Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

Download Full-text

Effectiveness of a resistance training program on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care: a cluster-randomized controlled trial

European Review of Aging and Physical Activity ◽

10.1186/s11556-020-00243-9 ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Hilde Bremseth Bårdstu ◽

Vidar Andersen ◽

Marius Steiro Fimland ◽

Lene Aasdahl ◽

Truls Raastad ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Resistance Training ◽

Home Care ◽

Physical Function ◽

Low Cost ◽

Community Dwelling ◽

Cluster Randomized ◽

Community Dwelling Older Adults

Abstract Background Aging is associated with reduced muscle mass and strength leading to impaired physical function. Resistance training programs incorporated into older adults’ real-life settings may have the potential to counteract these changes. We evaluated the effectiveness of 8 months resistance training using easily available, low cost equipment compared to physical activity counselling on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care. Methods This open label, two-armed, parallel group, cluster randomized trial recruited older adults above 70 years (median age 86.0 (Interquartile range 80–90) years) receiving home care. Participants were randomized at cluster level to the resistance training group (RTG) or the control group (CG). The RTG trained twice a week while the CG were informed about the national recommendations for physical activity and received a motivational talk every 6th week. Outcomes were assessed at participant level at baseline, after four, and 8 months and included tests of physical function (chair rise, 8 ft-up-and-go, preferred- and maximal gait speed, and stair climb), maximal strength, rate of force development, and body composition. Results Twelve clusters were allocated to RTG (7 clusters, 60 participants) or CG (5 clusters, 44 participants). The number of participants analyzed was 56–64 (6–7 clusters) in RTG and 20–42 (5 clusters) in CG. After 8 months, multilevel linear mixed models showed that RTG improved in all tests of physical function and maximal leg strength (9–24%, p = 0.01–0.03) compared to CG. No effects were seen for rate of force development or body composition. Conclusion This study show that resistance training using easily available, low cost equipment is more effective than physical activity counselling for improving physical function and maximal strength in community-dwelling older adults receiving home care. Trial registration ISRCTN1067873

Download Full-text

Changes in Objectively Measured Lifestyle Factors During the COVID-19 Pandemic in Community-Dwelling Older Adults

10.21203/rs.3.rs-847301/v1 ◽

2021 ◽

Author(s):

Takuya Ataka ◽

Noriyuki Kimura ◽

Atsuko Eguchi ◽

Etsuro Matsubara

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Wearable Sensors ◽

Lifestyle Factors ◽

Community Dwelling ◽

Activity Level ◽

Objectively Measured ◽

Community Dwelling Older Adults

Abstract Background: In this manuscript, we aimed at investigating whether objectively measured lifestyle factors, including walking steps, sedentary time, amount of unforced physical activity, level of slight and energetic physical activity, conversation time, and sleep parameters altered before and during the COVID-19 pandemic among community-dwelling older adults.Methods: Data were obtained from a prospective cohort study conducted from 2015 to 2019 and a subsequent dementia prevention study undertaken in September 2020. Community-dwelling adults aged ≥65 years wore wearable sensors before and during the pandemic.Results: A total of 56 adults were enrolled in this study. The mean age was 74.2±3.9 years, and 58.9% (n=33) of the participants were female. The moderate and vigorous physical activity time significantly decreased and sedentary time significantly increased during the pandemic. Conclusions: This is the first study to demonstrate differences in objectively assessed lifestyle factors before and during the COVID-19 pandemic among community-dwelling older adults. The findings show that the pandemic has adversely affected physical activity among older adults living on their own in Japan.

Download Full-text

Implementation of a Cost-Effective Physical Therapy Approach (Coach2Move) to Improve Physical Activity in Community-Dwelling Older Adults With Mobility Problems: Protocol for a Cluster-Randomized, Stepped Wedge Trial

Physical Therapy ◽

10.1093/ptj/pzz183 ◽

2019 ◽

Vol 100 (4) ◽

pp. 653-661 ◽

Cited By ~ 1

Author(s):

Ward Heij ◽

Steven Teerenstra ◽

Lieke Sweerts ◽

J Bart Staal ◽

Maria W G Nijhuis-van der Sanden ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Therapy ◽

Physical Therapist ◽

Community Dwelling ◽

Stepped Wedge ◽

Cluster Randomized ◽

Community Dwelling Older Adults ◽

Stepped Wedge Trial ◽

Insight Into

Abstract Background Coach2Move is a personalized treatment strategy by physical therapists to elicit physical activity in community-dwelling older adults with mobility problems. Objective The primary objective of this study is to assess the effectiveness and cost-effectiveness of the implementation of Coach2Move compared with regular care physical therapy in daily clinical practice. Design, Setting, Participants, and Intervention A multicenter cluster-randomized stepped wedge trial is being implemented in 16 physical therapist practices (4 clusters of 4 practices in 4 steps) in the Netherlands. The study aims to include 400 older adults (≥70 years) living independently with mobility problems and/or physically inactive lifestyles. The intervention group receives physical therapy conforming to the Coach2Move strategy; the usual care group receives typical physical therapist care. Measurements Measurements are taken at baseline and 3, 6, and 12 months after the start of treatment. The primary outcomes for effectiveness are the amount of physical activity (LASA Physical Activity Questionnaire) and functional mobility (Timed Up and Go test). Trial success can be declared if at least 1 parameter improves while another does not deteriorate. Secondary outcomes are level of frailty (Evaluative Frailty Index for Physical Activity), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire), quality of life (EQ-5D-5 L), and health care expenditures. Multilevel linear regression analyses are used to compare the outcomes between treatment groups according to an intention-to-treat approach. Alongside the trial, a mixed-methods process evaluation is performed to understand the outcomes, evaluate therapist fidelity to the strategy, and detect barriers and facilitators in implementation. Limitations An important limitation of the study design is the inability to blind treating therapists to study allocation. Discussion The trial provides insight into the effectiveness and cost-effectiveness of the Coach2Move strategy compared with usual care. The process evaluation provides insight into influencing factors related to outcomes and implementation.

Download Full-text

AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.603 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S169-S169

Author(s):

Junxin Li ◽

Sarah Szanton ◽

Minhui Liu ◽

Nada Lukkahatai ◽

Junxin Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Quality ◽

Behavioral Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Tnf Α ◽

Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

Download Full-text

An mHealth-Facilitated Personalized Intervention for Physical Activity and Sleep in Community-Dwelling Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0463 ◽

2021 ◽

pp. 1-10

Author(s):

Junxin Li ◽

Sarah L. Szanton ◽

Miranda V. McPhillips ◽

Nada Lukkahatai ◽

Grace W. Pien ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Financial Incentives ◽

Pilot Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Subjective Sleep Quality ◽

Community Dwelling Older Adults ◽

Personalized Intervention

This randomized controlled pilot trial tested the preliminary effect of a 24-week mHealth-facilitated, personalized intervention on physical activity (PA) and sleep in 21 community-dwelling older adults. The intervention included a personalized exercise prescription, training, goal setting, and financial incentives. mHealth strategies, including self-monitoring, motivational messages, activity reminders, and phone coaching, were used to facilitate PA participation. PA and sleep were measured using actigraphy and questionnaires at baseline and 8-, 16-, and 24-week visits. Participants in the intervention group had lower objective PA levels at 24 weeks than at 8 and 16 weeks, although levels of PA remained higher than at baseline. Compared with the control group, the intervention increased PA at 8, 16, and 24 weeks; improved subjective sleep quality at 16 and 24 weeks; and increased actigraphy-measured sleep duration and sleep efficiency at 24 weeks. mHealth PA interventions may benefit PA and sleep in older adults. Strategies for maintaining long-term PA behavioral changes are needed.

Download Full-text

The Gender-Specific Relationship between Nutritional Status, Physical Activity and Functional Mobility in Irish Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168427 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8427

Author(s):

Maeve Lorraine O’Connell ◽

Tara Coppinger ◽

Seán Lacey ◽

Tijana Arsenic ◽

Aoife Louise McCarthy

Keyword(s):

Physical Activity ◽

Older Adults ◽

Nutritional Status ◽

Short Form ◽

Community Dwelling ◽

Functional Mobility ◽

Activity Level ◽

Specific Relationship ◽

Community Dwelling Older Adults ◽

Gender Specific

Research suggests that both nutrition and physical activity can protect mobility in older adults, but it is yet to be determined whether these relationships are affected by gender. Thus, we investigated the gender-specific relationship between nutritional status, physical activity level and functional mobility in Irish older adults. A cross-sectional study was undertaken in 176 community-dwelling older adults (73.6 ± 6.61 years) living in Cork, Ireland. Nutritional status was measured using the Mini Nutritional Assessment-Short Form (MNA-SF) and physical activity was assessed via the Physical Activity Scale for the Elderly (PASE). Functional mobility was measured using the Timed Up and Go (TUG) test. The gender-stratified relationship between variables was assessed using Pearson’s correlations and multiple linear regression. Partial correlations (p < 0.05) were observed for TUG with PASE score in both genders, and with MNA-SF score in females, only. Multiple regression showed that physical activity was a predictor of TUG in both genders (β = 0.257 for males, β = 0.209 for females, p < 0.05), while nutritional status was a predictor of TUG in females, only (β = −0.168, p = 0.030). Our results suggest that physical activity is associated with functional mobility in both genders, while the relationship between nutritional status and mobility may be specific to older females. These findings may be of interest for the design of functional preservation strategies.

Download Full-text

Physical activity level and fall risk among community-dwelling older adults

Journal of Physical Therapy Science ◽

10.1589/jpts.29.1121 ◽

2017 ◽

Vol 29 (7) ◽

pp. 1121-1124 ◽

Cited By ~ 3

Author(s):

Sok Teng Low ◽

Thirumalaya Balaraman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Activity Level ◽

Fall Risk ◽

Community Dwelling ◽

Activity Level ◽

Community Dwelling Older Adults

Download Full-text

Use of Clinical and Impairment-Based Tests to Predict Falls by Community-Dwelling Older Adults

Physical Therapy ◽

10.1093/ptj/83.4.328 ◽

2003 ◽

Vol 83 (4) ◽

pp. 328-339 ◽

Cited By ~ 215

Author(s):

Lois K Boulgarides ◽

Susan M McGinty ◽

Jayne A Willett ◽

Carole W Barnes

Keyword(s):

Physical Activity ◽

Older Adults ◽

At Risk ◽

Physical Activity Level ◽

Community Dwelling ◽

Activity Level ◽

Eyes Closed ◽

Balance Tests ◽

Speed Accuracy ◽

Community Dwelling Older Adults

Abstract Background and Purpose. Few tests have been found to be strongly predictive of falls in community-dwelling older adults. The purpose of this study was to determine whether data from 5 balance tests—combined with data regarding fall history, number of medications, dizziness, visual problems, use of an assistive device, physical activity level, sex, and age—could predict falls in community-dwelling older adults who were independent. Subjects. Ninety-nine community-dwelling older adults aged 65 to 90 years (X̄= 74.02, SD=5.64) were tested. Methods. Subjects were tracked for falls over a 1-year period following testing. Impairment-based tests, which are tests that attempt to specifically identify which sensory systems are impaired or how motor control is impaired (eg, speed, accuracy of movement), were the Modified Clinical Tests of Sensory Interaction for Balance (Modified CTSIB) and the 100% Limits of Stability Test, both of which were done on the Balance Master 6.1. Performance-based tests, which are functional tests that identify functional limitations without necessarily identifying their causes, were the Berg Balance Scale, the Timed “Up & Go” Test, and the Dynamic Gait Index. Demographic and health data included age, sex, number of medications, physical activity level, presence of dizziness, vision problems, and history of falls over the previous year. Logistic regression was used to determine which combinations of data from balance tests, demographics, and health factors were predictive of falls. Results. Two models—(1) the “standing on a firm surface with eyes closed” (FEC) condition of the Modified CTSIB and (2) the FEC combined with age and sex—were predictive of falls, but predicted only 1 and 2 subjects who were at risk for falling, respectively, out of 20 people who were at risk for falling. Discussion and Conclusion. Five balance tests combined with health and demographic factors did not predict falls in a sample of community-dwelling older adults who were active and independent.

Download Full-text

Community-Based Group Physical Activity and/or Nutrition Interventions to Promote Health and Mobility in Older Adults: An Umbrella Review

10.21203/rs.3.rs-578194/v1 ◽

2021 ◽

Author(s):

Sarah E Neil-Sztramko ◽

Kylie Teggart ◽

Caroline Moore ◽

Diana Sherifali ◽

Donna Fitzpatrick-Lewis ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Resistance Training ◽

Systematic Reviews ◽

Community Dwelling ◽

Umbrella Review ◽

Group Setting ◽

Nutrition Interventions ◽

General Physical ◽

Community Dwelling Older Adults

Abstract Background Physical activity and a healthy diet are important in helping to maintain mobility and quality of life with aging. Delivery of physical activity and nutrition interventions in a group setting adds the benefits of social participation. Objectives This umbrella review aims to identify group-based physical activity and nutrition interventions for community-dwelling older adults that improve mobility. Methods Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Sociological Abstracts) were searched from inception to April 28, 2020. Eligibility criteria included systematic reviews exploring the effectiveness of physical activity and/or nutrition interventions, delivered in a group setting for community-dwelling older adults. Two reviewers independently performed eligibility screening, critical appraisal (using AMSTAR 2) and data extraction. Older adult/provider research partners informed data synthesis and results presentation. Results In total, 54 systematic reviews (1 high, 21 moderate, 32 low/critically low quality) were identified; 46 included physical activity only, and eight included both physical activity and nutritional supplements. No reviews included nutrition interventions alone. Combined aerobic/resistance, general physical activity, and mind-body exercise all improved physical function and balance (moderate-high certainty). Aerobic/resistance training improved aerobic capacity (high certainty). Resistance training and general physical activity improved muscle strength (moderate certainty). Aerobic/resistance training and general physical activity are likely to reduce falls among older adults (moderate certainty). There was no evidence of benefit for nutritional supplementation with physical activity. Conclusions Multicomponent group-based physical activity interventions can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.

Download Full-text