Exercise Programs For Older Adults Research Articles

Self-management strategies and multicomponent training to mitigate the effects of the interruption of physical exercise programmes in the pandemic context on functionality, sedentary behaviour, physical capacity, mental health, body composition and quality of life in older adults: a blinded randomized controlled study protocol

BackgroundConsidering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults.MethodsThis will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2.DiscussionThe results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics.Trial registrationRBR-10zs97gk. Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.

Online Exercise Training Program for Brazilian Older Adults: Effects on Physical Fitness and Health-Related Variables of a Feasibility Study in Times of COVID-19.

The COVID-19 pandemic brought negative consequences such as social isolation and limited access to health services, especially for older adults. The objective was to evaluate effects of an online exercise training program and physical fitness and health-related variables on Brazilian older adults during the COVID-19 pandemic and secondarily to assess the feasibility and application of an online program. A study was developed with twenty older adults who participated in a 9-month online exercise program. The physical fitness, depressive symptoms, concern about falling, and quality of life were assessed pre- and post-intervention. One-way repeated measures ANOVA and effect size was used. The feasibility was proven by the adherence to the program, in addition to the absence of identification of adverse effects. The results showed that physical fitness was improved (upper limb strength) or maintained (lower limb strength, lower and upper limb flexibility, cardiorespiratory fitness), as well as for most of the health-related variables (depressive symptoms, concern about falling, and quality of life domains). The study was developed in the first COVID-19 lockdown in Brazil, but positive and important results were obtained. This research supports the feasibility of the online exercise training program and provides a basis for an online exercise program for older adults.

Limits of stability and falls during a multicomponent exercise program in faller older adults: A retrospective cohort study

Background/ObjetivesMulticomponent exercise programs have been demonstrated to prevent falls in older adults. However, the underlying responsible mechanisms are not clear. We aimed to analyze the association between changes in the limits of stability (LOS) as a relevant balance component, and falls occurrence during a multicomponent physical exercise program. MethodsRetrospective study, including ninety-one participants who had experienced a fall in the previous year, and were attended in a falls unit. All of them were included in a twice-a-week multicomponent exercise program during 16 weeks. Pre- and post-program measurements were collected for leg press, gait speed, the short physical performance battery (SPPB), and LOS (point of excursion [POE] and maximal excursion [MEX]) with posturography. Falls occurrence was assessed between the beginning and the completion of the exercise program (16 week). ResultsThe mean age was 77.2 years, and 72 were female. Thirty-two participants fell at least once during the exercise period. The global baseline POE was 47.6 %, and the MEX was 64.7 %, and there were no differences between fallers and nonfallers. Nonfallers presented greater improvements in POE (6.3 % versus 1.3 %; p < .05) and MEX (9.2 % versus 3.0 %; p < .01) than fallers. The POE and MEX were independently associated with a reduced probability of having had a fall, OR: 0.95 (95 % CI: 0.91 to 0.99) and 0.94 (95 % CI: 0.90 to 0.99), respectively. Changes in SPPB results or leg press strength were not associated with decreased falls. Adjusted probability of fall occurrence decreased by 5 % and 6 % per 1 % improvement in absolute values in POE and MEX, respectively. ConclusionsImprovements in LOS after a multicomponent physical exercise program in older adults with previous falls may be associated with a decreased occurrence of falls.

Coordinative Dance Programs: A Viable Option For Improving Physical Fitness Among Older Adults

PURPOSE: The use of LaBlast, low impact coordinative dance, has previously been used as an alternative exercise to increase strength and stamina in older adults. However, it is unknown if structured exercise yields superior results in comparison to unstructured exercise (i.e., aerobic or strength training). The purpose was to determine if there is a difference in muscular strength and endurance between older adults who practiced LaBlast and unstructured exercise. METHODS: Older adults, 50+ y/o, were recruited from a senior-serving fitness center. Prior to the study, each participant self-selected to join either a structured or unstructured exercise (i.e., dance vs non-dance) group. Physical function was assessed cross-sectionally through the chair stand, arm curl, back scratch, chair sit & reach, tandem leg stand, 8 foot up-and-go, foot-tapping and 2-min step tests. A one-way between subjects MANOVA was conducted to compare the effect of exercise on physical function. RESULTS: Participants (n = 29) were 69.78 ± 9.55 (range 51-92) years of age, who were 93.15% non-Hispanic white, and 97% female. The LaBlast (n = 13) and Non-dance (n = 16) groups were homogenous in demographic variables (p = 0.019). There was no significant difference in the demographic variables between groups (p = 0.19). A One-way MANOVA showed a statistically significant difference in muscular strength and endurance between exercise groups [Wilks’s λ = 0.28, F(12,16) = 3.37, p = 0.01, partial η2 = 0.71]. The LaBlast exercise group demonstrated significantly greater physical function for chair stand (15.38 ± 4.05), arm curl (21.38 ± 5.36), and 2-min step test (107.69 ± 19.57) (p < 0.001) than non-dancers. Participants who chose an unstructured exercise had statistically greater strength for the 8 foot-up-and-go assessment, 7.90 ± 3.04; p = 0.01. CONCLUSIONS: Findings suggest the use of LaBlast, which is a coordinative dance program, to be an effective exercise program for older adults. The study contributes novel evidence on structured and unstructured physical activities and their health benefits. These findings help advance the literature by informing physical activity recommendations for older adult populations. Further research is needed to determine the minimum duration for participating in a structured exercise to achieve health benefits.

Musculoskeletal Biomarkers Response to Exercise in Older Adults.

Exercise is an essential component of any good health style, being particularly important for older adults to counteract the effects of aging, including sarcopenia and osteoporosis, which can result in lower fall probability. Exercise programs for older adults are especially designed for that population. A rigorous evaluation of those programs is necessary to assure most benefit is achieved. Serum biomarkers of proteins intrinsic to musculoskeletal homeostasis could contribute objectively to the assessment of the benefits of exercise. In this work, in addition to the usual physical fitness and balance tests, ELISA assays quantified the serum levels of six proteins and one polysaccharide important for the homeostasis of muscle (troponin T and alpha-actinin), tendon/ligament (tenomodulin), cartilage (cartilage oligomeric matrix protein and hyaluronan) and bone (osteocalcin and sclerostin), before and after 8 weeks of an exercise program tailored to older adults, Stay Strong Stay Healthy, offered at a Community Center and at an Independent Senior Living facility. Statistical significance was determined by non-parametric tests (Wilcoxon Signed Ranks and Mann-Whitney U). Physical fitness and balance improved as expected along with a significant decrease in sclerostin, pointing to less inhibition of bone deposition. However, when considering each type of dwelling separately, older adults always saw a significant decrease of the isoform of troponin T associated with fast-twitch muscles, suggesting that daily levels of physical activity may also have a role in the benefit of older adults from exercise.

A mixed-methods feasibility study of a comorbidity-adapted exercise program for low back pain in older adults (COMEBACK): a protocol

BackgroundThe prevalence of low back pain increases with age and has a profound impact on physical and psychosocial health. With increasing age comes increasing comorbidity, and this also has pronounced health consequences. Whilst exercise is beneficial for a range of health conditions, trials of exercise for low back pain management often exclude older adults. It is currently unknown whether an exercise program for older adults with low back pain, tailored for the presence of comorbidities, is acceptable for participants and primary healthcare providers (PHCPs). Therefore, this mixed-methods study will assess the feasibility of an 8-week comorbidity-adapted exercise program for older people with low back pain and comorbid conditions.MethodsThe 3-phased feasibility study will be performed in a primary healthcare setting. PHCPs will be trained to deliver a comorbidity-adapted exercise program for older people with low back pain and comorbidities. Healthcare-seeking adults > 65 will be screened for eligibility over telephone, with a recruitment target of 24 participants. Eligible participants will attend an initial appointment (diagnostic phase). During this initial appointment, a research assistant will collect patient demographics, self-reported outcome measurement data, and perform a physical and functional examination to determine contraindications and restrictions to an exercise program. During the development phase, PHCPs will adapt the exercise program to the individual and provide patient education. During the intervention phase, there will be two supervised exercise sessions per week, over 8 weeks (total of 16 exercise sessions). Each exercise session will be approximately 60 min in duration. A qualitative evaluation after the last exercise program session will explore the feasibility of the exercise program for participants and PHCPs. Progression criteria will determine the suitability for a fully powered randomised controlled trial.DiscussionThis mixed-methods feasibility study will assess an exercise program for older adults with low back pain and comorbidities. Once assessed for feasibility, the exercise program may be tested for effectiveness in a larger, fully powered randomised controlled trial. This information will add to the sparse evidence base on appropriate options for managing back pain in older adults.Trial registrationAustralian and New Zealand Clinical Trials Registry registration number: ACTRN12621000379819p (06/04/2021; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621000379819p).Trial sponsorMacquarie University, Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.

An interprofessional community-based program for diabetes education and exercise self-management

An interprofessional group of students were brought together to develop and implement an effective interprofessional, educational and exercise program for older adults with diabetes living in an independent senior living community. Students were from a doctor of physical therapy (DPT), undergraduate nursing (BSN), and masters of public health program (MPH) at the same university. The primary objective of this offering was to develop the Community Partners in a Diabetes Education Program in an interprofessional context to lead to improved student values and beliefs about interprofessional collaboration. The program included weekly activities focused on the self-management of diabetes, including exercise, prevention of complications, and nutrition. Student learning was assessed using the Interprofessional Socialization and Valuing Scale before and after program implementation as well as focus group interviews after the program was delivered. Student learners felt the program was beneficial to the seniors, but that interprofessional interactions were limited and could be improved by increasing opportunities for communication and designating a clear leader.

Effectiveness of home-based exercise for improving physical activity, quality of life and function in older adults after hospitalisation: A systematic review and meta-analysis

Objective To determine if home-based exercise programmes for older adults after hospitalisation are effective at improving physical activity, quality of life, activities of daily living (ADL) and mobility compared to no intervention, standard care or centre-based exercise. Methods Databases were searched from inception to March 2022. Randomised controlled trials which included home-based exercise in older adults recently discharged from hospital were included. The primary outcome was physical activity. Secondary outcomes were quality of life, ADL performance, mobility, adverse events and hospital readmissions. Two reviewers independently selected relevant studies and extracted data. Quantitative synthesis with meta-analyses using a random-effects model and qualitative synthesis were performed. Results Ten trials (PEDro score 6-8) were included. Three trials reported on physical activity but meta-analysis was not possible due to heterogeneity. Home-based exercise was more effective than no intervention at improving ADL performance (SMD 0.60, 95% CI 0.03 to 1.17); and standard care at improving quality of life (SMD 0.30, 95% CI 0.11 to 0.49) and mobility (SMD 0.23, 95% CI 0.00 to 0.45). Few and minor adverse events were associated with home-based exercise. Conclusion Based on individual trials, home-based exercise has the potential to improve physical activity compared to no intervention or standard care. Meta-analyses indicate that home-based exercise is more effective than no intervention at improving activities of daily living performance, and standard care at improving mobility and quality of life. It is unclear if home-based exercise is more effective than centre-based exercise at improving these outcomes.

Health economic evaluation of exercise interventions in people over 60years old: A systematic review.

This systematic review was conducted to examine the cost-effectiveness of exercise interventions in community-dwelling older adults. A systematic search for articles published in English or Spanish was carried out in PubMed, Web of Science and Cochrane Library that covered the period from the respective start date of each database to October 2021. Methodological quality was assessed with the Physiotherapy Evidence Database scale and quality of economic evaluation with the Quality of Health Economic Studies and Consolidated Health Economic Evaluation Reporting Standards. A total of 12 out of 15 studies on exercise programmes for older adults reported cost-effective results. The most cost-effective training appears to be a multicomponent training programme, including aerobic exercise, muscle-strengthening of lower extremities, and balance and stretching training. The training methodology should be of progressive moderate or vigorous intensity performed at least twice per week with each session lasting 60min for ≥6months. The exercise programme should be delivered as a group-based intervention, doing extra exercise at home to increase the cost-effectiveness. These findings suggest that exercise interventions in non-institutionalized older people are a cost-effective tool. Sex, age, cognitive status, frailty, frequency and training duration could modify the cost-effectiveness of exercise interventions. Systematic review registration. PROSPERO CRD42021231530 (date of registration: 20/02/2021).

Predictors of adherence to prescribed exercise programs for older adults with medical or surgical indications for exercise: a systematic review

Background and objectivesPrescribed exercise to treat medical conditions and to prepare for surgery is a promising intervention to prevent adverse health outcomes for older adults; however, adherence to exercise programs may be low. Our objective was to identify and grade the quality of predictors of adherence to prescribed exercise in older adults.MethodsProspective observational and experimental studies were identified using a peer-reviewed search strategy applied to MEDLINE, EMBASE, Cochrane, and CINAHL from inception until October 6, 2020. Following an independent and duplicate review of titles, abstracts, and full texts, we included prospective studies with an average population age >65 years, where exercise was formally prescribed for a medical or surgical condition. We excluded studies where exercise was prescribed for a chronic musculoskeletal condition. Risk of bias was assessed using the Quality in Prognostic studies tool or Cochrane risk of bias tool, as appropriate. Predictors of adherence were identified and graded for quality using an adaptation of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for predictor studies.ResultsWe included 19 observational studies and 4 randomized controlled trials (n=5785) Indications for exercise included cardiac (n=6), pulmonary rehabilitation (n=7), or other (n=10; surgical, medical, and neurologic). Of the 10 studies that reported adherence as the percent of prescribed sessions completed, average adherence was 80% (range 60–98%; standard deviation (SD) 11%). Of the 10 studies that reported adherence as a categorical threshold demarking adherent vs not adherent, average adherence was 57.5% (range 21–83%; SD 21%). Moderate-quality evidence suggested that positive predictors of adherence were self-efficacy and good self-rated mental health; negative predictors were depression (high quality) and distance from the exercise facility. Moderate-quality evidence suggested that comorbidity and age were not predictive of adherence.ConclusionsThese findings can inform the design of future exercise programs as well as the identification of individuals who may require extra support to benefit from prescribed exercise.Systematic review registrationPROSPERO CRD42018108242

Evaluation of an Arnis-Based Exercise Program for Community-Dwelling Older Adults in the Philippines: An Exploratory Study

Aim: Arnis is the national martial art of the Philippines. Similar to Tai Chi, a martial art with established therapeutic effects, it can improve the balance control of older adults. However, there has been no study conducted to prove this. This study aimed to design and evaluate an Arnis-based exercise program to improve the static and dynamic balance control of community-dwelling Filipino older adults. Methods: A qualitative exploratory study using the Delphi Method was conducted. A 12-week moderate-intensity Arnis-based exercise program for older adults was designed. A Physical Therapist, Geriatrician, Sports Scientist, Arnis Expert, and Senior Citizen separately evaluated the video-recorded exercise program. Semi-structured interviews were individually completed online to gather their feedback. Three researchers completed the thematic analysis. Results: Four themes represented the evaluation of the Arnis-based exercise program: Program presentation, Participant consideration, Program aspects, and safety provisions. After one round of interviews, a strong consensus was reached based on the program's appropriateness, difficulty level, benefits, and feasibility for older adults. However, the exercise program needs to be revised to improve on the aspects of safety, instructions, structure, and progression. Conclusion and Implications: The resource persons recommend the Arnis-based exercise program as an appropriate and feasible intervention to improve the static and dynamic balance control of older adults. However, the second round of interviews is recommended to evaluate further the revised program. More studies also are necessary to establish the actual effect of this Arnis-based exercise program using experimental design.

Barriers and enablers for older adults participating in a home-based pragmatic exercise program delivered and monitored by Amazon Alexa: a qualitative study

BackgroundThe remote delivery and monitoring of individually-tailored exercise programs using voice-controlled intelligent personal assistants (VIPAs) that support conversation-based interactions may be an acceptable alternative model of digital health delivery for older adults. The aim of this study was to evaluate the enablers and barriers for older adults participating in a home-based exercise program delivered and monitored by VIPAs.MethodThis qualitative study used videoconferencing to conduct semi-structured interviews following a 12-week, prospective single-arm pilot study in 15 adults aged 60 to 89 years living alone in the community. All participants were prescribed an individualized, brief (10 min, 2–4 times per day), home-based muscle strengthening and balance exercise program delivered and monitored using an Amazon Echo Show 5 device (Alexa). Qualitative interview data were analysed using inductive thematic analysis.ResultsAll 15 participants (aged 70.3 ± 4.3 years, mean ± SD) attended the semi-structured interview. Themes including enjoyability and ease of use, social engagement and motivation were enablers for participation in the exercise program. Errors in voice recognition, lack of feedback, and preference for other existing digital health modes of exercise delivery were barriers associated with the Alexa technology.ConclusionsThis qualitative study identified enablers and barriers associated with using an Alexa device to deliver and monitor an individualized, home-based exercise program in older adults living alone. Future interventions using VIPAs should focus on reducing technical errors, providing regular exercise feedback, and comparing participants’ experiences of exercise programs delivered by VIPAs to programs delivered via other digital health tools.

Programa de ejercicio multimodal para mejorar la función muscular en adultos mayores del Hospital de la Fuerza Aérea del Perú, 2018

Objective: To find out the benefits of a multimodal exercise program for muscle function improvement in older adults from the Hospital de la Fuerza Aérea del Perú in 2018. Materials and methods: An interventional, analytical, prospective and longitudinal study. A total of 66 patients were assessed, out of whom only 24 completed the six-month intervention period. Results: The patients’ median age was 75 ± 7.01. The Short Physical Performance Battery (SPPB), which combines the results of the balance, gait speed and chair stand tests, had a positive impact on the intervention group and showed statistically significant results. No statistical significance was found in grip strength in kilograms or calf circumference measurement. Conclusions: The multimodal exercise program for older adults from the Peruvian Air Force has a positive impact on muscle function.

Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia.

Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC90) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable.

Assessment of a Community-Based Exercise Program for Older Adults in a Mixed Rural/Urban Catchment Area: Silver Sneakers in Central Pennsylvania.

The purpose of our study was to understand the capacity of Silver Sneakers, a federally funded and community-based exercise program, to serve older adults (aged ≥65 years) in our mixed rural/urban catchment area of central Pennsylvania. We identified 139 registered Silver Sneakers program locations; of these, 18 were closed because of the COVID-19 pandemic. We used questionnaires to interview Silver Sneakers program staff by telephone (n = 80 of 121, response rate of 66%). Most programs were offered by private gyms (52%). Fewer programs were in rural counties than in urban counties. Most facilities reported that membership was equally mixed by gender, and member retention strategies included program perks and promotion of Silver Sneakers as a Medicare benefit. Most (89%) programs were able to continue classes during the pandemic, in part by adapting to video platforms. Overall, Silver Sneakers programs offer a sustainable option to facilitate access to exercise programs and reduce barriers to physical activity among older adults in our catchment area.

Using Sensor Graphs for Monitoring the Effect on the Performance of the OTAGO Exercise Program in Older Adults.

The OTAGO exercise program is effective in decreasing the risk for falls of older adults. This research investigated if there is an indication that the OTAGO exercise program has a positive effect on the capacity and as well as on the performance in mobility. We used the data of the 10-months observational OTAGO pilot study with 15 (m = 1, f = 14) (pre-)frail participants aged 84.60 y (SD: 5.57 y). Motion sensors were installed in the flats of the participants and used to monitor their activity as a surrogate variable for performance. We derived a weighted directed multigraph from the physical sensor network, subtracted the weights of one day from a baseline, and used the difference in percent to quantify the change in performance. Least squares was used to compute the overall progress of the intervention (n = 9) and the control group (n = 6). In accordance with previous studies, we found indication for a positive effect of the OTAGO program on the capacity in both groups. Moreover, we found indication that the OTAGO program reduces the decline in performance of older adults in daily living. However, it is too early to conclude causalities from our findings because the data was collected during a pilot study.

Current Changes at JAPT for 2022

As we floated into 2022, there were several changes to the coeditors’ position of the Journal of Aquatic Physical Therapy (JAPT). Our coeditor, Dr Yasser Salem, decided to step down at the end of 2021. The decision to step down was prompted by Dr Salem's assuming a leadership position as the Founding Program Director of a Doctor of Physical Therapy Program at Hofstra University, Long Island, New York. Dr Salem will continue to serve the JAPT as a member of the journal's editorial board and as a reviewer. We are honored to share his farewell message: Dr Salem says, “After more than nine happy years as a coeditor, I feel it's time for a new phase in my career life.” Dr Salem also says, “I have been honored to serve the Journal of Aquatic Physical Therapy (JAPT) for these many years and see the journal grow over the years.” With the leadership of myself and Dr Anita Van Wingerden, and the support of the Academy of Aquatic Physical Therapy Presidents and leaders, the journal increased from 2 to 3 issues per year and also increased the number of articles published each year. In 2021, the journal successfully transitioned to its current online format with Wolters Kluwer. Dr Salem wishes Drs Anita Van Wingerden and Natalie Michaels, the new coeditors, “All the best in leading the journal—with their expertise and compassion, I am confident that they will move the JAPT forward for further success.” Yasser Salem, PT, PhD, NCS, PCS Although Dr Salem will be greatly missed, we wish him great success in his new endeavor and appreciate the dedication and scholarly guidance he provided as a coeditor for JAPT since 2013. An additional change we would like to share is the acceptance of Dr Natalie Michaels as the new coeditor of JAPT. Natalie Michaels, PT, EdD, GCS Emeritus, is a professor in the College of Health Sciences at Belmont University, with the School of Occupational Therapy. Natalie Michaels, PT, EdD, GCS Emeritus, ATRIC Dr Michaels received her bachelor's degree in Physical Therapy from Ithaca College, a master's degree in Applied Psychology from Fairfield University, and a doctorate in Curriculum and Instruction from the University of Central Florida. She first began teaching as a professor at Tennessee State University in the Department of Physical Therapy in 2006 and then at Belmont University from 2014 until present. Dr Michaels is a certified Geriatric Clinical Specialist (GCS) Emeritus with the American Board of Physical Therapy Specialties. She is also a Credentialed Clinical Instructor with the APTA and a Certified Aquatic Therapist with the Aquatic Therapy and Rehabilitation Institute (ATRI), and she completed her Aquatic Clinical Competency from the APTA in 2015. She serves as an item writer for the GCS examination and has served as a reviewer for multiple journals, including the JAPT. She has also been active in the community with the development and implementation of Aquatic Exercise Programs for Older Adults and for children with neurodevelopmental disabilities. Dr Michaels has more than 40 peer-reviewed publications since 2008 on topics such as aquatic exercise, the accuracy of activity monitors in the water, fall prevention, balance, and scoliosis. Dr Michaels reports, “I am excited to begin this journey with Anita Van Wingerden and the Journal of Aquatic Physical Therapy.” Her contact information is: Natalie Michaels, PT, EdD, GCS Emeritus, ATRIC Professor School of Occupational Therapy College of Health Sciences Belmont University Nashville, Tennessee Phone: [615.460.6791] | Mobile: [615.604.3727] [email protected] On behalf of the JAPT, we wish all of you a happy, healthy, and successful New Year! Sincerely your new coeditors, Anita Van Wingerden and Natalie Michaels.

High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease.

Both high-intensity interval training (HIIT) and resistance exercises (R) are used in cardiac rehabilitation in patients with coronary artery disease (CAD). However, the combined effect of an HIIT+ R exercise program in older adults with CAD is not well investigated. The study's purpose was to assess the changes in anthropometric parameters, physical activity, functional capacity, physiological parameters, and quality of life (QoL) in this population following a combined HIIT+ R program. The study was a 2-group (n= 45 each) randomized controlled single-blinded trial. The study was done at a treatment clinic of a tertiary hospital. The mean age of participants was 69.23 ± 4.9years. The HIIT+ R group performed 8 sessions (1/wk) of HIIT+ R training. The 30minutes of the active exercise phase consisted of ten 3-minute bouts. Each bout comprised of 1minute of high-intensity treadmill walking at 85% to 90% maximum heart rate (MHR), followed by a low-intensity walking at 60%-70% MHR, followed by low-to moderate-intensity resistance training. The Usual Care group underwent conventional medical treatment. Anthropometric measurements [weight, body mass index (BMI), waist circumference, body fat percentage, lean body mass], physical activity (International Physical Activity Questionnaire), functional capacity (Incremental Shuttle Walking Test), physiologic measurements (blood pressure, heart rate), and QoL (36-Item Short Form Health Survey) were measured pre- and postintervention. Significant group and time interaction were found for the participants in the HIIT+ R Group for BMI (P= .001), body fat percentage (P= .001), waist circumference (P < .001), physical activity (P < .001), functional capacity (P < .001), and QoL (P= .001) compared with the UC Group. Significant improvement in systolic blood pressure (P= .001) was seen in the HIIT+ R group. A combined HIIT+ R training protocol in older adults with CAD can be useful in producing desired health outcomes. Further evaluation of longer duration exercise programs with more frequent dosing needs to be evaluated for their benefits and sustainability.

복합운동프로그램이 노인의 스트레스와 자율 신경계 활성도에 미치는 영향

Purpose: The purpose of this study was to examine the effects of combined exercise program in older adults. Methods: We selected 14 subjects who older adults aged 65∼75, who performed a combined exercise program for 7 older adults and walking exercise for 7 older adults twice a week for 12weeks. We measured pre and post effect of stress and autonomic nervous system activity change. We analyzed data b using the SPSS 23.0 program with t-test, and repeated measure ANOVA. Results: It turned out that after the combined exercise belonging to the experimental group showed a significantly increased standard deviation of normal to normal R-R interval (SDNN), total power(TP). Conclusion: Therefore, we propose a combined exercise program as an exercise program to prevent cardiovascular diseases by increasing autonomic nervous system activity in older adults.

Feasibility and Acceptability of Tele-Enhance Fitness in Older Adults With Knee Osteoarthritis

Enhance Fitness (EF) is an evidence-based, group exercise program for older adults. When COVID-19 halted in-person EF classes nationally, we adapted EF for remote delivery (tele-EF) by engaging key stakeholders. To determine feasibility and acceptability of tele-EF, we conducted a mixed methods study among 42 older adults (≥65 years) with knee osteoarthritis. Participants attended EF classes for 1-hour, 3 days/week for 4-5 months (1-3 months in-person EF and 2-4 months in tele-EF). Attendance for in-person EF was 80.0% versus 91.0% for tele-EF. Nearly all participants (95.2%) reported that they were satisfied or very satisfied with tele-EF. Qualitative exit interview data mapped well onto Social Cognitive Theory constructs. With tele-EF, participants found that livestream classes facilitated accountability and self-efficacy to participate in exercise and that interactive instruction provided encouragement and support to exercise. Thus, tele-EF is a viable remotely-delivered exercise program for older adults that retains many features of in-person EF.