Exercise Training for Older Adults with Limitations in Physical Function

This study aimed to evaluate the effects of an 8-week supervised exercise program on physiological measurements during treadmill walking, muscle strength, functional performance, and health status in older adults limited in physical function. Twenty-four participants were randomly assigned to an exercise group (EG, N = 13) or a control group (CG, N = 11), and were evaluated before and after the exercise program (EG) or 8-week period (CG). Evaluations included a progressive treadmill lest, strength testing, the Physical Performance Test (PPT), and the SF-36 Health Survey. The exercise program consisted of 3 sessions per week of brisk walking and strengthening exercises. The EG demonstrated increases in cardiorespiratory fitness and increases in treadmill walking time. The EG also demonstrated increases in force production in 3 of the 6 muscle groups that were tested. Both the EG and CG demonstrated improvements in PPT scores and in 2 health concepts on the SF-36 Health Survey.

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Effects of a multicomponent high intensity exercise program on physical function and health-related quality of life in older adults with or at risk of mobility disability after discharge from hospital: a randomised controlled trial

BMC Geriatrics ◽

10.1186/s12877-020-01829-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sylvia Sunde ◽

Karin Hesseberg ◽

Dawn A. Skelton ◽

Anette Hylen Ranhoff ◽

Are Hugo Pripp ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Older People ◽

Physical Function ◽

High Intensity ◽

Intervention Group ◽

Exercise Program ◽

Control Group ◽

Mobility Disability ◽

Discharge From Hospital

Abstract Background Many older people suffer from mobility limitations and reduced health-related quality of life (HRQOL) after discharge from hospital. A consensus regarding the most effective exercise-program to optimize physical function and HRQOL after discharge is lacking. This study investigates the effects of a group-based multicomponent high intensity exercise program on physical function and HRQOL in older adults with or at risk of mobility disability after discharge from hospital. Methods This single blinded parallel group randomised controlled trial recruited eighty-nine home dwelling older people (65–89 years) while inpatient at medical wards at a general hospital in Oslo, Norway. Baseline testing was conducted median 49 (25 percentile, 75 percentile) (26, 116) days after discharge, before randomisation to an intervention group or a control group. The intervention group performed a group-based exercise program led by a physiotherapist twice a week for 4 months. Both groups were instructed in a home-based exercise program and were encouraged to exercise according to World Health Organisation’s recommendations for physical activity in older people. The primary outcome, physical performance, was measured by the Short Physical Performance Battery (SPPB). Secondary outcomes were 6-min walk test (6MWT), Berg Balance Scale (BBS), grip strength, Body Mass Index (BMI), and HRQOL (the Short-Form 36 Health Survey (SF-36)). Data were analysed according to the intention-to-treat principle. Between-group differences were assessed using independent samples t-test. Results The groups were comparable at baseline. Intention-to-treat analysis showed that the intervention group improved their functional capacity (6MWT) and the physical component summary of SF-36 significantly compared to the control group. No further between group differences in change from baseline to 4 months follow-up were found. Conclusions A high intensity multicomponent exercise program significantly improved functional capacity and physical HRQOL in older adults with or at risk of mobility disability after discharge from hospital. The study suggests that this population can benefit from systematic group exercise after hospital-initial rehabilitation has ended. Trial registration ClinicalTrials.gov. NCT02905383. September 19, 2016.

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The effects of supervision on three different exercises modalities (supervised vs. home vs. supervised+home) in older adults: Randomized controlled trial protocol

PLoS ONE ◽

10.1371/journal.pone.0259827 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259827

Author(s):

Sabrine Nayara Costa ◽

Luis Henrique Boiko Ferreira ◽

Paulo Cesar Barauce Bento

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Clinical Trial ◽

Physical Function ◽

Exercise Program ◽

Secondary Outcome ◽

Randomized Controlled ◽

Supervised Exercise ◽

Home Based

Background Multicomponent physical exercise programs are a viable strategy for treating physical decline resulting from the aging process in older populations and can be applied in supervised and home-based modalities. However, the magnitude of the intervention effects in terms of physical function development may vary according to the modalities application due to different supervision degrees. Objective This study aims to compare the effects of supervision in a multicomponent exercise program in different application modalities (supervised vs. home vs. supervised+home) in neuromuscular adaptations, muscle strength, gait, physical function, and quality of life, analyzing the differences between intensity, volume, and density of home and supervised sessions in community older adults. Methods This protocol is a randomized controlled clinical trial with a sample of 66 older adults divided into three groups: supervised exercise (SUP = 22), home-based exercise (HB = 22), and supervised plus home-based exercise (SUP+HB = 22). The multicomponent exercise program will last 12 weeks, three times per week, for 60 min per session and include warm-up, balance, muscle-strengthening, gait, and flexibility exercises. The study’s primary outcomes will be neuromuscular function, composed of the assessment of muscle isokinetic strength, muscle architecture, and neuromuscular electrical activation. The secondary outcome will be physical function, usual and maximum gait speed with and without dual-task, and quality of life. All outcomes will be assessed at baseline and post-intervention (week 12). Conclusion This study will be the first clinical trial to examine the effects of different supervision levels on home-based exercises compared to supervised protocols. The results of this study will be essentials for planning coherent and viable home-based programs for older adults. Trial registration Brazilian Registry of Clinical Trials. Number RBR- 7MZ2KR. https://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-7mz2kr.

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Effectiveness of Hydro-Galvanic Bath Therapy on Global Health Status, Quality of Life, Depression, and Pain in Individuals with Fibromyalgia – A Quasi-Experimental Study

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1137-0054 ◽

2020 ◽

Cited By ~ 1

Author(s):

Mastour Saeed Alshahrani ◽

Ravi Shankar Yerragonda Reddy ◽

Jaya Shankar Tedla

Keyword(s):

Quality Of Life ◽

Experimental Study ◽

Aerobic Exercise ◽

Health Survey ◽

Exercise Program ◽

Control Group ◽

Sf 36 ◽

Quasi Experimental ◽

Bath Therapy

Abstract Purpose Although a number of treatments are widely prescribed for fibromyalgia (FM), many are not fully effective. In clinical practice, the effectiveness of electrotherapy is limited in particular to hydro-galvanic bath therapy in the management of FM. This experiment aims to evaluate whether hydro-galvanic bath therapy can be beneficial in decreasing pain and increasing quality of life for individuals with FM. Material and Methods This quasi-experimental study recruited 92 individuals diagnosed with FM who were then divided equally either into a galvanic group or control group. The galvanic group received both hydro-galvanic bath therapy and a 12-week supervised aerobic exercise program, whereas the control group only received the exercise program. Outcomes were assessed at baseline and post-intervention using the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), SF-36 Health Survey, and Visual Analog Scale (VAS). Results and discussion Individuals in both groups showed excellent compliance with interventions by attending more than 85% of sessions. Both groups showed a significant change in all outcome measures evaluated (p<0.001), but the galvanic group showed greater improvements when compared with the control group (p<0.001). The galvanic group showed a 16.6% of FIQ score, 8.2% of SF-36 score, 25.0% of BDI score, and 53.2% of VAS score from baseline. In turn, the control group demonstrated a reduction of 6.8% of FIQ score, 11.8% of SF-36 score, 22.0% of BDI score, and 41.6% of VAS score. Conclusion The galvanic group who received galvanic bath therapy along with aerobic exercise for 12 weeks evoked greater change in FIQ, BDI, and SF-36 Health Survey scores compared with results of aerobic exercise alone in control group.

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Effects of a Physical Exercise Program on Physiological, Psychological, and Physical Function of Older Adults in Rural Areas

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168487 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8487

Author(s):

Sunmi Kim ◽

Eun-Jee Lee ◽

Hyeon-Ok Kim

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Physical Function ◽

Psychological Health ◽

Rural Areas ◽

Exercise Program ◽

Control Group ◽

Exact Test ◽

Chi Squared ◽

Quasi Experimental

With the increase in the older population, there is a concern for health in older adults. This study aimed to develop a physical exercise program that combined walking and gymnastics for older adults residing in rural areas and to evaluate its effect on their physiological and psychological health and physical function. A quasi-experimental design was adopted. Participants were aged 65 years or older, with 94 and 130 participants in the experimental and control group, respectively. The program was implemented for seven months, from April–October 2016. Walking and gymnastics were performed once a week each, for about 60 and 50 min, respectively. Data were analyzed using the Chi-squared test, Fisher’s exact test, independent t-test, or Mann–Whitney U test. Results revealed that the experimental group participants displayed improved waist circumference (t = 1.70, p = 0.045), body mass index (U = 4691.00, p = 0.002), depressive symptoms (t = −2.94, p = 0.002), upper limb strength (t = 2.27, p = 0.012), and lower limb strength (t = 3.86, p < 0.001). Therefore, it can be presumed that the physical exercise program was effective and beneficial for older adults living in rural areas. This program is expected to contribute to maintaining and improving their health if implemented regularly in the future.

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Peer-led exercise program for ageing adults to improve physical functions - a randomized trial

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00257-x ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

D. R. Bouchard ◽

J. V. Olthuis ◽

V. Bouffard-Levasseur ◽

C. Shannon ◽

T. McDonald ◽

...

Keyword(s):

Physical Function ◽

Controlled Trial ◽

Intervention Group ◽

Exercise Program ◽

Control Group ◽

Walk Test ◽

Blood Draw ◽

Chair Stand ◽

Significant Difference ◽

Physical Functions

Abstract Background A peer-led exercise program is one way to empower people sharing similar characteristics to encourage others to be active, but there is a lack of evidence that these programs have physical function and other benefits when delivered to ageing adults. Methods This randomized controlled trial lasting 12 weeks proposed an exercise peer-led program offered to 31 adults aged 50 and above, twice a week, by a trained leader of the same age from March to May 2019. The program was offered for free with limited space and equipment. Valid tests of physical function (e.g., 30-s chair stand, 6-min walk test) were used to assess the functional benefits. Psychosocial outcomes were assessed using self-reported questionnaires and metabolic outcomes via a fasted blood draw. Results A significant difference was found between pre-and post-values in most physical function tests in the intervention group (all p < 0.05). When adjusted for potential confounders, the intervention group was significantly associated with a more significant improvement on the chair stand test (ß = .26; p < 0.001; r2 = 0.26), the arm curl (ß = .29; p < 0.001; r2 = 0.49), as well as the 6-min walk test (ß = -.14; p < 0.001; r2 = 0.62) compared with the control group. Using repetitive measures generalized linear model, the interaction between the changes and the group was significant for all three tests. Benefits were also observed for participants’ stress level and perceived health in the intervention group compared to the control. Finally, no significant difference was observed between groups for metabolic health. Conclusions The current work suggests that a 12-week peer-led exercise program can improve physical function for adults age 50 and above. Trial registration NCT03799952(ClinicalTrials.gov) 12/20/2018.

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Effects of Self RehAbilitation Video Exercises (SAVE) on Functional Restorations in Patients with Subacute Stroke

Healthcare ◽

10.3390/healthcare9050565 ◽

2021 ◽

Vol 9 (5) ◽

pp. 565

Author(s):

Seung-Hwan Jung ◽

Eunhee Park ◽

Ju-Hyun Kim ◽

Bi-Ang Park ◽

Ja-Won Yu ◽

...

Keyword(s):

Acute Stroke ◽

Short Form ◽

Intervention Group ◽

Exercise Program ◽

Berg Balance Scale ◽

Control Group ◽

Early Recovery ◽

Subacute Stroke ◽

Sf 36 ◽

State Examination

Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve the functional outcomes and facilitate early recovery by increasing the continuity of rehabilitation therapy after acute stroke. Methods: This study is a non-randomized trial. Eighty-eight patients were included in an intervention group (SAVE group), who received conventional rehabilitation therapies and an additional self-rehabilitation session by watching bedside exercise videos and continued their own exercises in their rooms for 60 min every day for 4 weeks. Ninety-six patients were included in a control group, who received only conventional rehabilitation therapies. After 4 weeks of hospitalization, both groups assessed several outcome measurements, including the Berg Balance Scale (BBS), Modified Barthel Index (MBI), physical component summary (PCS) and the mental component summary of the Short-Form Survey 36 (SF-36), Mini-Mental State Examination, and Beck Depression Inventory. Results: Differences in BBS, MBI, and PCS components in SF-36 were more statistically significant in the SAVE group than that in the control group (p < 0.05). Patients in the SAVE group showed more significant improvement in BBS, MBI, and PCS components in SF-36 as compared to that in the control group. Conclusions: This evidence-based SAVE intervention can optimize patient recovery after a subacute stroke while keeping the available resources in mind.

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Associations Between Heart Rate Variability Measured With a Wrist-Worn Sensor and Older Adults’ Physical Function: Observational Study

JMIR mhealth and uhealth ◽

10.2196/13757 ◽

2019 ◽

Vol 7 (10) ◽

pp. e13757 ◽

Cited By ~ 3

Author(s):

Sarah Anne Graham ◽

Dilip V Jeste ◽

Ellen E Lee ◽

Tsung-Chin Wu ◽

Xin Tu ◽

...

Keyword(s):

Older Adults ◽

Heart Rate ◽

Heart Rate Variability ◽

Health Status ◽

Physical Health ◽

Physical Function ◽

Significant Proportion ◽

Physical Health Status ◽

Sf 36 ◽

Composite Scores

Background Heart rate variability (HRV), or variation in beat-to-beat intervals of the heart, is a quantitative measure of autonomic regulation of the cardiovascular system. Low HRV derived from electrocardiogram (ECG) recordings is reported to be related to physical frailty in older adults. Recent advances in wearable technology offer opportunities to more easily integrate monitoring of HRV into regular clinical geriatric health assessments. However, signals obtained from ECG versus wearable photoplethysmography (PPG) devices are different, and a critical first step preceding their widespread use is to determine whether HRV metrics derived from PPG devices also relate to older adults’ physical function. Objective This study aimed to investigate associations between HRV measured with a wrist-worn PPG device, the Empatica E4 sensor, and validated clinical measures of both objective and self-reported physical function in a cohort of older adults living independently within a continuing care senior housing community. Our primary hypothesis was that lower HRV would be associated with lower physical function. In addition, we expected that HRV would explain a significant proportion of variance in measures of physical health status. Methods We evaluated 77 participants from an ongoing study of older adults aged between 65 and 95 years. The assessments encompassed a thorough examination of domains typically included in a geriatric health evaluation. We collected HRV data with the Empatica E4 device and examined bivariate correlations between HRV quantified with the triangular index (HRV TI) and 3 widely used and validated measures of physical functioning—the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), and Medical Outcomes Study Short Form 36 (SF-36) physical composite scores. We further investigated the additional predictive power of HRV TI on physical health status, as characterized by SF-36 physical composite scores and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) scores, using generalized estimating equation regression analyses with backward elimination. Results We observed significant associations of HRV TI with SPPB (n=52; Spearman ρ=0.41; P=.003), TUG (n=51; ρ=−0.40; P=.004), SF-36 physical composite scores (n=49; ρ=0.37; P=.009), and CIRS-G scores (n=52, ρ=−0.43; P=.001). In addition, the HRV TI explained a significant proportion of variance in SF-36 physical composite scores (R2=0.28 vs 0.11 without HRV) and CIRS-G scores (R2=0.33 vs 0.17 without HRV). Conclusions The HRV TI measured with a relatively novel wrist-worn PPG device was related to both objective (SPPB and TUG) and self-reported (SF-36 physical composite) measures of physical function. In addition, the HRV TI explained additional variance in self-reported physical function and cumulative illness severity beyond traditionally measured aspects of physical health. Future steps include longitudinal tracking of changes in both HRV and physical function, which will add important insights regarding the predictive value of HRV as a biomarker of physical health in older adults.

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Using Sensor Graphs for Monitoring the Effect on the Performance of the OTAGO Exercise Program in Older Adults

Sensors ◽

10.3390/s22020493 ◽

2022 ◽

Vol 22 (2) ◽

pp. 493

Author(s):

Björn Friedrich ◽

Carolin Lübbe ◽

Enno-Edzard Steen ◽

Jürgen Martin Bauer ◽

Andreas Hein

Keyword(s):

Older Adults ◽

Pilot Study ◽

Exercise Program ◽

Exercise Programme ◽

Control Group ◽

Motion Sensors ◽

Surrogate Variable ◽

Physical Sensor ◽

The Difference ◽

Positive Effect

The OTAGO exercise programme is effective in decreasing the risk for falls of older adults. This research investigated if there is an indication that the OTAGO exercise programme has a positive effect on the capacity and as well as on the performance in mobility. We used the data of the 10-months observational OTAGO pilot study with 15 (m = 1, f = 14) (pre-)frail participants aged 84.60 y (SD: 5.57 y). Motion sensors were installed in the flats of the participants and used to monitor their activity as a surrogate variable for performance. We derived a weighted directed multigraph from the physical sensor network, subtracted the weights of one day from a baseline, and used the difference in percent to quantify the change in performance. Least squares was used to compute the overall progress of the intervention (n = 9) and the control group (n = 6). In accordance with previous studies, we found indication for a positive effect of the OTAGO program on the capacity in both groups. Moreover, we found indication that the OTAGO program reduces the decline in performance of older adults in daily living. However, it is too early to conclude causalities from our findings because the data was collected during a pilot study.

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The Effect of Theory-lead Intervention for Knee Osteoarthritis in Older Adults: A Cluster Randomized Trial

10.21203/rs.2.22689/v1 ◽

2020 ◽

Author(s):

Limin Wang ◽

Hongbo Chen ◽

Han Lu ◽

Yunlin Wang ◽

Congying Liu ◽

...

Keyword(s):

Older Adults ◽

Knee Osteoarthritis ◽

Transtheoretical Model ◽

Intervention Group ◽

Exercise Program ◽

Exercise Adherence ◽

Cluster Randomized Trial ◽

Knee Function ◽

Control Group ◽

Cluster Randomized

Abstract Background: Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms and knee function in older adults with KOA. Methods: A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China via print and social media advertisements from April to October 2018. The intervention was a two-stage and 24-week transtheoretical model-based exercise program, and the control group underwent a same length but non-theory-based exercise program. Exercise adherence was measured by an 11-point numerical self-rating scale at weeks 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) and knee function (lower limb muscle strength and balance) were measured at baseline, week 24, and week 48. Latent growth model (GLM), repeated measures ANOVA and independent t-test were the main statistical tests.Results: A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.Conclusion: The TTM-HEI could improve the participants’ exercise adherence, knee osteoarthritis symptoms and knee function over time.

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Chronic exercise and left ventricular structure and function in healthy human subjects

Journal of Applied Physiology ◽

10.1152/jappl.1985.58.2.409 ◽

1985 ◽

Vol 58 (2) ◽

pp. 409-415 ◽

Cited By ~ 12

Author(s):

L. A. Wolfe ◽

R. P. Martin ◽

D. D. Watson ◽

R. D. Lasley ◽

D. E. Bruns

Keyword(s):

Human Subjects ◽

Exercise Program ◽

Left Ventricular ◽

Control Group ◽

Healthy Human ◽

Mean Values ◽

End Diastolic Volume ◽

Supervised Exercise ◽

Fitness Training ◽

And Function

Twelve healthy well-trained participants in a supervised exercise program (mean age, 41.3 yr) were compared with 12 sedentary control subjects (mean age, 38.9 yr) with physical characteristics similar to the exercised group (EG) before training. Resting echocardiograms revealed significantly lower heart rates (HR) in the EG compared with control group (CG) but no evidence for cardiac structural differences between groups. Radionuclide angiograms performed at rest and during two levels of supine cycling (HR targets: 120 and 140 beats X min-1) resulted in increases in background-corrected end-diastolic counts [EDC(bc)] and confirmed use of the Frank-Starling mechanism in the majority of subjects. Mean values (+/- SD) for ejection fraction (EF) and normalized peak systolic ejection rate (PSER) (P greater than 0.05 between groups) were the following. (Formula: see text) The results suggested that fitness training does not induce significant cardiac enlargement as apparent from measurements at rest or important changes in contractile state during exercise. Increases in exercise stroke volume with such training may be the result of an increased end-diastolic volume.

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