Evidence-based Exercise Program Research Articles

Guidelines for exercise prescription in elderly. Satus and limitations in the south of Italy

The elderly are generally less physically active than young adults [1]. In 2007 the American College of Sport Medicine (ACSM) and the American Heart Association (AHA) published an updated recommendation on physical activity specific for older adults that emphasized the role of a regular physical activity [2]. Recently, the U.S. Department of Health and Human Services published national physical activity guidelines that provides guidance about physical activity for adults aged 65 years and older [3]. In particular these guidelines stress that if older adults cannot perform 150 min of moderate-intensity aerobic activity per week because of chronic conditions, they may be physically active based on their abilities and conditions. Despite these recommendations, in Italy data on physical activity and sport practice in the elderly are rather critical. After 65 years old only 9% of people practice sports and after 75 years old or over this value drops to 2.8%, while physical activity is 21,6% and 36.3% respectively. From 65 years old or over more than 50% people are sedentary and 75% of 75 year-olds claim no sport or physical activity practice in their leisure time [4]. In the South of Italy, particularly, 40% of elderly men and 64% of elderly women don’t perform any physical activity in their leisure time. Nevertheless we must consider that a significant part of elderly people living alone have few opportunities to socialize, so their participation in structured exercise programs may be very useful. In Italy the elderly who live alone are 5.6 million and most need help and assistance at home. Actually other countries apply health programs such as Enhance Fitness: a low-cost, evidence-based group exercise program developed specifically for older adults [5]. Based on these considerations we think it’s necessary to realize specific physical activities for elderly people, following the latest scientific recommendations and characteristics: simplicity, safety, economy and efficacy.

Suggestions for Increasing Physical Activity Levels of Korean Older Adults: A Public Health Perspective

2010 is the year when the Korean baby boomer generation faces retirement. With the need for affective strategies to keep this population healthy, the government has placed much effort to increase the regular physical activity (PA) level of older adults. Yet the prevalence of active seniors is still relatively low. This paper reviews the recent government strategies and efforts to enhance the physical activity levels of older adults and the PA programs provided in the community settings by major organizations and institutions. In addition, the problems of the current approaches are shown, and based on a review, the author provides five suggestions for promoting the PA level of older adults as follows. First, specific physical activity goals and objectives for older adults should be included in the National Health Plan 2020. Second, the recommendations for PA for seniors, which include a proper intensity, duration and frequency of exercise, should be provided. Third, the role of organizations and institutions should be rearranged for the proper dissemination of government provided community-based exercise programs. Fourth, a standard quality-control system should be provided, and finally, an evidence-based exercise program, which should be specifically created for the older Korean population, should be developed. Physical activity offers opportunities for people to extend the years of their active independent life and reduce functional limitations. To maximize the effects of government efforts to promote PA for seniors, we feel the comments provided in this paper should be closely examined.

High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson's disease: A preliminary study

Persons with Parkinson disease (PD) often demonstrate bradykinesia during mobility tasks. Bradykinesia combined with other PD-related movement deficits may contribute to self-reported reductions in quality of life. At this time, no studies have examined the effects of resistance exercise as an intervention to reduce bradykinesia and improve self-reported quality of life. Therefore, we examined changes in muscle force production, clinical measures of bradykinesia, and quality of life following 12 weeks of a high intensity eccentric resistance exercise program in persons with mild to moderate PD. Twenty individuals with idiopathic PD were matched into an experimental or an active control group. All participants were tested prior to and following a 12-week intervention period. The experimental group performed high intensity quadriceps contractions on an eccentric ergometer 3 days a week for 12 weeks. The active control group participated in an evidence based exercise program of PD. The outcome variables were quadriceps muscle force, clinical bradykinesia measures (gait speed, timed up and go) and disease specific quality of life (Parkinson's disease questionairre-39 [PDQ-39]). Data was analyzed using separate 2 (group) × 2 (time period) ANOVAs. Results demonstrated significant time by group interaction effects for gait speed, timed up and go, and the composite PDQ-39 score ( p < 0.05). Muscle force, bradykinesia, and QOL were improved to a greater degree in those that performed high intensity eccentric resistance training compared to an active control group. Additional research is needed to determine if this type of training has long-term impact and if it results in an alteration of the natural history of mobility and QOL decline in persons with PD.

Effects Of First Step To Active Health® Program In Older Adults: Class-based Vs. Home-based Exercise

The First Step to Active Health® (FSAH), which was recently translated into Japanese, is an evidence-based exercise program designed for implementation in either home-based or group-based settings. The program includes 4 key components of physical activity (cardio, strength, flexibility, and balance activities) as well as behavioral modification strategies. While program's effectiveness has been shown in several group-based studies of older adults, its efficacy as a home-based intervention has not been evaluated. PURPOSE: The purpose of this study was to compare the effects of well-rounded exercise using the Japanese FSAH program on functional fitness between class-based exercise and individual home-based exercise in older adults. METHODS: Twenty-eight older adults volunteered for this study. They were randomly assigned to either a class-based exercise (CBE) group that participated in classes at a senior center or an individual home-based exercise (HBE) group. Each group completed the program over 12 weeks. The CBE group attended 2 group exercise classes per week for 90 minutes per session, while the HBE group performed the program unsupervised at home for 12 weeks for as many days as possible. RESULTS: At baseline, the two groups were not different, except the HBE group had significantly less BMI and body weight. After 12 weeks, significant improvements were noted in: Chair Stand 12% (CBE), 19% (HBE); Arm Curl 11% (CBE), 19% (HBE); Up-&-Go 8% (HBE); Timed Walk 6% (CBE), 8% (HBE); and Sit-&-Reach 6% (HBE). Static balance tended to improve (CBE) although not significantly. There were no significant differences between groups. CONCLUSIONS: These results indicate that the FSAH Program is effective in both supervised and unsupervised settings and results in improvements in many components of functional fitness over a 12 week period. Supported by the Grants-in-for Scientific Research of MEXT Japan.

An Evidence-Based Exercise Program Implemented in Congregate-Meal Sites

This study examined the feasibility of implementing the EnhanceFitness Program (formerly Lifetime Fitness Program), an evidence-based exercise program, at congregate-meal sites that generally serve low-income older adults. A 12-week aerobic and strength training exercise program was held at senior centers 3 times a week. The mean age of the 31 participants was 73.5 years+/-6.7 years (60-86). Participants' compliance with attending the exercise class was 74%. Paired t tests were used to evaluate change after the intervention. Three out of six components of the Senior Fitness Test increased significantly after the exercise intervention (P<.003). Three out of the eight self-reported health concepts of the SF-36 demonstrated significant improvement after the exercise intervention (P<.003). These data indicate that an evidence-based exercise program can be successfully implemented in this population.

Evaluation of a Community‐Based Exercise Program for Elderly Korean Immigrants

To evaluate feasibility and effectiveness of a modified exercise program for elderly Korean immigrants (EKIs). Intervention study with EKI residents of a senior house (n = 13, age range 67-86 years, mean age 77 years), recruited through posted fliers and with help from a Korean social worker. A Korean-American instructor taught a modified version of an evidence-based exercise program 3 times weekly, 50 min per session, for 12 weeks. Program was evaluated with the Quality Health Outcomes Model. System and client characteristics were taken into consideration because elderly Koreans have their own values and beliefs, which influence their health management behaviors. Evaluation measures included exercise adherence, preintervention and postintervention health outcomes, and satisfaction with the exercise program. Group discussion was used to evaluate satisfaction with the exercise program. Participants showed improved health outcomes on muscle strength, agility/balance, and blood pressure after the exercise program. All participants were satisfied with the exercise program, and participation rates were good (nine participants attended > or = 80% of classes). The exercise program was feasible for this sample and should be evaluated in a larger population of EKIs and in populations of other ethnic minorities.

Evidence-based Exercise Programme to Reduce Falls in an Elderly Population

Evidence-based Exercise Programme to Reduce Falls in an Elderly Population