed brochures and flyers to 69 FBOs, held 118 meetings, and made 20 trips over a period of 31 days (8,933 miles traveled). Nineteen of 22 trained exercise instructors started classes, an instructor adoption rate of 86%. Key issues regarding adoption were the age requirement for participants, trust, education, and competing priorities. Although we had recruitment challenges, our adoption rates were similar to or higher than those reported in other studies, and the objectives of the community engagement project were met. Clustering the FBOs and having them located closer geographically to our location may have reduced our resource use, and using a recruitment coordinator from the local community may have enabled us to gain the trust of congregants and clergy support.

The effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients' respiratory muscle activation.

PubMed

Seo, KyoChul; Hwan, Park Seung; Park, KwangYong

2017-03-01

[Purpose] The purpose of this study is to examine the effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients' respiratory muscle activation. [Subjects and Methods] All experimental subjects performed exercises five times per week for four weeks. Thirty chronic stroke patients were randomly assign to an experimental group of 15 patients and a control group of 15 patients. The experimental group underwent exercises consisting of basic exercise treatment for 15 minutes and inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise for 15 minutes and the control group underwent exercises consisting of basic exercise treatment for 15 minutes and auto-med exercise for 15 minutes. The activation levels of respiratory muscles were measured before and after the experiment using MP 150WSW to obtain the results of the experiment. [Results] In the present study, when the pulmonary functions of the experimental group and the control group before and after the experiment were compared, whereas the experimental group showed significant differences in all sections. In the verification of intergroup differences between the experimental group and the control group before and after the experiment. [Conclusion] The respiratory rehabilitation exercise is considered to be capable of inducing positive effects on stroke patients' respiratory muscles through diaphragm breathing exercise and lip puckering breathing exercise.

Effect of BCAA supplement timing on exercise-induced muscle soreness and damage: a pilot placebo-controlled double-blind study.

PubMed

Ra, Song-Gyu; Miyazaki, Teruo; Kojima, Ryo; Komine, Shoichi; Ishikura, Keisuke; Kawanaka, Kentaro; Honda, Akira; Matsuzaki, Yasushi; Ohmori, Hajime

2017-09-22

The aim of present study was to compare the effects of branched-chain amino acid (BCAA) supplementation taken before or after exercise on delayed onset muscle soreness (DOMS) and exercise-induced muscle damage (EIMD). Fifteen young men (aged 21.5 ± 0.4 years) were given either BCAA (9.6 g·day-1) or placebo before and after exercise (and for 3 days prior to and following the exercise day) in three independent groups: the Control group (placebo before and after exercise), the PRE group (BCAA before exercise and placebo after exercise), and the POST group (placebo before exercise and BCAA after exercise). Participants performed 30 repetitions of eccentric exercise with the non-dominant arm. DOMS, upper arm circumference (CIR), elbow range of motion (ROM), serum creatine kinase (CK), lactate dehydrogenase (LDH), and aldolase, BCAA, and Beta-hydroxy-Beta-methylbutyrate (3HMB) were measured immediately before and after the exercise and on the following 4 days. Serum BCAA and 3HMB concentrations increased significantly in the PRE group immediately after the exercise, recovering to baseline over the following days. In the days following the exercise day, DOMS, CIR, and ROM were significantly improved in the PRE group compared to the Control group, with weaker effects in the POST group. Serum activities of CK, LDH, and aldolase in the days following the exercise day were significantly suppressed in the PRE group compared to Control group. Present study confirmed that repeated BCAA supplementation before exercise had a more beneficial effect in attenuating DOMS and EIMD induced by eccentric exercise than repeated supplementation after exercise.

Exercises in Emergency Preparedness for Health Professionals in Community Clinics

PubMed Central

Blossom, H. John; Sandrock, Christian; Mitchell, Brenda; Brandstein, Kendra

2010-01-01

Health professionals in community settings are generally unprepared for disasters. From 2006 to 2008 the California Statewide Area Health Education Center (AHEC) program conducted 90 table top exercises in community practice sites in 18 counties. The exercises arranged and facilitated by AHEC trained local coordinators and trainers were designed to assist health professionals in developing and applying their practice site emergency plans using simulated events about pandemic influenza or other emergencies. Of the 1,496 multidisciplinary health professionals and staff participating in the exercises, 1,176 (79%) completed learner evaluation forms with 92–98% of participants rating the training experiences as good to excellent. A few reported helpful effects when applying their training to a real time local disaster. Assessments of the status of clinic emergency plans using 15 criteria were conducted at three intervals: when the exercises were scheduled, immediately before the exercises, and for one-third of sites, three months after the exercise. All sites made improvements in their emergency plans with some or all of the plan criteria. Of the sites having follow up, most (N = 23) were community health centers that made statistically significant changes in two-thirds of the plan criteria (P = .001–.046). Following the exercises, after action reports were completed for 88 sites and noted strengths, weaknesses, and plans for improvements in their emergency plans Most sites (72–90%) showed improvements in how to activate their plans, the roles of their staff, and how to participate in a coordinated response. Challenges in scheduling exercises included time constraints and lack of resources among busy health professionals. Technical assistance and considerations of clinic schedules mitigated these issues. The multidisciplinary table top exercises proved to be an effective means to develop or improve clinic emergency plans and enhance the dialogue and coordination among health professionals before an emergency happens. PMID:20146093

Assessing the feasibility of using uniaxial accelerometers with an online support platform in the delivery of a community-based exercise referral scheme.

PubMed

Hawkins, Jemma L; Oliver, Emily J; Wyatt-Williams, Jeannie; Scale, Elaine; van Woerden, Hugo C

2014-10-01

Exercise referral schemes are established within community-based health care; however, they have been criticized for failing to evidence long-term behavior change relative to usual care. As such, recent reviews have called for refinement of their delivery with a focus on embedded strategies targeting client motivation. This research letter presents findings from an initial pilot trial conducted within Wales' National Exercise Referral Scheme (NERS), examining the feasibility of using validated physical activity monitoring devices and an accompanying online platform within standard scheme delivery. 30 individuals referred to generic or cardiovascular pathways were offered the system; of these 17 agreed to participate. Common reasons for declining were clustered into lack of technology literacy or access, condition severity, or fear of costs associated with losing the device. Analysis of follow-up interviews after 4 weeks of use indicated that while participants found the monitoring devices practical and informative, only a minority (n = 4) were using the system in full. Crucially, the system element most aligned with contemporary theories of motivation (the online portal) was not used as expected. In addition, feedback from exercise referral professionals indicated that there were demands for support from clients, which might be mitigated by more effective independent system use. Recommendations for larger scale trials using similar systems include consideration of targeted patient groups, equity of access, and providing adequate technological support that is currently beyond the capacity of the NERS system. © The Author(s) 2014.

The importance of community consultation and social support in adhering to an obesity reduction program: results from the Healthy Weights Initiative.

PubMed

Lemstra, Mark; Rogers, Marla R

2015-01-01

Few community-based obesity reduction programs have been evaluated. After 153 community consultations, the City of Moose Jaw, SK, Canada, decided to initiate a free comprehensive program. The initiative included 71 letters of support from the Mayor, every family physician, cardiologist, and internist in the city, and every relevant community group including the Heart and Stroke Foundation, the Canadian Cancer Society, and the Public Health Agency of Canada. To promote strong adherence while positively influencing a wide range of physical and mental health variables measured through objective assessment or validated surveys. The only inclusion criterion was that the individuals must be obese adults (body mass index >30 kg/m(2)). Participants were requested to sign up with a "buddy" who was also obese and identify three family members or friends to sign a social support contract. During the initial 12 weeks, each individual received 60 group exercise sessions, 12 group cognitive behavioral therapy sessions, and 12 group dietary sessions with licensed professionals. During the second 12-week period, maintenance therapy included 12 group exercise sessions (24 weeks in total). To date, 243 people have been referred with 229 starting. Among those who started, 183 completed the program (79.9%), while 15 quit for medical reasons and 31 quit for personal reasons. Mean objective reductions included the following: 31.0 lbs of body fat, 3.9% body fat, 2.9 in from the waist, 2.3 in from the hip, blood cholesterol by 0.5 mmol/L, systolic blood pressure by 5.9 mmHg, and diastolic blood pressure by 3.2 mmHg (all P<0.000). There were no changes in blood sugar levels. There was also statistically significant differences in aerobic fitness, self-report health, quality of life measured by Short Form-36, and depressed mood measured by Beck Depression Inventory-II (all P<0.000). Independent risk factors for not completing the program were not having a family member or friend sign a social support contract (odds ratio 2.91, 95% confidence interval 1.01-8.34, P=0.047) and lower education (odds ratio 2.90, 95% confidence interval 1.20-7.03, P=0.018). Comprehensive obesity reduction programs can be effective when there is extensive consultation at the community level and social support at the individual level.

Effects of muscular and aqua aerobic combined exercise on metabolic indices in elderly women with metabolic syndrome

PubMed Central

Yoo, Yong-Kwon; Kim, Soo-Keun; Song, Min-Sun

2013-01-01

The purpose of this study was to investigate the effects of muscle strengthening exercise using elastic thera-band and aquatic aerobic combined exercise on metabolic syndrome index in elderly with metabolic syndrome. Fifty-four were assigned to muscle strengthening exercise group (n = 19), aquatic aerobic exercise group (n = 19), and combined exercise group (n = 16). The muscle strength exercise, aquatic aerobic exercise and combined exercise were provided three times a week for 12 weeks. Metabolic syndrome indices[Fasting blood glucose, triglyceride, high density lipoprotein cholesterol (HDL-C), systolic blood pressure, diastolic blood pressure and waist circumference] were measured before and after the program. One-way ANOVA, paired t-test and two-way repeated ANOVA were used with the SPSS program for data analysis. There was a significant difference in triglyceride (p < .001), HDL-C (p = .010) and waist circumference (p = .016). Triglyceride and waist circumference was significantly decreased in combined group than muscle strength exercise group and aquatic exercise group. HDL-C was significantly increased in combined group than muscle strength exercise group. The results indicate that combined exercise was more effective in the improvement of dyslipidemia and abdominal obesity. PMID:25566424

Effects of muscular and aqua aerobic combined exercise on metabolic indices in elderly women with metabolic syndrome.

PubMed

Yoo, Yong-Kwon; Kim, Soo-Keun; Song, Min-Sun

2013-12-01

The purpose of this study was to investigate the effects of muscle strengthening exercise using elastic thera-band and aquatic aerobic combined exercise on metabolic syndrome index in elderly with metabolic syndrome. Fifty-four were assigned to muscle strengthening exercise group (n = 19), aquatic aerobic exercise group (n = 19), and combined exercise group (n = 16). The muscle strength exercise, aquatic aerobic exercise and combined exercise were provided three times a week for 12 weeks. Metabolic syndrome indices[Fasting blood glucose, triglyceride, high density lipoprotein cholesterol (HDL-C), systolic blood pressure, diastolic blood pressure and waist circumference] were measured before and after the program. One-way ANOVA, paired t-test and two-way repeated ANOVA were used with the SPSS program for data analysis. There was a significant difference in triglyceride (p < .001), HDL-C (p = .010) and waist circumference (p = .016). Triglyceride and waist circumference was significantly decreased in combined group than muscle strength exercise group and aquatic exercise group. HDL-C was significantly increased in combined group than muscle strength exercise group. The results indicate that combined exercise was more effective in the improvement of dyslipidemia and abdominal obesity.

The effects of a nurse-supervised home exercise programme on improving patients' perceptions of the benefits and barriers to exercise: A randomised controlled trial.

PubMed

Tao, Xingjuan; Chow, Susan Ka Yee; Wong, Frances Ky

2017-09-01

To explore the effects of a home exercise programme on patients' perceptions of the barriers and benefits to exercise and adherence to the programme. Great efforts have been made to encourage dialysis patients to participate in rehabilitation regimens. The promotion of exercise in this population is still limited. This was a post hoc analysis of a randomised, two-group parallel study. A total of 113 adult patients recruited from the haemodialysis units were randomised into two groups on a 1:1 ratio. Both groups received in-centre group exercise training weekly for 6 weeks. The intervention group patients were provided with an additional individualised nurse-led home exercise prescription and behavioural support for 12 weeks. The patients' perceptions of the barriers and benefits to exercise, adherence to the home exercise prescription and their exercise level at weeks 6 and 12 were evaluated. There was a significant between-group difference in the score on patient perceptions of the barriers and benefits to exercise, with the intervention group reporting a greater reduction in perceived barriers to exercise. Significant group differences were noted in exercise level upon the completion of the programme, with the intervention group reporting higher such levels. The average adherence rate to the negotiated exercise plans was 78.9%. The intervention group of patients did better at meeting or exceeding the minimum exercise goal than did the control group. Home exercise prescriptions and behavioural support provided by trained nurses are effective at helping patients to remove barriers to engaging in exercise training. Physical exercise in a clinical arena should not be considered the exclusive domain of physical therapists; the team could collaborate with nurses to play a core role in making physical exercise for patients an essential practice of care in a multidisciplinary team. © 2017 John Wiley & Sons Ltd.

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

PubMed

Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-04-01

Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Balance circuit classes to improve balance among rehabilitation inpatients: a protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Impaired balance and mobility are common among rehabilitation inpatients. Poor balance and mobility lead to an increased risk of falling. Specific balance exercise has been shown to improve balance and reduce falls within the community setting. However few studies have measured the effects of balance exercises on balance within the inpatient setting. The aim of this randomised controlled trial is to investigate whether the addition of circuit classes targeting balance to usual therapy lead to greater improvements in balance among rehabilitation inpatients than usual therapy alone. Methods/Design A single centre, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. One hundred and sixty two patients admitted to the general rehabilitation ward at Bankstown-Lidcombe Hospital will be recruited. Eligible participants will have no medical contraindications to exercise and will be able to: fully weight bear; stand unaided independently for at least 30 seconds; and participate in group therapy sessions with minimal supervision. Participants will be randomly allocated to an intervention group or usual-care control group. Both groups will receive standard rehabilitation intervention that includes physiotherapy mobility training and exercise for at least two hours on each week day. The intervention group will also receive six 1-hour circuit classes of supervised balance exercises designed to maximise the ability to make postural adjustments in standing, stepping and walking. The primary outcome is balance. Balance will be assessed by measuring the total time the participant can stand unsupported in five different positions; feet apart, feet together, semi-tandem, tandem and single-leg-stance. Secondary outcomes include mobility, self reported physical functioning, falls and hospital readmissions. Performance on the outcome measures will be assessed before randomisation and at two-weeks and three-months after randomisation by physiotherapists unaware of intervention group allocation. Discussion This study will determine the impact of additional balance circuit classes on balance among rehabilitation inpatients. The results will provide essential information to guide evidence-based physiotherapy at the study site as well as across other rehabilitation inpatient settings. Trial registration The protocol for this study is registered with the Australian New Zealand, Clinical Trials Registry: ACTRN=12611000412932 PMID:23870654

State of practice and emerging application of analytical techniques of nuclear forensic analysis: highlights from the 4th Collaborative Materials Exercise of the Nuclear Forensics International Technical Working Group (ITWG)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwantes, Jon M.; Marsden, Oliva; Pellegrini, Kristi L.

Founded in 1996 upon the initiative of the “Group of 8” governments (G8), the Nuclear Forensics International Technical Working Group (ITWG) is an ad hoc organization of official nuclear forensics practitioners (scientists, law enforcement, and regulators) that can be called upon to provide technical assistance to the global community in the event of a seizure of nuclear or radiological materials. The ITWG is supported by and is affiliated with roughly 40 countries and international partner organizations including the International Atomic Energy Agency (IAEA), EURATOM, INTERPOL, EUROPOL, and the United Nations Interregional Crime and Justice Research Institute (UNICRI). Besides providing amore » network of nuclear forensics laboratories that are able to assist law enforcement during a nuclear smuggling event, the ITWG is also committed to the advancement of the science of nuclear forensic analysis, largely through participation in periodic table top and Collaborative Materials Exercises (CMXs). Exercise scenarios use “real world” samples with realistic forensics investigation time constraints and reporting requirements. These exercises are designed to promote best practices in the field and test, evaluate, and improve new technical capabilities, methods and techniques in order to advance the science of nuclear forensics. The ITWG recently completed its fourth CMX in the 20 year history of the organization. This was also the largest materials exercise to date, with participating laboratories from 16 countries or organizations. Three samples of low enriched uranium were shipped to these laboratories as part of an illicit trafficking scenario, for which each laboratory was asked to conduct nuclear forensic analyses in support of a fictitious criminal investigation. An objective review of the State Of Practice and Art of international nuclear forensic analysis based upon the outcome of this most recent exercise is provided.« less

Dietary intakes and antioxidant status in mind-body exercising pre- and postmenopausal women.

PubMed

Palasuwan, A; Margaritis, I; Soogarun, S; Rousseau, A-S

2011-08-01

The decline in antioxidant defenses due to both estrogen loss and frequent adoption of poor dietary choices exposes postmenopausal women to cardiovascular diseases. Adequate nutrition and physical exercise are two factors of health promotion. This study investigated whether regular practice of mind-body exercise (yoga and/or tai chi) alters dietary intake and antioxidant status and balances the menopause-related increases in lipid peroxidation and cardiovascular risk. Cross-sectional study. The study was conducted in an urban community in Bangkok (Thailand) between May and August 2007. Premenopausal (Pre M; 39±8 yrs; n=56) and postmenopausal (Post M; 54±5 yrs; n=39) women who had been practicing yoga (Y) and/or tai chi (TC) more than 3 hours/week for a year, or who had no regular physical activity practice (sedentary, S). All participants completed food frequency questionnaires and 4-day food and activity records. Blood was collected on day 5. Factorial ANOVA tests were performed according to menopause status, exercise, and hormone replacement therapy (HRT) groups. Post M had higher (p = 0.01) dietary fiber intake compared with Pre M. Yoga practitioners had lower BMI (p = 0.004) and lower fat intake (p = 0.02) compared with their S and TC counterparts. Plasma total antioxidant status was significantly and independently lower and higher in Y and Post M groups, respectively. However, no difference was shown after adjusting for BMI. Regardless of menopause status and HRT, the activity of erythrocyte glutathione peroxidase - an aerobic training-responsive enzyme - was higher (p < 0.001) in TC practitioners compared with other groups. No effects were shown on erythrocyte superoxide dismutase activity, plasma lipid peroxidation (TBARS) or total homocysteine concentrations. Yoga and tai chi exercises can be used as components of a strategy to promote healthy lifestyles (balanced diet and moderate intensity exercise) in vulnerable populations, such as menopausal women, in order to prevent aging induced oxidative stress-related diseases.

Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial

PubMed Central

Spink, Martin J; Fotoohabadi, Mohammad R; Wee, Elin; Landorf, Karl B; Hill, Keith D; Lord, Stephen R

2011-01-01

Objective To determine the effectiveness of a multifaceted podiatry intervention in preventing falls in community dwelling older people with disabling foot pain. Design Parallel group randomised controlled trial. Setting University health sciences clinic in Melbourne, Australia. Participants 305 community dwelling men and women (mean age 74 (SD 6) years) with disabling foot pain and an increased risk of falling. 153 were allocated to a multifaceted podiatry intervention and 152 to routine podiatry care, with 12 months’ follow-up. Interventions Multifaceted podiatry intervention consisting of foot orthoses, advice on footwear, subsidy for footwear ($A100 voucher; £65; €74), a home based programme of foot and ankle exercises, a falls prevention education booklet, and routine podiatry care for 12 months. The control group received routine podiatry care for 12 months. Main outcome measures Proportion of fallers and multiple fallers, falling rate, and injuries resulting from falls during follow-up. Results Overall, 264 falls occurred during the study. 296 participants returned all 12 calendars: 147 (96%) in the intervention group and 149 (98%) in the control group. Adherence was good, with 52% of the participants completing 75% or more of the requested three exercise sessions weekly, and 55% of those issued orthoses reporting wearing them most of the time. Participants in the intervention group (n=153) experienced 36% fewer falls than participants in the control group (incidence rate ratio 0.64, 95% confidence interval 0.45 to 0.91, P=0.01). The proportion of fallers and multiple fallers did not differ significantly between the groups (relative risk 0.85, 0.66 to 1.08, P=0.19 and 0.63, 0.38 to 1.04, P=0.07). One fracture occurred in the intervention group and seven in the control group (0.14, 0.02 to 1.15, P=0.07). Significant improvements in the intervention group compared with the control group were found for the domains of strength (ankle eversion), range of motion (ankle dorsiflexion and inversion/eversion), and balance (postural sway on the floor when barefoot and maximum balance range wearing shoes). Conclusions A multifaceted podiatry intervention reduced the rate of falls in community dwelling older people with disabling foot pain. The components of the intervention are inexpensive and relatively simple to implement, suggesting that the programme could be incorporated into routine podiatry practice or multidisciplinary falls prevention clinics. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12608000065392. PMID:21680622

Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial.

PubMed

Spink, Martin J; Menz, Hylton B; Fotoohabadi, Mohammad R; Wee, Elin; Landorf, Karl B; Hill, Keith D; Lord, Stephen R

2011-06-16

To determine the effectiveness of a multifaceted podiatry intervention in preventing falls in community dwelling older people with disabling foot pain. Parallel group randomised controlled trial. University health sciences clinic in Melbourne, Australia. 305 community dwelling men and women (mean age 74 (SD 6) years) with disabling foot pain and an increased risk of falling. 153 were allocated to a multifaceted podiatry intervention and 152 to routine podiatry care, with 12 months' follow-up. Multifaceted podiatry intervention consisting of foot orthoses, advice on footwear, subsidy for footwear ($A100 voucher; £65; €74), a home based programme of foot and ankle exercises, a falls prevention education booklet, and routine podiatry care for 12 months. The control group received routine podiatry care for 12 months. Proportion of fallers and multiple fallers, falling rate, and injuries resulting from falls during follow-up. Overall, 264 falls occurred during the study. 296 participants returned all 12 calendars: 147 (96%) in the intervention group and 149 (98%) in the control group. Adherence was good, with 52% of the participants completing 75% or more of the requested three exercise sessions weekly, and 55% of those issued orthoses reporting wearing them most of the time. Participants in the intervention group (n=153) experienced 36% fewer falls than participants in the control group (incidence rate ratio 0.64, 95% confidence interval 0.45 to 0.91, P=0.01). The proportion of fallers and multiple fallers did not differ significantly between the groups (relative risk 0.85, 0.66 to 1.08, P=0.19 and 0.63, 0.38 to 1.04, P=0.07). One fracture occurred in the intervention group and seven in the control group (0.14, 0.02 to 1.15, P=0.07). Significant improvements in the intervention group compared with the control group were found for the domains of strength (ankle eversion), range of motion (ankle dorsiflexion and inversion/eversion), and balance (postural sway on the floor when barefoot and maximum balance range wearing shoes). A multifaceted podiatry intervention reduced the rate of falls in community dwelling older people with disabling foot pain. The components of the intervention are inexpensive and relatively simple to implement, suggesting that the programme could be incorporated into routine podiatry practice or multidisciplinary falls prevention clinics. Australian New Zealand Clinical Trials Registry ACTRN12608000065392.

Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study.

PubMed

Draper, Catherine E; Davidowitz, Kesiah J; Goedecke, Julia H

2016-02-01

A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Khayelitsha, Cape Town, SA. Twenty-one black SA women. The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. These findings highlight the complexities surrounding participants' perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.

Changes in Brain Volume and Cognition in a Randomized Trial of Exercise and Social Interaction in a Community-Based Sample of Non-Demented Chinese Elders

PubMed Central

Mortimer, James A.; Ding, Ding; Borenstein, Amy R.; DeCarli, Charles; Guo, Qihao; Wu, Yougui; Zhao, Qianhua; Chu, Shugang

2013-01-01

Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly. Although greater social engagement was found to reduce dementia risk in observational studies, randomized trials of social interventions have not been reported. A representative sample of 120 elderly from Shanghai, China was randomized to four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRIs were obtained, one before the intervention period, the other after. A neuropsychological battery was administered at baseline, 20 weeks, and 40 weeks. Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests. Time-intervention group interactions for neuropsychological measures were evaluated with repeated-measures mixed models. Compared to the No Intervention group, significant increases in brain volume were seen in the Tai Chi and Social Intervention groups (p < 0.05). Improvements also were observed in several neuropsychological measures in the Tai Chi group, including the Mattis Dementia Rating Scale score (p = 0.004), the Trailmaking Test A (p = 0.002) and B (p = 0.0002), the Auditory Verbal Learning Test (p = 0.009), and verbal fluency for animals (p = 0.01). The Social Interaction group showed improvement on some, but fewer neuropsychological indices. No differences were observed between the Walking and No Intervention groups. The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise (Tai Chi). In addition, intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements. PMID:22451320

Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese elders.

PubMed

Mortimer, James A; Ding, Ding; Borenstein, Amy R; DeCarli, Charles; Guo, Qihao; Wu, Yougui; Zhao, Qianhua; Chu, Shugang

2012-01-01

Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly. Although greater social engagement was found to reduce dementia risk in observational studies, randomized trials of social interventions have not been reported. A representative sample of 120 elderly from Shanghai, China was randomized to four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRIs were obtained, one before the intervention period, the other after. A neuropsychological battery was administered at baseline, 20 weeks, and 40 weeks. Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests. Time-intervention group interactions for neuropsychological measures were evaluated with repeated-measures mixed models. Compared to the No Intervention group, significant increases in brain volume were seen in the Tai Chi and Social Intervention groups (p < 0.05). Improvements also were observed in several neuropsychological measures in the Tai Chi group, including the Mattis Dementia Rating Scale score (p = 0.004), the Trailmaking Test A (p = 0.002) and B (p = 0.0002), the Auditory Verbal Learning Test (p = 0.009), and verbal fluency for animals (p = 0.01). The Social Interaction group showed improvement on some, but fewer neuropsychological indices. No differences were observed between the Walking and No Intervention groups. The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise (Tai Chi). In addition, intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements.

Health promotion health center project.

PubMed

Lee, Tae Wha; Lee, Chung Yul; Kim, Hee Soon; Ham, Ok Kyung

2007-01-01

As part of a major government support for health promotion, a health promotion health center (HPHC) project was launched at the national level in Korea. The purpose of the study was to describe this 2-year HPHC project within the framework of the Ottawa Charter for Health Promotion and to evaluate the preliminary outcomes of the community residents. A cross-sectional design was used. A total of 2,261 community residents participated in the survey, with 792 in HPHC sites and 1,469 in non-HPHC sites. The instrument included questions on participants' demographic characteristics, awareness, participation, health behavior (smoking, exercise, meat consumption, and blood pressure checkup), and satisfaction with the health promotion programs. The 5 main health promotion strategies of the Ottawa Charter were evident in the HPHCs. HPHCs were successful in enhancing awareness, participation, and satisfaction through their health promotion programs, although health behaviors were not significantly different between the 2 groups, except exercise. Ottawa Charter strategies embedded within the practice of the community health promotion activities were effective in increasing the short-term outcomes (awareness, participation, and satisfaction with health promotion programs), which is a promising finding for the development of health promotion behaviors in the future.

Nurturing the Respectful Community through Practical Life

ERIC Educational Resources Information Center

Bettmann, Joen

2015-01-01

Joen Bettmann's depiction of practical life exercises as character-building reveals how caring, careful, and independent work leads to higher self-esteem, more concern for others, better understanding for academic learning, and a self-nurturing, respectful classroom community. Particular aspects of movement and silence exercises bring out what…

Practical Exercises for the Study of Community Ecology at Advanced Level.

ERIC Educational Resources Information Center

Putman, R. J.

1984-01-01

Describes a series of short-term modular experiments which focus on community structure (standing crop biomass) and function (system energy flow). One exercise examines decomposers while another shows energy use by individuals. Equipment needed, procedures used, and results obtained are included. (Author/DH)

Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis.

PubMed

Frost, Rachael; Belk, Celia; Jovicic, Ana; Ricciardi, Federico; Kharicha, Kalpa; Gardner, Benjamin; Iliffe, Steve; Goodman, Claire; Manthorpe, Jill; Drennan, Vari M; Walters, Kate

2017-07-20

Mild or pre-frailty is common and associated with increased risks of hospitalisation, functional decline, moves to long-term care, and death. Little is known about the effectiveness of health promotion in reducing these risks. This systematic review aimed to synthesise randomised controlled trials (RCTs) evaluating home and community-based health promotion interventions for older people with mild/pre-frailty. We searched 20 bibliographic databases and 3 trials registers (January 1990 - May 2016) using mild/pre-frailty and associated terms. We included randomised controlled and crossover trials of health promotion interventions for community-dwelling older people (65+ years) with mild/pre-frailty and excluded studies focussing on populations in hospital, long term care facilities or with a specific condition. Risk of bias was assessed by two reviewers using the Cochrane Risk of Bias tool. We pooled study results using standardised mean differences (SMD) where possible and used narrative synthesis where insufficient outcome data were available. We included 10 articles reporting on seven trials (total n = 506 participants) and included five trials in a meta-analysis. Studies were predominantly small, of limited quality and six studies tested group exercise alone. One study additionally investigated a nutrition and exercise intervention and one evaluated telemonitoring. Interventions of exercise in groups showed mixed effects on functioning (no effects on self-reported functioning SMD 0.19 (95% CI -0.57 to 0.95) n = 3 studies; positive effects on performance-based functioning SMD 0.37 (95% CI 0.07 to 0.68) n = 3 studies). No studies assessed moves to long-term care or hospitalisations. Currently the evidence base is of insufficient size, quality and breadth to recommend specific health promotion interventions for older people with mild or pre- frailty. High quality studies of rigorously developed interventions are needed. CRD42014010370 (Review 2).

Physiotherapy exercise programmes: are instructional exercise sheets effective?

PubMed

Smith, Jo; Lewis, Jeremy; Prichard, Diana

2005-01-01

Effective compliance with physiotherapy exercises is only possible if patients remember the exercises accurately. The purpose of this study was to assess how well elderly in-patients remembered simple physiotherapy exercises, by comparing the ability to accurately reproduce a set of exercises in a group of patients that had received a written exercise sheet, with a group that had not. The study also aimed to investigate the relationship between memory for exercises and cognition. Sixty-four in-patients in an acute hospital were taught 3 exercises. Half of the subjects were randomised to receive exercise sheets to reinforce the teaching (Group 1). The rest of the subjects did not receive this memory aid (Group 2). Two to three days later subjects were asked to demonstrate their exercises. The accurate recall of the exercises was scored using a new assessment scale with a maximum score of 24. The mean exercise score was 17.19 for group 1 (SD = 5.91) and 16.24 for Group 2 (SD = 6.01). There was no significant difference in exercise score between groups (Mann Whitney U test p = 0.44). There was a statistically significant small positive correlation between exercise score and cognition (tau = 0.263). The study showed that older adult in-patients do not remember physiotherapy exercises effectively after a single teaching session and that their memory is not significantly improved by provision of an exercise sheet.

The Effects of Two Self-Regulation Interventions to Increase Self-Efficacy and Group Exercise Behavior in Fitness Clubs

PubMed Central

Middelkamp, Jan; van Rooijen, Maaike; Wolfhagen, Peter; Steenbergen, Bert

2016-01-01

Studies on the adoption and maintenance of group exercise behavior are scarce. The objective of this study is to test two self-efficacy based interventions to increase barrier self-efficacy and group exercise behavior. In total 122 participants (Mage 42.02 yr.; SD 12.29; 67% females) were recruited and randomly assigned to one control and two experimental groups. The control group was limited to participate in one virtual group exercise program only (group 1). The first experimental group was able to self-set their activities and participate in multiple group exercise programs (group 2). The second experimental group received an additional monthly coaching protocol to manage self-set goals (group 3). A validated scale for barrier self-efficacy was used, group exercise sessions were measured and drop-out rates were registered. An ANOVA indicated that mean amount of sessions of group 1 and 3, and 2 and 3 differed significantly (p < 0.05) in 12 weeks. Descriptive statistics demonstrate mean group exercise sessions over the total of 12 weeks of 2.74 (SD 4.65) in the control group; 4.75 (SD 6.08) in the first experimental group, and 12.25 (SD 9.07) for the second experimental group. Regression analysis indicated that self-efficacy at 8-weeks explained the highest variance in overall group exercise sessions (R2 = 0.18; p < 0.05). Overall drop-out rates were 88% in group 1, 78% in group 2 and 48% in group 3. The results showed that group exercise behavior can significantly be improved by a coaching protocol on self-set goals. Future research should address the effectiveness of self-set activities and self-set goals for a longer period of time and in other types of exercise programs. Key points Approximately 144 million individuals exercise in fitness clubs worldwide. About 50% participate in at least one group exercise program and 23% participate only in group exercise classes with instructor. Research on attendance and exercise behavior in fitness clubs is limited but there are strong indications that the frequencies are low. This study demonstrates that group exercise behavior in fitness clubs can be improved significantly by a coaching protocol on self-set goals based on tenets of self-efficacy theory. PMID:27274676

The effects of exercise on oxidative stress (TBARS) and BDNF in severely depressed inpatients.

PubMed

Schuch, Felipe Barreto; Vasconcelos-Moreno, Mirela Paiva; Borowsky, Carolina; Zimmermann, Ana Beatriz; Wollenhaupt-Aguiar, Bianca; Ferrari, Pamela; de Almeida Fleck, Marcelo Pio

2014-10-01

Exercise can be an effective treatment for depression. Although the efficacy of exercise is well established, little is known concerning the biological changes associated with the antidepressant effects of exercise. A randomized, controlled trial was conducted to evaluate the effects of adding exercise to the usual treatment on the thiobarbituric acid-reactive substances (TBARS) and brain-derived neurotrophic factor (BDNF) serum levels of severely depressed inpatients. Twenty-six participants were randomized to an exercise group (n=15, exercise+treatment as usual) or a control group (n=11, treatment as usual). The participants in the exercise group completed a targeted dose of 16.5 kcal/kg/week of aerobic exercise, three times per week, throughout their hospitalizations. The control group did not exercise during their hospitalizations. The mean hospitalization length was of 21.63 (4.5)×23.82 (5.7) days for exercise and control groups, respectively. The exercise group performed a median of nine sessions. After adjusting for previous tobacco use, a significant group×time interaction was found for TBARS serum levels (p=0.02). A post hoc Bonferroni test revealed differences between the exercise and control groups at discharge. A significant time effect (p<0.001) but no group×time interaction was found (p=0.13) for BDNF serum levels. Adding exercise to the usual treatment of severely depressed inpatients decreases the TBARS serum levels of severely depressed inpatients after 3 weeks. Adding exercise had no additional effects on BDNF serum levels.

Effect of vitamin E (Tri E®) on antioxidant enzymes and DNA damage in rats following eight weeks exercise

PubMed Central

2011-01-01

Background Exercise is beneficial to health, but during exercise the body generates reactive oxygen species (ROS) which are known to result in oxidative stress. The present study analysed the effects of vitamin E (Tri E®) on antioxidant enzymes; superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (Cat) activity and DNA damage in rats undergoing eight weeks exercise. Methods Twenty four Sprague-Dawley rats (weighing 320-370 gm) were divided into four groups; a control group of sedentary rats which were given a normal diet, second group of sedentary rats with oral supplementation of 30 mg/kg/d of Tri E®, third group comprised of exercised rats on a normal diet, and the fourth group of exercised rats with oral supplementation of 30 mg/kg/d of Tri E®. The exercising rats were trained on a treadmill for 30 minutes per day for 8 weeks. Blood samples were taken before and after 8 weeks of the study to determine SOD, GPx, Cat activities and DNA damage. Results SOD activity decreased significantly in all the groups compared to baseline, however both exercised groups showed significant reduction in SOD activity as compared to the sedentary groups. Sedentary control groups showed significantly higher GPx and Cat activity compared to baseline and exercised groups. The supplemented groups, both exercised and non exercised groups, showed significant decrease in Cat activity as compared to their control groups with normal diet. DNA damage was significantly higher in exercising rats as compared to sedentary control. However in exercising groups, the DNA damage in supplemented group is significantly lower as compared to the non-supplemented group. Conclusions In conclusion, antioxidant enzymes activity were generally reduced in rats supplemented with Tri E® probably due to its synergistic anti-oxidative defence, as evidenced by the decrease in DNA damage in Tri E® supplemented exercise group. PMID:21513540

Effect of vitamin E (Tri E®) on antioxidant enzymes and DNA damage in rats following eight weeks exercise.

PubMed

Abd Hamid, Noor Aini; Hasrul, Mohd A; Ruzanna, Rusdiah J; Ibrahim, Ibrahim A; Baruah, Prasamit S; Mazlan, Musalmah; Yusof, Yasmin Anum Mohd; Ngah, Wan Zurinah Wan

2011-04-23

Exercise is beneficial to health, but during exercise the body generates reactive oxygen species (ROS) which are known to result in oxidative stress. The present study analysed the effects of vitamin E (Tri E®) on antioxidant enzymes; superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (Cat) activity and DNA damage in rats undergoing eight weeks exercise. Twenty four Sprague-Dawley rats (weighing 320-370 gm) were divided into four groups; a control group of sedentary rats which were given a normal diet, second group of sedentary rats with oral supplementation of 30 mg/kg/d of Tri E®, third group comprised of exercised rats on a normal diet, and the fourth group of exercised rats with oral supplementation of 30 mg/kg/d of Tri E®. The exercising rats were trained on a treadmill for 30 minutes per day for 8 weeks. Blood samples were taken before and after 8 weeks of the study to determine SOD, GPx, Cat activities and DNA damage. SOD activity decreased significantly in all the groups compared to baseline, however both exercised groups showed significant reduction in SOD activity as compared to the sedentary groups. Sedentary control groups showed significantly higher GPx and Cat activity compared to baseline and exercised groups. The supplemented groups, both exercised and non exercised groups, showed significant decrease in Cat activity as compared to their control groups with normal diet. DNA damage was significantly higher in exercising rats as compared to sedentary control. However in exercising groups, the DNA damage in supplemented group is significantly lower as compared to the non-supplemented group. In conclusion, antioxidant enzymes activity were generally reduced in rats supplemented with Tri E® probably due to its synergistic anti-oxidative defence, as evidenced by the decrease in DNA damage in Tri E® supplemented exercise group.

Framing new pathways in transformative exercise for individuals with existing and newly acquired disability

PubMed Central

Rimmer, James; Lai, Byron

2017-01-01

Abstract Purpose: This paper describes a continuum of customized exercise options for people with an existing and newly acquired disability or diagnosis referred to as the Transformative Exercise Framework. Background: The period directly after rehabilitation is a critical juncture where many individuals return to life with high rates of sedentary behavior. After rehabilitation discharge, people with newly acquired disability or diagnoses often never make the transition into usage of community-based exercise services that are tailored, safe and effective. Methods: Narrative review. Results: The Transformative Exercise Framework supports a patient-to-participant, rehab-to-wellness model that emphasizes a linkage between physical and occupational therapists and community-based exercise trainers. The four focus areas – Rehabilitation, Condition-specific Exercise, Fitness and Lifetime Physical Activity – emphasize a range of options for people with newly acquired disability and diagnoses, or for people with existing disability and/or chronic health conditions who have a new injury, secondary condition or are severely deconditioned. Conclusion: The concept of transformative exercise is to support people with disabilities and diagnoses with a seamless restore–improve–prevent continuum of programs and services. This continuum connects individuals to rehabilitation and exercise professionals in a dynamic framework, which maximizes the expertise of both sets of professionals and provides the most effective interventions to achieve the greatest gains in health and function and/or to avoid future health decline.Implications for RehabilitationPatients discharged from rehabilitation should be transformed into participants in lifelong physical activity through a continuum of health services, which we refer to as Transformative Exercise.Transformative exercise is a continuum of individually tailored exercise strategies/programs that aims to improve the function of underperforming systems, which inhibit community and/or lifelong physical activity participation.The Transformative Exercise Framework can be used by a therapist or exercise trainer to design a program that maximizes performance and time and is based on a specific process for identifying short and long term goals. PMID:26161458

Framing new pathways in transformative exercise for individuals with existing and newly acquired disability.

PubMed

Rimmer, James; Lai, Byron

2017-01-01

This paper describes a continuum of customized exercise options for people with an existing and newly acquired disability or diagnosis referred to as the Transformative Exercise Framework. The period directly after rehabilitation is a critical juncture where many individuals return to life with high rates of sedentary behavior. After rehabilitation discharge, people with newly acquired disability or diagnoses often never make the transition into usage of community-based exercise services that are tailored, safe and effective. Narrative review. The Transformative Exercise Framework supports a patient-to-participant, rehab-to-wellness model that emphasizes a linkage between physical and occupational therapists and community-based exercise trainers. The four focus areas - Rehabilitation, Condition-specific Exercise, Fitness and Lifetime Physical Activity - emphasize a range of options for people with newly acquired disability and diagnoses, or for people with existing disability and/or chronic health conditions who have a new injury, secondary condition or are severely deconditioned. The concept of transformative exercise is to support people with disabilities and diagnoses with a seamless restore-improve-prevent continuum of programs and services. This continuum connects individuals to rehabilitation and exercise professionals in a dynamic framework, which maximizes the expertise of both sets of professionals and provides the most effective interventions to achieve the greatest gains in health and function and/or to avoid future health decline. Implications for Rehabilitation Patients discharged from rehabilitation should be transformed into participants in lifelong physical activity through a continuum of health services, which we refer to as Transformative Exercise. Transformative exercise is a continuum of individually tailored exercise strategies/programs that aims to improve the function of underperforming systems, which inhibit community and/or lifelong physical activity participation. The Transformative Exercise Framework can be used by a therapist or exercise trainer to design a program that maximizes performance and time and is based on a specific process for identifying short and long term goals.

Trunk muscle exercises as a means of improving postural stability in people with Parkinson's disease: a protocol for a randomised controlled trial.

PubMed

Hubble, Ryan P; Naughton, Geraldine A; Silburn, Peter A; Cole, Michael H

2014-12-31

Exercise has been shown to improve clinical measures of strength, balance and mobility, and in some cases, has improved symptoms of tremor and rigidity in people with Parkinson's disease (PD). However, to date, no research has examined whether improvements in trunk control can remedy deficits in dynamic postural stability in this population. The proposed randomised controlled trial aims to establish whether a 12-week exercise programme aimed at improving dynamic postural stability in people with PD; (1) is more effective than education; (2) is more effective when training frequency is increased; and (3) provides greater long-term benefits than education. Forty-five community-dwelling individuals diagnosed with idiopathic PD with a falls history will be recruited. Participants will complete baseline assessments including tests of cognition, vision, disease severity, fear of falling, mobility and quality of life. Additionally, participants will complete a series of standing balance tasks to evaluate static postural stability, while dynamic postural control will be measured during walking using head and trunk-mounted three-dimensional accelerometers. Following baseline testing, participants will be randomly-assigned to one of three intervention groups, who will receive either exercise once per week, exercise 3 days/week, or education. Participants will repeat the same battery of tests conducted at baseline after the 12-week intervention and again following a further 12-week sustainability period. This study has the potential to show that low-intensity and progressive trunk exercises can provide a non-invasive and effective means for maintaining or improving postural stability for people with PD. Importantly, if the programme is noted to be effective, it could be easily performed by patients within their home environment or under the guidance of available allied health professionals. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001175763). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does self-efficacy mediate functional change in older adults participating in an exercise program after hip fracture? A randomized controlled trial.

PubMed

Chang, Feng-Hang; Latham, Nancy K; Ni, Pengsheng; Jette, Alan M

2015-06-01

To examine whether self-efficacy mediated the effect of the Home-based Post-Hip Fracture Rehabilitation program on activity limitations in older adults after hip fracture and whether the mediating effect was different between sex and age groups. Randomized controlled trial. Community. Participants with hip fracture (N=232; mean age ± SD, 79±9.4y) were randomly assigned to intervention (n=120, 51.7%) and attention control (n=112, 48.3%) groups. The 6-month intervention, the Home-based Post-Hip Fracture Rehabilitation, is a functionally oriented, home-based exercise program. Data were collected at baseline, postintervention (6mo), and follow-up (9mo). Activity Measure for Post-Acute Care. The mediating effect of the Home-based Post-Hip Fracture Rehabilitation program on Basic Mobility function through self-efficacy for exercise was significant at 9 months (βindirect=.21). Similarly, the mediating effect of the intervention on Daily Activity function through self-efficacy for exercise was significant at 9 months (βindirect=.49). In subgroup analyses, the mediating effect was significant at 9 months in the younger group (age, ≤79y) in comparison to the older group and was significant in women in comparison to men. Self-efficacy may play a partial mediating role in the effect on some longer-term functional outcomes in the Home-based Post-Hip Fracture Rehabilitation intervention. The results suggest that program components that target self-efficacy should be incorporated in future hip fracture rehabilitation interventions. Age and sex of the targeted participants may also need to be considered when developing interventions. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

“Any Movement at All Is Exercise”: A Focused Ethnography of Rural Community-Dwelling Older Adults' Perceptions and Experiences of Exercise as Self-Care

PubMed Central

Connelly, Denise M.

2013-01-01

ABSTRACT Purpose: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care. Methods: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation. Results: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants preferred exercise that was enjoyable and previously experienced. Conclusions: Prescribing exercise for older adults may be particularly effective if the focus is on enjoyable and previously experienced physical activity and if it incorporates interpretation of exercise guidelines and training principles in relation to chronic conditions and potential health benefits. PMID:24396160

Reducing falls among older people in general practice: The ProAct65+ exercise intervention trial.

PubMed

Gawler, S; Skelton, D A; Dinan-Young, S; Masud, T; Morris, R W; Griffin, M; Kendrick, D; Iliffe, S

2016-01-01

Falls are common in the older UK population and associated costs to the NHS are high. Systematic reviews suggest that home exercise and group-based exercise interventions, which focus on progressively challenging balance and increasing strength, can reduce up to 42% of falls in those with a history of falls. The evidence is less clear for those older adults who are currently at low risk of falls. ProAct65+, a large, cluster-randomised, controlled trial, investigated the effectiveness of a home exercise programme (Otago Exercise Programme (OEP)) and a group-based exercise programme (Falls Management Exercise (FaME)) compared to usual care (UC) at increasing moderate to vigorous physical activity (MVPA). This paper examines the trial's secondary outcomes; the effectiveness of the interventions at reducing falls and falls-related injuries. 1256 community-dwelling older adults (aged 65+) were recruited through GP practices in two sites (London and Nottingham). Frequent fallers (≥3 falls in last year) and those with unstable medical conditions were excluded, as were those already reaching the UK Government recommended levels of physical activity (PA) for health. Baseline assessment (including assessment of health, function and previous falls) occurred before randomisation; the intervention period lasted 24 weeks and there was an immediate post-intervention assessment; participants were followed up every six months for 24 months. Falls data were analysed using negative binomial modelling. Falls data were collected prospectively during the intervention period by 4-weekly diaries (6 in total). Falls recall was recorded at the 3-monthly follow-ups for a total of 24 months. Balance was measured at baseline and at the end of the intervention period using the Timed Up & Go and Functional Reach tests. Balance confidence (CONFbal), falls risk (FRAT) and falls self-efficacy (FES-I) were measured by questionnaire at baseline and at all subsequent assessment points. 294 participants (24%) reported one or two falls in the previous year. There was no increase in falls in either exercise group compared to UC during the intervention period (resulting from increased exposure to risk). The FaME arm experienced a significant reduction in injurious falls compared to UC (incidence rate ratio (IRR) 0.55, 95% CI 0.31, 0.96; p=0.04) and this continued during the 12 months after the end of the intervention (IRR 0.73, 95% CI 0.54, 0.99; p=0.05). There was also a significant reduction in the incidence of all falls (injurious and non-injurious) in the FaME arm compared with UC (IRR 0.74, 95% CI 0.55, 0.99; p=0.04) in the 12 month period following the cessation of the intervention. There was a non-significant reduction in the incidence of all falls in the OEP arm compared with UC (IRR 0.76, 95% CI 0.53, 1.09; p=0.14) in the 12 months following the cessation of the intervention. The effects on falls did not persist at the 24 months assessment in either exercise arm. However, when those in the FaME group who continued to achieve 150min of MVPA per week into the second post-intervention year were compared to those in the FaME group who did not maintain their physical activity, there was a significant reduction in falls incidence (IRR=0.49, 95% CI 0.30, 0.79; p=0.004). CONFbal was significantly improved at 12 months post intervention in both intervention arms compared with UC. There were no significant changes in any of the functional balance measures, FES-I or FRAT, between baseline and the end of the intervention period. Community-dwelling older adults who joined an exercise intervention (FaME) aimed at increasing MVPA did not fall more during the intervention period, fell less and had fewer injurious falls in the 12 months after cessation of the intervention. However, 24 months after cessation of exercise, the beneficial effects of FaME on falls reduction ceased, except in those who maintained higher levels of MVPA. OEP exercise appears less effective at reducing falls in this functionally more able population of older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Telerehabilitation Approach to Enhance Quality of Life Through Exercise Among Adults With Paraplegia: Study Protocol.

PubMed

Sweet, Shane Norman; Rocchi, Meredith; Arbour-Nicitopoulos, Kelly; Kairy, Dahlia; Fillion, Brigitte

2017-10-19

Despite compelling evidence linking physical activity and quality of life among adults with spinal cord injury (SCI), exercise participation rates are extremely low in this population. Unfortunately, a lack of behavioral exercise interventions, in particular theory-based randomized controlled trials (RCT), exists within the SCI literature. A pilot RCT is needed to first examine the feasibility to conduct such interventions and determine the appropriate effect size to inform future full-scale interventions. The overall goal of this pilot RCT is to test an 8-week innovative, video-based telerehabilitation intervention based on self-determination theory and aimed at enhancing the basic psychological needs, motivation, exercise participation, and quality of life‒related outcomes of adults with paraplegia. The objectives are to (1) determine if individuals in the intervention group have greater increases in their basic psychological needs and autonomous motivation and a decrease in controlled motivation compared to the control group, (2) determine whether the intervention group reports greater increases in exercise participation and quality of life‒related variables (eg, life satisfaction, participation in daily/social activities, depressive symptoms) compared to the control group, and (3) examine if adults with paraplegia who received the intervention report improved scores on psychosocial predictors of exercise (eg, action planning) and well-being (eg, positive affect) compared to the control group. We also aimed to examine the implementation characteristics of the intervention (eg, satisfaction with the technology, counselor's ability to foster the psychological needs). Adults with paraplegia (N=24) living in the community will be recruited. All participants will be invited to complete assessments of their psychological needs, motivation, exercise, and quality of life‒related variables at three time points (baseline, 6, and 10 weeks). Following the baseline assessment, participants will be randomly assigned to the intervention or control group. Participants in the intervention group will participate in 8 weekly, 1-hour video-based telerehabilitation sessions with a trained physical activity counselor, while participants in the control group will be asked to continue with their regular routine. We expect higher ratings of the basic psychological needs and autonomous motivation and lower scores for controlled motivation for the intervention group compared to the control group (Objective 1). We also expect that our video-based intervention will have moderate effects on exercise participation, as well as small-to-moderate positive effects on the quality of life‒related variables (Objective 2). Finally, we expect the intervention to have a small positive effect on psychosocial predictors of physical activity and well-being (Objective 3). We anticipate that the results will show that the intervention is appropriate for adults with paraplegia and feasible to test in a full-scale RCT. ClinicalTrials.gov NCT02833935; https://clinicaltrials.gov/ct2/show/NCT02833935 (Archived by WebCite at http://www.webcitation.org/6u8U9x2yt). ©Shane Norman Sweet, Meredith Rocchi, Kelly Arbour-Nicitopoulos, Dahlia Kairy, Brigitte Fillion. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 19.10.2017.

The effectiveness of Cognitive Behavioral Therapy (CBT) with general exercises versus general exercises alone in the management of chronic low back pain.

PubMed

Khan, Muhammad; Akhter, Saeed; Soomro, Rabail Rani; Ali, Syed Shahzad

2014-07-01

To evaluate the effectiveness of Cognitive Behavioural Therapy (CBT) along with General exercises and General exercises alone in chronic low back pain. Total 54 patients with chronic low back pain who fulfilled inclusion criteria were recruited from Physiotherapy, Department of Alain Poly Clinic Karachi and Institute of Physical Medicine & Rehabilitation Dow University of Health Sciences Karachi. Selected patients were equally divided and randomly assigned into two groups with simple randomisation method. The Cognitive Behavioural Therapy (CBT) and General exercises group received Operant model of CBT and General Exercises whereas General exercises group received General exercises only. Both groups received a home exercise program as well. Patients in both groups received 3 treatment sessions per week for 12 consecutive weeks. Clinical assessment was performed using Visual Analogue Scale (VAS) and Ronald Morris Disability Questionnaire at baseline and after 12 weeks. Both study groups showed statistically significant improvements in both outcomes measures p=0.000. However, mean improvements in post intervention VAS score and Ronald Morris score was better in CBT and exercises group as compared to General exercise group. In conclusion, both interventions are effective in treating chronic low back pain however; CBT & General exercises are clinically more effective than General exercises alone.

Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program.

PubMed

Renfro, Mindy; Bainbridge, Donna B; Smith, Matthew Lee

2016-01-01

Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. Despite the limited number of participants ( n  = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more participants in diverse geographic regions with longer lengths of participation and follow-up.

Independent, Community-Based Aerobic Exercise Training for People With Moderate-to-Severe Traumatic Brain Injury.

PubMed

Devine, Jennifer M; Wong, Bonnie; Gervino, Ernest; Pascual-Leone, Alvaro; Alexander, Michael P

2016-08-01

To determine whether people with moderate-to-severe traumatic brain injury (TBI) can adhere to a minimally supervised, community-based, vigorous aerobic exercise program. Prospective trial. Young Men's Christian Association (YMCA) facilities. Community-dwelling volunteers (N=10; 8 men, 2 women; age range, 22-49y) 6 to 15 months after moderate-to-severe TBI. Participants received memberships to local YMCAs and brief orientations to exercise. They were then asked to independently complete ≥12 weeks of ≥3 training sessions per week, performed at 65% to 85% of maximum heart rate for ≥30 minutes per session. Participants could self-select exercise modality, provided they met intensity and duration targets. Programmable heart rate monitors captured session intensity and duration. Independence with equipment and facility use and compliance with training goals (session frequency, duration, intensity, total weeks of training). All participants achieved independence with equipment and facility use. All met at least 2 of 4 training goals; half met all 4 goals. Participants averaged (±SD) 3.3±0.7 sessions per week for 13 weeks (range, 6-24). Average ± SD session duration was 62±23 minutes, of which 51±22 minutes occurred at or above individuals' heart rate training targets. People in recovery from moderate-to-severe TBI can, with minimal guidance, perform vigorous, community-based exercise. This suggests that decentralized exercise may be logistically and economically sustainable after TBI, expanding its potential therapeutic utility and rendering longer-duration exercise studies more feasible. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Community-based Randomized Controlled Trial of Non-pharmacological Interventions in Prevention and Control of Hypertension among Young Adults.

PubMed

Saptharishi, Lg; Soudarssanane, Mb; Thiruselvakumar, D; Navasakthi, D; Mathanraj, S; Karthigeyan, M; Sahai, A

2009-10-01

Hypertension is a major chronic lifestyle disease. Several non-pharmacological interventions are effective in bringing down the blood pressure (BP). This study focuses on the effectiveness of such interventions among young adults. To measure the efficacy of physical exercise, reduction in salt intake, and yoga, in lowering BP among young (20-25) pre-hypertensives and hypertensives, and to compare their relative efficacies. The study was done in the urban service area of JIPMER. Pre-hypertensives and hypertensives, identified from previous studies, constituted the universe. The participants were randomized into one control and three interventional groups. A total of 113 subjects: 30, 28, 28 and 27 in four groups respectively participated for eight weeks: control (I), physical exercise (II) - brisk walking for 50-60 minutes, four days/week, salt intake reduction (III) - to at least half of their previous intake, and practice of yoga (IV) - for 30-45 minutes/day on at least five days/week. Efficacy was assessed using paired t test and ANOVA with Games Howell post hoc test. An intention to treat analysis was also performed. A total of 102 participants (29, 27, 25 and 21 in groups I, II, III and IV) completed the study. All three intervention groups showed a significant reduction in BP (SBP/DBP: 5.3/6.0 in group II, 2.6/3.7 in III, and 2.0/2.6 mm Hg in IV respectively). There was no significant change (SBP/DBP: 0.2/0.5 mmHg) of BP in control group (I). Physical exercise was most effective (considered individually); salt intake reduction and yoga were also effective. Physical exercise, salt intake reduction, and yoga are effective non-pharmacological interventions in significantly reducing BP among young hypertensives and pre-hypertensives. These can therefore be positively recommended for hypertensives. There is also a case to deploy these interventions in the general population.

Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: "feet first" randomized controlled trial.

PubMed

Kruse, Robin L; Lemaster, Joseph W; Madsen, Richard W

2010-11-01

Weight-bearing exercise has been discouraged for people with diabetes mellitus and peripheral neuropathy (DM+PN). However, people with diabetes mellitus and insensate feet have an increased risk of falling. Lower-extremity exercise and balance training reduce fall risk in some older adults. It is unknown whether those with neuropathy experience similar benefits. As part of a study of the effects of weight-bearing exercise on foot ulceration in people with DM+PN, the effects of a lower-extremity exercise and walking intervention on balance, lower-extremity strength (force-generating capacity), and fall incidence were determined. Design The study was an observer-masked, 12-month randomized controlled trial. Part 1 of the intervention took place in physical therapy offices, and part 2 took place in the community. The participants were 79 people who were mostly sedentary, who had DM+PN, and who were randomly assigned to either a control group (n=38) or an intervention group (n=41). Intervention Part 1 included leg strengthening and balance exercises and a graduated, self-monitored walking program; part 2 included motivational telephone calls. Both groups received regular foot care, foot care education, and 8 sessions with a physical therapist. The measurements collected were strength, balance, and participant-reported falls for the year after enrollment. There were no statistically significant differences between the groups for falls during follow-up. At 12 months, there was a small increase in the amount of time that participants in the intervention group could stand on 1 leg with their eyes closed. No other strength or balance measurements differed between the groups. The study was designed to detect differences in physical activity, not falls. The intensity of the intervention was insufficient to improve strength and balance in this population. The training program had a minimal effect on participants' balance and lower-extremity strength. Increasing weight-bearing activity did not alter the rate of falling for participants in the intervention group relative to that for participants in the control group. People who are sedentary and who have DM+PN appear to be able to increase activity without increasing their rate of falling.

Role-Reversal Exercise with Deaf Strong Hospital to Teach Communication Competency and Cultural Awareness

PubMed Central

Parkhill, Amy L.; Schlehofer, Deirdre A.; Starr, Matthew J.; Barnett, Steven

2011-01-01

Objective To implement a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing patients. Design Volunteers from the local deaf community conducted Deaf Strong Hospital, a role-reversal exercise in which students were the “patients.” Students navigated through a reception area, encounter with a physician, and having a prescription filled at a pharmacy without receiving or using any spoken language. Assessment A debriefing session was held in which small groups of students had the opportunity to ask questions of a panel of deaf and hard-of-hearing volunteers. On a survey administered to assess students' learning, 97% agreed or strongly agreed that the experience would likely impact their attitudes and behavior in future interactions with patients who did not speak English. Conclusions The role-reversal exercise was an effective method of teaching students that the delivery of health care is dependent on adequate communication between health care providers and the patient. PMID:21655407

A randomized trial of individual versus group-format exercise and self-management in individuals with Parkinson's disease and comorbid depression.

PubMed

Sajatovic, Martha; Ridgel, Angela L; Walter, Ellen M; Tatsuoka, Curtis M; Colón-Zimmermann, Kari; Ramsey, Riane K; Welter, Elisabeth; Gunzler, Steven A; Whitney, Christina M; Walter, Benjamin L

2017-01-01

Depression is common in people with Parkinson's disease (PD), and exercise is known to improve depression and PD. However, lack of motivation and low self-efficacy can make exercise difficult for people with PD and comorbid depression (PD-Dep). A combined group exercise and chronic disease self-management (CDSM) program may improve the likeli-hood that individuals will engage in exercise and will show a reduction in depression symptoms. The purpose of this study was to compare changes in depression in PD-Dep between individual versus group exercise plus CDSM and to examine participant adherence and perception of the interventions. Participants (N=30) were randomized to either Enhanced EXerCisE thErapy for PD (EXCEED; group CDSM and exercise) or self-guided CDSM plus exercise. Outcomes were change in depression assessed with the Montgomery-Asberg Depression Rating Scale (MADRS), cognition, apathy, anxiety, sleep, quality of life, motor function, self-efficacy, and patient satisfaction. Both groups showed significant improvement in MADRS ( P <0.001) with no significant group difference. Individuals in EXCEED group enjoyed the group dynamics but noted difficulty with the fixed-time sessions. Both group CDSM plus exercise and self-guided CDSM plus exercise can improve depression in PD-Dep. These findings suggest that development of a remotely delivered group-based CDSM format plus manualized exercise program could be useful for this population.

Effects of an exercise programme for chronically ill and mobility-restricted elderly with structured support by the general practitioner's practice (HOMEfit) - study protocol of a randomised controlled trial

PubMed Central

2011-01-01

Background Exercise programmes can be administered successfully as therapeutic agents to patients with a number of chronic diseases and help to improve physical functioning in older adults. Usually, such programmes target either healthy and mobile community-dwelling seniors or elderly individuals living in nursing institutions or special residences. Chronically ill or mobility-restricted individuals, however, are difficult to reach when they live in their own homes. A pilot study has shown good feasibility of a home-based exercise programme that is delivered to this target group through cooperation between general practitioners and exercise therapists. A logical next step involves evaluation of the effects of the programme. Methods/design The study is designed as a randomised controlled trial. We plan to recruit 210 patients (≥ 70 years) in about 15 general practices. The experimental intervention (duration 12 weeks)-a multidimensional home-based exercise programme-is delivered to the participant by an exercise therapist in counselling sessions at the general practitioner's practice and on the telephone. It is based on methods and strategies for facilitating behaviour change according to the Health Action Process Approach (HAPA). The control intervention-baseline physical activities-differs from the experimental intervention with regard to content of the counselling sessions as well as to content and frequency of the promoted activities. Primary outcome is functional lower body strength measured by the "chair-rise" test. Secondary outcomes are: physical function (battery of motor tests), physical activity (step count), health-related quality of life (SF-8), fall-related self-efficacy (FES-I), and exercise self-efficacy (SSA-Scale). The hypothesis that there will be differences between the two groups (experimental/control) with respect to post-interventional chair-rise time will be tested using an ANCOVA with chair-rise time at baseline, treatment group, and study centre effects as explanatory variables. Analysis of the data will be undertaken using the principle of intention-to-treat. Trial registration Current Controlled Trials ISRCTN17727272. PMID:22188781

Aerobic Interval Exercise Training Induces Greater Reduction in Cardiac Workload in the Recovery Period in Rats

PubMed Central

Borges, Juliana Pereira; Masson, Gustavo Santos; Tibiriçá, Eduardo; Lessa, Marcos Adriano

2014-01-01

Background Aerobic interval exercise training has greater benefits on cardiovascular function as compared with aerobic continuous exercise training. Objective The present study aimed at analyzing the effects of both exercise modalities on acute and subacute hemodynamic responses of healthy rats. Methods Thirty male rats were randomly assigned into three groups as follows: continuous exercise (CE, n = 10); interval exercise (IE, n = 10); and control (C, n = 10). Both IE and CE groups performed a 30-minute exercise session. The IE group session consisted of three successive 4-minute periods at 60% of maximal velocity (Max Vel), with 4-minute recovery intervals at 40% of Max Vel. The CE group ran continuously at 50% of Max Vel. Heart rate (HR), blood pressure(BP), and rate pressure product (RPP) were measured before, during and after the exercise session. Results The CE and IE groups showed an increase in systolic BP and RPP during exercise as compared with the baseline values. After the end of exercise, the CE group showed a lower response of systolic BP and RPP as compared with the baseline values, while the IE group showed lower systolic BP and mean BP values. However, only the IE group had a lower response of HR and RPP during recovery. Conclusion In healthy rats, one interval exercise session, as compared with continuous exercise, induced similar hemodynamic responses during exercise. However, during recovery, the interval exercise caused greater reductions in cardiac workload than the continuous exercise. PMID:24270864

The benefits and tolerance of exercise in myasthenia gravis (MGEX): study protocol for a randomised controlled trial.

PubMed

Birnbaum, Simone; Hogrel, Jean-Yves; Porcher, Raphael; Portero, Pierre; Clair, Bernard; Eymard, Bruno; Demeret, Sophie; Bassez, Guillaume; Gargiulo, Marcela; Louët, Estelle; Berrih-Aknin, Sonia; Jobic, Asmaa; Aegerter, Philippe; Thoumie, Philippe; Sharshar, Tarek

2018-01-18

Research exploring the effects of physical exercise in auto-immune myasthenia gravis (MG) is scarce. The few existing studies present methodological shortcomings limiting the conclusions and generalisability of results. It is hypothesised that exercise could have positive physical, psychological as well as immunomodulatory effects and may be a beneficial addition to current pharmacological management of this chronic disease. The aim of this study is to evaluate the benefits on perceived quality of life (QOL) and physical fitness of a home-based physical exercise program compared to usual care, for patients with stabilised, generalised auto-immune MG. MGEX is a multi-centre, interventional, randomised, single-blind, two-arm parallel group, controlled trial. Forty-two patients will be recruited, aged 18-70 years. Following a three-month observation period, patients will be randomised into a control or experimental group. The experimental group will undertake a 40-min home-based physical exercise program using a rowing machine, three times a week for three months, as an add-on to usual care. The control group will receive usual care with no additional treatment. All patients will be followed up for a further three months. The primary outcome is the mean change in MGQOL-15-F score between three and six months (i.e. pre-intervention and immediately post-intervention periods). The MGQOL-15-F is an MG-specific patient-reported QOL questionnaire. Secondary outcomes include the evaluation of deficits and functional limitations via MG-specific clinical scores (Myasthenia Muscle Score and MG-Activities of Daily Living scale), muscle force and fatigue, respiratory function, free-living physical activity as well as evaluations of anxiety, depression, self-esteem and overall QOL with the WHO-QOL BREF questionnaire. Exercise workload will be assessed as well as multiple safety measures (ECG, biological markers, medication type and dosage and any disease exacerbation or crisis). This is the largest randomised controlled trial to date evaluating the benefits and tolerance of physical exercise in this patient population. The comprehensive evaluations using standardised outcome measures should provide much awaited information for both patients and the scientific community. This study is ongoing. ClinicalTrials.gov, NCT02066519 . Registered on 13 January 2014.

Effect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damage

PubMed Central

2012-01-01

Background Exercise-induced muscle damage (EIMD) is accompanied by localized oxidative stress / inflammation which, in the short-term at least, is associated with impaired muscular performance. Dietary antioxidants have been shown to reduce excessive oxidative stress; however, their effectiveness in facilitating recovery following EIMD is not clear. Blueberries demonstrate antioxidant and anti-inflammatory properties. In this study we examine the effect of New Zealand blueberries on EIMD after strenuous eccentric exercise. Methods In a randomized cross-over design, 10 females consumed a blueberry smoothie or placebo of a similar antioxidant capacity 5 and 10 hours prior to and then immediately, 12 and 36 hours after EIMD induced by 300 strenuous eccentric contractions of the quadriceps. Absolute peak and average peak torque across the knee, during concentric, isometric, and eccentric actions were measured. Blood biomarkers of oxidative stress, antioxidant capacity, and inflammation were assessed at 12, 36 and 60 hours post exercise. Data were analyzed using a two-way ANOVA. Results A significant (p < 0.001) decrease in isometric, concentric and eccentric torque was observed 12 hours following exercise in both treatment groups. During the 60 hour recovery period, a significant (p = 0.047) interaction effect was seen for peak isometric tension suggesting a faster rate of recovery in the blueberry intervention group. A similar trend was observed for concentric and eccentric strength. An increase in oxidative stress and inflammatory biomarkers was also observed in both treatment groups following EIMD. Although a faster rate of decrease in oxidative stress was observed in the blueberry group, it was not significant (p < 0.05) until 36 hours post-exercise and interestingly coincided with a gradual increase in plasma antioxidant capacity, whereas biomarkers for inflammation were still elevated after 60 hours recovery. Conclusions This study demonstrates that the ingestion of a blueberry smoothie prior to and after EIMD accelerates recovery of muscle peak isometric strength. This effect, although independent of the beverage’s inherent antioxidant capacity, appears to involve an up-regulation of adaptive processes, i.e. endogenous antioxidant processes, activated by the combined actions of the eccentric exercise and blueberry consumption. These findings may benefit the sporting community who should consider dietary interventions that specifically target health and performance adaptation. PMID:22564864

Effect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damage.

PubMed

McLeay, Yanita; Barnes, Matthew J; Mundel, Toby; Hurst, Suzanne M; Hurst, Roger D; Stannard, Stephen R

2012-07-11

Exercise-induced muscle damage (EIMD) is accompanied by localized oxidative stress / inflammation which, in the short-term at least, is associated with impaired muscular performance. Dietary antioxidants have been shown to reduce excessive oxidative stress; however, their effectiveness in facilitating recovery following EIMD is not clear. Blueberries demonstrate antioxidant and anti-inflammatory properties. In this study we examine the effect of New Zealand blueberries on EIMD after strenuous eccentric exercise. In a randomized cross-over design, 10 females consumed a blueberry smoothie or placebo of a similar antioxidant capacity 5 and 10 hours prior to and then immediately, 12 and 36 hours after EIMD induced by 300 strenuous eccentric contractions of the quadriceps. Absolute peak and average peak torque across the knee, during concentric, isometric, and eccentric actions were measured. Blood biomarkers of oxidative stress, antioxidant capacity, and inflammation were assessed at 12, 36 and 60 hours post exercise. Data were analyzed using a two-way ANOVA. A significant (p < 0.001) decrease in isometric, concentric and eccentric torque was observed 12 hours following exercise in both treatment groups. During the 60 hour recovery period, a significant (p = 0.047) interaction effect was seen for peak isometric tension suggesting a faster rate of recovery in the blueberry intervention group. A similar trend was observed for concentric and eccentric strength. An increase in oxidative stress and inflammatory biomarkers was also observed in both treatment groups following EIMD. Although a faster rate of decrease in oxidative stress was observed in the blueberry group, it was not significant (p < 0.05) until 36 hours post-exercise and interestingly coincided with a gradual increase in plasma antioxidant capacity, whereas biomarkers for inflammation were still elevated after 60 hours recovery. This study demonstrates that the ingestion of a blueberry smoothie prior to and after EIMD accelerates recovery of muscle peak isometric strength. This effect, although independent of the beverage's inherent antioxidant capacity, appears to involve an up-regulation of adaptive processes, i.e. endogenous antioxidant processes, activated by the combined actions of the eccentric exercise and blueberry consumption. These findings may benefit the sporting community who should consider dietary interventions that specifically target health and performance adaptation.

The effects of dance music jump rope exercise on pulmonary function and body mass index after music jump rope exercise in overweight adults in 20's.

PubMed

Seo, KyoChul

2017-08-01

[Purpose] The purpose of this study was to examine the effect of a dance music jump rope exercise on changes Pulmonary Function and body mass index in female overweight subjects in their 20's. [Subjects and Methods] The subjects were randomly assigned to the dance music jump rope exercise group and the stationary cycle exercise group. All subjects have conducted the exercises three times a week for four weeks. Pulmonary function was evaluated using a spirometer, and body mass index was evaluated using an InBody 3.0. [Results] The findings of this study showed significant improvements in the voluntary capacity and body mass index of the experimental groups. Vital capacity was higher in the music jump rope exercise group than the stationary cycle exercise group, and body mass index was lower in the music jump rope exercise group than the stationary cycle exercise group. [Conclusion] This study showed that the dance music jump rope exercise can be used to improve vital capacity and body mass index.

Shadow Bowl 2003: a collaborative exercise in community readiness, agency cooperation, and medical response.

PubMed

Balch, David; Taylor, Carl; Rosenthal, David; Bausch, Chris; Warner, Dave; Morris, Ray

2004-01-01

This paper describes a model for homeland security, community readiness, and medical response that was applied during an operational exercise around Super Bowl XXXVII. In addition, it describes the products provided by private companies involved in the exercise and how they would have contributed to a medical disaster had one occurred. The purpose of Shadow Bowl was to demonstrate community readiness and medical response to a mass casualty event. The goals of the project were to: (1) provide enhanced public safety using an advanced communication network and sensor grid; (2) develop mass casualty surge capabilities through medical reach-back; and (3) build a collaboration model between civilian, military, public, and private partners. The results of the Shadow Bowl Exercise accentuated the value of new telehealth and disaster medicine tools in treating large numbers of patients when infrastructure overload occurs.

Peer associations for substance use and exercise in a college student social network.

PubMed

Barnett, Nancy P; Ott, Miles Q; Rogers, Michelle L; Loxley, Michelle; Linkletter, Crystal; Clark, Melissa A

2014-10-01

Substance use and exercise have opposite trajectories in young adulthood, and research indicates that peers are influential for both of these health behaviors, but simultaneous investigations of peer associations with substance use and exercise have not been conducted. Use a college residence hall peer network to examine associations between peer behaviors and alcohol use, marijuana use, and exercise behavior. 129 undergraduates (51.9% female, 48.1% non-Hispanic White; 84.5% first-year students) in one residence hall completed a Web-based survey of substance use and exercise and identified up to 10 students in the residence hall who were important to them. Two social network analytic methods, community detection cluster analysis and network autocorrelation modeling, were used to identify peer groupings and to examine the associations between peer and participant behaviors, respectively. Participants nominated an average of 4.1 residence hall members, and 53.9% of the ties were reciprocal. 6 clusters were identified that differed significantly on demographics, college activities, substance use, and exercise. Weekly volume of alcohol consumed among nominated peers was significantly associated with that of participants, and all other covariates, including gender and athlete status, were not significant. Peer marijuana use also was associated with participant use after controlling for covariates. Exercise levels of nominated peers were not associated with exercise levels of participants. College student networks may be good targets for health-related prevention programs. Programs that use close-proximity peers to influence the behavior of others might be more effective with substance use as the target behavior than exercise.

A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong.

PubMed

Leung, Ying-Ying; Kwan, Jackie; Chan, Patsy; Poon, Peter K K; Leung, Christine; Tam, Lai-Shan; Li, Edmund K; Kwok, Anna

2016-04-01

The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of "shared care collaboration" between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.

Community preferences for a social health insurance benefit package: an exploratory study among the uninsured in Vietnam.

PubMed

Nguyen, Hoa Thi; Luu, Tinh Viet; Leppert, Gerald; De Allegri, Manuela

2017-01-01

Understanding public preferences in terms of health benefit packages (HBPs) remains limited, yet gathering community insights is an important endeavour when developing people-centred health systems and moving towards universal health coverage. Our study aimed to address this gap in knowledge by eliciting community preferences for the social health insurance benefit package among the uninsured in Vietnam. We adopted a mixed methods approach that included a ranking exercise followed by focus group discussions. We collected quantitative and qualitative data from 174 uninsured people in Bac Giang, a province in northern Vietnam. Study participants were purposively selected from 12 communities and assembled in 14 group sessions that entailed three stages: participants first selected and ranked benefit items individually, then in groups and finally they engaged in a discussion regarding their decisions. The majority of respondents (both as individuals and as groups) preferred an HBP that covers both curative and preventive care, with a strong preference for the inclusion of high-cost care, resulting from rare and costly events (inpatient care), as well as frequent and less costly events (drugs, tests and outpatient care). The process of group discussion highlighted how individual choices could be modified in the context of group negotiation. The shift in preferences was motivated by the wish to protect low-income people from catastrophic expenditure while maximising community access to vital yet costly healthcare services. Future research, interventions and policies can built on this initial exploration of preferences to explore how stakeholders can engage communities and support greater public involvement in the development of HBPs in Vietnam and other low-income and middle-income countries.

Whole body vibration exercise improves body balance and walking velocity in postmenopausal osteoporotic women treated with alendronate: Galileo and Alendronate Intervention Trail (GAIT).

PubMed

Iwamoto, J; Sato, Y; Takeda, T; Matsumoto, H

2012-09-01

A randomized controlled trial was conducted to determine the effect of 6 months of whole body vibration (WBV) exercise on physical function in postmenopausal osteoporotic women treated with alendronate. Fifty-two ambulatory postmenopausal women with osteoporosis (mean age: 74.2 years, range: 51-91 years) were randomly divided into two groups: an exercise group and a control group. A four-minute WBV exercise was performed two days per week only in the exercise group. No exercise was performed in the control group. All the women were treated with alendronate. After 6 months of the WBV exercise, the indices for flexibility, body balance, and walking velocity were significantly improved in the exercise group compared with the control group. The exercise was safe and well tolerated. The reductions in serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen during the 6-month period were comparable between the two groups. The present study showed the benefit and safety of WBV exercise for improving physical function in postmenopausal osteoporotic women treated with alendronate.

Lessons learned from recent geomagnetic disturbance model validation activities

NASA Astrophysics Data System (ADS)

Pulkkinen, A. A.; Welling, D. T.

2017-12-01

Due to concerns pertaining to geomagnetically induced current impact on ground-based infrastructure, there has been significantly elevated interest in applying models for local geomagnetic disturbance or "delta-B" predictions. Correspondingly there has been elevated need for testing the quality of the delta-B predictions generated by the modern empirical and physics-based models. To address this need, community-wide activities were launched under the GEM Challenge framework and one culmination of the activities was the validation and selection of models that were transitioned into operations at NOAA SWPC. The community-wide delta-B action is continued under the CCMC-facilitated International Forum for Space Weather Capabilities Assessment and its "Ground Magnetic Perturbations: dBdt, delta-B, GICs, FACs" working group. The new delta-B working group builds on the past experiences and expands the collaborations to cover the entire international space weather community. In this paper, we discuss the key lessons learned from the past delta-B validation exercises and lay out the path forward for building on those experience under the new delta-B working group.

Integrated Modeling, Mapping, and Simulation (IMMS) Framework for Exercise and Response Planning

NASA Technical Reports Server (NTRS)

Mapar, Jalal; Hoette, Trisha; Mahrous, Karim; Pancerella, Carmen M.; Plantenga, Todd; Yang, Christine; Yang, Lynn; Hopmeier, Michael

2011-01-01

EmergenCy management personnel at federal, stale, and local levels can benefit from the increased situational awareness and operational efficiency afforded by simulation and modeling for emergency preparedness, including planning, training and exercises. To support this goal, the Department of Homeland Security's Science & Technology Directorate is funding the Integrated Modeling, Mapping, and Simulation (IMMS) program to create an integrating framework that brings together diverse models for use by the emergency response community. SUMMIT, one piece of the IMMS program, is the initial software framework that connects users such as emergency planners and exercise developers with modeling resources, bridging the gap in expertise and technical skills between these two communities. SUMMIT was recently deployed to support exercise planning for National Level Exercise 2010. Threat, casualty. infrastructure, and medical surge models were combined within SUMMIT to estimate health care resource requirements for the exercise ground truth.

Effects of grape seed polyphenols on oxidative damage in liver tissue of acutely and chronically exercised rats.

PubMed

Belviranlı, Muaz; Gökbel, Hakkı; Okudan, Nilsel; Büyükbaş, Sadık

2013-05-01

The objective of the present study was to investigate the effects of grape seed extract (GSE) supplementation on oxidative stress and antioxidant defense markers in liver tissue of acutely and chronically exercised rats. Rats were randomly assigned to six groups: Control (C), Control Chronic Exercise (CE), Control Acute Exercise (AE), GSE-supplemented Control (GC), GSE-supplemented Chronic Exercise(GCE) and GSE-supplemented Acute Exercise (GAE). Rats in the chronic exercise groups were subjected to a six-week treadmill running and in the acute exercise groups performed an exhaustive running. Rats in the GSE supplemented groups received GSE (100 mg.kg(-1) .day(-1) ) in drinking water for 6 weeks. Liver tissues of the rats were taken for the analysis of malondialdehyde (MDA), nitric oxide (NO) levels and total antioxidant activity (AOA) and xanthine oxidase (XO) activities. MDA levels decreased with GSE supplementation in control groups but increased in acute and chronic exercise groups compared to their non-supplemented control. NO levels increased with GSE supplementation. XO activities were higher in AE group compared to the CE group. AOA decreased with GSE supplementation. In conclusion, while acute exercise triggers oxidative stress, chronic exercise has protective role against oxidative stress. GSE has a limited antioxidant effect on exercise-induced oxidative stress in liver tissue.

Comparison of Effects of a Proprioceptive Exercise Program in Water and on Land the Balance of Chronic Stroke Patients

PubMed Central

Han, Seul Ki; Kim, Myung Chul; An, Chang Sik

2013-01-01

[Purpose] The purpose of this study was to compare changes in balance ability of land exercise and underwater exercise on chronic stroke patients. [Subjects] A total of 60 patients received exercise for 40 minutes, three times a week, for 6 weeks. [Methods] Subjects from both groups performed general conventional treatment during the experimental period. In addition, all subjects engaged in extra treatment sessions. This extra treatment consisted of unstable surface exercise. The underwater exercise group used wonder boards in a pool (depth 1.1m, water temperature 33.5 °C, air temperature 27 °C) dedicated to underwater exercise, and the land exercise group used balance mats. [Result] The joint position sense, sway area, Berg Balance Scale showed significant improvements in both groups. However, the joint position sense test, sway area, and Berg Balance Scale showed there was more improvement in the underwater exercise group than in the land exercise group. [Conclusion] The results suggest that underwater exercise is more effective than land exercise at improving the joint position sense and balance of stroke patients. PMID:24259761

Comparison of effects of a proprioceptive exercise program in water and on land the balance of chronic stroke patients.

PubMed

Han, Seul Ki; Kim, Myung Chul; An, Chang Sik

2013-10-01

[Purpose] The purpose of this study was to compare changes in balance ability of land exercise and underwater exercise on chronic stroke patients. [Subjects] A total of 60 patients received exercise for 40 minutes, three times a week, for 6 weeks. [Methods] Subjects from both groups performed general conventional treatment during the experimental period. In addition, all subjects engaged in extra treatment sessions. This extra treatment consisted of unstable surface exercise. The underwater exercise group used wonder boards in a pool (depth 1.1m, water temperature 33.5 °C, air temperature 27 °C) dedicated to underwater exercise, and the land exercise group used balance mats. [Result] The joint position sense, sway area, Berg Balance Scale showed significant improvements in both groups. However, the joint position sense test, sway area, and Berg Balance Scale showed there was more improvement in the underwater exercise group than in the land exercise group. [Conclusion] The results suggest that underwater exercise is more effective than land exercise at improving the joint position sense and balance of stroke patients.

[Efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model].

PubMed

Ding, R J; Gao, L M; Chu, L; Xie, W L; Wang, X R; Tang, Q; Wang, H L; Hu, D Y

2017-03-24

Objective: To explore the efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model. Methods: This study was a prospective randomized controlled study, 80 patients from Beijing Electrical Power Hospital and Beijing Jingmei Group General Hospital with acute coronary syndrome were included from June to December 2015 and divided into 2 groups. Patients in rehabilitation group ( n =52) received tertiary hospital(Peiking University Peoples' Hospital) guided and community-driven family self-help cardiac rehabilitation for 3 months, and patients in control group ( n =28) received routine secondary treatment for 3 months. Following parameters including 6 minutes walk distance, score of life quality (evaluated by Short Form-12), score of anxiety (evaluated by Generalized Anxiety Disorder-7), score of depression (evaluated by Perceived Health Questionnaire-9), self-management competency (evaluated by questionnaire) were collected at baseline and after treatment for 3 months. Results: Compared with control group, 6 minutes walk distance was longer in rehabilitation group((60.2±6.8) meters vs. (24.9±10.5)meters, P <0.01). The difference values between after and before intervention of life quality scores((0.14±3.90)scores vs.(-7.44±5.85)scores, P >0.05), anxiety scores((-0.16±2.12 ) scores vs.(0.70±1.13)scores, P >0.05) and depression scores((-1.17±2.79) scores vs.(0.60±0.36)scores, P >0.05) were similar between the 2 groups. The amplification of patients with regular exercise (50.26% vs. 0, P <0.05), limit sugary foods usually and always (53.22% vs. 3.98%, P <0.05), eat 200-400 g fruits usually and always (78.61 % vs. 0, P <0.05), eat 300-500 g vegetables usually and always (9.74% vs. 0, P <0.05), and answering very confident to questions such as let the physicians know about your diseases (40.17% vs. 5.00%, P <0.05), know how to take medicines (44.52% vs. 5.00%, P <0.05), know how much exercise was right for yourself (26.43% vs.0, P <0.05) were significantly higher in rehabilitation group than in control group. There were no cardiac rehabilitation training related cardiovascular events. Conclusion: Tertiary hospital guided and community-driven family self-help cardiac rehabilitation model is an effective and safe management model of cardiovascular disease in chronic phase, and it is necessary to further expand the study population to verify the efficacy of this model.

The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials.

PubMed

El-Khoury, Fabienne; Cassou, Bernard; Charles, Marie-Aline; Dargent-Molina, Patricia

2013-10-29

To determine whether, and to what extent, fall prevention exercise interventions for older community dwelling people are effective in preventing different types of fall related injuries. Electronic databases (PubMed, the Cochrane Library, Embase, and CINAHL) and reference lists of included studies and relevant reviews from inception to July 2013. Randomised controlled trials of fall prevention exercise interventions, targeting older (>60 years) community dwelling people and providing quantitative data on injurious falls, serious falls, or fall related fractures. Based on a systematic review of the case definitions used in the selected studies, we grouped the definitions of injurious falls into more homogeneous categories to allow comparisons of results across studies and the pooling of data. For each study we extracted or calculated the rate ratio of injurious falls. Depending on the available data, a given study could contribute data relevant to one or more categories of injurious falls. A pooled rate ratio was estimated for each category of injurious falls based on random effects models. 17 trials involving 4305 participants were eligible for meta-analysis. Four categories of falls were identified: all injurious falls, falls resulting in medical care, severe injurious falls, and falls resulting in fractures. Exercise had a significant effect in all categories, with pooled estimates of the rate ratios of 0.63 (95% confidence interval 0.51 to 0.77, 10 trials) for all injurious falls, 0.70 (0.54 to 0.92, 8 trials) for falls resulting in medical care, 0.57 (0.36 to 0.90, 7 trials) for severe injurious falls, and 0.39 (0.22 to 0.66, 6 trials) for falls resulting in fractures, but significant heterogeneity was observed between studies of all injurious falls (I(2)=50%, P=0.04). Exercise programmes designed to prevent falls in older adults also seem to prevent injuries caused by falls, including the most severe ones. Such programmes also reduce the rate of falls leading to medical care.

Exercise for everyone: a randomized controlled trial of project workout on wheels in promoting exercise among wheelchair users.

PubMed

Froehlich-Grobe, Katherine; Lee, Jaehoon; Aaronson, Lauren; Nary, Dorothy E; Washburn, Richard A; Little, Todd D

2014-01-01

To compare the effectiveness of 2 home-based behavioral interventions for wheelchair users to promote exercise adoption and maintenance over 12 months. Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability. Exercise occurred in participant-preferred locations (eg, home, recreation center), with physiological data collected at a university-based exercise laboratory. Inactive wheelchair users (N=128; 64 women) with sufficient upper arm mobility for arm-based exercise were enrolled. Participants on average were 45 years of age and lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment. Both groups received home-based exercise interventions. The staff-supported group (n=69) received intensive exercise support, while the self-guided group (n=59) received minimal support. Both received exercise information, resistance bands, instructions to self-monitor exercise, regularly scheduled phone calls, and handwritten cards. The primary outcome derived from weekly self-reported exercise. Secondary outcomes included physical fitness (aerobic/muscular) and predictors of exercise participation. The staff-supported group reported significantly greater exercise (∼17min/wk) than the self-guided group over the year (t=10.6, P=.00), with no significant between-group difference in aerobic capacity (t=.76, P=.45) and strength (t=1.5, P=.14). Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant because they also exercised more frequently. The staff-supported approach holds promise for encouraging exercise among wheelchair users, yet additional support may be necessary to achieve more exercise to meet national recommendations. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Exercise for Everyone: A randomized controlled trial of Project Workout On Wheels in promoting exercise among wheelchair users

PubMed Central

Froehlich-Grobe, Katherine; Lee, Jaehoon; Aaronson, Lauren; Nary, Dorothy E.; Washburn, Richard A; Little, Todd D

2015-01-01

Objective To compare the effectiveness of two home-based behavioral interventions to promote wheelchair users exercise adoption and maintenance over 12 months. Design Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability. Setting Exercise occurred in participant preferred locations (e.g., home, recreation center), with physiological data collected at the university-based exercise lab. Participants One hundred twenty-eight inactive wheelchair users (64 women) with sufficient upper arm mobility for arm-based exercise enrolled. Participants on average were 45 years old, lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment. Interventions Both groups received home-based exercise interventions. The staff-supported group (n= 69) received intensive exercise support, while the self-guided group (n= 59) received minimal support. Both received exercise information, resistance bands, instructions to self-monitor exercise, regularly-scheduled phone calls, and handwritten cards. Main Outcome Measures The primary outcome derived from weekly self-reported exercise. Secondary outcomes included physical fitness (aerobic/muscular) and predictors of exercise participation. Results The staff-supported group reported significantly greater exercise (~ 16 minutes/week) than the self-guided group over the year (t=10.6, p=0.00), with no significant between group difference in aerobic capacity (t=0.76, p=0.45) and strength (t=1.5, p=0.14). Conclusions Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant as they also exercised more frequently. The staff-supported approach holds promise for encouraging exercise among wheelchair users, yet additional support may be necessary to achieve more exercise to meet national recommendations. PMID:23872080

[Effects of TES program on exercise capacity, self-efficacy and patient compliance in patients with myocardial infarction].

PubMed

Choo, Jina; Kim, Ja-Mae; Hong, Kyung-Pyo

2003-12-01

This study aimed to develop a TES program to improve exercise capacity to promote patient compliance to the prescribed exercise, and to test the feasibility of the program. The 8-week TES program consisted of three components : exercise training, self-efficacy enhancement and social support. Using the matching of gender, age, and the left ventricular ejection fraction, thirty one subjects were consecutively assigned to either TES group (n=15, 52+7 years) or Control group (n=16, 58+11 years) 3 weeks after MI. With the exception of exercise compliance (only after the TES program), the exercise capacity and exercise self-efficacy were both measured both before and after the 8-week TES program. The VO2peak (p=.043), anaerobic threshold (p=.023) and exercise duration (p=.015) improved in TES group compared to Control group after 8 weeks. The cardiac exercise self-efficacy (p=.036) was significantly higher in TES group than Control group. There was a significant increase of exercise compliance(p=.005) in TES group compared to Control group. The 8-week TES program improved the exercise capacity, exercise self-efficacy and exercise compliance. A appropriately implemented TES program in cardiovascular nursing practice may promote healthy behavioral modification and, therefore, contributing to reduce the risk of mortality and morbidity in MI patients.

Which Treatment is More Effective for Functional Ankle Instability: Strengthening or Combined Muscle Strengthening and Proprioceptive Exercises?

PubMed

Kim, Ki-Jong; Kim, Young-Eok; Jun, Hyun-Ju; Lee, Jin-Su; Ji, Sung-Ha; Ji, Sang-Goo; Seo, Tae-Hwa; Kim, Young-Ok

2014-03-01

[Purpose] The purpose of this study was to implement combined muscle strengthening and proprioceptive exercises to examine the effects of combined exercises on functional ankle instability. [Subjects and Methods] Experiments were conducted with 30 adult males and females. The study subjects were randomly assigned to either a control group (Group A), a muscle strengthening exercise group (Group B), or a combined muscle strengthening and proprioceptive exercise group (Group C) consisting of 10 subjects each. In Group A, measurements were only conducted before and after the experiment without any intervention, whereas the exercise programs for Group B and Group C were implemented three days per week for four weeks. [Results] Muscle strength showed significant increases in Groups B and C compared with the control group during plantar flexion, dorsiflexion, inversion, and eversion. The Cumberland ankle instability tool showed significant increases in Group B and Group C compared with Group A and significant increases in Group C compared with Group B. [Conclusion] Applying combined muscle strengthening and proprioceptive exercises to those who have functional ankle instability is more effective than applying only muscle strengthening exercises.

A process evaluation: does recruitment for an exercise program through ethnically specific channels and key figures contribute to its reach and receptivity in ethnic minority mothers?

PubMed

Hartman, Marieke A; Nierkens, Vera; Cremer, Stephan W; Stronks, Karien; Verhoeff, Arnoud P

2013-08-19

Ethnic minority women from low-income countries who live in high-income countries are more physically inactive than ethnic majority women in those countries. At the same time, they can be harder to reach with health promotion programs. Targeting recruitment channels and execution to ethnic groups could increase reach and receptivity to program participation. We explored using ethnically specific channels and key figures to reach Ghanaian, Antillean, and Surinamese mothers with an invitation for an exercise program, and subsequently, to determine the mothers' receptivity and participation. We conducted a mixed methods process evaluation in Amsterdam, The Netherlands. To recruit mothers, we employed ethnically specific community organizations and ethnically matched key figures as recruiters over Dutch health educators. Reach and participation were measured using reply cards and the attendance records from the exercise programs. Observations were made of the recruitment process. We interviewed 14 key figures and 32 mothers to respond to the recruitment channel and recruiter used. Content analysis was used to analyze qualitative data. Recruitment through ethnically specific community channels was successful among Ghanaian mothers, but less so among Antillean and Surinamese mothers. The more close-knit an ethnic community was, retaining their own culture and having poorer comprehension of the Dutch language, the more likely we were to reach mothers through ethnically specific organizations. Furthermore, we found that using ethnically matched recruiters resulted in higher receptivity to the program and, among the Ghanaian mothers in particular, in greater participation. This was because the ethnically matched recruiter was a familiar, trusted person, a translator, and a motivator who was enthusiastic, encouraging, and able to adapt her message (targeting/tailoring). Using a health expert was preferred in order to increase the credibility and professionalism of the recruitment. Recruitment for an exercise program through ethnically specific organizations seems to contribute to its reach, particularly in close-knit, highly organized ethnic communities with limited fluency in the local language. Using ethnically matched recruiters as motivator, translator, and trusted person seems to enhance receptivity of a health promotion program. An expert is likely to be needed for effective information delivery.

Health-related physical fitness assessment in a community-based cancer rehabilitation setting.

PubMed

Kirkham, Amy A; Neil-Sztramko, Sarah E; Morgan, Joanne; Hodson, Sara; Weller, Sarah; McRae, Tasha; Campbell, Kristin L

2015-09-01

Assessment of physical fitness is important in order to set goals, appropriately prescribe exercise, and monitor change over time. This study aimed to determine the utility of a standardized physical fitness assessment for use in cancer-specific, community-based exercise programs. Tests anticipated to be feasible and suitable for a community setting and a wide range of ages and physical function were chosen to measure body composition, aerobic fitness, strength, flexibility, and balance. Cancer Exercise Trainers/Specialists at cancer-specific, community-based exercise programs assessed new clients (n = 60) at enrollment, designed individualized exercise programs, and then performed a re-assessment 3-6 months later (n = 34). Resting heart rate, blood pressure, body mass index, waist circumference, handgrip strength, chair stands, sit-and-reach, back scratch, single-leg standing, and timed up-and-go tests were considered suitable and feasible tests/measures, as they were performed in most (≥88 %) participants. The ability to capture change was also noted for resting blood pressure (-7/-5 mmHg, p = 0.02), chair stands (+4, p < 0.01), handgrip strength (+2 kg, p < 0.01), and sit-and-reach (+3 cm, p = 0.03). While the submaximal treadmill test captured a meaningful improvement in aerobic fitness (+62 s, p = 0.17), it was not completed in 33 % of participants. Change in mobility, using the timed up-and-go was nominal and was not performed in 27 %. Submaximal treadmill testing, handgrip dynamometry, chair stands, and sit-and-reach tests were feasible, suitable, and provided meaningful physical fitness information in a cancer-specific, community-based, exercise program setting. However, a shorter treadmill protocol and more sensitive balance and upper body flexibility tests should be investigated.

Vision and agility training in community dwelling older adults: incorporating visual training into programs for fall prevention.

PubMed

Reed-Jones, Rebecca J; Dorgo, Sandor; Hitchings, Maija K; Bader, Julia O

2012-04-01

This study aimed to examine the effect of visual training on obstacle course performance of independent community dwelling older adults. Agility is the ability to rapidly alter ongoing motor patterns, an important aspect of mobility which is required in obstacle avoidance. However, visual information is also a critical factor in successful obstacle avoidance. We compared obstacle course performance of a group that trained in visually driven body movements and agility drills, to a group that trained only in agility drills. We also included a control group that followed the American College of Sports Medicine exercise recommendations for older adults. Significant gains in fitness, mobility and power were observed across all training groups. Obstacle course performance results revealed that visual training had the greatest improvement on obstacle course performance (22%) following a 12 week training program. These results suggest that visual training may be an important consideration for fall prevention programs. Copyright © 2011 Elsevier B.V. All rights reserved.

Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults With Knee Osteoarthritis

PubMed Central

Messier, Stephen P.; Mihalko, Shannon L.; Legault, Claudine; Miller, Gary D.; Nicklas, Barbara J.; DeVita, Paul; Beavers, Daniel P.; Hunter, David J.; Lyles, Mary F.; Eckstein, Felix; Williamson, Jeff D.; Carr, J. Jeffery; Guermazi, Ali; Loeser, Richard F.

2015-01-01

IMPORTANCE Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. OBJECTIVE To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. DESIGN, SETTING, AND PARTICIPANTS Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27–41) with pain and radiographic knee OA. INTERVENTIONS Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. MAIN OUTCOMES AND MEASURES Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0–20), function (range, 0–68), mobility, and health-related quality of life (range, 0–100). RESULTS At 18 months, 399 participants (88%) completed the study. Compared with exercise participants, knee compressive forces were lower in diet participants and IL-6 levels were lower in diet and diet + exercise participants. 18-mo Outcomes, Mean (95% CI) Exercise(E) Diet (D) D + E Difference,E vs D Difference, Evs D+E Weight loss, kg −1.8(−5.7to1.8) −8.9(−12.4 to −5.3) −10.6(−14.1 to −7.1) Knee compressiveforces, N 2687(2590 to 2784) 2487(2393 to 2581) 2543(2448 to 2637) 200(55 to 345)a 144(1 to 287) IL-6, pg/mL 3.1(2.9 to 3.4) 2.7(2.4 to 3.0) 2.7(2.5 to 3.0) 0.43(0.01 to 0.85)a 0.39(−0.03 to 0.81)a Pain 4.7(4.2 to 5.1) 4.8(4.3 to 5.2) 3.6(3.2 to 4.1) −0.11(−0.81 to 0.59) 1.02(0.33 to 1.71)a Function 18.4(16.9 to 19.9) 17.4(15.9 to 18.9) 14.1(12.6 to 15.6) 0.98(−1.24 to 3.20) 4.29(2.07 to 6.50)a SF-36 physical 41.9(40.5 to 43.2) 42.4(41.1 to 43.7) 44.7(43.4 to 46.0) −0.55(−2.53 to 1.43) −2.81(−4.76 to −0.86)a a Differences were significant. CONCLUSIONS AND RELEVANCE Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00381290 PMID:24065013

Effect of weight loss, exercise, or both on cognition and quality of life in obese older adults1234

PubMed Central

Napoli, Nicola; Shah, Krupa; Waters, Debra L; Sinacore, David R; Qualls, Clifford; Villareal, Dennis T

2014-01-01

Background: Obesity impairs cognition and health-related quality of life (HRQOL) in older adults; however, the appropriate treatment of obese older adults remains controversial. Objective: The objective was to determine the independent and combined effects of weight loss and exercise on cognition, mood, and HRQOL in obese older adults. Design: One hundred seven frail, obese older adults were randomly assigned to a control, weight-management (diet), exercise, or weight-management-plus-exercise (diet-exercise) group for 1 y. In this secondary analysis, main outcomes were Modified Mini-Mental State Examination (3MS) and total Impact of Weight on Quality of Life-Lite (IWQOL) scores. Other outcomes included Word Fluency Test, Trail Making Test Parts A and B, and Geriatric Depression Scale (GDS) scores. Results: Scores on the 3MS improved more in the diet (mean ± SE: 1.7 ± 0.4), exercise (2.8 ± 0.4), and diet-exercise (2.9 ± 0.4) groups than in the control group (0.1 ± 0.4) (between-group P = 0.0001–0.04); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. Scores on the Word Fluency Test improved more in the exercise (4.1 ± 0.8) and diet-exercise (4.2 ± 0.7) groups than in the control group (−0.8 ± 0.8; both P = 0.001). For the Trail Making Test Part A, scores in the diet-exercise group (−11.8 ± 1.9) improved more than in the control group (−0.8 ± 1.9) (P = 0.001); a similar finding was observed for the Trail Making Test Part B. Scores on the IWQOL improved more in the diet (7.6 ± 1.6), exercise (10.1 ± 1.6), and diet-exercise (14.0 ± 1.4) groups than in the control group (0.3 ± 1.6) (P = 0.0001–0.03); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. In the diet-exercise group, peak oxygen consumption and strength changes were independent predictors of 3MS changes; weight and strength changes were independent predictors of IWQOL changes. GDS scores did not change. Conclusions: Weight loss and exercise each improve cognition and HRQOL, but their combination may provide benefits similar to exercise alone. These findings could inform practice guidelines with regard to optimal treatment strategies for obese older adults. This trial was registered atclinicaltrials.govas NCT00146107. PMID:24787497

Disordered eating attitudes and exercise in women undergoing fertility treatment.

PubMed

Rodino, Iolanda S; Byrne, Susan; Sanders, Katherine A

2016-02-01

Previous research has found a higher lifetime prevalence of eating disorders in women undergoing fertility treatment. This study aimed to gauge the prevalence of eating disorders in women attending a fertility clinic and to compare current disordered eating attitudes and exercise amongst different infertility categories. Three hundred and eighty-five women were grouped according to infertility diagnosis: male factor, unexplained infertility, ovulatory disorders, polycystic ovarian syndrome (PCOS) and heterogeneous causations. Participants anonymously completed the Eating Disorder Examination Questionnaire (EDE-Q), the International Physical Activity Questionnaire (IPAQ) and a Demographics questionnaire. The lifetime history of self-reported eating disorders for women in the sample was similar to Australian community rates. Profile analysis revealed on the EDE-Q that women with ovulatory disorders were not significantly different from women with PCOS; however, they were significantly different to women with other infertility diagnoses (all P < 0.05), suggesting increased vulnerability to disordered eating. There were no between-group differences in exercise quantity (IPAQ, P = 0.625) although women with ovulatory disorders and PCOS had a significantly higher risk of engaging in compulsive, 'driven' exercise (OR = 6.98, CI = 1.39, 34.90, P = 0.018) as a means to control weight or shape. Contrary to previous research, our findings do not confirm a greater lifetime prevalence rate of eating disorders in women attending an infertility clinic. This study does highlight the importance of screening women with forms of an ovulatory disorder for features of disordered eating attitudes and driven exercise behaviours. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

κ-opioid receptor is involved in the cardioprotection induced by exercise training

PubMed Central

Li, Juan; Tian, Fei; Feng, Na; Fan, Rong; Jia, Min; Guo, Haitao; Cheng, Liang; Liu, Jincheng; Chen, Wensheng; Pei, Jianming

2017-01-01

The present study was designed to test the hypothesis that exercise training elicited a cardioprotective effect against ischemia and reperfusion (I/R) via the κ-opioid receptor (κ-OR)-mediated signaling pathway. Rats were randomly divided into four groups: the control group, the moderate intensity exercise (ME) group, the high intensity exercise (HE) group, and the acute exercise (AE) group. For the exercise training protocols, the rats were subjected to one week of adaptive treadmill training, while from the second week, the ME and HE groups were subjected to eight weeks of exercise training, and the AE group was subjected to three days of adaptive treadmill training and one day of vigorous exercise. After these protocols, the three exercise training groups were divided into different treatment groups, and the rats were subjected to 30 min of ischemia and 120 min of reperfusion. Changes in infarct size and serum cTnT (cardiac troponin T) caused by I/R were reduced by exercise training. Moreover, cardiac dysfunction caused by I/R was also alleviated by exercise training. These effects of exercise training were reversed by nor-BNI (a selective κ-OR antagonist), Compound C (a selective AMPK inhibitor), Akt inhibitor and L-NAME (a non-selective eNOS inhibitor). Expression of κ-OR and phosphorylation of AMPK, Akt and eNOS were significantly increased in the ME, HE and AE groups. These findings demonstrated that the cardioprotective effect of exercise training is possibly mediated by the κ-OR-AMPK-Akt-eNOS signaling pathway. PMID:28301473

Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine.

PubMed

Pratt, Sarah I; Jerome, Gerald J; Schneider, Kristin L; Craft, Lynette L; Buman, Matthew P; Stoutenberg, Mark; Daumit, Gail L; Bartels, Stephen J; Goodrich, David E

2016-09-01

Adults with serious mental illness die more than 10 years earlier than the average American. Premature mortality is due to the high prevalence of preventable diseases including cardiovascular disease and diabetes. Poor lifestyle behaviors including lack of exercise and physical inactivity contribute to the epidemic levels of obesity, diabetes, and cardiovascular disease observed among adults with serious mental illness. Not surprisingly, people with serious mental illness are among the most costly consumers of health services due to increased visits for poorly managed mental and physical health. Recent studies have demonstrated that exercise interventions based on community mental health settings can significantly improve physical and mental health in people with serious mental illness. However, current funding regulations limit the ability of community mental health settings to offer exercise programming services to people with serious mental illness. Policy efforts are needed to improve the dissemination and sustainability of exercise programs for people with serious mental illness.

Psychophysiological Responses to Group Exercise Training Sessions: Does Exercise Intensity Matter?

PubMed

Vandoni, Matteo; Codrons, Erwan; Marin, Luca; Correale, Luca; Bigliassi, Marcelo; Buzzachera, Cosme Franklim

2016-01-01

Group exercise training programs were introduced as a strategy for improving health and fitness and potentially reducing dropout rates. This study examined the psychophysiological responses to group exercise training sessions. Twenty-seven adults completed two group exercise training sessions of moderate and vigorous exercise intensities in a random and counterbalanced order. The %HRR and the exertional and arousal responses to vigorous session were higher than those during the moderate session (p<0.05). Consequently, the affective responses to vigorous session were less pleasant than those during moderate session (p<0.05). These results suggest that the psychophysiological responses to group exercise training sessions are intensity-dependent. From an adherence perspective, interventionists are encouraged to emphasize group exercise training sessions at a moderate intensity to maximize affective responses and to minimize exertional responses, which in turn may positively affect future exercise behavior.

Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults.

PubMed

Okamoto, N; Nakatani, T; Morita, N; Saeki, K; Kurumatani, N

2007-12-01

The objective of our study was to investigate the effects of a home-based walking program on physical fitness and QOL among community residents. Subjects (n = 200, mean age: 64.2 years, range: 42 - 75 years) who participated in the 32-week trial were randomly allocated to one of two groups: an exercise (E) group and a control (C) group. The E group was instructed to increase the number of steps a day that they walked and to perform aerobic walking at a target heart rate for 20 minutes or more daily, 2 or more days a week. The C group was told to continue their normal level of activity. Outcome measures were the 3-minute shuttle stamina walk test (SSWT), 30-second chair-stand test (CS-30), and SF-36. Increases in SSWT values were significantly greater in the E group than in the C group (men 24.1 m vs. 6.3 m; women 8.8 m vs. 2.4 m), as were increases in CS-30 values (men 5.9 vs. 2.6; women 4.5 vs. - 0.1). On the SF-36, the scores in the E group for vitality and mental health increased significantly. Home-based walking is considered to be an effective and feasible method to improve physical fitness and QOL among community residents.

Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee.

PubMed

Wang, Tsae-Jyy; Belza, Basia; Elaine Thompson, F; Whitney, Joanne D; Bennett, Kim

2007-01-01

This paper reports a study of the effects of aquatic exercise on physical fitness (flexibility, strength and aerobic fitness), self-reported physical functioning and pain in adults with osteoarthritis of the hip or knee. Osteoarthritis is a common cause of disability and a primary reason for hip and knee joint replacement. Exercise is important for preventing and/or managing the functional limitations associated with joint disease. Aquatic exercise is thought to be beneficial and is often recommended for people with osteoarthritis; however, few studies have examined the effects on people with osteoarthritis, and these have yielded inconsistent results. A two-group randomized controlled trial with a convenience sample was used. Participants were recruited from community sources and randomly assigned to a 12-week aquatic programme or a non-exercise control condition. Data for 38 participants were collected at baseline, week 6, and week 12 during 2003 and 2004. Instruments were a standard plastic goniometer, a handheld dynamometer, the 6-minute walk test, the multidimensional Health Assessment Questionnaire, and a visual analogue scale for pain. Repeated measures analysis of variance showed that aquatic exercise statistically significantly improved knee and hip flexibility, strength and aerobic fitness, but had no effect on self-reported physical functioning and pain. The exercise adherence rate was 81.7%, and no exercise-related adverse effect was observed or reported. Beneficial short-term effects of aquatic exercise were found in adults with osteoarthritis of the hip or knee. Although the programme may not offer pain relief or self-reported improvements in physical functioning, results suggest that aquatic exercise does not worsen the joint condition or result in injury. Nurses engaging in disease management and health promotion for these patients should consider recommending or implementing aquatic classes for patients.

Effectiveness of balance training exercise in people with mild to moderate severity Alzheimer's disease: protocol for a randomised trial.

PubMed

Hill, Keith D; LoGiudice, Dina; Lautenschlager, Nicola T; Said, Catherine M; Dodd, Karen J; Suttanon, Plaiwan

2009-07-16

Balance dysfunction and falls are common problems in later stages of dementia. Exercise is a well-established intervention to reduce falls in cognitively intact older people, although there is limited randomised trial evidence of outcomes in people with dementia. The primary objective of this study is to evaluate whether a home-based balance exercise programme improves balance performance in people with mild to moderate severity Alzheimer's disease. Two hundred and fourteen community dwelling participants with mild to moderate severity Alzheimer's disease will be recruited for the randomised controlled trial. A series of laboratory and clinical measures will be used to evaluate balance and mobility performance at baseline. Participants will then be randomized to receive either a balance training home exercise programme (intervention group) from a physiotherapist, or an education, information and support programme from an occupational therapist (control group). Both groups will have six home visits in the six months following baseline assessment, as well as phone support. All participants will be re-assessed at the completion of the programme (after six months), and again in a further six months to evaluate sustainability of outcomes. The primary outcome measures will be the Limits of Stability (a force platform measure of balance) and the Step Test (a clinical measure of balance). Secondary outcomes include other balance and mobility measures, number of falls and falls risk measures, cognitive and behavioural measures, and carer burden and quality of life measures. Assessors will be blind to group allocation. Longitudinal change in balance performance will be evaluated in a sub-study, in which the first 64 participants of the control group with mild to moderate severity Alzheimer's disease, and 64 age and gender matched healthy participants will be re-assessed on all measures at initial assessment, and then at 6, 12, 18 and 24 months. By introducing a balance programme at an early stage of the dementia pathway, when participants are more likely capable of safe and active participation in balance training, there is potential that balance performance will be improved as dementia progresses, which may reduce the high falls risk at this later stage. If successful, this approach has the potential for widespread application through community based services for people with mild to moderate severity Alzheimer's disease. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12608000040369).