Exercise In Older Adults Research Articles

Brachial vascular function after acute aerobic exercise in older adults with and without type 2 Diabetes mellitus

Brachial vascular function after acute aerobic exercise in older adults with and without type 2 diabetes Purpose: The acute exercise model provides clinical insights regarding vascular dysfunction in adults with type 2 Diabetes Mellitus (T2DM), as it uncovers abnormalities not normally present at rest. However, whether vascular responses to acute exercise in adults with T2DM are intensity-dependent, and whether response patterns differ with aging and disease, remains unknown. Thus, we examined brachial artery flow-mediated dilation (FMD) and flow-mediated slowing (FMS) of pulse wave velocity (PWV), 10 and 60-min after an acute bout of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in middle-aged and older men with and without T2DM compared to young men without T2DM. Hypothesis: HIIE would induce a larger decrease in FMD immediately after exercise cessation compared to MICE in older men with and without T2DM. Methods: Twelve males with (57-84 yr) and without (57-76 yr) T2DM, and 12 healthy young adults (20-40 yr), completed an isocaloric acute exercise bout of HIIE, MICE, and a non-exercise condition in randomized order. FMD and FMS were evaluated and offline analyzed by the same researcher following standard guidelines. Central and peripheral arterial stiffness were measured via applanation tonometry estimates of carotid-femoral PWV (cfPWV) and carotid dorsalis pedis PWV (cdPWV), respectively. Statistical inferences were performed using linear mixed models. Results: %FMD was reduced (d= - 5.94, 95% CI: -10.50 to -1.38 %, p=0.002), whereas %FMS was increased (d= 4.55, 95% CI: 0.62 to 8.48%, p=0.01), 10-min after HIIE only in older adults with T2DM, returning to resting values 60-min into recovery. Conversely, %FMD was increased (d= 5.33, 95% CI: 0.76 to 9.89%, p=0.009) 10-min after MICE only in older adults with T2DM, while cfPWV and cdPWV remained unchanged following HIIE and MICE in all groups. There were no group differences at rest in brachial %FMD and %FMS, while cfPWV and cdPWV were higher in older adults with T2DM compared to age-matched controls (cfPWV: d= 1.94, 95% CI: 0.44 to 3.44 m. s-1, p=0.009). Conclusions: We found evidence of intensity- and disease-dependent vascular responses to acute aerobic exercise. These findings suggest that high-intensity acute exercise transiently impairs vascular function in older adults with T2DM, which may constitute an important trigger for exercise-based long-term improvements in vascular function. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

An Exploration of Robot-Mediated Tai Chi Exercise for Older Adults

In this fast-aging society, many older adults fail to meet the required level of exercise due to trainer shortages. Therefore, we developed a robot tutor to investigate the feasibility of robot-mediated exercise for older adults. Twenty older adults participated in an experimental study. A pre-exercise survey was used to assess their background. Each participant experienced a 30-min robot-led Tai Chi exercise followed by a post-exercise survey to evaluate the easiness of following the robot and expectations for future robot design. Participants’ Tai Chi performances were evaluated in terms of completion and accuracy. Associations between the surveys and the performance were also analyzed. All participants completed the study. Fifteen out of the twenty subjects had at least one chronic condition, and most practiced Tai Chi before the study but had never interacted with a robot. On average, the participants scored 93.09 and 85.21 out of 100 for movement completion and accuracy, respectively. Their initial movement accuracy was correlated with their attitude towards exercise. Most subjects reported that they could follow the robot’s movements and speeches well and were interested in using a robot tutor in the community. The study demonstrated the initial feasibility of robot-led Tai Chi exercise for older adults.

THE EFFECTS OF EXERCISING ON PSYCHOLOGICAL WELL-BEING IN OLDER ADULTS

Exercising is an essential component of healthy aging. The benefits of exercise are numerous. There are certain benefits on physical performance. Exercise in older adults can increase endurance, improve balance and quality of life. The benefits of exercise are not limited to physical health. Psychological variables such as depressive mood and anxiety can also be modified by regular exercise. There are several types of exercise regimens. The most common exercise types tailored to older adults include aerobic training, strengthening, flexibility exercises and balance exercises. Specific exercises can be directed to individuals with certain health disorders. Exercising may mediate psychological health through the hypothalamus-pituitary-adrenal axis. Improved sleep via exercise can further lead to an improvement in mood and cognition. The current article reviewed the recent literature regarding the effects of exercising on psychological well-being in older adults.

VR exergame interventions among older adults living in long-term care facilities: A systematic review with Meta-analysis.

To improve the motivation toward exercise in older adults, exergames have shifted from entertainment to rehabilitation. To review the training focus of exergames and analyze the effectiveness of exergame training on physical, psychological, or cognitive outcomes among older adults in long-term care facilities (LTCFs). This review followed the PRISMA guidelines. By searching 7 electronic databases up to April 30, 2022, studies were included if they 1) involved adults ≥65 years old residing in LTCFs, 2) were randomized controlled trials (RCTs) with virtual reality-based exergames as the intervention, 3) compared the effects of exergames to usual care or conventional exercises, and 4) reported physical, psychological, or cognitive outcomes. The Cochrane Risk-of-Bias tool for randomized trials version 2 (RoB 2) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to evaluate the methodological quality of studies and levels of evidence for outcomes. The meta-analysis was conducted with Review Manager 5.4. Results are presented as standardized mean differences (SMDs) and 95% confidence intervals (CIs). A total of 12 RCTs were included in the systematic review and meta-analysis. For overall methodological quality, 10 studies showed some concerns and 2 studies showed high risk. Levels of evidence for outcomes were assessed as low (n=8) and very low (n=4). The studies involved a total of 482 older adults. Most studies implemented balance exercise as the exergame intervention. Older adults who completed exergame interventions showed improvements in cognitive outcomes (SMD 0.90, 95%CI 0.61-1.19, p<0.001) and in balance self-efficacy (SMD 1.04, 95%CI 0.47-1.61, p<0.001) as compared with those in usual care. They also showed improvements in balance (SMD 0.49, 95%CI 0.20-0.78, p<0.001) as compared with those in conventional exercise programs. Overall, exergames had a positive effect on balance (SMD 0.62, 95%CI 0.29-0.95, p<0.001). This review revealed that exergames can improve the balance ability of older adults in LTCFs.

Acceptability, Feasibility, and Effectiveness of Immersive Virtual Technologies to Promote Exercise in Older Adults: A Systematic Review and Meta-Analysis.

This review aimed to synthesize the literature on the acceptability, feasibility, and effectiveness of immersive virtual technologies to promote physical exercise in older people. We performed a literature review, based on four databases (PubMed, CINAHL, Embase, and Scopus; last search: 30 January 2023). Eligible studies had to use immersive technology with participants aged 60 years and over. The results regarding acceptability, feasibility, and effectiveness of immersive technology-based interventions in older people were extracted. The standardized mean differences were then computed using a random model effect. In total, 54 relevant studies (1853 participants) were identified through search strategies. Concerning the acceptability, most participants reported a pleasant experience and a desire to use the technology again. The average increase in the pre/post Simulator Sickness Questionnaire score was 0.43 in healthy subjects and 3.23 in subjects with neurological disorders, demonstrating this technology's feasibility. Regarding the effectiveness, our meta-analysis showed a positive effect of the use of virtual reality technology on balance (SMD = 1.05; 95% CI: 0.75-1.36; p < 0.001) and gait outcomes (SMD = 0.7; 95% CI: 0.14-0.80; p < 0.001). However, these results suffered from inconsistency and the number of trials dealing with these outcomes remains low, calling for further studies. Virtual reality seems to be well accepted by older people and its use with this population is feasible. However, more studies are needed to conclude its effectiveness in promoting exercise in older people.

Potential Benefits of a Single Session of Remote Ischemic Preconditioning and Walking in Sedentary Older Adults: A Pilot Study.

Ischemic preconditioning (IPC) has shown positive effects in endurance-type sports among healthy young individuals; however, its effects in endurance-type exercises in older adults have not been explored. We aimed to examine the acute effects of a single session of IPC prior to an endurance-type exercise on cardiovascular- and physical-function-related parameters in sedentary older adults. A pilot study with a time-series design was carried out. Nine participants were enrolled consecutively in the following intervention groups: (i) SHAM (sham IPC + walking) and (ii) IPC (IPC + walking) groups. The main outcomes were resting systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), peripheral oxygen saturation (SpO2), maximum isometric voluntary contraction (MIVC), endurance performance, and perceived fatigue. After the intervention, the IPC group showed a significant reduction in SBP, whereas SpO2 decreased in the SHAM group. The IPC group maintained quadriceps MIVC levels, whereas these levels dropped in the SHAM group. No changes in DBP, resting HR, endurance, or fatigue in any group were observed. These findings are of interest for the promotion of cardiovascular and physical health in older people.

The Effects of Exercise and Reminiscence Therapy on Depression and Quality of Life Among the Older Adults with Mild Alzheimer’s Disease

Alzheimer’s disease (AD) is the most common cause of dementia in older adults. Depression is an important co-morbid disorder in this group, as it may decrease their quality of life (QoL). Exercise or Reminiscence therapy (RT) is thought to be viable in lessening the degree of depression in older adults. To investigate and compare the impacts of integrated exercise and reminiscence therapy on depression level and QoL in older adults. A single-blinded quasi-experimental study with a comparison group design was conducted on 51 institutionalized older adults with mild-to-moderate AD and were grouped into (i) Reminiscence (RT, n = 17), (ii) exercise (EX, n = 16), and (iii) exercise coupled with Reminiscence (ER, n = 18). The depression level was assessed using the Cornell Scale for Depression in Dementia (CSDD); the QoL was assessed using the QOL–AD scale. A repeated-measures ANOVA was used for data analyses. Results: The reminiscence therapy alone or in combination with the exercise was effective in reducing depression levels and improved QoL in the older adults (p&lt;.05). The reminiscence therapy alone or in combination with the exercise was effective in reducing depression levels and improved QoL in older adults. This study found significant improvements in the mean score of CSDD and QOL–AD of the ER, thus supporting its effectiveness in reducing depressive symptoms and improving QoL in mild AD. These results help as a contribute to the healthcare practices to deliver an integrated reminiscence and exercise in older adults’ rehabilitation.

Barriers to and Facilitators of Adherence to Prescribed Home Exercise in Older Adults at Risk of Falling in Singapore: A Qualitative Study.

Adherence to prescribed exercise poses significant challenges for older adults despite proven benefits. The aim of this exploratory descriptive qualitative study was to explore the perceived barriers to and facilitators of prescribed home exercise adherence in community-dwelling adults 65 years and older. Three focus groups with 17 older adults (Mage ± SD = 77 ± 5.12) living in Singapore were conducted. Inductive thematic analysis revealed that "the level of motivation" of individuals constantly influenced their exercise adherence (core theme). The level of motivation appeared to be a fluid concept and changed due to interactions with two subthemes: (a)individual factors (exercise needs to be tailored to the individual) and (b)environmental factors (i.e.,support is essential). Hence, these factors must be considered when designing strategies to enhance exercise adherence in this vulnerable population. Strategies must be informed by the culturally unique context, in this case, a developed country with a multiethnic urban Asian population.

Excess Postexercise Oxygen Consumption Following Isocaloric Bouts of Resistance and Aerobic Exercise in Older Adults

ABSTRACT Purpose: Albeit being a major determinant of exercise-related energy expenditure (EE), there is a lack of research on the excess post-exercise oxygen consumption (EPOC) after different exercise modalities in older adults. This study compared the EPOC after isocaloric bouts of resistance (RE) and aerobic (AE) exercise. Methods: The EE during exercise was determined through telemetric indirect calorimetry in ten physically active participants aged 63 to 82 years (5 women, 73 ± 6 years, 70.5 ± 9.9 kg, 161 ± 8 cm). The target EE in AE corresponded to values achieved during RE, and the EPOC was assessed for 30 min in the supine position. Results: The EE during AE and RE were 126.0 ± 30.7 kcal and 123.9 ± 30.6 kcal, respectively. The time to achieve the target EE was 2.3 times shorter in AE vs. RE. The EPOC magnitude was greater after AE (7.9 ± 2.4 L, 40.1 ± 11.1 kcal) than RE (5.9 ± 1.8 L, 26.9 ± 11.5 kcal). Conclusion: Older adults showed greater EPOC after isocaloric sessions of AE vs. RE. Additionally, AE had better temporal efficiency than RE to elicit a given EE.

The acute leukocyte and cytokine response of older adults to resistance exercise in normobaric hypoxia.

Ageing causes a decline in leukocyte function and blunted leukocyte responses to resistance exercise. Systemic hypoxia exposure augments the leukocyte response to resistance exercise in young adults, yet this response remains uncharacterised in older adults. This study characterised the effects of normobaric hypoxia on the acute leukocyte and inflammatory cytokine responses to resistance exercise in older adults. We recruited 20 adults aged 60-70 years to perform an acute bout of resistance exercise in normobaric hypoxia (FiO2 14.4%; n = 10) or normoxia (FiO2 20.93%; n = 10). Participants completed 4 × 10 repetitions of lower and upper body exercises at 70% of their predicted 1-repetition maximum. Venous blood was sampled before and up to 24 hours post-exercise to quantify neutrophils, lymphocytes, monocytes, eosinophils, basophils and cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNFα). Flow cytometry was used to classify lymphocytes as T (CD4+ helper and CD8+ cytotoxic), B and NK cells, in addition to the expression of the senescence marker CD45RA on T cells. The hypoxic group showed a larger lymphocyte response over the 24 hours post-exercise compared to the normoxic group (p = 0.035). Specifically, there were greater concentrations of CD4+ T helper cells following hypoxic exercise compared to normoxia (p = 0.046). There was also a greater proportion of CD45RA+ CD4+ T helper cells, suggesting that the cells were more senescent (p = 0.044). Hypoxia did not impact any other leukocyte population or cytokine following exercise. Normobaric hypoxia increases the lymphocyte response to an acute bout of resistance exercise in older adults.

Differences in motor cortex synaptic plasticity associated with two forms of exercise in older adults: Evidence from TMS studies

Differences in motor cortex synaptic plasticity associated with two forms of exercise in older adults: Evidence from TMS studies

Effects of water exercise on body composition and components of metabolic syndrome in older females with sarcopenic obesity.

[Purpose] Very few studies have been conducted on the benefits of water exercise for older adults with sarcopenic obesity. Whether the water exercise intervention is effective for improving sarcopenia and/or obesity remains unclear. This study aimed to investigate the effects of water exercise on body composition and components of metabolic syndrome in older females with sarcopenic obesity. [Participants and Methods] Participants (aged ≥60 years) were divided into a water exercise group and a control group. Water-based strength and endurance exercises were performed three times a week for 12 weeks. Lean soft tissue mass, fat mass, and body fat percentage were measured by dual-energy x-ray absorptiometry. [Results] Two-way analysis of variance revealed significant interactions (time × group) for total body fat percentage and leg body fat percentage. In the exercise group, leg body fat percentage significantly decreased after the intervention, but no significant change was observed in the control group. The components of metabolic syndrome showed no significant interactions in either group (time × group). [Conclusion] No significant changes were observed in the components of metabolic syndrome. However, 12-week water exercise may be effective for reducing fat mass in females with sarcopenic obesity.

Depression and PTSD as Predictors of Attrition in Older Adult Exercise Programs

Background: In older adults, exercise is extremely important and has been demonstrated to improve physical health, cognition, and mood. However, attrition in exercise programs in general is high, with up to 50% of participants leaving in the first 3 to 6 months. Methods: A systematic review of PubMed and PsycINFO databases was conducted using PRISMA criteria assessing the association of baseline depression and/or posttraumatic stress disorder (PTSD) with attrition rates in older adult exercise programs. Results: Ten articles were identified that assessed baseline depression and attrition in older adult exercise programs. No studies assessed baseline PTSD as a risk for attrition. Attrition rate overall ranged from 19% to 38%, and depression at baseline was found to be significantly associated with higher attrition rates. Other factors associated with attrition included anxiety, lower life satisfaction, worse cognitive health, higher illness rating, shorter program duration, common illnesses, lower social support, male sex, single relationship status, and transportation dependence. Discussion: Depression at baseline was significantly related with increased attrition in older adult exercise programs. Screening and consideration of adjunctive mood treatment are recommended. Further study of PTSD as an attrition risk is recommended, particularly in veteran or other populations with greater base rates.

Older adults as designers of behavior change strategies to increase physical activity-Report of a participatory design process.

Despite the significant value of physical activity for the health of older adults, this population often fails to achieve recommended activity levels. Digital interventions show promise in providing support for self-managed physical activity. However, more information is needed about older adults' preferences for digital support to change physical activity behaviors as well as the process of designing them. The aim of this paper was to describe the participatory design process in which older adults were involved in the co-creation of digitally supported behavioral change strategies to support self-managed physical activity, and how the results were integrated in a prototype. The participatory design process involved with nine older adults and two researchers. The participants were divided in two groups, and each group participated in three workshops and completed home tasks in between workshops. Following an iterative design process influenced by theories of behavior change, the workshops and home tasks were continuously analyzed, and the content and process were developed between groups and the next set of workshops. Prototypes of a mobile health (mHealth) solution for fall preventive exercise for older adults were developed in which the conceptualized strategies were integrated. To support coherence in reporting and evaluation, the developed techniques were mapped to the Behavior Change Technique Taxonomy v1 and the basic human psychosocial needs according to the Self-determination Theory. The results highlight different preferences of older adults for feedback on physical activity performance, as well as the importance of transparency regarding the identification of the sender of feedback. Preferences for content and wording of feedback varied greatly. Subsequently, the design process resulted in a virtual health coach with three different motivational profiles and tools for goal setting and self-monitoring. These behavior change strategies were integrated in the exercise application Safe Step v1. The conformity of the design concepts with the needs of Self-determination Theory and Behavior Change Technique Taxonomy v1 are presented. The participatory design process exemplifies how older adults successfully contributed to the design of theory-based digital behavior change support, from idea to finished solution. Tailoring feedback with a transparent sender is important to support and not undermine motivation.

GEROFIT TO HOME: REDUCING BARRIERS TO GROUP EXERCISE TO RURAL AND NONRURAL OLDER ADULTS IN A SUCCESSFUL FASHION

Abstract Transportation, scheduling and travel distance can present as barriers to participation in facility based exercise programs. Gerofit to Home(GTH) eliminates aforementioned burdens commonly associated with in-person programs. Understanding participant satisfaction and retention in rural(R) and non-rural(NR) groups assists in planning to better serve these populations with group exercise. This study aims to explore GTH participant satisfaction and retention in over 100 participants, through 3 months, for veterans over 65yo in rural and non-rural areas. Current results illustrate “Highly Satisfied” in majority of both R and NR groups. Retention at 3 months, in both groups, and factors associated with 3-month retention will be discussed in this presentation. Further research into the reasoning for participant stoppage prior to 3 months will aide in understanding how to better cater group exercise to these groups. Satisfaction scores in this study endorse further efforts for virtual group exercise in older adults.

Real-Life Outcomes of a Multicomponent Exercise Intervention in Community-Dwelling Frail Older Adults and Its Association with Nutritional-Related Factors.

Most of the studies on physical exercise in older adults have been conducted through randomized clinical trials performed under tight experimental conditions. Data regarding Real-Life physical exercise intervention programs in older adults with different conditions and in different settings, are lacking. This is an interventional, prospective and pragmatic Real-Life study in which fifty sedentary and frail individuals were enrolled. We aimed at determining if a Real-Life exercise intervention outweighs previously reported improvements in a Clinical Trial (NCT02331459). We found higher improvements in the Real-Life exercise intervention vs. the Clinical Trial in functional parameters, such as Fried's frailty criteria, Tinetti, Barthel and Lawton & Brody scales. Similar results were found in the dietary habits, emotional and social networking outcomes determined through the Short-MNA, Yesavage, EuroQol and Duke scales. The Real-Life intervention led to a significant reduction in the number of falls, visits to the primary care centers and emergency visits when compared to the results of our previously published Clinical Trial. The implementation of a Real-Life exercise intervention is feasible and should be a major priority to improve health-span in the older population.

Affective and ergogenic effects of beat‐accented synchronous music on acute exercise training in older adults with mild cognitive impairment or mild dementia

AbstractBackgroundGiven the increasing dementia population and that no cure for dementia is available, exercise may be important for older adults in the early stages of cognitive decline (ESCD) to delay the progression of cognitive deterioration. However, functional limitations are prevalent in older adults, which often hinder their exercise participation. Exercising with music is a novel approach to facilitate exercise and maximize health benefits because humans like to move in synchrony with music and because both music and exercise can help improve cognitive health. As part of a proof‐of‐concept study, we tested the acute effects of beat‐accented synchronous music (BSM) on affective and psychophysiological responses to exercise in older adults with ESCD.MethodWe developed a chair‐based group exercise program consisting of 30 min of aerobic, strength, and balance training for older adults with functional limitations. A BSM playlist at 85 beats/min was created by imposing 4/4 drumbeats on top of instrumental country music that matched participants’ exercise pace and music preference. Nine older adults with ESCD (M age = 80.9±15.1 years; 2 females; Montreal Cognitive Assessment scores ranged 11‐24) exercised with and without BSM (twice each, counterbalanced) and provided their ratings of feelings (FS) and perceived exertion (RPE) immediately before, midway through, and immediately after each exercise session. Data were analyzed by Friedman tests.ResultWe found significant effects of BSM on FS [χ 2(1) = 4, p&lt;0.05] and RPE [χ 2(1) = 4.5, p&lt;0.05] during exercise. Participants reported more positive feelings (9.78±0.22 &gt; 8.56±0.56) and higher exertion (6±0.96 &gt; 3.94±0.49) during BSM‐based exercise compared with no‐BSM exercise. No effects of BSM on FS and RPE were found before or after exercise (p’s&gt;0.5).ConclusionCognitive and functional decline restrains exercise participation in older adults, which exacerbates the cognitive and functional decline, creating a vicious cycle. Our findings suggest that BSM can make exercise more pleasurable while increasing perceived exercise intensity from ‘somewhat hard’ to above ‘hard’ in older adults with ESCD. These are important findings because positive affect during an acute bout of exercise is associated with future exercise participation. Future research needs to test the efficacy of a long‐term BSM‐based exercise intervention for older adults.

Inter-individual responses of post-exercise hypotension in older adults with hypertension: An exploratory analysis of different exercise modalities.

Background: Various physical exercise modalities can acutely reduce blood pressure (BP). However, not all individuals respond similarly after an exercise session. Purpose: To measure inter-individual variations in 24-hBP after a single bout of various exercise modalities in older adults with hypertension. Methods: This retrospective study analyzed data from participants with hypertension (≥60years) previously included in three randomized controlled trials on this topic. BP was assessed using ambulatory BP monitoring. We compared the mean changes in total 24-h, daytime, and nighttime BP after aerobic (AE, n = 19), combined (COMB, n = 19), resistance (RES, n = 23), and isometric handgrip (ISO, n = 18) exercise sessions to a non-exercising control session (C). The minimum detectable changes to classify the participant as a "Responder" for the corresponding exercise protocol were 4 and 2mmHg for systolic and diastolic BP, respectively. Results: The prevalence of Responders for systolic BP was as follows: AE 24-h: 37%, daytime: 47% and nighttime: 37%; COMB 24-h: 26%, daytime: 21% and nighttime: 32%; RES 24-h: 26%, daytime: 26% and nighttime: 35%; and ISO 24-h: 22%, daytime: 22% and nighttime: 39%. For diastolic BP, the prevalence of Responders was as follows: AE 24-h: 53%, daytime: 53% and nighttime: 31%; COMB 24-h: 26%, daytime: 26% and nighttime: 31%; RES 24-h: 35%, daytime: 22% and nighttime: 52%; and ISO 24-h: 44%, daytime: 33% and nighttime: 33%. Conclusion: There was a high inter-individual variation of BP after a single bout of various exercises in older adults. Responders had higher BP values on the control day without exercise. Various exercise modalities might acutely reduce 24-h BP in older adults with hypertension.

Does High-Velocity Resistance Exercise Elicit Greater Physical Function Benefits Than Traditional Resistance Exercise in Older Adults? A Systematic Review and Network Meta-Analysis of 79 Trials.

A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests in older adults. CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus, and Web of Science databases were searched up to February 2022. Eligible randomized trials examined the effects of supervised high-velocity or traditional resistance exercise in older adults (ie, ≥60 years). The primary outcome for this review was physical function measured by fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests, while maximal muscle power and muscle strength were secondary. A random-effects network meta-analysis was undertaken to examine the effects of different resistance exercise interventions. Eighty articles describing 79 trials (n = 3 575) were included. High-velocity resistance exercise was the most effective for improving fast walking speed (standardized mean difference [SMD] -0.44, 95% confidence interval [CI]: 0.00 to 0.87), timed-up and go (SMD -0.76, 95% CI: -1.05 to -0.47), and 5-times sit-to-stand (SMD -0.74, 95% CI: -1.20 to -0.27), while traditional resistance exercise was the most effective for 30-second sit-to-stand (SMD 1.01, 95% CI: 0.68 to 1.34) and 6-minute walking (SMD 0.68, 95% CI: 0.34 to 1.03). Our study provides evidence that resistance exercise velocity effects are specific in older adults, as evidenced by physical function test dependence. We suggest that prescriptions based on the velocity of contraction should be individualized to address the specific functional needs of participants.

Dopamine D2/3-receptor availability and its association with autonomous motivation to exercise in older adults: An exploratory [11C]-raclopride study.

Autonomous motivation to exercise occurs when the activity is voluntary and with a perceived inherent satisfaction from the activity itself. It has been suggested that autonomous motivation is related to striatal dopamine D2/3-receptor (D2/3R) availability within the brain. In this study, we hypothesized that D2/3R availability in three striatal regions (nucleus accumbens, caudate nucleus, and putamen) would be positively associated with self-reported autonomous motivation to exercise. We also examined this relationship with additional exploratory analyses across a set of a priori extrastriatal regions of interest (ROI). Our sample comprised 49 older adults (28 females) between 64 and 78 years of age. The D2/3R availability was quantified from positron emission tomography using the non-displaceable binding potential of [11C]-raclopride ligand. The exercise-related autonomous motivation was assessed with the Swedish version of the Behavioral Regulations in Exercise Questionnaire-2. No significant associations were observed between self-reported autonomous motivation to exercise and D2/3R availability within the striatum (nucleus accumbens, caudate nucleus, and putamen) using semi-partial correlations controlling for ROI volume on D2/3R availability. For exploratory analyses, positive associations were observed for the superior (r = 0.289, p = 0.023) and middle frontal gyrus (r = 0.330, p = 0.011), but not for the inferior frontal gyrus, orbitofrontal cortex, anterior cingulate cortex, or anterior insular cortex. This study could not confirm the suggested link between striatal D2/3R availability and subjective autonomous motivation to exercise among older adults. The exploratory findings, however, propose that frontal brain regions may be involved in the intrinsic regulation of exercise-related behaviors, though this has to be confirmed by future studies using a more suitable ligand and objective measures of physical activity levels.