Effectiveness of Outdoor Exercise Parks on Health Outcomes in Older Adults—A Mixed-Methods Systematic Review and Meta-Analysis

Author(s):  
Yoke Leng Ng ◽  
Keith D. Hill ◽  
Pazit Levinger ◽  
Elissa Burton

The objective of this systematic review was to examine the effectiveness of outdoor exercise park equipment on physical activity levels, physical function, psychosocial outcomes, and quality of life of older adults living in the community and to evaluate the evidence of older adults’ use of outdoor exercise park equipment. A search strategy was conducted from seven databases. Nine articles met the inclusion criteria. The study quality results were varied. Meta-analyses were undertaken for two physical performance tests: 30-s chair stand test and single-leg stance. The meta-analysis results were not statistically significant. It was not possible to conclude whether exercise parks were effective at improving levels of physical activity. The review shows that older adults value the benefits of health and social interaction from the use of exercise parks. Findings should be interpreted with caution due to the small sample sizes and the limited number of studies.

2022 ◽  
Author(s):  
Cassandra D'Amore ◽  
Julie C Reid ◽  
Matthew Chan ◽  
Samuel Fan ◽  
Amanda Huang ◽  
...  

BACKGROUND This is a systematic review of randomized controlled trials and a meta-analysis comparing smart-technology to face-to-face physical activity (PA) interventions, in community-dwelling older adults, mean age greater than or equal 60 years. OBJECTIVE To determine the effect of smart-technology interventions compared to face-to-face PA interventions on PA and physical function in older adults. Our secondary outcomes were depression, anxiety, and health-related quality of life. METHODS We searched four electronic databases from inception to February 2021. Two independent reviewers screened titles/abstracts, full texts, and performed data extraction and risk of bias assessments using the Cochrane risk of bias tool. GRADE was used to evaluate the quality of the evidence. We provided a narrative synthesis on all included studies and, where possible, we performed meta-analyses for similar outcomes. RESULTS 19 studies with a total of 3455 patients were included. Random-effects meta-analyses showed that smart-technology interventions resulted in improved step count (mean difference 1440 steps, 95% confidence interval (CI) 500, 2390) and total PA (standardized mean difference 0.17, 95% CI 0.02, 0.32) compared to face-face interventions. The quality of the evidence for the effects of smart-technology interventions was very low based on GRADE criteria. There was no difference between groups for measures of physical function. CONCLUSIONS Interventions that include smart-technology may improve daily step counts by an average of 1440 steps in community dwelling older adults, however the quality of the evidence was very low. Future studies are needed to improve the certainty of results.


Author(s):  
Michail Georgiou ◽  
Gordon Morison ◽  
Niamh Smith ◽  
Zoë Tieges ◽  
Sebastien Chastin

Blue spaces have been found to have significant salutogenic effects. However, little is known about the mechanisms and pathways that link blue spaces and health. The purpose of this systematic review and meta-analysis is to summarise the evidence and quantify the effect of blue spaces on four hypothesised mediating pathways: physical activity, restoration, social interaction and environmental factors. Following the PRISMA guidelines, a literature search was conducted using six databases (PubMed, Scopus, PsycInfo, Web of Science, Cochrane Library, EBSCOHOST/CINAHL). Fifty studies were included in our systematic review. The overall quality of the included articles, evaluated with the Qualsyst tool, was judged to be very good, as no mediating pathway had an average article quality lower than 70%. Random-effects meta-analyses were conducted for physical activity, restoration and social interaction. Living closer to blue space was associated with statistically significantly higher physical activity levels (Cohen’s d = 0.122, 95% CI: 0.065, 0.179). Shorter distance to blue space was not associated with restoration (Cohen’s d = 0.123, 95% CI: −0.037, 0.284) or social interaction (Cohen’s d = −0.214, 95% CI: −0.55, 0.122). Larger amounts of blue space within a geographical area were significantly associated with higher physical activity levels (Cohen’s d = 0.144, 95% CI: 0.024, 0.264) and higher levels of restoration (Cohen’s d = 0.339, 95% CI: 0.072, 0.606). Being in more contact with blue space was significantly associated with higher levels of restoration (Cohen’s d = 0.191, 95% CI: 0.084, 0.298). There is also evidence that blue spaces improve environmental factors, but more studies are necessary for meta-analyses to be conducted. Evidence is conflicting on the mediating effects of social interaction and further research is required on this hypothesised pathway. Blue spaces may offer part of a solution to public health concerns faced by growing global urban populations.


Author(s):  
Nadja Willinger ◽  
James Steele ◽  
Lou Atkinson ◽  
Gary Liguori ◽  
Alfonso Jimenez ◽  
...  

Background: Structured physical activity (PA) interventions (ie, intentionally planned) can be implemented in a variety of facilities, and therefore can reach a large proportion of the population. The aim of the authors was to summarize the effectiveness of structured interventions upon PA outcomes, in addition to proportions of individuals adopting and maintaining PA, and adherence and retention rates. Methods: Systematic review with narrative synthesis and exploratory meta-analyses. Twelve studies were included. Results: Effectiveness on PA levels during adoption (pre- to first time point) showed a trivial standardized effect (0.15 [−0.06 to 0.36]); during maintenance (any time point after the first and >6 mo since initiation) the standardized effect was also trivial with a wide interval estimate (0.19 [−0.68 to 1.07]). Few studies reported adoption (k = 3) or maintenance rates (k = 2). Retention at follow-up did not differ between structured PA or controls (75.1% [65.0%–83.0%] vs 75.4% [67.0%–82.3%]), nor did intervention adherence (63.0% [55.6%–69.6%] vs 77.8% [19.4%–98.1%]). Conclusion: Structured PA interventions lack evidence for effectiveness in improving PA levels. Furthermore, though retention is often reported and is similar between interventions and controls, adoption, maintenance, and adherence rates were rarely reported rendering difficulty in interpreting results of effectiveness of structured PA interventions.


Author(s):  
Ava Oliaei

Introduction: Obesity is associated with multiple health-related complications, which together can decrease quality of life, disability-adjusted life years and life expectancy.1 Systematic reviews and meta-analyses have demonstrated that sex can influence the association between obesity and health complications, such as rheumatoid arthritis and many types of cancer.2-4 However, no systematic review or meta-analysis has been conducted to review the effect of sex on the association between obesity and hypertension, thus far. Knowing whether or not sex influences this relationship can help tailor the prevention, prediction, and care of this condition towards each sex.    Objectives: To evaluate current studies on the association between sex, obesity, and hypertension, so as to obtain an overall estimate of the effect of sex on the prevalence of hypertension in obese individuals.     Methods: A systematic search of EMBASE, MEDLINE, and PubMed was conducted. Search terms, such as “obesity,” “sex differences,” and “hypertension,” were used to filter results. After reviewing 406 articles, eight articles were included.    Results: Four articles showed that obese women were at a greater risk of developing hypertension than obese men.5-8 Conversely, the results of two studies found that obese men are at a greater risk of developing hypertension.9,10 The remaining two studies showed that the difference between the sexes was insignificant.11,12     Discussion/Limitations: Stronger evidence shows that obese women are at a greater risk of developing hypertension than obese men. The two studies that had contradictory conclusions had small sample sizes relative to the other studies. Additionally, the two studies that concluded that both sexes are at a similar risk highlighted that most other studies have determined that obese women are at a greater risk and that their limitations may have caused this discrepancy. Limitations of this review include the limited ethnicity of participants and the use of BMI to classify obesity, which can sometimes lead to misclassification due to varying muscle to fat ratios. These factors limit the generalizability of the results.     Conclusion: Obese women are seemingly at a greater risk of developing hypertension than obese men. However, this conclusion remains statistically inconclusive. Therefore, it would be beneficial to complete a meta-analysis in order to conclusively determine which sex is statistically more at risk of developing hypertension, when obese.  


2022 ◽  
Author(s):  
Alaa Abd-alrazaq ◽  
Dari Alhuwail ◽  
Arfan Ahmed ◽  
Mowafa Househ

BACKGROUND Executive functions are one of the known cognitive abilities that decline by age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for specific purposes other than entertainment, could play a positive role in improving executive functions. Several systematic reviews have pooled the evidence about the effectiveness of serious games in improving executive functions; however, they are limited by some weaknesses. OBJECTIVE This study aims to investigate the effectiveness of serious games in improving executive functions among elderly people with cognitive impairment. METHODS A systematic review of randomized controlled trials (RCTs) was conducted. To retrieve relevant studies, 8 electronic databases were searched. Further, reference lists of the included studies and relevant reviews were screened, and we checked studies that cited our included studies. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, assessed the risk of bias, and appraised the quality of the evidence. We used a narrative and statistical approach, as appropriate, to synthesize results of the included studies. RESULTS Out of 548 publications identified, 16 RCTs were eventually included in this review. Our meta-analyses showed that serious games are as effective as no or passive interventions in improving executive functions (P=0.29). Surprisingly, conventional exercises were more effective than serious games in improving executive functions (P=0.03). Our subgroup analysis showed that both types of serious games (cognitive training games (P=0.08) and exergames (P=0.16)) are as effective as conventional exercises in improving executive functions. No difference was found between adaptive serious games and non-adaptive serious games in improving executive functions (P=0.59). CONCLUSIONS Serious games are not superior to no or passive interventions and conventional exercises in improving executive functions among older adults with cognitive impairment. However, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Accordingly, until more robust evidence is available, serious games should not be offered by healthcare providers nor used by patients for improving executive functions among older adults with cognitive functions. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment.


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