Exercise Programs For Older Adults Research Articles

Cognitive Function in Frail Older Adults With Multiple Sclerosis: An Exploratory Study Using Secondary Data Analysis

ABSTRACT BACKGROUND: Studies addressing frailty in the context of multiple sclerosis (MS) are emergent. This study explores cognitive function in older adults with MS as a function of frailty status. METHODS: This cross-sectional study used baseline data from a feasibility randomized controlled trial of a home-based exercise program for older adults with MS. Frailty was verified using performance scores from the Short Physical Performance Battery (SPPB) and cut points available in the literature. Cognitive function was assessed using the Brief International Cognitive Assessments for Multiple Sclerosis (BICAMS). Data were analyzed using inferential statistics adopting a significance of P < .05. RESULTS: Data from 26 older adults with MS (≥60 years) were analyzed. The majority of the participants were women, and over 85% of the sample had the relapsing-remitting form of MS. Participants reported a mean of more than 20 years of disease and a moderate level of disability (Expanded Disability Status Scale score = 4). Nearly 58% of the sample was classified as frail based on SPPB scores. Univariate analysis demonstrated that frail older adults performed significantly worse (P < .05) on all 3 BICAMS tests. However, after controlling for age and disability level, only visuospatial memory remained significant between frailty groups (P = .043). CONCLUSIONS: Our findings suggest reduced cognitive function in frail older adults with MS compared with their nonfrail counterparts. This highlights the need to develop interventions to improve cognitive function and to reverse frailty for older adults with MS.

A live online exercise program for older adults improves depression and life-space mobility: A mixed-methods pilot randomized controlled trial

Background Aging is the primary risk factor for sarcopenia and mobility limitations. Exercise reduces these risks, but older adults have low levels of participation in physical activity and exercise. We investigated the preliminary effectiveness of a live, online exercise program on community-dwelling older adults’ physical activity levels. Methods A mixed-method pilot randomized controlled trial was conducted according to CONSORT 2010 statement: extension for pilot and feasibility trials. Sedentary older adults (65–80 years) were randomly assigned to the online exercise intervention (ACTIVE) or a waitlist control (CON) group. Outcomes were measured pre-randomization and following the 8-week intervention for ACTIVE and CON and two months following the end of the intervention for the ACTIVE group. Outcomes included habitual physical activity levels, depression, anxiety, loneliness, life-space mobility, nutrition risk, and feasibility. All participants were invited to participate post-intervention in individual semi-structured qualitative interviews. Reporting of the qualitative research followed the checklist for the Consolidated Criteria for Reporting research. Results Seventeen older adults (71% women) were allocated to ACTIVE group, while 15 were allocated to CON group (87% women). Following the intervention, participants in the ACTIVE group reported reduced symptoms of depression (ACTIVE: pre = 4.2 ± 2.5; post = 2.2 ± 1.9; CON: pre = 3.5 ± 2.1, post = 3.5 ± 2.1; p <0.001) and improved life-space mobility (ACTIVE: pre = 62.4 ± 14.7; post = 71.8 ± 16.0; CON: pre = 65.1 ± 19.0, post = 63.6 ± 22.0; p = 0.003) compared to waitlist control participants. The ACTIVE group had good adherence (97%) and acceptability (98%). Twenty-two participants participated in qualitative interviews. Five themes were identified, including (1) Feasibility of the online exercise program; (2) Perceived health benefits and improvements; (3) Registered Kinesiologists and Physiotherapists contributed to perceived safety; (4) Social connectivity associated with synchronous/live delivery; and (5) Growing old gracefully and preventing disability. Conclusions Our online exercise program was acceptable to older adults, had good adherence, reduced depression, and increased life space. Participants reported improved functional and mental health benefits. Further research is warranted to expand on these findings. Trial registration NCT04627493; 13/11/2020.

Effects of the Vitality Acupunch Exercise Program on Older Adults With Probable Sarcopenia: A Mixed Methods Pilot Study.

Purpose: Age-related loss of muscle mass and strength is a highly prevalent condition in older adults in long-term care (LTC) facilities. This pilot study aimed to test the effects of a vitality acupunch (VA) exercise program on muscle mass, muscle strength, muscle endurance, functional fitness, activities of daily living, quality of life, and sleep quality of older adults in LTC facilities with probable sarcopenia in the United States and understand the experiences of residents who participated in the VA program. Design: A mixed-methods experimental design was used for this study. Methods: The quantitative phase included a sample of 27 participants randomly assigned to the control (n = 13) or VA (n = 14) condition. The VA condition consisted of three weekly 40-minute instructor-led seated exercise sessions over 24 weeks. Measures were obtained at baseline, three, and sixmonth intervals. Semi-structured interviews were conducted to explore participant's experiences of the program. Findings: Statistical comparison revealed significantly higher handgrip strength for the VA group (p = .008). Narrative analysis revealed that the program had a positive impact on participant's daily lives. Conclusions: The VA program offers a holistic, evidence-based exercise program for older adults with probable sarcopenia living in LTC facilities.

Impact of telephone coaching supporting a physical maintenance exercise programme for older adults at risk of falls: a randomised controlled trial

BackgroundEncouraging compliance with recommended levels of exercise for older adults is a public health challenge. A minimal-resource solution is telephone coaching.ObjectivesPrimary aim: to compare timed up and go (TUG) performance 6 months after beginning a home exercise program between a group of older individuals who received additional telephone coaching, and a control group performing the home exercise program alone. Secondary aims: to compare functional and fall-related outcomes between groups at 6 and 12 months.MethodsMulticentre, assessor-blinded, randomised, controlled, open label, prospective study. Inclusion criteria included age ≥ 65 years, ≥ 1 fall in the past year, and discharged home from hospital rehabilitation or outpatient physiotherapy. All participants received a home exercise booklet and were asked to perform a set of exercises as often as possible (daily). The coaching group additionally received a monthly telephone call (total 5 calls) from their previous physiotherapist. Primary outcome was TUG performance at 6 months. Outcomes were measured at inclusion, and at 6 and 12 months. The primary outcome was analysed using a linear mixed model adjusted for the baseline value.ResultsIn total, 99 individuals were included (coaching group n = 50, control group, n = 49; mean [SD] age 83.1 [5.8] years and 77% women). TUG performance did not differ between groups at 6 months (adjusted difference 1.37, SE 1.32, 95% CI 1.26 to 4.01, p = 0.30). Secondary outcomes did not differ between groups at 6 or 12 months except compliance to the exercise program was higher in the coaching than the control group at 6 months (adjusted difference 1.0, SE 0.5, 95% CI 0.02 to 2.0, p = 0.05).ConclusionsThe lack of difference between the groups in the time taken to complete the TUG at 6 months suggests that the monthly telephone coaching sessions did not improve the effectiveness of a home exercise programme in elderly people who had suffered at least one fall. The trial was registered on ClinicalTrials.gov (NCT02828826; 11th of july 2016, last modification 16th of September 2024).

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.

Current Trends of Exercise Programs for Improving Cognitive Function in Older Adults

PURPOSE: Limited studies have analyzed exercise protocols for cognitive improvement in older adults. Therefore, we closely examined the composition, content, and operation methods of these exercise programs to identify current trends.METHODS: We searched the Web of Science, PubMed, and Google Scholar databases for studies published between 2019 and 2024. The search terms used included “older adults”, “cognitive function”, “mild cognitive impairment”, “dementia”, “exercise”, “physical activity”, and other related terms, in both Korean and English.RESULTS: Aerobic exercises primarily comprised step-based exercises (walking and stepping) and dance routines, typically lasting 15-60 minutes per session, 1-3 times per week for 6-24 weeks, regardless of the individual’s cognitive level. Assistant instructors often participated, and in cases of severe cognitive impairment, patients’ caregivers also participated. Resistance exercises were most often performed using body weight and elastic bands, along with other tools and equipment, such as balls, water bottles, or specialized equipment. The exercises commonly involved 8-12 repetitions, 2-3 sets, with 1-minute rest between sets. Several programs included functional exercises to improve daily living performance. Other activities that were incorporated into the exercise programs included exergames and balance, mind-body, peripheral, and eye exercises.CONCLUSIONS: Recent cognitive exercise programs for older adults typically last three months and use a variety of tools or digital technologies within the scope of older adult exercise guidelines. Exercises for people with severe cognitive impairment tend to be more individualized, gradual, and flexible in their approach.

On the Move in the community: Protocol for a hybrid 1 trial examining effectiveness and fidelity of a community-based group exercise program for older adults

On the Move (OTM), a group exercise program to improve mobility in older adults, is efficacious when delivered by research staff. The next step in the development of OTM as a fully implementable intervention is to conduct an effectiveness study in which the intervention is delivered in community settings by community providers. We describe the methods of a hybrid 1 cluster randomized, single-blind, intervention trial to compare the effectiveness of OTM to a delayed intervention control in 502 community-dwelling older adults across 44 sites. OTM classes are taught by certified instructors in the community twice a week for 12weeks. Control centers receive no intervention for the first 12weeks followed by 12-weeks of OTM classes. Participants are assessed at baseline, 12 and 24weeks. The primary outcome is gait speed. Intervention fidelity, measured by adherence and competence in intervention delivery, is assessed by review of instructor intervention diaries and observation. Organizational, instructor, and participant-level factors which may impact fidelity are assessed using questionnaires, focus groups, and structured interviews. The findings of this trial will 1) establish the effectiveness of OTM on improvements in walking and post-intervention persistence of benefits, 2) assess intervention fidelity and identify the impact of organizational, instructor, and participant level factors on fidelity, and 3) determine the extent to which fidelity moderates the effectiveness of OTM. The information derived from this project will provide valuable insight into the real-world effectiveness of OTM as a health promotion program for improving mobility in older adults.

Expert recommendations for an online, fall-prevention exercise program for older adults

ABSTRACT Introduction Uptake of fall-prevention programs by older adults prior to the COVID-19 pandemic was low. We identified a pre-pandemic need to develop an online, fall-prevention exercise program for community-dwelling older adults. Purpose The purpose of this qualitative study was to obtain recommendations from experts on exercise for fall prevention, fall prevention, and online education to inform the development of an online, fall-prevention exercise program for community-dwelling adults aged 65 years and older. Methods Three virtual focus groups were held to obtain recommendations from: 1) exercise experts (n = 4) on design of an exercise program intended to reduce falls among community-dwelling older adults, 2) fall-prevention experts (n = 6) on key considerations for fall prevention and transitioning to an online fall-prevention program, and 3) online education experts (n = 5) on online technical/design considerations. Data were analyzed using directed content analysis. Results Collectively, the experts recommended designing an online program that: 1) contained strengthening, balance, and stretching exercises; 2) was beta tested in older adults; 3) replicated a group dynamic; 4) included an instructional designer; 5) provided tailored feedback to participants; 6) made exercises portable/accessible across devices; 7) offered computer training; 8) monitored safety and exercise performance; 9) included strategies to sustain participant behavior; and 10) was delivered by health or fitness professionals. Conclusion This study generated expert recommendations to inform the development of an online, fall-prevention exercise program. Implementation of these recommendations has the potential to expand the reach of fall-prevention programs and protect the health and safety of older adults in a post-COVID-19 world.

The Impact of the COVID-19 Pandemic on Older Adults Who Participate in Group Physical Exercise Program.

The COVID pandemic exposed the vulnerability of older adults in myriad ways and social service organizations faced unprecedented challenges in safely providing support for older adults. Since 2007, Hawai'i Healthy Aging Partnership (HHAP) has offered Enhance®Fitness, an evidence-based program to reduce the risk of falls and promote health among older adults. Due to the pandemic, all the Enhance®Fitness sites had to close and stop offering the program. The HHAP started to provide alternative activities remotely in May 2020. To explore the pandemic's impact, the feasibility of online exercise programs, and the support needed among older adults to stay physically active, HHAP surveyed existing Enhance®Fitness participants and received 291 responses (59% response rate). The study used frequency distributions, comparison of means, and chi-square to analyze the survey data. Findings showed that the shutdown of the group exercise program during the pandemic led to a health status decline, a reduction in physical activities, and a shift from group to individual physical activities among older adult participants. Most respondents tried the remote exercise opportunities during the pandemic and would consider joining the remote programs in the future. However, about one-fourth of the respondents did not participate in remote exercise activities due to the lack of electronic devices, internet access, or interest in remote activity formats. To ensure equitable access to physical exercise programs for older adults in the post-pandemic era, it is critical to address the access challenges and resources needed for providing multiple programming options.

Clinical effects of walking exercise program for older adults applied with an exercise assist robot (Bot Fit): A randomized controlled trial

BackgroundInterval walking exercise (IWE) consists of repeated walking for 3 min with high intensity, followed by 3 min of walking with low intensity. A wearable robot is an exoskeleton system that is worn on the body and helps the body move. Research questionThe purpose of this study is to verify the effects of performing IWE using Bot Fit (Samsung Electronics, Korea) on older adults. MethodsThe experimental group (EG; n = 10) performed the IWE program with Bot Fit, and the control group (CG; n = 12) performed the IWE program without Bot Fit, three times a week for six weeks. Both groups were evaluated for spatio-temporal parameters, pelvic movement, function, muscle power, and waist-to-hip ratio (WHR) at before, after three weeks and after six weeks of exercise. ResultsThere was a significant difference between the two groups in the pelvic tilt range after six weeks of exercise (P < 0.05). The pelvic rotation range showed a significant difference after six weeks of exercise in the EG (P < 0.01). During the stance phase, rectus abdominis (RA) muscle power and its contraction ratio significantly increased after six weeks of exercise in the EG (P < 0.05). The WHR was significantly lower after six weeks of exercise in EG than in the CG (P < 0.05). SignificanceBot Fit maximizes the normal walking effect, promotes correct posture and physical activity to prevent falls, improves quality of life (QOL). It has shown clinical effects and has been used for successful aging of older adults.

ENGAGE: COMMUNITY – A STUDENT LED, TELEHEALTH EXERCISE PHYSIOLOGY SERVICE DELIVERY MODEL TO COMBAT SOCIAL ISOLATION IN OLDER ADULTS

BACKGROUND AND AIMS EngAGE: Community is a student-led Exercise Physiology service delivery model that provides accessible, enjoyable and socially engaged exercise programs for older adults to combat loneliness. We aimed to assess the impact of EngAGE: Community on social, psychological, and quality of life outcomes in community-dwelling older adults, and student development. METHODS EngAGE: Community was a 15-week telehealth group-exercise program that recruited community-dwelling older adults and student Exercise Physiology practitioners. Classes were supervised by an Accredited Exercise Physiologist. Each EngAGE session consisted of exercise, educational and community-developing activities. Participant survey outcomes for social and psychological health, and quality of life were collected online before and following the program. Student development outcomes were also collected online before and following the program. RESULTS Across four programs, 73 community participants and 15 student participants were recruited, providing 1042 community engagement hours and 900 student development hours. Of these, 45 community participants completed sufficient attendance for data inclusion, and 14 student datasets were included. Community participants reported significant improvements in social [UCLA Loneliness Scale (p=0.001), Social Anxiety and Phobias Scale (p=0.007)] and psychological health [Kessler-10 (p=0.03)], as well as quality of life [SF-12 (p=0.02) and Satisfaction with Life Scale (p=0.05)]. A subset of the population demonstrated significant improvements in lower (p&amp;lt;0.001) and upper body strength (p=0.003). Student practitioners reported significant improvements in Work Self-Efficacy (p=0.002), Confidence in Skills (p=0.02) and Work Readiness (p=0.03). Community participants (n=48) provided an 81-98% agree/strongly agree response to qualifying statements suggesting the program was enjoyable, educational, social, and beneficial for their wellbeing. The cost per practitioner contact minute for all EngAGE: Community rotations was calculated as $1.92 compared to $4.21 for usual care (45% saving). CONCLUSION EngAGE: Community is a viable and cost-effective telehealth strategy to improve older Australians social and psychological health while developing Exercise Physiology student practitioners.

Compared Block Periodized and Non-Periodized Physical Activity Programs in Older Adults.

The periodization of physical exercise to optimize objectives is common in competitive sports. However, physical exercise programs for older adults only sometimes present periodization in their programming. Therefore, this article aims to research the results of applying the sports periodized method to older adults. A total of 137 participants over 60 years old performed a physical exercise program; 71 participated in a multi-component non-periodized program as the Control Group (CG), and 66 participated in a program periodized in blocks as the Experimental Group (EG). The block periodization program was oriented to the development of strength and was carried out in 86 sessions thrice weekly for eight months. Anthropometric assessments were made using weight, height, Body Mass Index, and electrical bioimpedance; and functional evaluations were made through standardized tests: Short Performance Physical Battery (SPPB), Timed Up & Go (TUG), handgrip, and a two-minute stair test. After the intervention, the EG significantly improved TUG, weight, and BMI. On the other hand, the CG showed significant improvements in fat weight, BMI, and the 2 min stair test. The SPPB did not show changes after the intervention. The periodization of physical exercise for older adults does not significantly impact functional capacity in this population group.

Barriers and Benefits of Online Group Exercise Programs for Older Adults.

Engaging in regular physical activity offers a myriad of benefits, including the improvement of mental health, social well-being, and cognitive function. Unfortunately, obstacles, such as transportation constraints, time limitations, and inadequate exercise facilities, hinder the regular participation of older adults in physical activity. Online group physical activity programs present a promising solution to enhance the involvement of older adults; however, several barriers impede their effective utilization. To explore these barriers and benefits, we conducted semi-structured interviews with participants and instructors of a community-based exercise program. Thematic analysis of interviews with 12 physical activity instructors and eight program participants unveiled key hindrances, including limited awareness and accessibility of online programs, challenges in assessing performance during exercise sessions, lack of social component, and technological difficulties. On the positive side, the benefits encompass convenience, wide accessibility, and enhanced social comfort. We also deliberate on future considerations to further bolster participation in these programs.

The role of supervision and motivation during exercise on physical and mental health in older adults: a study protocol for a randomized controlled trial (PRO-Training project)

BackgroundAlthough supervised exercise is frequently recommended for older adults, its superiority over unsupervised exercise remains uncertain. Furthermore, whether motivational techniques could help to enhance the effectiveness of the latter remains to be elucidated. The present randomized controlled trial aims to determine the role of supervision and motivational strategies on the safety, adherence, efficacy, and cost-effectiveness of different exercise programs for improving physical and mental health in older adults.MethodsParticipants (n = 120, aged 60–75 years) will be randomly allocated into five groups: 1-Control (CON), 2-Supervised exercise without motivational intervention (SUP), 3- Supervised exercise with motivational intervention (SUP +), 4- Unsupervised exercise without motivational intervention (UNSUP) and 5- Unsupervised exercise with motivational intervention (UNSUP +). Over 24 weeks, all exercise groups will participate in a multicomponent exercise program three times/week (performed in group classes at a center for SUP and SUP + , or home without supervision but with the help of a mobile app for UNSUP and UNSUP +), while the CON group will maintain their usual lifestyle. The motivational intervention (for SUP + and UNSUP + groups) will be based on the self-determination theory, including strategies such as phone calls, interactive workshops, motivational messages, informative infographics and videos. Primary outcomes will include safety, adherence, costs, and lower-body muscular function using a leg press machine. Secondary outcomes will include upper-body muscular function, physical and cardiorespiratory function, blood pressure and heart rate, body composition, health-related quality of life, cognitive performance, anxiety, depression, physical activity levels, sleep and sedentarism, biochemical markers, motivators and barriers to exercise. Assessments will be conducted at baseline, mid-intervention (i.e., week 13), at the end of the intervention (i.e., week 25), and 24 weeks later (i.e., week 49).DiscussionThe findings of this trial might provide valuable insights into the role of supervision and motivational strategies on the effectiveness of exercise programs for older adults. Additionally, the study could contribute to developing cost-effective interventions, supporting the design of future public policies for healthy aging.Trial registrationNCT05619250. Registered 16 November 2022.

How to Build and Sustain a Transdisciplinary Community-based Exercise Program for Older Adults

We have built a community-based program called Stay Strong, Stay Healthy, which helps older adults improve muscle strength and flexibility while reducing fall risk. This report details lessons learned and keys to success for Extension practitioners. First, maximize the potential of your state’s Extension framework by building a program that centers around your target population and is fun and easy to implement. Second, partner with researchers who can help to improve program effectiveness and logistical feasibility on larger scales. Lastly, continue to evaluate and adapt based on feedback from those who utilize and implement the program.

The impact of digitalized community-based square-stepping exercise program on cognitive and balance functions among older adults living in senior facilities: a pilot study

Abstract Objectives: Older adults exhibit a high desire for active and healthy aging without physical or mental dysfunction, particularly those living independently in senior facilities. Preserving or improving cognitive function and minimizing fall risks are essential for older adults to live a happy and active lifestyle. The purpose of this pilot study was to examine the feasibility, safety, and preliminary effectiveness of the innovative digitalized community-based square-stepping exercise program (DC-SSEP) in improving cognitive and physical function among older adults residing in senior facilities. Methods: Guided by the Health Promotion Model and Social Cognitive Theory, this pilot study used a quasi-experiment design with one intervention group. A total of 17 older adults recruited from a senior facility in Southern Texas participated in 40 sessions of DC-SSEP over 20 weeks. Cognitive function was measured using the latest version (8.1) of Montreal Cognitive Assessment and the balance function focusing on balance and functional mobility was measured using Berg Balance Scale and Time to Up and Go. Results: Most participants were non-Hispanic white women. The DC-SSEP was a feasible and safe exercise program for older adults living in senior facilities; and the results showed the preliminary effectiveness of the DC-SSEP in improving cognitive and balance function (P &lt; 0.01) among older adults. Conclusion: This pilot study is distinctive as it is among the first to evaluate the multi-layered impacts of DC-SSEP using Internet of Things (IoT) technology and integrated operating software in the United States. Despite the small sample size and homogeneity of participants, this pilot study suggests multiple valuable directions for future research using DC-SSEP.

The effect of CLOSER-computer-based exercise program in older adults with a history of falls: a pilot study

ABSTRACT CLOSER is a computer-based exercise program that aims to improve older adults’ health, fitness and social lives. This pilot study aimed to examine the effect of CLOSER, the first computer-based exercise program developed for older adults on a national scale, on those with a history of falls. Forty-eight older adults (71.33 ± 7.47) with a history of falling at least once in the last year were included in the study. Older adults performed CLOSER exercises for (balance maintenance, neck rotation, rhythmic walking, knee flexion and trunk rotation) 2 sessions per week for eight weeks. All individuals were evaluated at baseline and the end of the eighth week. The primary outcome measures were the 30-s Chair-Stand Test (p = 0.002), the Berg Balance Scale (p = 0.002), the Falls Efficacy Scale International (p = 0.003), the Timed Up and Go Test (p = 0.008) and the motivation level (p = 0.007) statistically significant improvements were observed. The results show that a CLOSER-computer-based exercise program effectively increases balance and reduces the risk and fear of falling. In the future, CLOSER could significantly contribute to the healthcare system as an alternative aid for home-based exercise.

Comparing Online and In-Person Delivery of a Fall Prevention Exercise Program for Older Adults.

Exercise is the single most effective strategy to reduce the risk of falls. Online classes have grown in popularity, but the benefits of online classes remain unknown. Zoomers on the Go is a peer-led 12-week exercise program offered twice weekly to adults 50+years old. The main outcome was lower body strength measured by the 30-s chair stand test. Other outcomes included dropout, attendance, balance, cardiorespiratory fitness, and perceived health. A total of 74 participants (age 66.3 ± 7.1years) in the online group and 84 participants in the in-person group (age 67.3 ± 7.2years) completed the program, with attendance for the online group. Both groups significantly improved their 30-s chair stand, cardiorespiratory fitness, and balance (p < .001) with no difference in functional benefits between groups. The in-person group improved their perceived health and significantly reduced levels of stress and depression, while no such changes were observed in the online group.

Synchronous Group-Based Online Exercise Programs for Older Adults Living in the Community: A Scoping Review.

Older adults are the least physically active group with specific barriers to regular exercise, and online exercise programs could overcome some of those barriers. This scoping review aimed to describe the characteristics of supervised group-based synchronous online exercise programs for older adults living in the community, their feasibility, acceptability, and potential benefits. MEDLINE (Ovid), Embase, SPORTDiscus, and the Cumulative Index to Nursing and Allied Health Literature were searched until November 2022. The included studies met the following criteria: participants aged 50years and above, a minimum of a 6-week group-based supervised and synchronous intervention, and original articles available in English. Eighteen articles were included, with 1,178 participants (67% female, average age of 71 [57-93]years), most (83%) published in the past 3years. From the limited reported studies, delivering supervised, synchronous online exercise programs (one to three times/week, between 8 and 32weeks) for older adults living in the community seems feasible, accepted, and can improve physical function.

A Practice Guide for Physical Therapists Prescribing Physical Exercise for Older Adults.

Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual. This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population. Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults. Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities. An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality. Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population.