scholarly journals Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review

Author(s):  
Andrew Powell

Increasing the physical activity (PA) levels of inactive older adults to promote healthy aging and to reduce preventable health conditions is a public health priority. However, there remains uncertainty on what constitutes the most important components and characteristics of effective PA interventions for older adults, and previous research has largely focused on the cognitive and behavioral strategies they adopt to increase uptake and adherence to PA. This narrative review puts forward the novel idea, with supporting evidence, that the strength, quality, and collaborative nature of the professional–client relationship, a concept drawn from the field of psychotherapy and known as therapeutic alliance, may be a vital and foundational element of effective PA interventions. This article will offer a new understanding, and a new direction of research to aid the future conceptualization, design, and development of interventions that aim to increase the PA levels of older adults.

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1780 ◽  
Author(s):  
Miguel Ferrer ◽  
Xavier Capó ◽  
Miquel Martorell ◽  
Carla Busquets-Cortés ◽  
Cristina Bouzas ◽  
...  

A chronic inflammatory state is a major characteristic of the aging process, and physical activity is proposed as a key component for healthy aging. Our aim was to evaluate the body composition, hypertension, lipid profile, and inflammatory status of older adults, and these factors’ association with physical activity. A total of 116 elderly volunteers were categorized into terciles of quantitative metabolic equivalents of task (MET). Subjects in the first and third terciles were defined as sedentary and active subjects, respectively. Anthropometric and biochemical parameters, hemograms, and inflammatory markers were measured in plasma or peripheral mononuclear blood cells (PBMCs). The active groups exercised more than their sedentary counterparts. The practice of physical activity was accompanied by lower weight, fat mass, body mass index, and diastolic blood pressure when compared to a more sedentary life-style. Physical activity also lowered the haematocrit and total leukocyte, neutrophil, and lymphocyte counts. The practice of exercise induced a decrease in the IL-6 circulating levels and the TLR2 protein levels in PBMCs, while the expression of the anti-inflammatory IL-10 was activated in active subjects. The regular practice of physical activity exerts beneficial effects on body composition and the anti-inflammatory status of old people.


2014 ◽  
Vol 3 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Wojtek J. Chodzko-Zajko

For more than half a century fellows of the National Academy of Kinesiology have enthusiastically advocated for the promotion and adoption of physically active lifestyles as an affordable and effective means to prevent chronic diseases and conditions, and enhance independence and high quality of life for older adults. It is possible to discern distinct evolutionary stages when examining scholarship related to the role of physical activity in the promotion of healthy aging. Research into physical activity and aging began with critical early studies that established the underlying scientific evidence for a relationship between physical activity and healthy aging. More recent work has addressed such topics as building consumer demand, developing policies and legislation to support active aging, and understanding the complex interrelationships between physical activity and other lifestyle factors in the prevention and treatment of chronic diseases and conditions. It is increasingly apparent that strategies to promote active and successful aging must be integrated into an effective public policy. Kinesiologists and other health professionals, working in collaboration with colleagues from other disciplines, can help to reduce risk factors for chronic disease and improve quality of life for older adults by building awareness of the importance of physical activity and by assisting with the development and implementation of appropriate and effective interventions that reduce risk factors and improve quality of life.


2020 ◽  
Vol 5 (6) ◽  
pp. 282-291
Author(s):  
N. P. Koval ◽  
◽  
M. G. Aravitska

The constant increase in the proportion of the disabled or partially disabled elderly population and, accordingly, patients of this age contingent, leads to the need for rehabilitation and physical therapy of persons with geriatric syndromes and various comorbid pathologies. The purpose of the study was to determine the effectiveness of a physical therapy program based on the dynamics of indicators of the fall-risk and physical status in older adults with frailty syndrome and metabolic syndrome. Material and methods. 96 older adults were examined. The control group consisted of persons without metabolic syndrome and without frailty syndrome. The main group 1 consisted of persons with metabolic syndrome and frailty syndrome who did not express a desire to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations on the WHO CINDI program (diet modification, extension of household and training physical activity). Main group 2 included patients who showed consent to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). We developed a physical therapy program for them using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for one year. The dynamics of the state was assessed according to the results of the Short Physical Performance Battery, hand dynamometry, Senior Fitness Test, the Berg Balance Scale. Results and discussion. Older adults with metabolic syndrome and frailty syndrome demonstrated a high fall-risk (according to the results of a Short battery of physical activity tests and the Berg scale) and a statistically significant lag in physical status parameters (coordination, balance, strength, flexibility, endurance, agility) according to the parameters of the Senior Fitness Test, hand dynamometry, Short battery of physical activity tests) from their peers. These results increase the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in main group 1 subjects led to a statistically significant (р<0.05) improvement in physical qualities, a decrease in the intensity of frailty signs; leveling the fall-risk in them. The low level of therapeutic alliance of persons in the main group 2 led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided and is associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology of frailty and metabolic syndrome


Author(s):  
Vítor Häfele ◽  
César Augusto Häfele ◽  
Jeferson Santos Jerônimo ◽  
Rodrigo Wiltgen Ferreira ◽  
Steve Anthony Maravillo ◽  
...  

Introduction: Health behaviors are fundamental for healthy aging. In this sense, the practice of physical activity is one of the most beneficial factors for the health of individuals. Objective: To describe the prevalence of leisure-time physical activity among the older adults and analyze in terms of sociodemographic characteristics, national regions, Federative Units of Brazil, and types of physical activity practiced. Methods: Study utilizing data from the Brazilian National Health Survey - 2013. Leisure-time physical activity was analyzed with two distinct cutoff points: 1) Some physical activity - 10 or more minutes/week; 2) Meeting recommended 150 minutes/week of physical activity. Results: Nearly 21% of the older adults completed some physical activity, and 13.2% reached the physical activity recommendations. There was no difference in the prevalence of physical activity between men and women. Individuals aged 60-69 years and those with higher income were more active than their peers. As for the national regions, the North had the lowest prevalence of physically active older adults. Among all regions, walking was the most frequent form of physical activity practiced. Conclusion: The prevalence of older adults who practiced some physical activity and reached the physical activity recommendations was low, with walking being the most common form of physical activity. Older adults with higher age, low socioeconomic status and from the Northern Brazilian regions were the least active.


2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 201-208
Author(s):  
Noah J. Webster ◽  
Toni C. Antonucci ◽  
Neil B. Alexander

Objective: Only 16% of people aged >65 years engage in recommended levels of physical activity, putting a vast major­ity at risk for multiple chronic conditions including heart disease. Physical activity is even lower among older adults with fewer economic resources. Research is needed to develop context-specific approaches to pair with physical activity interventions to increase effectiveness. In this pilot study, we examine social ties and physical activity levels of older adults living in a US Depart­ment of Housing and Urban Development subsidized senior housing community to test feasibility of a social network-based approach to physical activity interventions. This study is grounded in Social Contagion Theory and the Convoy Model of Social Relations, which argue health and health-related behaviors are facilitated through network ties.Methods: Data were collected through face-to-face interviews conducted over the course of three months (September- November 2018) with 46 residents living in a low-income senior housing community in southeast Michigan. Residents were asked about physical activity, people they know in the community, and their close social network composition.Results: Residents reported knowing, on average, six other residents and approxi­mately 28% of those in their close networks were also residents. Sociocentric network analysis identified two socially engaged (known by seven or more other residents) physically active residents, whereas ego-centric analysis identified four (60% or more of their network comprised residents).Conclusions: This study demonstrates potential feasibility of a strategic partnership that involves pairing social resources with physical activity interventions in afford­able senior housing. Multiple approaches, which need to be evaluated, exist to identify socially engaged residents.Ethn Dis. 2019;29(Suppl 1): 201-208; doi:10.18865/ ed.29.S1.201.


2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.


2020 ◽  
Vol 2020 ◽  
pp. 1-15 ◽  
Author(s):  
Adria Quigley ◽  
Marilyn MacKay-Lyons ◽  
Gail Eskes

Physical activity and exercise have emerged as potential methods to improve brain health among older adults. However, there are currently no physical activity guidelines aimed at improving cognitive function, and the mechanisms underlying these cognitive benefits are poorly understood. The purpose of this narrative review is to present the current evidence regarding the effects of physical activity and exercise on cognition in older adults without cognitive impairment, identify potential mechanisms underlying these effects, and make recommendations for exercise prescription to enhance cognitive performance. The review begins with a summary of evidence of the effect of chronic physical activity and exercise on cognition. Attention then turns to four main biological mechanisms that appear to underlie exercise-induced cognitive improvement, including the upregulation of growth factors and neuroplasticity, inhibition of inflammatory biomarker production, improved vascular function, and hypothalamic-pituitary-adrenal axis regulation. The last section provides an overview of exercise parameters known to optimize cognition in older adults, such as exercise type, frequency, intensity, session duration, and exercise program duration.


2020 ◽  
Vol 123 (4) ◽  
pp. 1279-1282
Author(s):  
Divyangana Rakesh ◽  
Kavisha B. Fernando ◽  
Sina Mansour L.

Nonpathological aging is associated with significant cognitive deficits. Thus, the underlying neurobiology of aging-associated cognitive decline warrants investigation. In a recent study, Chong et al. (Chong JSX, Ng KK, Tandi J, Wang C, Poh J-H, Lo JC, Chee MWL, Zhou JH. J Neurosci 39: 5534–5550, 2019) provided insights into the association between cognitive decline and the loss of functional specialization in the brains of older adults. Here, we introduce the novel graph theoretical approach utilized and discuss the significance of their findings and broader implications on aging. We also provide alternate perspectives of their findings and suggest directions for future work.


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