Exercise In Older Adults Research Articles

Effectiveness of Balance Exercise Circuit (BEC) on Improving Gait Parameters and Functional Performance in Older Adults.

Introduction: As age progresses, the degree of body sway increases even in simple postural forms, such as an upright posture, causing elderly individuals to sway more than young adults. Changes associated with the aging process, especially those associated with balance, start around the age of 60 years and affect the sensory system (visual, vestibular, and somatosensory) and physical attributes like flexibility, strength, balance, and coordination. These changes also affect reaction time, causing the elderly to develop many balance-related issue. Balance Exercise circuit (BEC) program, a new comprehensive design that includes exercise stations that specifically challenge sensory inputs from mechanoreceptors as well as form the visual and vestibular systems. Exercise stations were also designed to stimulate activities of daily living and potential to improve Gait and functional performance on older adults. This study intends to examine the effects of balance exercise circuit (BEC) improve gait parameters and functional performance in older adults Aim and objectives- This study aims to examine the effects of balance exercise circuit (BEC) improve gait parameters and functional performance in older adults. Methodology-Quasi Experimental study design was used in this study. Total 30 patients were selected. Pre-test and post test values were measured by using Time up and Go test (TUG) and Gait Parameters (cadence, stride length, step length) as outcome measure and were given Balance exercise circuit(BEC) for 40 minute 2 weeks and 5 days per week. Results-The collected data was tabulated and analyzed using paired t test were used. Paired t-test was used to analyze significant changes between pre-test and post-test measurements in the group. There was a significant difference between the pre test and post test measurements p value was P<0.0001. Conclusion-From this study it is concluded that the Balance exercise circuit (BEC) exercises in older adults improved gait parameters and functional performance.

The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging.

Alveolar‐capillary surface area for pulmonary gas exchange falls with aging, causing a reduction in lung diffusing capacity for carbon monoxide (DLCO). However, during exercise additional factors may influence DLCO, including pulmonary blood flow and pulmonary vascular pressures. First, we sought to determine the age‐dependent effect of incremental exercise on pulmonary vascular pressures and DLCO. We also aimed to investigate the dependence of DLCO on pulmonary vascular pressures during exercise via sildenafil administration to reduce pulmonary smooth muscle tone. Nine younger (27 ± 4 years) and nine older (70 ± 3 years) healthy subjects performed seven 5‐min exercise stages at rest, 0 (unloaded), 10, 15, 30, 50, and 70% of peak workload before and after sildenafil. DLCO, cardiac output (Q), and pulmonary artery and wedge pressure (mPAP and mPCWP; subset of participants) were collected at each stage. mPAP was higher (P = 0.029) and DLCO was lower (P = 0.009) throughout exercise in older adults; however, the rate of rise in mPAP and DLCO with increasing Q was not different. A reduction in pulmonary smooth muscle tone via sildenafil administration reduced mPAP, mPCWP, and the transpulmonary gradient (TPG = mPAP–mPCWP) in younger and older subjects (P < 0.001). DLCO was reduced following the reduction in mPAP and TPG, regardless of age (P < 0.001). In conclusion, older adults successfully adapt to age‐dependent alterations in mPAP and DLCO. Furthermore, DLCO is dependent on pulmonary vascular pressures, likely to maintain adequate pulmonary capillary recruitment. The rise in pulmonary artery pressure with aging may be required to combat pulmonary vascular remodeling and maintain lung diffusing capacity, particularly during exercise.

Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada.

This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20–1.67) and older adults (OR: 2.09; 95%CI: 1.51–2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15–2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking.

Prescription of Exercise in Older Adults, Physiotherapeutic Approach

• Identify the changes related to aging that must be taken into account for the prescription of the exercise • Define the appropriate functional assessmentsforthe prescription of the exercise in the older adult • Recognize the factors that influence the adherence to exercise by older adults • Describe according to the objectives the correct exercise prescription for older adults.

Effects of physical exercise in older adults with reduced physical capacity: meta-analysis of resistance exercise and multimodal exercise.

Older adults with reduced physical capacity are at greater risk of progression to care dependency. Progressive resistance strength exercise and multimodal exercise have been studied to restore reduced physical capacity. To summarize the best evidence of the two exercise regimes, this meta-analysis study appraised randomized-controlled trials from published systematic reviews. Medline, Embase, and the Cochrane Database of Systematic Review and Cochrane Central Register of Controlled Clinical Trials were searched for relevant systematic reviews. Two reviewers independently screened the relevant systematic reviews to identify eligible trials, assessed trial methodological quality, and extracted data. RevMan 5.3 software was used to analyze data on muscle strength, physical functioning, activities of daily living, and falls. Twenty-three eligible trials were identified from 22 systematic reviews. The mean age of the trial participants was 75 years or older. Almost all multimodal exercise trials included muscle strengthening exercise and balance exercise. Progressive resistance exercise is effective in improving muscle strength of the lower extremity and static standing balance. Multimodal exercise is effective in improving muscle strength of the lower extremity, dynamic standing balance, gait speed, and chair stand. In addition, multimodal exercise is effective in reducing falls. Neither type of exercise was effective in improving activities of daily living. For older adults with reduced physical capacity, multimodal exercise appears to have a broad effect on improving muscle strength, balance, and physical functioning of the lower extremity, and reducing falls relative to progressive resistance exercise alone.

Acute effect of dietary nitrate on forearm muscle oxygenation, blood volume and strength in older adults: A randomized clinical trial.

Both recovery time of post-exercise muscle oxygenation and muscle strength decline with aging. Although beetroot consumption has been shown to improve muscle oxygenation and exercise performance in adults, these effects in the elderly has not been addressed. The aim of the present study was to evaluate the effect of a beetroot-based gel (BG) on muscle O2 saturation, blood volume (tHb) and handgrip strength in the elderly in response to handgrip exercise. In a randomized crossover double-blind design, twelve older subjects consumed BG (100 g of beetroot-based gel containing ~ 12 mmol nitrate) or PLA (100 g of nitrate-depleted gel nitrate-depleted). The subjects performed a rhythmic handgrip exercise which consisted of a one 1-min set at 30% of the maximal voluntary contraction (MVC) of each subject, followed by a 1 min recovery. The muscle oxygenation parameters and tHb were continuously monitored by using near-infrared spectroscopy. MVC was evaluated at baseline, immediately after exercise, and 30 min afterwards. The muscle O2 resaturation rate during exercise recovery was greater in the BG when compared to PLA condition (1.43 ± 0.77 vs 1.02 ± 0.48%.s-1; P < 0.05). Significant increase was observed in tHb during exercise recovery (10.25 ± 5.47 vs 6.72 ± 4.55 μM; P < 0.05) and significant reduction of handgrip strength decline was observed 30 min after exercise in BG (- 0.24 ± 0.18 vs—0.39 ± 0.20 N; P < 0.05). In summary, a single dose of a beetroot-based gel speeds up muscle O2 resaturation, increases blood volume and improves recovery of handgrip strength after handgrip exercise in older adults.

The Effectiveness of Combining Visual Art Activities and Physical Exercise for Older Adults on Well-Being or Quality of Life and Mood: A Scoping Review.

Visual art activities and physical exercise are both low-intensity and low-cost interventions. The present study aims to comprehensively describe published literature on the effectiveness of a combination of these interventions on well-being or quality of life (QoL) and mood of older adults. Embase, CINAHL, Ovid Medline (R), PsycINFO, and Web of Science databases were searched for studies published between 1990 and 2015 that evaluated interventions combining visual art therapy and exercise for people aged 50 years or older with at least one resultant well-being or QoL or mood outcome. We found 10 studies utilizing different combination programs and outcome measures, and most had small sample sizes. Seventy percent of the studies reported that combining both interventions was effective in improving well-being or QoL and mood in older adults. Future studies are, however, requisite to investigate whether in the respective population such a combination is more effective than either of the interventions alone.

The perceptual responses to high-velocity, low-load and low-velocity, high-load resistance exercise in older adults

ABSTRACT The present study examined exercise affect during volume-load matched, high-velocity, low-load and low-velocity, high-load resistance exercise conditions in older adults. Ten older adults completed three sets of eight exercises on six separate occasions (three high-velocity, low-load and three low-velocity, high-load sessions) in a crossover study design. High-velocity, low-load was performed at 40% of predicted one repetition maximum, and low-velocity, high-load at 80%. The Physical Activity Affect Scale, Felt Arousal Scale, Feeling Scale, Rating of Perceived Exertion, Visual Analogue Scales, and the Physical Activity Enjoyment Scale examined exercise intensity and affect. There were moderate effects of exercise condition on positive exercise affect (P = 0.067; = 0.33), and trivial effects on negative exercise affect (P = 0.904; = 0.002). Rating of perceived exertion (P < 0.001; = 0.41) and fatigue (P = 0.012; = 0.52) were greater during low-velocity, high-load. Furthermore, high-velocity, low-load facilitated statistically insignificant, favourable changes (less exertion, more enjoyment etc.) for all other measures. These findings combined with emerging evidence that high-velocity, low-load is superior for improving muscle power and/or functional performance, indicates that high-velocity, low-load should be prescribed preferentially. However, both exercise conditions were enjoyed similarly, demonstrating that individual preference is an important consideration.

Socio-behavioral risk factors among older adults living with HIV in Thailand.

BackgroundThere has been a global increase in HIV infection in persons 50 years of age and older. This group is at risk for development of chronic illness that may be exacerbated by socio-behavioral risk factors such as smoking, unhealthy alcohol use, and sedentary lifestyle. However, socio-behavioral risk factors in this older HIV infected population are not well described. The current study aims to describe and document factors related to alcohol use, tobacco smoking, and physical exercise in older adults living with HIV (OALHIV).MethodsThis cross-sectional quantitative study was conducted between August and September 2015, and enrolled HIV-infected participants aged 50 years and older from 12 community hospitals in Chiang Mai Province, Northern Thailand.ResultsOf the 364 participants recruited in the study, 57.1% were female, and 67.3% were between 50–59 years of age. Respectively, 15.1%, 59.1%, and 18.7% were current smokers, currently engaged in physical exercises, and reported ever drank alcohol in the past year. 22.1% of those who drank alcohol reported experience of heavy episodic drinking. Male gender was one of the strongest predictors of ever drank alcohol in the past year (AOR, 4.66; CI, 2.28–9.49; P<0.001) and of being a current smoker (AOR, 13.41; CI, 7.23–24.87; P<0.001). Lower household income was associated with increased odds of ever drank alcohol in the past year (household income (1 USD = 35 THB) of ≤ 5,000 Baht versus > 20,000 Baht: AOR, 5.34; CI, 1.28–22.25; P = 0.021). Lower educational level was associated with decreased odds of physical exercises (no education versus secondary and higher: AOR, 0.22; CI, 0.08–0.55; P = 0.001).ConclusionSmoking and alcohol use is common among OALHIV, with a substantial proportion not engaging in physical exercises. Interventions for OALHIV should particularly target males and those of lower socio-economic status to deter smoking and alcohol use and to promote physical exercises.

Examining Exercise in Older Adults Using the Theory of Planned Behavior and Temporal Discounting

Exercise is one of the most important health behaviors to reduce and prevent the severity of many chronic diseases. The purpose of the current study was to determine if adding temporal discounting (TD) would affect the predictability of the Theory of Planned Behavior (TPB) in exercising among older adults. One hundred thirty-seven older adults were recruited from 11 churches in rural Arkansas using a cross-sectional design. Information regarding participants' exercise behavior, constructs of the TPB, TD rates, and demographics was collected. Path analysis was used to examine the relationships between and among each of the concepts of the TPB and TD. TD was not a significant predictor (p = 0.413) for exercise behavior after adjusting for intention. Adding TD to the existing TPB did not significantly affect the predictability of the model negatively or positively. [Res Gerontol Nurs. 2017; 10(6):252-259.].

Comparing Class-Based and Home-Based Exercise for Older Adults With Chronic Health Conditions: 12-Month Follow-Up of a Randomized Clinical Trial

To assess the maintenance of physical activity (PA) and health gains among participants in a class-based (CB) or home-based (HB) PA intervention over a 12-month study period. A total of 172 adults aged 50 years and older were randomly allocated to either a CB or an HB intervention, each involving an intensive 3-month phase with a 9-month follow-up period. Measures at baseline, 3, 6, and 12 months included self-reported PA and health, body mass index, waist circumference (WC), blood pressure, cardiovascular endurance (6-min walk test), physical function, and functional fitness (senior fitness test). Outcomes were analyzed using generalized estimating equations. Maximum improvement was typically observed at 3 or 6months followed by a modest diminution, with no differences between groups. For body mass index, waist circumference, 6-min walk test, and senior fitness test, there was progressive improvement through the study period. Greater improvement was seen in the CB group compared with the HB group on three items on the senior fitness test (lower body strength and endurance [29% vs. 21%, p < .01], lower body flexibility [2.8cm vs. 0.4cm, p < .05], and dynamic agility [14% vs. 7%, p < .05]). The interventions were largely comparable; thus, availability, preferences, and cost may better guide program choice.

The acute physiological effects of high- and low-velocity resistance exercise in older adults

The aim of the present study was to determine if workload matched, high-velocity (HVE) and low-velocity (LVE) resistance exercise protocols, elicit differing acute physiological responses in older adults. Ten older adults completed three sets of eight exercises on six separate occasions (three HVE and three LVE sessions). Systolic blood pressure, diastolic blood pressure and blood lactate were measured pre- and post-exercise, heart rate was measured before exercise and following each set of each exercise. Finally, a rating of perceived exertion was measured following each set of each exercise. There were no significant differences in blood lactate (F(1,9)=0.028; P=0.872; =0.003), heart rate (F(1,9)=0.045; P=0.837; =0.005), systolic blood pressure (F(1,9)=0.023; P=0.884; =0.003) or diastolic blood pressure (F(1,9)=1.516; P=0.249; =0.144) between HVE and LVE. However, LVE elicited significantly greater ratings of perceived exertion compared to HVE (F(1,9)=13.059; P=0.006; =0.592). The present workload matched HVE and LVE protocols produced comparable physiological responses, although greater exertion was perceived during LVE.

Psychosocial benefits of exercise for older adults with amnestic Mild Cognitive Impairment: Innovative practice.

The aim of this study was to explore the perceived psychosocial benefits of a three-month exercise program for 10 older adults with amnestic Mild Cognitive Impairment, a condition in which memory loss is the main symptom. Qualitative data were collected by observation (research diary) and 20 semi-structured interviews with the participants (10) and their caregivers (10). The narratives showed remarkable psychosocial benefits, such as improved mood, motivation, autonomy, perceived competence, self-esteem, and social relationships. The results of this study should provide new insights into the importance of exercise for this population, and may help to design appropriate programs for them.

Training load does not affect detraining's effect on muscle volume, muscle strength and functional capacity among older adults

Research underlines the potential of low-load resistance exercise in older adults. However, while the effects of detraining from high-load protocols have been established, it is not known whether gains from low-load training would be better/worse maintained. The current study evaluated the effects of 24weeks of detraining that followed 12weeks of high- and low-load resistance exercise in older adults. Fifty-six older adults (68.0±5.0years) were randomly assigned to leg press and leg extension training at either HIGH load (2×10–15 repetitions at 80% of one-repetition maximum (1-RM)), LOW load (1×80–100 repetitions at 20% of 1-RM), or LOW+ load (1×60 repetitions at 20% of 1-RM, immediately followed by 1×10–20 repetitions at 40% 1-RM). All protocols ended with volitional fatigue. The main outcome measures included mid-thigh muscle volume, leg press 1-RM, leg extension isometric and isokinetic strength, and functional performance. Tests were performed at baseline, post-intervention and after 24weeks of detraining. Results show no effect of load on preservation of muscle volume, which returned to baseline after detraining. Training-induced gains in functional capacity and isometric strength were maintained, independent of load. HIGH and LOW+ were more beneficial than LOW for long-lasting gains in training-specific 1-RM. To conclude, gains in muscle volume are reversed after 24weeks of detraining, independent of load. This emphasises the need for long-term resistance exercise adherence. The magnitude of detraining in neuromuscular and functional adaptations was similar between groups. These findings underline the value of low-load resistance exercise in older age. Clinical Trial Registration NCT01707017.

Cardiorespiratory responses during aquatic treadmill exercise and land treadmill exercise in older adults with type 2 diabetes.

The purpose of this study was to compare the effect of aquatic treadmill exercise (ATM) to land treadmill exercise (LTM) in adults with and without type 2 diabetes (T2D). Five participants with T2D (4 females, 1 male; age=51±3 years; height=170±3 cm; weight=96±11 kg; body fat=32±1%) and five participants without T2D (4 females, 1 male; age=51±3 years; height=170±3 cm; weight=71±15 kg; body fat=27±2%) completed the study. Participants completed three, 5-minute stages of exercise at 3.2 km/h, 4.8 km/h and 6.4 km/h with 0% grade on land and aquatic treadmills. Heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), absolute and relative oxygen consumption (VO2), and energy expenditure were measured at rest and during steady-state exercise at each intensity. A 2x2x4 Mixed Factorial ANOVA and Bonferroni post-hoc test with a significance level of 0.05 was used. All variables increased as speed increased (P<0.05) independent of group or mode. The HR value was higher on the LTM versus the ATM independent of group and treadmill stage (P=0.002) and SBP was higher in the T2D group versus no T2D independent of treadmill mode and stage (P=0.01). Relative VO2 was higher in the group without T2D compared to the T2D group at 6.4 km/h independent of treadmill mode (P=0.032). Although there is some evidence for the varying effects of aquatic and land exercise when comparing those with and without T2D, cardiorespiratory and metabolic variables are similar in both groups during locomotion on land and in an aquatic environment.

Dietary nitrate does not modify blood pressure and cardiac output at rest and during exercise in older adults: a randomised cross-over study

Dietary nitrate (NO3-) supplementation has been associated with improved vascular and metabolic health. We conducted a double-blind, cross-over, placebo-controlled RCT to investigate the effects of 7-d consumption of beetroot juice compared with placebo on (1) blood pressure (BP) measured in resting conditions and during exercise, (2) cardiac and peripheral vascular function and (3) biomarkers of inflammation, oxidative stress and endothelial integrity. Twenty non-smoking healthy participants aged 60–75 years and BMI 20.0–29.9 kg/m2 were recruited. Measurement was conducted before and after each 7-d intervention period. Consumption of NO3- had no effect on resting systolic and diastolic BP. NO3- consumption did not improve indexes of central and peripheral cardiac function responses during cardiopulmonary exercise testing. Dietary NO3- supplementation did not modify biomarkers of inflammation, oxidative stress and endothelial integrity. This study does not support the short-term benefits of dietary NO3- supplementation on physiological and biochemical markers of vascular health in older healthy adults.

Recognising Bone Loading Exercises In Older Adults Using Machine Learning

Machine learning has been used to accurately recognise physical activity patterns; however, classifiers for recognising targeted bone loading exercises have not been developed. PURPOSE: The purpose of this study was to determine the accuracy of machine learning models for classifying the intensity of exercises necessary for bone adaption in older adults. METHODS: Triaxial accelerometer data was collected from forty-four older participants (60-70 yrs) wearing a GCDC X16-1C accelerometer on their hip during three aerobics classes consisting of impact aerobic exercises performed at high and low intensities. Multi-class support vector machine (M-SVM) classifiers were trained in parallel for activity type detections where one classifier trained with low intensity activity samples and the other with high intensity samples. In a multi-view scoring manner, the classification confidence of these two learners was utilised for predicting the activity intensity. The leave-one-out cross-validation technique was used for assessment purpose. RESULTS: Overall recognition accuracy of the M-SVM classifier for detecting exercise intensity was 73%. For each aerobics class, the M-SVM classifier accurately recognised exercise intensity by 82%, 73% and 65%. CONCLUSIONS: Machine learning techniques such as M-SVM accurately recognised the intensity of bone promoting exercises from triaxial accelerometer data in community-dwelling older adults. First results of the developed classifier demonstrate significant potential of machine learning models for the evaluation of exercise adherence and performance in older adults.

Effects of Low-Intensity Exercise in Older Adults With Chronic Heart Failure During the Transitional Period From Hospital to Home in China: A Randomized Controlled Trial.

The transitional period from hospital to home is critical to decreasing rates of preventable, poor post-discharge outcomes. Older adults with chronic heart failure (CHF) may be challenged to exercise during the transitional period. The purpose of the current study was to test the effects of low-intensity exercise on health-related quality of life (HRQoL), physical function, and heart function in Chinese older adults with CHF during the transitional period. The study was randomized, single-blinded, and controlled. Seventy-eight older adults with stable CHF were evaluated. The intervention group (n = 41) participated in a regular low-intensity walking protocol and the control group (n = 38) did not. Measures included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), 6-minute walk distance (6MWD), Timed Up and Go (TUG) test, resting heart rate (RHR), and left ventricular ejection fraction (LVEF). After 12 weeks, the intervention group showed significant improvements in MLHFQ, 6MWD, and TUG scores compared to the control group (p < 0.05), and no significant improvements in RHR and LVEF (p > 0.05). Low-intensity exercise during the transitional period is an effective way to improve HRQoL and physical function in older adults. [Res Gerontol Nurs. 2017; 10(3):121-128.].

The Effects of Caffeine on Selective Attention after Exercise in Older Adults

The Effects of Caffeine on Selective Attention after Exercise in Older Adults

Preservation of skeletal muscle mitochondrial content in older adults: relationship between mitochondria, fibre type and high-intensity exercise training.

Ageing is associated with an upregulation of mitochondrial dynamics proteins mitofusin 2 (Mfn2) and mitochondrial dynamics protein 49 (MiD49) in human skeletal muscle with the increased abundance of Mfn2 being exclusive to type II muscle fibres. These changes occur despite a similar content of mitochondria, as measured by COXIV, NDUFA9 and complexes in their native states (Blue Native PAGE). Following 12weeks of high-intensity training (HIT), older adults exhibit a robust increase in mitochondria content, while there is a decline in Mfn2 in type II fibres. We propose that the upregulation of Mfn2 and MiD49 with age may be a protective mechanism to protect against mitochondrial dysfunction, in particularly in type II skeletal muscle fibres, and that exercise may have a unique protective effect negating the need for an increased turnover of mitochondria. Mitochondrial dynamics proteins are critical for mitochondrial turnover and maintenance of mitochondrial health. High-intensity interval training (HIT) is a potent training modality shown to upregulate mitochondrial content in young adults but little is known about the effects of HIT on mitochondrial dynamics proteins in older adults. This study investigated the abundance of protein markers for mitochondrial dynamics and mitochondrial content in older adults compared to young adults. It also investigated the adaptability of mitochondria to 12weeks of HIT in older adults. Both older and younger adults showed a higher abundance of mitochondrial respiratory chain subunits COXIV and NDUFA9 in type I compared with type II fibres, with no difference between the older adults and young groups. In whole muscle homogenates, older adults had higher mitofusin-2 (Mfn2) and mitochondrial dynamics protein 49 (MiD49) contents compared to the young group. Also, older adults had higher levels of Mfn2 in type II fibres compared with young adults. Following HIT in older adults, MiD49 and Mfn2 levels were not different in whole muscle and Mfn2 content decreased in type II fibres. Increases in citrate synthase activity (55%) and mitochondrial respiratory chain subunits COXIV (37%) and NDUFA9 (48%) and mitochondrial respiratory chain complexes (∼70-100%) were observed in homogenates and/or single fibres. These findings reveal (i) a similar amount of mitochondria in muscle from young and healthy older adults and (ii) a robust increase of mitochondrial content following 12weeks of HIT exercise in older adults.