Exercise Interventions For Older Adults Research Articles

A pilot randomized controlled trial of a virtual peer-support exercise intervention for female older adults with cancer

BackgroundRegular exercise can mitigate side effects of cancer treatment. However, only a small proportion of adults with cancer meet exercise guidelines, and older adults (> 65 years) are underrepresented in cancer rehabilitation research. Peer support facilitates health-promoting behaviours in general populations, but interventions merging exercise and peer support for older adults with cancer are not examined. The purpose of this study was to determine the feasibility and preliminary effectiveness of a virtual partner-based peer support exercise intervention for older adult female cancer survivors.MethodsOlder adult female cancer survivors with internet access and currently participating in < 150 min of moderate-vigorous physical activity per week were included in this study. Participants were matched with a partner and given a peer support guide, exercise guidelines, and a Fitbit Inspire©. In addition, intervention group dyads (AgeMatchPLUS) had weekly 1-h virtual sessions with a qualified exercise professional for 10 weeks. Dyads randomized to the control group (AgeMatch) independently supported their partner around exercise for 10 weeks. The primary outcome was feasibility, measured using retention and adherence rates. Secondary outcomes included exercise volume, social support, quality of life, physical function, and physical activity enjoyment. Descriptive statistics were used to report feasibility and an ANCOVA was used to explore between group differences on secondary outcomes at post-intervention (10 weeks post baseline) and post-tapering timepoints (14 weeks post baseline).ResultsEighteen participants (9 dyads; mean age 72 years (SD: 5.7 years)) were included in the pilot trial. Retention and adherence rates to the AgeMatchPLUS intervention were 100% and 95% respectively. All but one participant was satisfied with the quality of their peer match. Preliminary effects were seen between group, favouring AgeMatchPLUS for exercise-related social support post-intervention (effect size (d) = 0.27, 95% CI = 0,0.54) and physical activity enjoyment at post-tapering (d = 0.25, 95% CI = 0,0.52) and favouring the AgeMatch group for 30 s sit-to-stand repetitions at post-tapering (d = 0.31, 95% CI = 0.004, 0.57). No other effects were found.ConclusionsA virtual partner-based exercise intervention for older adults with cancer is feasible and shows preliminary effect benefits. Findings inform future trials aimed at increasing exercise in older adults with cancer.Trial registrationClinicaltrials.gov (ID: NCT05549479, date: 22/09/22).

Effectiveness of community-based Baduanjin exercise intervention for older adults with varying frailty status: a randomized controlled trial

BackgroundDue to poorer exercise tolerance, it may be challenging for frail older adults to engage in moderate- or vigorous-intensity exercise. While low-intensity exercise interventions may be more feasible, its effectiveness for such population group remains unclear. We examined the effectiveness and implementation of community-based Baduanjin Qigong, a low-intensity exercise program in older adults with varying frailty status.MethodsA two-arm, multicenter assessor-blind parallel group randomized controlled trial was conducted at three local senior activity centers. Fifty-six community-dwelling older adults with low handgrip strength were randomly allocated to either the intervention (IG) or wait-list control (CG) group. The IG underwent a supervised 16-week Baduanjin exercise program at a frequency of 2–3 × 60 min sessions/week. The CG was instructed to maintain their usual activity and received a monthly health education talk. The primary outcome measures were knee extension strength, vital exhaustion, and fear of falling. Secondary outcome measures include physiological falls risk, handgrip strength, gait speed, timed up and go test, 30-second sit-to-stand, quality of life, depression, and frailty. All outcome measures were assessed at baseline and 4-month follow-up.ResultsOverall, there were no statistically significant differences in all outcome measures between CG and IG at 4-month follow-up. However, in exploratory compliance analysis, a statistically significant group x time interaction was found for vital exhaustion (B = -3.65, 95% CI [-7.13, -0.16], p = .047) among participants with at least 75% attendance. In post-hoc within-group comparisons, IG showed improved vital exhaustion by 4.31 points (95% CI [1.41, 7.20], d = 0.60). The average participant attendance rate was 81.3%. No major adverse events occurred, and all participants reported positive experiences with the exercise intervention.ConclusionsOur study demonstrated that Baduanjin is a safe, feasible, and acceptable exercise program that can be successfully implemented in community settings for older adults with varying frailty status. With good adherence, Baduanjin exercise could potentially be effective in alleviating vital exhaustion. However, the effectiveness of Baduanjin on physical performance, psychological measures and frailty in community-dwelling older adults remains equivocal.Trial registrationClinicalTrials.gov NCT04549103. Registered September 16, 2020.

Effectiveness of digital health exercise interventions on muscle function and physical performance in older adults with possible, confirmed or severe sarcopenia: a protocol for a systematic review

IntroductionSarcopenia is characterised by the progressive weakening of muscle function that occurs with age. This condition frequently leads to frailty, disability and even death. Research on sarcopenia prevention is growing....

Exploring the Feasibility of Digital Voice Assistants for Delivery of a Home-Based Exercise Intervention in Older Adults With Obesity and Type 2 Diabetes Mellitus: Randomized Controlled Trial.

Current clinical guidelines for the management of type 2 diabetes mellitus (T2DM) in older adults recommend the use of antihyperglycemic medications, monitoring of blood glucose levels, regular exercise, and a healthy diet to improve glycemic control and reduce associated comorbidities. However, adherence to traditional exercise programs is poor (<35%). Common barriers to adherence include fear of hypoglycemia and the need for blood glucose level monitoring before exercise. Digital health strategies offer great promise for managing T2DM as they facilitate patient-practitioner communication, support self-management, and improve access to health care services for underserved populations. We have developed a novel web-based software program allowing practitioners to create tailored interventions and deliver them to patients via digital voice assistants (DVAs) in their own homes. We aim to evaluate the feasibility of a 12-week, home-based, personalized lifestyle intervention delivered and monitored by DVAs for older adults with obesity and T2DM. In total, 50 older adults with obesity aged 50-75 years with oral hypoglycemic agent-treated T2DM were randomized to the intervention (DVA, n=25) or a control group (n=25). Participants allocated to the DVA group were prescribed a home-based muscle strengthening exercise program (~20- to 30-min sessions) and healthy eating intervention, delivered via DVAs (Alexa Echo Show 8; Amazon) using newly developed software ("Buddy Link"; Great Australian Pty Ltd). Control group participants received generalized physical activity information via email. Outcomes were feasibility, DVA usability (System Usability Scale), and objectively assessed physical activity and sedentary time (wrist-worn accelerometers). In total, 45 (90%) out of 50 participants completed this study. Mean adherence to prescribed exercise was 85% (SD 43%) with no intervention-related adverse events. System usability was rated above average (70.4, SD 16.9 out of 100). Compared with controls, the DVA group significantly decreased sedentary time (mean difference -67, SD 23; 95% CI -113 to -21 min/d), which was represented by a medium to large effect size (d=-0.6). A home-based lifestyle intervention delivered and monitored by health professionals using DVAs was feasible for reducing sedentary behavior and increasing moderate-intensity activity in older adults with obesity and T2DM. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621000307808; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381364&isReview=true.

Non invasive techniques for direct muscle quality assessment after exercise intervention in older adults: a systematic review

BackgroundThe aging process induces neural and morphological changes in the human musculoskeletal system, leading to a decline in muscle mass, strength and quality. These alterations, coupled with shifts in muscle metabolism, underscore the essential role of physical exercise in maintaining and improving muscle quality in older adults. Muscle quality's morphological domain encompasses direct assessments of muscle microscopic and macroscopic aspects of muscle architecture and composition. Various tools exist to estimate muscle quality, each with specific technical requirements. However, due to the heterogeneity in both the studied population and study methodologies, there is a gap in the establishment of reference standards to determine which are the non-invasive and direct tools to assess muscle quality after exercise interventions. Therefore, the purpose of this review is to obtain an overview of the non-invasive tools used to measure muscle quality directly after exercise interventions in healthy older adults, as well as to assess the effects of exercise on muscle quality.Main textTo address the imperative of understanding and optimizing muscle quality in aging individuals, this review provides an overview of non-invasive tools employed to measure muscle quality directly after exercise interventions in healthy older adults, along with an assessment of the effects of exercise on muscle quality.ResultsThirty four studies were included. Several methods of direct muscle quality assessment were identified. Notably, 2 studies harnessed CT, 20 utilized US, 9 employed MRI, 2 opted for TMG, 2 adopted myotonometry, and 1 incorporated BIA, with several studies employing multiple tests. Exploring interventions, 26 studies focus on resistance exercise, 4 on aerobic training, and 5 on concurrent training.ConclusionsThere is significant diversity in the methods of direct assessment of muscle quality, mainly using ultrasound and magnetic resonance imaging; and a consistent positive trend in exercise interventions, indicating their efficacy in improving or preserving muscle quality. However, the lack of standardized assessment criteria poses a challenge given the diversity within the studied population and variations in methodologies.. These data emphasize the need to standardize assessment criteria and underscore the potential benefits of exercise interventions aimed at optimizing muscle quality.

A Fullerton Functional Fitness Test-based exercise intervention for older adults yields quick physical and psychological benefits

ObjectivesFunctional fitness is essential for healthy living in older adults. Specially targeted fitness programs might be the most beneficial. This intervention study aimed to assess the efficacy of a specific 16-week exercise program in improving functions as measured by the Fullerton Functional Fitness Test (FFFT), also known as the Senior Test, in older adults. ParticipantsThirty-eight participants (66 % women, Mage = 80.15, SD = 7.21) were randomized into an exercise group (n = 24) and a waiting list control group (n = 14). The exercise group trained three times a week for 1 h. MethodsObjective tests (FFFT and handgrip power) and subjective psychological measures (life satisfaction, resilience, happiness, perceived stress, and well-being) were obtained at baseline, after eight weeks, and after 16 weeks. The data were analyzed using mixed-effect regression models. ResultsThe results yielded statistically significant group-by-time interactions in all models, indicating improvements in physical and psychological measures over time in the treatment group compared to the control group. Significant differences between the groups in the estimated marginal means (with adjusted 95 % confidence intervals) emerged after 16 weeks in happiness (−3.5 [-6.5, −0.4]), resilience (−5.5 [-9.9, −1.2]), perceived stress (2.2 [0.2, 4.2]), well-being (−5.8 [-7.9, −3.6]), upper limb strength (−5.7 [-9.0, −2.4]), upper body flexibility (−8.7 [-16.4, −1.0]), and agility and balance (4.6 [1.2, 8.1]). Except for happiness and resilience, these differences surfaced already after eight weeks. ConclusionThe here-employed 16-week exercise program, targeting the test elements of the FFFT, efficiently induced physical and mental improvements in older adults.

Development steps of multimodal exercise interventions for older adults with multimorbidity: A systematic review.

Multicomponent exercise interventions are recommended for older adults and for those with chronic diseases. While multiple programs have been tested, no one has yet explored how these programs were developed. This review set out to determine what development steps multicomponent exercise intervention studies that include older adults with multimorbidity have taken. Systematic review and narrative synthesis. One hundred and thirty-eight studies meeting review criteria (Population: adults ≥60 years with multimorbidity; Intervention: exercise interventions with ≥2 components; Comparator: any considered; Outcome: any considered) were retrieved. Most studies (70%) do not report intervention development actions as suggested by available guidance. Notable deviations from recommendations include limited performance of systematic review of previously published evidence, lack of engagement with theory, and few examples of design then refine. Exercise interventions for older adults with multimorbidity do not appear to follow best practice in terms of their developing. Disregard of development recommendations risks contributing to research redundancy and/or avoidable waste, as important steps that make sure the intervention is warranted, suitable for the population in question, and tested using optimal methods and outcome measures are overlooked.

Therapeutic Quality Affects Physical Fitness Benefits of Home Exercise Interventions in Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression.

The international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool is a new instrument developed to evaluate the therapeutic quality of exercise interventions. Home-based exercise has been shown to improve physical fitness in older adults, but its effects may be influenced by therapeutic quality. The purpose of this systematic review was to describe the therapeutic quality of home-based exercise interventions for community-dwelling older adults and examine the relationship between therapeutic quality and changes in physical fitness. Six electronic databases and 2 clinical trial registries were searched for randomized controlled trials investigating the effects of home-based exercise on physical fitness in community-dwelling older adults (≥60 years). Therapeutic quality was evaluated using the i-CONTENT tool for items of patient selection, type of exercise, safety, type/timing of outcomes, exercise dose, and adherence. International Consensus on Therapeutic Exercise aNd Training items were used to explain heterogeneity in meta-regression analyses. Risk of bias, certainty of evidence and credibility of analyses were assessed. Thirty-six trials (n = 6157 participants) were identified. Most studies (≥66.7%) had high or probably high therapeutic quality for i-CONTENT items, except exercise dose (47.2%) and adherence (16.7%). Interventions improved upper- (N = 20 trials; standardized mean difference [SMD] = 0.39; 95% CI, 0.13-0.64; low certainty of evidence) and lower-body strength (N = 28; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty), and aerobic fitness (N = 8; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty). For exercise dose, low- or probably low-quality studies negatively influenced effects on upper- (estimated β = -.48; P = .049; moderate credibility) and lower-body strength (estimated β = -.77; P = .048; moderate credibility). For adherence, low- or probably low-quality studies negatively influenced effects on aerobic fitness (estimated β = -.97; P = .02; low credibility). Home-based exercise may improve upper- and lower-body strength, as well as aerobic fitness in older adults. However, the effectiveness of interventions is affected by inadequate dosing of exercise programs and adherence issues. Physical therapists should have the best available evidence to support their clinical decision making, especially when designing and monitoring home programs.

What are physical exercise interventions in older age? Literature review for physical and cognitive function

Background and Study Aim. The elderly represent a growing age group and an integral part of modern society. The aging process introduces significant health challenges, making exercise an essential component in maintaining quality of life and well-being among the elderly. This study reviews the impact of physical exercise interventions on the physical and cognitive functions of the elderly population. Material and Methods. The search for this study was conducted using the ScienceDirect and PubMed databases. The search strategy employed a combination of keywords ("Elderly Physical Exercise" AND "Physical Exercise Intervention" AND "Elderly Fitness and Cognitive" AND "Physical Exercise for Physical and Cognitive Functions" AND "Physical and Cognitive Benefits" AND "Elderly Physical Exercise Prevalence"). This search adhered to the PRISMA guidelines. Initially, 1,854 publications were identified through the database searches (ScienceDirect: 981 articles; PubMed: 873 articles). After applying the exclusion criteria, only 11 articles remained. Results. It has been found that physical exercise interventions for the elderly significantly impact their physical and cognitive functions. In the first group, exercises such as home-based e-Health programs, multicomponent exercises, moderate aerobic exercises, dance training, and balance training have been identified. All these have been shown to provide substantial benefits. These programs enhanced not only physical function but also cognitive performance and the overall quality of life for older adults without physical and cognitive health complaints. This showcases the potential of physical exercise interventions to prevent morbidity and reduce disability. The second group focused on physical exercise interventions for older adults with degenerative disease complaints, such as type 2 diabetes and multiple sclerosis. Dual-task exercise programs and tai chi chuan exercises have demonstrated improvements in cognitive function for this demographic. They also improved physical fitness. The research also points out some limitations related to the implementation and budgeting for these programs. Conclusions. The literature review suggests that physical exercise interventions play a crucial role in maintaining physical and cognitive functions in older adults. Exercise programs tailored to the specific health conditions of individuals can significantly improve the quality of life and reduce the risk of declining physical and cognitive functions in the elderly population.

Development of a frailty prevention program including nutrition and exercise interventions for older adults in senior daycare centers in South Korea using a mixed methods research design.

The growing aging population has led to an increased utilization of senior daycare centers. This study was conducted to design a program to enhance the health of older adults in senior daycare centers in Chuncheon City, South Korea. The study explored the health conditions and dietary patterns of older adults in senior daycare centers. Participants included staff and older adults from senior daycare centers in Chuncheon City. A mixed methods research design was used to obtain both qualitative and quantitative data. Qualitative insights were obtained through in-depth interviews with 26 staff members and older adults, coupled with observations made at 10 senior daycare centers. The quantitative component comprised structured questionnaires and physical measurements of 204 older adults at these centers. Many of the older adults relied on the meals provided by the center due to their limited cooking abilities. Dental health issues and dysphagia were common. Interviews highlighted the budgetary constraints of the centers in providing wholesome meals and the need for government support to alleviate meal expenses and enhance quality. A structured survey of older adults showed that the average age was 83.3 yrs, with an average of 2 chronic conditions per participant. Frailty analysis of the participants revealed that 56.2% were prefrail and 32.0% were frail. Almost half of the participants (47.0%) used dentures. Based on these findings, a preventive intervention program was proposed, addressing the specific needs and challenges of older adults while promoting overall well-being and preventing frailty. Tailored health promotion strategies are crucial in senior daycare centers. Recommended interventions include staff nutrition education, improved dietary plans, and cost-effective strength training programs. These interventions aim to reduce frailty and enhance the quality of life of older adults in the community via interventions in daycare centers.

Effects of different types of physical exercise on executive function of older adults: a scoping review.

This scoping review examined the impact of physical exercise on executive function (EF) in older adults and investigated the moderating effects of exercise types. We systematically searched four electronic databases for randomized controlled trials (RCTs) investigating the effects of exercise on EF, published until November 26, 2023. The proportions of positive and null/negative effects across all studies were calculated. In total, 91 studies were included in the analysis. Among these, 27 (29.7%) studies employed aerobic exercise interventions for older adults' EF, with 19 (70.4%) studies reporting positive effects. Additionally, 18 (19.8%) studies utilized strength exercise interventions for older adults' EF, with 15 (83.3%) studies demonstrating positive benefits. Furthermore, 32 (35.2%) studies employed coordination exercise interventions for older adults' EF, with 25 (78.1%) studies showing positive benefits. Similarly, 30 (33%) studies applied mixed exercise interventions for older adults' EF, with 25 (83.3%) studies indicating positive benefits. Overall, all four types of physical exercise enhance EF in older adults, with mixed exercises being the most effective.

Sex Differences in Effects of Exercise on Physical Function in Aging: A Systematic Review with Meta-Analysis.

Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex. Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a randomeffects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I²). A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=-0.40, 95% CI: -0.71 to -0.09; I²=75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I²=52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I²=89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I²=0%; n=7). Limited and inconsistent results were observed for flexibility. Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population.

The ESCAPE Trial for Older People With Chronic Low Back Pain: A Feasibility Study of a Clinical Trial of Group-Based Exercise in Primary Health Care.

Low back pain is a highly disabling health condition that generates high costs for patients and healthcare systems. For this reason, it is considered a serious public health problem worldwide. This pilot study aimed to assess the feasibility of a future randomized controlled trial (RCT) by evaluating adherence to treatment, contamination between groups, satisfaction with treatment, and understanding of the exercise instructions provided by the physiotherapist. Additionally, we sought to identify and implement necessary modifications to the exercise protocol for better suitability in older people. We conducted a prospective, registered pilot RCT comparing an 8-week group-based exercise program with a waiting list in older people (≥60years old) with chronic low back pain. Sixty participants were recruited through social media, pamphlets, and invitations at community referral centers. The study demonstrated the feasibility of a full RCT. Participants reported high satisfaction with the treatment (i.e.,100% indicated willingness to return for future services) and a high understanding of the exercise instructions (i.e.,81.8% reported "very easy" comprehension). Adherence to the exercise program exceeded the average reported for group exercise interventions in older adults (i.e.,82.58%). Dropout was associated solely with preexisting physical activity levels. The exercise protocol was successfully adapted to better suit the needs of the older adult population. This pilot RCT demonstrates the feasibility of a full-scale RCT to evaluate the effectiveness of group exercise in improving pain intensity and disability in older adults with chronic low back pain. The implemented adjustments to the exercise protocol and overall study approach strengthen the methodological foundation and expected accuracy of the future RCT.

Power training in older adults: A pilot and feasibility study

Background: Previous research shows that power training can increase power output in older adults and may also improve physical performance, physical functioning, and independence. However, power training interventions have not been optimized for older adults. The aim of this study was to assess the feasibility and preliminary effectiveness of a power training program called Powerful Ageing in older adults. Methods: A total of 28 older adults participated in a 12-week power training intervention at an intensity of 20-30% 1RM. The primary outcome, feasibility, was assessed through intervention retention, adherence (attendance and compliance), and safety. Secondary outcomes were measured in health domains of the ICF. In the function domain, muscle power and anaerobic power were assessed using a weighted squat and Wingate test, respectively. In the activities domain, physical performance was measured using the 6-minute walk test, and in the participation domain, physical activity in daily life and health status were evaluated using an accelerometer and the SF-36 questionnaire, respectively. Results: With intervention retention and adherence at 100%, and 0% drop-out due to injuries, Powerful Ageing was considered feasible and safe for older adults. Power training significantly improved muscle power, anaerobic power, and physical performance in older adults, but did not have a significant effect on physical activity in daily life or health status. Conclusions: Preliminary results suggest that Powerful Ageing is a feasible and safe intervention that may improve muscle power, anaerobic power, and physical performance in older adults. Randomized clinical trials are necessary to fully assess the potential of power training as an exercise intervention for older adults.

Personalized Exercise Intervention for Older Adults with Sickle Cell Disease: The Sicklefit Study

Background Older adults with sickle cell disease (SCD) (defined as age ≥ 40 years) experience both SCD and age-related conditions such as recurrent pain episodes, avascular necrosis of the joints, and cardiopulmonary disease that can result in accelerated functional decline. Individuals with SCD experience vaso-occlusive events that lead to reduced oxygen delivery to organs such as bones, muscles, and lungs. Due to these unique risk factors, existing generic exercise programs may be too intense– and even detrimental– for older adults with SCD. Gerofit is a supervised exercise program designed for veterans age ≥ 65 years with chronic disease and/or impaired mobility that has been shown to improve physical function, mental health, quality of life, and survival. The purpose of the study is a pilot evaluation of the feasibility and safety of SickleFit, an exercise training program for older adults with SCD adapted from Gerofit. Methods SickleFit is a group exercise program held on Zoom 3 days a week and includes a safety check in, warm-up, cardio segment, strength training, flexibility, balance, and mindfulness. Our primary endpoint is feasibility measured by proportion of participants attending at least 50% of the sessions over 6 weeks. The secondary outcomes are safety and acceptability. We measured safety as the number of moderate or severe adverse events within 48 hours after each exercise session. Acceptability was measured as the proportion of participants reporting the intervention as satisfactory. Exploratory outcomes were changes in physical performance in a battery of physical assessments including: Usual Gait Speed, 6 Minute Walk Distance (6MWD), Plank duration, Timed Up-and-go (TUG), Seated Grip Strength, Weight, and Neck Circumference. Results Cohort 1 consisted of 2 male (aged 55 and 66 both with SS genotype) and 2 female participants (aged 43 and 53 with Beta + Thalassemia and SS genotype). All 4 participants met the feasibility endpoint of attending at least 50% of exercise sessions, with a mean attendance of 83%. The majority of absences were due to schedule conflicts (2), property maintenance (2), and general malaise (4). Over a third of the missed sessions were due to minor (2) or major (3) adverse events unrelated to the intervention (motor vehicle incident, work-related injury). There were no major or life-threatening adverse events as a result of the exercise intervention. Minor adverse events related to exercise were knee, shoulder, and back soreness and pain. All participants responded as either ‘Pleased’ (50%) or ‘Delighted’ (50%) with the program on the acceptability survey. In addition, all participants saw a positive increase in their performance of the Usual Gait Speed, TUG, 6MWD, and plank duration. Minor improvement in grip strength was seen in 3 participants, but a slight loss in grip strength occurred in one individual whom also lost the most weight. While no significant change occurred in the BMI of the participants, a reduction in neck circumference did occur. Conclusion In cohort 1, we found that the SickleFit exercise program is feasible, acceptable, and safe for older adults with SCD. Participants demonstrated improvements in Usual Gait Speed, TUG, 6MWD, and plank duration, among other physical metrics. Participants expressed satisfaction in the program and a desire to continue in the program, even after the program ended. Based on patient feedback, The Sicklefit program is being optimized further to better meet the needs of older adults with SCD. Optimizations include shortening of the cardio section for the initial weeks of the program, dedicating more time to discussing the biomechanics and form involved in the exercises, integration of more ground-based and vertical pulling patterns with resistance bands, and adding further diversity in the movement practices included in the sessions.

32 An evaluation of a 6 week physiotherapy strength and balance intervention for the older person in primary care

Abstract Background Ageing is associated with a decline in skeletal muscle mass, strength and function, resulting in sarcopenia and frailty. Guidelines for physical activity in older adults recommend multimodal exercise. The aim of this study was to evaluate a group exercise intervention for older adults attending Primary Care Physiotherapy. Methods Participants were over 65 years, independently mobile with or without an aid, and deemed suitable by the referring Physiotherapist. The 6 week intervention based on the Otago programme, with additional upper limb strength training. It was delivered once weekly with additional independent home sessions advised. Outcome measures included SARC-F (Sarcopenia Screening Tool), grip strength, 5 Times Sit to Stand (5XSTS), and Timed Up and Go (TUG). Data was analysed using descriptive statistics. Results 31 participants completed the intervention (22 women and 9 men). Mean age 80 years (SD = 5.6). 52% of participants (n = 16) had a score of ≥4 greater using the SARC-F Tool indicating a need for further evaluation. The mean grip strength for women was 15.70 kg (SD 4.4) suggestive of probable sarcopenia based on EWGSOP2 definition. Mean grip for men of 29 kg (SD = 8) was within normal range. Mean TUG was 13.8 seconds, indicating falls risk. Mean 5XSTS in all age categories was lower than aged matched norms suggesting functional impairment (60–69 years = 11.14 sec, 70–79 years = 18.58 sec, 80–89 years = 17.2 sec). Following intervention, mean grip strength for men improved (33.5 kg, SD = 8.8). Mean grip strength for women improved to within normal range (18.4 kg, SD = 4.3). Mean TUG score improved to 12.6 sec. Mean 5XSTS improved but remained lower than age matched norms (60–69 years 9.84 sec, 70–79 years 16.72 sec, 80–89 years 15.52 sec). Conclusion The study demonstrated the accessibility, feasibility and benefits of a Physiotherapy group strength and balance intervention in Primary Care.

Feasibility Testing of Neurobic Exercise Intervention in Older Adults with Mild Cognitive Impairment

Objective: To explore the feasibility of neurobic exercise intervention among older adults with mild cognitive impairment (MCI). Material and Methods: This pilot study used a two-group pre-post test, with a follow-up design. Older adults with MCI were randomly assigned to the intervention group (n=10) or the control group (n=10). Measurements included: the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and the Common Objects Memory Test (COMT). Acceptability was assessed using a satisfaction and helpfulness rating scale and open-ended questions. Results: The intervention group had a significant reduction in IQCODE relative change score, indicating improvement in cognitive decline, and had a significantly higher COMT relative change score, indicating improvement in cognitive performance at 3 and 6 weeks. Participants reported high satisfaction with the overall activities, and rated the intervention helpful. Conclusion: The neurobic exercise intervention was feasible and acceptable for Thai community-dwelling older adults.

Management of Sarcopenia in Primary Care Settings.

With aging, loss of skeletal muscle mass and muscle function increases, resulting in an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even death. Sarcopenia, which is derived from the Greek words "sarx" or flesh+"penia" or loss, is defined as a condition characterized by low muscle mass and low muscle strength and performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, specifically, presented strategies for case-finding and assessment to help diagnose "possible sarcopenia" in primary care settings. For case finding, the AWGS 2019 guideline proposed an algorithm that recommends calf circumference measurement (cut-off <34 cm in men, <33 cm in women) or the SARC-F (strength, assistance with walking, rising from a chair, climbing stairs, and falls) questionnaire (cut-off ≥4). If this case finding is confirmed, handgrip strength (cutoff <28 kg in men, <18 kg in women) or the 5-time chair stand test (≥12 seconds) should be performed to diagnose "possible sarcopenia." If an individual is diagnosed as "possible sarcopenia," AWGS 2019 recommends that the individual should start lifestyle interventions and related health education for primary healthcare users. Because no medication is available to treat sarcopenia, exercise and nutrition is essential for sarcopenia management. Many guidelines, recommend physical activity, with a focus on progressive resistance (strength) training, as a first-line therapy for the management of sarcopenia. It is essential to educate older adults with sarcopenia on the need to increase protein intake. Many guidelines recommended that older people should consume at least 1.2 g of proteins/kg/d. This minimum threshold can be increased in the presence of catabolic or muscle wasting. Previous studies reported that leucine, a branched-chain amino acid, is essential for protein synthesis in muscle, and a stimulator for skeletal muscle synthesis. A guideline conditionally recommends that diet or nutritional supplements should be combined with exercise intervention for older adults with sarcopenia.

Effects of exergame and bicycle exercise intervention on blood pressure and executive function in older adults with hypertension: A three-group randomized controlled study

Management of hypertension and prevention of cognitive decline are challenging public health problems. However, the effects of exergame intervention on blood pressure (BP) remain to be explored, and whether exergame intervention is an effective alternative to traditional physical exercise intervention for older adults with hypertension remains to be demonstrated. This study aimed to explore the effectiveness of moderate-intensity exergame intervention and bicycle exercise training on BP and executive function in older hypertensive patients. A total of 128 participants were randomly assigned to the exergame intervention group (n = 41), bicycle exercise intervention group (n = 44), and control group (n = 43). The intervention groups exercised for 60 min, 3 times per week, for 16 weeks, while the control group maintained their normal lifestyle. The results revealed that there were no significant differences between two intervention groups and control group in systolic BP and diastolic BP changes (ps > 0.05). Both intervention groups demonstrated significant improvements in working memory when compared with control group (exergame intervention group: −461.9 ms, p = 0.025; bicycle exercise intervention group: −470.1 ms, p = 0.021). There were no significant differences in systolic BP, diastolic BP, or working memory between the two intervention groups after 16 weeks of training (ps > 0.05). No difference in inhibition or cognitive flexibility was observed between the intervention and control groups (ps > 0.05). The current results showed that moderate-intensity exergame intervention did not produce significant benefits in reducing BP, but yielded similar beneficial effects in working memory to that of bicycle exercise intervention. More studies are needed on whether exergame intervention has the potential to be a promising supplemental therapeutic tool for older adults with hypertension.

Online physical exercise intervention in older adults during lockdown: Can we improve the recipe?

Recorded and live online physical exercise (PE) interventions are known to provide health benefits. However, the effects of prioritizing the number of live or recorded sessions remain unclear. To explore which recorded-live sessions ratio leads to the best implementation and benefits in older adults. Forty-six community-dwelling adults (> 60y.o.) were randomized into two groups completing a 12-week online PE intervention. Each group had a different ratio of live-recorded online sessions as follows: Live-Recorded-Live sessions (LRL; n = 22) vs. Recorded-Live-Recorded sessions (RLR; n = 24). Drop-out rates did not reach significance (LRL:14% vs. RLR: 29%, p = 0.20), and adherence was similar (> 85%) between groups. Both groups reported similar levels of satisfaction (> 70%), enjoyment (> 75%), and perceived exertion (> 60%). Both groups increased physical health and functional capacities, with greater improvements in muscle power (LRL: LRL: + 35 ± 16.1% vs. RLR: + 7 ± 13.9%; p = 0.010) and endurance (LRL: + 34.7 ± 15.4 vs. RLR: + 27.0 ± 26.5, p < 0.001) in the LRL group. Both online PE intervention modalities were adapted to the participants' capacities and led to a high level of enjoyment and retention. The greater physical improvements observed in the LRL group are likely due to the higher presence of the instructor compared to the RLR group. Indeed, participants received likely more feedback to appropriately adjust postures and movements, increasing the quality of the exercises. When creating online PE interventions containing both recorded and live sessions, priority should be given to maximizing the number of live sessions and not the number of recorded sessions.