Exercise Intervention Research Articles

Effects of open-skill exercise on executive functions in children and adolescents: a systematic review and meta-analysis

BackgroundThe research on the intervention of open-skill exercise on the executive functions of children and adolescents still requires quantitative synthesis, and there is inconsistency in the effects of intervention by strategic and interceptive skills, which are sub-divided from open-skill exercise. Therefore, this study systematically explores the aforementioned issues and examines the potential moderating factors in the effects of open-skill exercise intervention on executive functions.MethodsComputer searches of the CNKI, WOS, PubMed, ScienceDirect and SPORTDiscus databases were conducted. Two researchers independently screened the articles and extracted data, and used the bias risk assessment tool recommended by the Cochrane Collaboration Network and the Methodological Index for Non- Randomized Studies (MINORS) scale to assess included randomized controlled trials (RCTs) and quasi-experimental designs (QEDs). Statistical analyses were performed using Stata 16.0 software.ResultsA total of 16 articles and 17 studies were included, comprising 11 RCTs and 6 QEDs. The participants were 1,298 children and adolescents aged 5 to 16. Open skill exercises have significant intervention effects (p < 0.01) on inhibitory control (SMD = −0.627, 95%CI = −0.890 to −0.363), working memory (SMD = −0.517, 95%CI = −0.768 to −0.266), and cognitive flexibility (SMD = −0.652, 95%CI = −1.085 to −0.219). The effects of strategic skill exercises are higher than those of interceptive skills, particularly in the dimension of inhibitory control (SMD = −0.707, 95%CI = −0.819 to −0.594, p < 0.05). In addition, moderate-intensity and higher-frequency exercises overall have a more positive effect on promoting executive functions (p < 0.05); interventions of 6 to 10 weeks are more effective for working memory (p < 0.05), while 30-min sessions are the most effective for working memory (p < 0.05), and sessions lasting 75 to 120 min are the most effective for cognitive flexibility (p < 0.05). Open-skill exercise has a more positive impact on inhibitory control in the 5–9 age group and on working memory in the 10–16 age group (p < 0.05); open-skill exercise, especially, has a more positive intervention effect on inhibitory control in the Eastern group (p < 0.05). Both Egger linear regression analyses and literature sensitivity analyses suggested that the Meta-analysis results were stable and reliable.ConclusionOpen-skill exercise has a positive intervention effect on executive functioning in children and adolescents, and strategic skill exercise interventions are more effective. In addition, the quantitative elements of exercise (intensity, frequency, and duration per session) and demographic factors (age and ethnicity) play a potential moderating role in this context. Based on this, it is recommended that children and adolescents choose more strategic open-skill exercises according to their actual situation and select appropriate quantitative exercise factors to maximize the enhancement of their executive functions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#myprospero, CRD42025636714.

Aquatic exercise interventions in the treatment of musculoskeletal upper extremity disorders: A scoping review.

To identify literature on aquatic exercise therapy used to manage upper extremity musculoskeletal disorders and identify key concepts, intervention components, and gaps in the evidence base. The comprehensive search included MEDLINE (Ovid), CINAHL (EBSCOHost), Embase (Ovid), CENTRAL (Cochrane Central Register of Controlled Trials) databases and grey literature sources. JBI Scoping review methodology guided this review through protocol development, searching, screening, data extraction and analysis. Study Selection included: Participants - Adults with upper extremity musculoskeletal disorders; Concept - Aquatic based exercise therapy; Context - any setting in any very highly developed nation. The search identified 5045 sources with 68 studies included in the final synthesis. Findings outlined shoulder problems were the most reported upper extremity condition treated (n = 78) especially following rotator cuff repair (n = 17), followed by the hand and wrist (n = 9), and elbow (n = 6). Range of movement (n = 36) and resistance exercises (n = 17) were the most common interventions reported for aquatic therapy, however compliance with reporting guidance across included studies was poor. Sixteen health domains were identified with range of movement (n = 21) and pain (n = 20) the most common, and 62 outcome measures were reported related to the identified domains. Qualitative aspects of aquatic interventions were evaluated in two papers. There is a need for more primary experimental and qualitative studies related to the upper extremity and aquatic therapy. Improved reporting quality of aquatic therapy exercise intervention is required as is the need to establish specific core outcome sets and domains in this area.

Mechanisms and pharmacotherapy of cancer cachexia-associated anorexia.

Cachexia is a multifactorial metabolic syndrome characterized by weight and skeletal muscle loss caused by underlying illnesses such as cancer, heart failure, and renal failure. Inflammation, insulin resistance, increased muscle protein degradation, decreased food intake, and anorexia are the primary pathophysiological drivers of cachexia. Cachexia causes physical deterioration and functional impairment, loss of quality of life, lower response to active treatment, and ultimately morbidity and mortality, while the difficulties in tackling cachexia in its advanced phases and the heterogeneity of the syndrome among patients require an individualized and multidisciplinary approach from an early stage. Specifically, strategies combining nutritional and exercise interventions as well as pharmacotherapy that directly affect the pathogenesis of cachexia, such as anti-inflammatory, metabolism-improving, and appetite-stimulating agents, have been proposed, but none of which have demonstrated sufficient evidence to date. Nevertheless, several agents have recently emerged, including anamorelin, a ghrelin receptor agonist, growth differentiation factor 15 neutralization therapy, and melanocortin receptor antagonist, as candidates for ameliorating anorexia associated with cancer cachexia. Therefore, in this review, we outline cancer cachexia-associated anorexia and its pharmacotherapy, including corticosteroids, progesterone analogs, cannabinoids, anti-psychotics, and thalidomide which have been previously explored for their efficacy, in addition to the aforementioned novel agents, along with their mechanisms.

Does Self-Compassion Expressive Writing Benefit People With an Ostomy? A Randomized Controlled Trial.

The purpose of this study was to investigate whether a self-compassion expressive writing activity could improve psychological well-being in people with an ostomy, as assessed by changes in body image distress, ostomy-specific quality of life (QOL), self-compassion, and dispositional disgust. Randomized controlled trial design was used. The sample comprised 175 English-speaking patients over 18years of age with a fecal or urinary ostomy; all participants resided in Australia and New Zealand. All were recruited online between May and July 2019. Following completion of a baseline questionnaire, participants were randomly assigned to complete either an online self-compassion expressive writing exercise (intervention group; n =88; 50.29%) or a control expressive writing exercise (n =87; 49.71%). Online questionnaires were completed 1-week and 1-month following completion of either expressive writing task. Intent-to-treat repeated-measure ANOVA analyses assessed benefits to self-compassion, body image distress, and ostomy-specific quality of life. Dispositional disgust sensitivity and propensity, as assessed by baseline scores on the Dispositional Disgust Sensitivity and Propensity Scale (DPSS), were assessed as moderators. Analyses revealed that younger people with an ostomy had poorer self-compassion, greater body image distress, and poorer ostomy-specific QOL than older people, and those who had lived with their ostomy for longer had lower body image distress and greater QOL. There were no significant main effects of writing condition on primary measures; however, individuals in the intervention condition with low dispositional disgust had greater self-compassion, greater ostomy-specific QOL, and lower body image distress than those with high dispositional disgust. Although expressive writing is a pragmatic and accessible intervention, our findings suggested that it was of benefit only to people with low dispositional disgust. Further work is required to establish an effective psychological tool for this under-researched population.

Effects of exercise and transient estradiol exposure in middle-aged female rats.

The benefits of estrogen treatment on cognition in middle-aged and older women are dependent on many factors, including the timing of treatment. Moreover, the potential interactive effects with other lifestyle factors, such as exercise, are poorly understood. In this study, we tested for lasting benefits of independent and combined treatment with estrogen and voluntary exercise initiated in midlife, using a rat model of menopause. Twelve-month-old, retired female breeders were bilaterally ovariectomized and received six weeks of 17β-estradiol (E2) treatment via subcutaneous implant, with or without access to running wheels. After E2 treatment, animals in the exercise groups had running wheel access for seven additional weeks, including a two-week period of cognitive and affective testing. Thereafter, hippocampal neuronal and cellular plasticity were assessed. E2 and exercise independently exerted effects on behavioral and cellular outcome measures. Transient E2 treatment enduringly increased motor output, lowered body weight, and increased behavioral plasticity. Exercise decreased total hippocampal microglia number and increased brain weight. No additive effects of exercise and E2 treatment were observed. E2 treatment may provide a means by which to enduringly increase physical activity in middle age, but combined E2 and exercise do not produce additive benefits on hippocampal behavioral or cellular plasticity.

Sex Differences in Response to a 12-Week Resistance Training Exercise Intervention After Cardiac Surgery: A Proof-of-Concept Intervention Trial

Sex Differences in Response to a 12-Week Resistance Training Exercise Intervention After Cardiac Surgery: A Proof-of-Concept Intervention Trial

Integrated analysis of methylome and transcriptome responses to exercise training in children with overweight/obesity.

We examined the effects of a 20-wk exercise intervention on whole blood genome-wide DNA methylation signature and its association with the exercise-induced changes in gene expression profiles in boys and girls with overweight/obesity (OW/OB). Twenty-three children (10.05 ± 1.39 yr, 56% girls) with OW/OB were randomized to either a 20-wk exercise intervention [exercise group (EG); n = 10; 4 boys/6 girls] or to usual lifestyle [control group (CG); n = 13; 6 boys/7 girls]. Whole blood genome-wide methylome (CpG sites) analysis using Infinium Methylation EPIC array and transcriptome analysis using RNA-seq (STRT2 protocol) were performed. Exercise-induced modifications in DNA methylation at 485 and 386 CpGs sites in boys and girls, respectively. These CpG sites are mapped to loci enriched in distinct gene pathways related to metabolic diseases, fatty acid metabolism, and immune function. In boys, changes in the DNA methylation of 87 CpG sites (18% of the 485 CpGs sites altered by exercise) were associated with changes in the gene expression levels of 51 genes also regulated by exercise. Among girls, changes in DNA methylation at 46 CpG sites (12% of the initial 386 significant CpGs) were associated with changes in the expression levels of 30 exercise-affected genes. Genes affected by exercise that were associated with DNA methylation are related to obesity, metabolic syndrome, and inflammation. Multiomics analysis of whole blood samples from children with OW/OB suggests that gene expression response to exercise may be modulated by DNA methylation and involve gene pathways related to metabolism and immune functions.NEW & NOTEWORTHY This study pioneers the exploration into the effects of exercise on whole blood genome-wide DNA methylation patterns and its association with changes in transcriptome profiles in children with overweight/obesity. Exercise potentially impacts molecular pathways involved in metabolism and immune functions in children with overweight/obesity (sex-specific responses) through the modification of epigenetic and transcriptomic profiles. Our preliminary results provide initial steps to understand better the molecular mechanisms underlying cardiometabolic benefits of exercise in children with overweight/obesity.

Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables.

Regularly engaging in exercise has been recognized as the only therapy found to consistently manage frailty. This study applies structural equation modeling (SEM) to integrate the theoretical perspective of Social cognitive theory (SCT) to better understand and promote regular exercise behavior among frail older adults, providing a foundation for enhancing exercise engagement in this vulnerable population. A total of 306 frail older adults in Chengdu, China, were selected in this cross-sectional study. Participants completed the the FRAIL scale, the Self-Efficacy for Exercise (SEE) Scale, the behavioral regulation in exercise questionnaire (BREQ-2), the Outcome Expectations for Exercise (OEE), the Exercise Social Support (ESS) Scale. Structural equation modeling (SEM) was used to specify hypothesis between components of social-cognitive theory on regular exercise behavior among frail seniors. The percentage of regular exercise behavior was 29.1% among participants. There were statistically significant differences in the regular exercise behavior for demographic characters of occupation, disposable monthly income, frail phenotype of fatigue, resistance and weight loss (p < 0.05). SEM showed that the exercise self-efficacy (β = 0.52, p < 0.001) and exercise outcome expectation (β = 0.45, p < 0.011) are the strongest determinants of regular exercise behavior, while social support (β = 0.092, p > 0.05) and self-regulation (β = 0.05, p > 0.05) are non-determinant. Our study underscores that adherence to regular and structured exercise regimens remains low among frail older adults, suggesting that this population may not be fully benefiting from scientifically guided exercise programs. Integrating self-efficacy and outcome expectations into further exercise promotion is critical. Patient-centered approach is essential for developing more effective and sustainable exercise interventions.

A pilot study of the effects a multi- modal cervical exercise intervention on clinical concussion risk factors in female athletes

A pilot study of the effects a multi- modal cervical exercise intervention on clinical concussion risk factors in female athletes

A Systematic Review of Community-Based Exercise Interventions for Adults with Intellectual Disabilities

Background: Adults with intellectual disabilities are a particularly inactive sub-population who experience disproportionally poorer health and social exclusion when compared with the wider general population. This systematic review aimed to identify whether community-based exercise interventions were theoretically underpinned, whether they had an active single- or multi-exercise component, and how the interventions were objectively and/or subjectively measured, as well as deducing if they improved the health of this population. Method: A systematic search of five databases was conducted up to May 2024. The study was registered in PROSPERO and followed PRISMA reporting guidelines. Study methodological quality was appraised using the Critical Appraisal Skills Programme. Risk of bias was determined using the Cochrane collaboration tools ROB 2 and ROB 2 CRT. Articles were eligible for inclusion if they recruited adults with intellectual disability, were community-based, had an active exercise component and measured physical activity (PA) levels as an outcome measure. Results: In total, 9034 records were identified, with five studies meeting the eligibility criteria. All studies used a feasibility RCT or RCT methodology and all focused on weight loss or PA levels as the primary outcome measure. Two studies focused on walking as a single exercise, two combined walking with nutrition/weight loss, and one combined walking with aerobics. One multi-component walking and aerobics intervention led to statistically significant improvements in PA. Multi-component community-based exercise interventions led to statistically significant improvements in body composition measures. No studies showed statistically significant improvements in quality of life. Risk of bias was rated moderate to high across all included studies. Conclusions: Caution should be taken in drawing firm conclusions due to the small number of included studies, small sample sizes and high risk of bias. Multi-component community-based interventions are more effective at improving PA levels in adults with intellectual disabilities than walking-only studies. Future studies should be theoretically underpinned and explore the use of peer and student models of social support. The use of fitness facilities such as leisure centres and gyms requires further exploration in this population.

Exercise Training and Cardiovascular Risk Factors in Males with Overweight or Obesity: A Systematic Review of Randomized Controlled Trials

Background and Objectives: Obesity is a significant risk factor for cardiovascular disease. Physical exercise has been established as an effective intervention for reducing cardiovascular mortality. This systematic review aimed to investigate the effects of various exercise modalities on cardiovascular risk factors in men with obesity. Materials and Methods: This review included randomized controlled trials (RCTs) published between 2005 and November 2023. Studies were eligible if they assessed the impact of exercise interventions on blood pressure (BP), lipid profiles, and glucose/insulin regulation in males aged 18 years or older with a body mass index (BMI) of 25 kg/m2 or greater. The quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results: A total of 25 RCTs were included in the analysis, with PEDro scores ranging from 3 to 7. High-intensity interval training (HIIT) was associated with significant reductions in BP, with an average decrease of 12.5 mmHg. However, the magnitude of BP reduction varied across studies, likely due to differences in training protocols and study quality. Resistance training (RT) was associated with modest improvements in glycemic control, with some studies reporting a reduction in fasting blood glucose levels by 5–10%. Combined exercise (CT) programs, which included both aerobic and resistance training, as well as aerobic exercise alone, were shown to improve lipid profiles, with some studies showing reductions in total cholesterol levels ranging from 10–15%. However, the findings were inconsistent, highlighting the need for further research to better understand the potential benefits and optimal exercise regimens. Conclusions: This systematic review supports the potential of exercise training in reducing cardiovascular risk factors in men with obesity, though the effectiveness varies depends on the type of exercise. Combined exercise programs have shown promise for lipid profiles, but further research is needed to confirm these effects. HIIT has been linked to BP reductions in some studies, although the results are inconsistent and depend on protocols and study quality. The limitations in study quality may impact the reliability of these findings.

Physiological change of striatum and ventral midbrain's glia cell in response to different exercise modalities.

Exercise not only regulates neurotransmitters and synapse formation but also enhances the function of multiple brain regions, beyond cortical activation. Prolonged aerobic or resistance exercise modality has been widely applied to reveal the beneficial effects on the brain, but few studies have investigated the direct effects of different exercise modalities and variations in exercise intensity on the neuroinflammatory response in the brain and overall health. Therefore, in this study, we investigated changes in brain cells and the immune environment of the brain according to exercise modalities. This study was conducted to confirm whether different exercise modalities affect the location and function of dopaminergic neurons, which are responsible for regulating voluntary movement, before utilizing animal models of disease. The results showed that high-intensity interval exercise (HIE) increased the activity of A2-reactive astrocytes in the striatum (STR), which is directly involved in movement control, resulting in neuroprotective effects. Both HIE and combined exercises (CE) increased the expression of dopamine transporter (DAT) in the STR without damaging dopamine neurons in the ventral midbrain (VM). This means that exercise training can help improve and maintain exercise capacity. In conclusion, specific exercise modalities or intensity of exercise may contribute to preventing neurodegenerative diseases such as Parkinson's disease or enhancing therapeutic effects when combined with medication for patients with neurodegenerative diseases.

Novel psychotherapies for insomnia.

Insomnia disorder, characterized by a complaint of reduced sleep quality or quantity and associated daytime impairment, is highly prevalent and associated with reduced quality of life and productivity. Cognitive behavioural therapy for insomnia (CBT-I) is the current first-line treatment for chronic insomnia disorder. Here, we outline our perspective for the future optimization of psychotherapeutic treatment for insomnia. We identified the following areas as the most promising: first, optimizing efficacy of the CBT-I protocol; second, developing diagnostic and therapeutic approaches for non-responders and partial responders; and third, advancing widespread implementation of psychotherapy for insomnia. More specifically, we outline how the current CBT-I protocol could be optimized through an improved understanding of treatment mechanisms, and discuss the potential of adaptive treatment strategies. Another promising approach for improving the current CBT-I protocol is using add-ons such as physical exercise or circadian-based interventions. Both may be promising in certain subgroups of patients with insomnia. In terms of non-response, we identify acceptance and commitment therapy for insomnia (ACT-I) as a promising treatment for non-responders to CBT-I. ACT-I, however, still needs to be evaluated in actual non-responders to CBT-I. Implementing CBT-I in clinical practice is still one of the major challenges at hand. We outline how brief treatment, targeted treatment for challenging patient groups, and digital treatment may help improve implementation. For a future research agenda, we suggest that further research into treatment mechanisms, randomized-controlled trials in non-responders to CBT-I, and a focus on implementation science have a potential to bring the field forward.

Brain-derived neurotrophic factor drives muscle adaptation similar to aerobic training in mice.

This study, invivo and invitro, investigated the role of brain-derived neurotrophic factor (BDNF) in skeletal muscle adaptations to aerobic exercise. BDNF is a contraction-induced protein that may play a role in muscle adaptations to aerobic exercise. BDNF is involved in muscle repair, increased fat oxidation, and mitochondrial biogenesis, all of which are adaptations observed with aerobic training. The purpose of this study was two-pronged and investigated the skeletal muscle BDNF response to (1) acute and (2) chronic exercise in male C57BL/6J mice. It also examined if chronic BDNF treatment resulted in similar adaptations to chronic exercise. In aim 1, mice underwent a 2 hr. treadmill exercise bout. In aim 2, mice were assigned to one of four groups: (1) control (CON); (2) endurance training (ET; treadmill running 1 h/day, 5 days/wk); (3) BDNF (BDNF; 0.5 mg/kg·bw, 5 days/wk); (4) endurance training and BDNF (ET + BDNF) for 8 weeks. Results demonstrated that the soleus (SOL) had higher BDNF content compared with the extensor digitorum longus (EDL) and that SOL BDNF increased with acute exercise. After chronic exercise and BDNF treatment, treadmill testing to exhaustion demonstrated a main effect of BDNF and ET on increasing exercise capacity. Invitro contractile assessment of the EDL revealed BDNF treatment resulted in similar increases in the max rate of relaxation as ET. EDL force-frequency analysis showed ET + BDNF produced higher force than CON and BDNF, indicating an additive effect. BDNF increased EDL mitochondrial proteins, COXIV, and CS. These results demonstrate that BDNF contributes to muscle adaptations observed with ET.

Effects of High-Intensity Aerobic Exercise on Cardiovascular Disease Risk Factors and Inflammatory Markers in Normal Weight Obese Women Aged 20-30

OBJECTIVES This study aimed to evaluate the effects of high-intensity aerobic exercise on cardiovascular disease risk factors and inflammatory markers in normal weight obese women aged 20–30 years.METHODS Participants were divided into a high-intensity aerobic exercise group (HIEG, n=8) and a control group (CG, n=7). The aerobic exercise protocol was set at an intensity of 80-85% of the maximum oxygen uptake (VO&lt;sub&gt;2&lt;/sub&gt;max), which was determined through an exercise tolerance test, and consisted of a treadmill workout three times a week over a period of eight weeks. To assess the effects of the exercise intervention, the pre- and post-intervention body composition and VO&lt;sub&gt;2&lt;/sub&gt;max were measured. Additionally, blood samples were collected to analyze cardiovascular disease markers and inflammatory cytokines.RESULTS The results indicated that the HIEG group experienced a significant reduction in body weight and fat percentage (&lt;i&gt;p&lt;/i&gt;&lt;0.001) along with an increase in VO&lt;sub&gt;2&lt;/sub&gt;max (&lt;i&gt;p&lt;/i&gt;&lt;0.001) compared to the control group. Furthermore, the levels of total cholesterol, low-density lipoprotein cholesterol and triglycerides showed a significant reduction (&lt;i&gt;p&lt;/i&gt;&lt;0.01) and inflammatory markers such as tumor necrosis factor-α (TNF-α) and high sensitivity C-reactive protein (hs-CRP) were significantly decreased in the HIEG group (&lt;i&gt;p&lt;/i&gt;&lt;0.001). Moreover, high-density lipoprotein cholesterol levels were significantly elevated in the HIEG group (&lt;i&gt;p&lt;/i&gt;&lt;0.001).CONCLUSIONS These findings suggest that eight weeks of high-intensity aerobic exercise is effective in improving body composition and promoting positive changes in markers for cardiovascular disease and inflammation in normal weight obese women.

Web-Based Exercise and Nutrition Intervention to Improve Leg Muscle Strength and Physical Functioning in Older Adults: Pre-Post Pilot Study.

The lifestyle intervention ProMuscle, which combines resistance exercise and an increased protein intake, was effective in improving muscle strength, muscle mass, and physical functioning in older adults. However, due to a growing shortage of health care professionals, the rapidly growing aging population cannot be personally guided in the future. Therefore, Uni2Move, a scalable web-based variant of ProMuscle, was designed to reach larger groups of older adults without putting additional burden on health care professionals. The current study investigated the effects of a web-based lifestyle intervention on muscle strength, protein intake, and physical functioning in healthy older adults. In addition, we conducted a qualitative study to gather key insights of the participants involved, as little is known about older adults' perceptions of web-based lifestyle interventions. A pre-post pilot study was conducted in the Netherlands. In the 24-week intervention, 19 healthy adults aged >55 years were included. They performed resistance training at home twice a week for 24 weeks via web-based workout videos. Videos (45-60 minutes) were recorded by the fitness trainer and mainly focused on training leg muscles. In addition, older adults were advised on increasing protein intake via two web-based consultations by a dietitian in the first 12 weeks and via an e-learning course in the second 12 weeks. Intervention adherence and acceptance was measured in week 25. The 1 repetition maximum knee extension strength, repeated chair rise test, and protein intake were measured at baseline, week 13, and week 25. Linear mixed models were used to test differences over time. Semistructured interviews were used to gather experiences of participants. Atlas.ti version 22 was used to analyze the interviews. The mean age of participants (n=19) at baseline was 69 (SD 7) years. The 1 repetition maximum knee extension strength and repeated chair rise test improved significantly during the 24-week intervention with a mean difference of 7.0 kg (95% CI 4.8-9.3; P<.001) and -1.2 seconds (95% CI -1.7 to -0.6; P<.001), respectively. Total protein intake per day did not change, whereas protein intake during breakfast had increased significantly after 13 weeks with a mean difference of 6.9 g (95% CI 1.1-12.7; P=.01). Qualitative research revealed that advantages of the program included no need to travel and exercising in their own environment. Disadvantages were the lack of physical interaction and no corrections by the trainer. The results of the web-based exercise and nutrition intervention Uni2Move indicate potential improvements of muscle strength and physical functioning in healthy middle-aged and older adults. Providing such lifestyle interventions on the internet could reach an increased number of older adults, providing the opportunity to contribute to the health and independence of the rapidly growing aging population.

2799 Exploring the physiotherapy and exercise needs and preferences of nursing home residents with dementia: a qualitative study

Abstract Introduction Functional decline and restricted mobility are common issues among nursing home residents with dementia, resulting in frequent use of physiotherapy services. While these residents can typically articulate their therapy needs and preferences, these have not been investigated properly regarding physiotherapy and exercise, which may compromise therapy adherence. This study aims to explore the needs and preferences of nursing home residents with mild to moderate dementia in relation to physiotherapy and exercise interventions. Methods Semi-structured individual interviews were conducted with 15 nursing home residents diagnosed with mild to moderate dementia, who could understand and speak Dutch and were capable of providing informed consent. Thematic analysis was used to analyse interview data. Results From the interviews a total of 82 unique codes were identified, leading to four major themes: preferences regarding physiotherapeutic treatment, differences between physiotherapy and other exercises, preferences for unsupervised exercise, and communication and involvement preferences. Overall, residents wanted physiotherapy that included exercise and advice aimed at maintaining physical functioning and independence. Many participants indicated that a physiotherapist was not always required to supervise exercises as long as safety and quality were ensured. While residents wanted their family caregivers to stay informed about their therapy, they mostly preferred to exercise with someone other than a family caregiver. Conclusions Residents emphasised the importance of a physiotherapist providing information and understanding, and noted that sessions could be supervised by others if quality and safety are maintained. While residents preferred regular updates to their family, they did not want to exercise with them. A future coaching role for physiotherapists to oversee exercise interventions could enhance healthcare cost efficiency.

2860 Can clinical assessments be administered in a remotely delivered clinical trial targeting older adults at risk for dementia?

Abstract Introduction Research suggests that physical and cognitive exercise can have a positive effective on those with dementia, but less is known about such interventions in those at risk for dementia. Understanding the feasibility of administering clinical assessments remotely using Zoom for HealthcareTM in the context of a dementia prevention trial for at risk older adults is not well understood. Methods SYNERGIC@Home/SYNERGIE~Chez soi (NCT04997681) is a home-based, remotely delivered clinical trial targeting older adults at risk for dementia. Participants underwent a screening/baseline assessment and were randomised to one of four physical and cognitive exercise intervention arms for 16 weeks (3 times per week). They were reassessed immediately post-intervention and 6-months later. The standardised assessments of cognition, physical activity, mobility, mental health, nutrition, sleep, and quality of life were done at all three points. A research coordinator completed the assessments on a one-on-one basis via Zoom for HealthcareTM. The quality-of-life questionnaire was mailed to the participant. Results Forty-eight of 60 participants (80%) (mean age 68.7 ± 5.7 years, 81.3% female) completed the study. Most participants (75.0%) were cognitively intact with at least 2 dementia risk factors. No participants withdrew from the trial because of difficulty with the remote delivery of the assessments. There were no statistically significant changes in any of the assessments of cognition, physical activity, mobility, mental health, nutrition, sleep, or quality of life throughout the study. Conclusion This study demonstrates it is possible to administer standardised clinical assessments of cognition, physical activity, mobility, mental health, nutrition, sleep, and quality of life remotely in the context of a clinical trial. The study was not powered to detect meaningful differences in these assessments. Nevertheless, this confirms the feasibility of remotely administering clinical assessments to older adults at risk for dementia.

2785 Protocol for a feasibility randomised controlled trial of the OUTDOOR mobility intervention for older adults after hip fracture

Abstract Introduction A high proportion of patients do not regain outdoor mobility after hip-fracture. Rehabilitation explicitly targeting outdoor mobility is needed to enable older adults to resume activities that they value most. The aim of this study is to determine the feasibility of a randomised, controlled trial intended to assess the clinical and cost-effectiveness of an intervention enabling recovery of outdoor mobility post hip-fracture (the OUTDOOR intervention). Method OUTDOOR is a multi-centre, parallel group, randomised, controlled, feasibility trial. Adults 60 years and older, admitted to hospital and planned discharge to home; with self-reported outdoor mobility three-months pre-fracture, surgically treated for hip fracture, who are able to consent and participate, are eligible. Individuals requiring two or more people to support mobility upon discharge are excluded. Screening and consent (or consent to contact) will take place in hospital. Baseline assessment and randomisation will follow discharge. Participants will receive usual care (physiotherapy, occupational therapy), or usual care plus the OUTDOOR intervention. OUTDOOR intervention includes a goal-orientated outdoor mobility programme, therapist-led motivational dialogue supported by a past-patient led videos sharing recovery experiences; and support to transition to independent recovery. Therapists delivering the OUTDOOR intervention will receive training in motivational interviewing, and behaviour change techniques. Patient reported outcome measures—health-related quality of life, daily activities, pain, community mobility, falls related self-efficacy, resource use, and readmission; will be collected at baseline, 6-weeks, 12-weeks, and 6-months (if enrolled early in the trial) post-randomisation. Exercise adherence and intervention acceptability will be collected. Subset of 20 participants will support accelerometery data collection for 10 days at each time point. Trial received approval from East of England—Essex Research Ethics Committee (REF: 23/EE/0246) and the Health Research Authority. Findings will be disseminated to patients, the public, health professionals and researchers through publications, presentations, and social media. Trial registered at ISRCTN16147125.

Vascular health and exercise in females throughout the lifespan: Exploring puberty, pregnancy and menopause.

This narrative review highlights the impact of exercise on vascular health in females over the lifespan with an emphasis on puberty, pregnancy and menopause. These events encompass substantial changes in sex hormone levels, particularly oestrogens and progesterone. They are also accompanied by distinct adaptations of the central, peripheral and cerebral vasculature. Regular exercise is an effective mechanism to reduce vascular risk in females of all ages, especially for those at higher risk for vascular disorders. However, there are large variabilities in the vascular adaptations to exercise in females that may be related to circulating sex hormone levels. In addition, exogenous hormones, such as oral contraceptives taken after puberty or hormonal replacement therapy taken to mitigate symptoms of menopause, may interact with exercise-induced changes in vascular function. We highlight how more research is needed to understand the optimal exercise interventions to promote vascular health in females across the lifespan, especially during times of hormonal transition.