The effect of functional circuit training on physical frailty in frail older adults: a randomized controlled trial

The purpose of this study was to evaluate whether a 12-wk functional circuit-training program (FCT) could alter markers of physical frailty in a group of frail community-dwelling adults. Fifty-one individuals (31 women, 20 men), mean age (± SD) 84 (± 2.9) yr, met frailty criteria and were randomly assigned into groups (FCT = 26, control group [CG] = 25). FCT underwent a 12-wk exercise program. CG met once a week for health education meetings. Measures of physical frailty, function, strength, balance, and gait speed were assessed at Weeks 0, 12, and 36. Physical-frailty measures in FCT showed significant (p < .05) improvements relative to those in CG (Barthel Index at Weeks 0 and 36: 73.41 (± 2.35) and 77.0 (± 2.38) for the FCT and 70.79 (± 2.53) and 66.73 (± 2.73) for the CG. These data indicate that an FCT program is effective in improving measures of function and reducing physical frailty among frail older adults.     

The effect of guided relaxation and exercise imagery on self-reported leisure-time exercise behaviors in older adults

The purpose of this study was to examine the effects of a 6-wk intervention that used guided relaxation and exercise imagery (GREI) to increase self-reported leisure-time exercise behavior among older adults. A total of 93 community-dwelling healthy older adults (age 70.38 ± 8.15 yr, 66 female) were randomly placed in either a placebo control group or an intervention group. The intervention group received instructions to listen to an audio compact disk (CD) containing a GREI program, and the placebo control group received an audio CD that contained 2 relaxation tracks and instructions to listen to music of their choice for 6 wk. Results revealed that listening to a GREI CD for 6 wk significantly increased self-reported leisure-time exercise behaviors (p = .03). Further exploration of GREI and its effects on other psychological variables related to perceived exercise behaviors may substantiate its effectiveness.     

Tai Chi-based exercise for older adults with Parkinson's disease: a pilot-program evaluation

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson's disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.     

Effects of an 8-week multimodal exercise program on strength, flexibility, and golf performance in 55- to 79-year-old men

Substantial research has indicated the beneficial effect of physical activity on physical fitness and activities of daily living in older adults, but none have investigated the effects on performance of recreational activities. This investigation studied the effect of an exercise program on fitness and golf-clubhead speed in older men. Thirty-one golfers (mean age 65.1 +/- 6.2 years) were randomly assigned to a treatment (n = 19) or control (n = 12) group. The treatment group completed an 8-week strength and flexibility program. Assessments included 10-RM muscle strength; selected range-of-motion (ROM) measurements; and golf-clubhead speed (CHS). ANCOVA revealed significant differences between groups (p <.005) for all strength measurements and several ROM measurements. CHS was significantly different (p <.05) between groups after the intervention. Mean CHS improved from 85.0 to 87.1 miles/hr (136.8 to 140.2 km/hr). These results indicate that a strength and flexibility program can improve golf performance in older adults.     

Physical and psychological outcomes of a supported physical activity program for older carers

This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postintervention (p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component; p < .05). There was no change in the Zarit Carer Burden Scale (p > .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance (p < .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.     

Effects of exercise on health-related quality of life and fear of falling in home-dwelling older women

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at 12 or 24 mo. In conclusion, despite beneficial physiological changes, the exercise intervention showed rather limited effects on HRQoL and FoF among relatively high-functioning older women. This modest result may be partly because of insufficient responsiveness of the assessment instruments used.     

The effects of life events and interpersonal loss on exercise adherence in older adults

Associations of life events and interpersonal loss with participation in home- and group-based exercise were studied in 97 older adults (64 % women, 70.2 +/- 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 +/- 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p <.05); among women, this association approached significance (p =.06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p =.02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.     

Comparison of heart-rate and blood-pressure increases during isokinetic eccentric versus isometric exercise in older adults

The authors compared heart-rate and blood-pressure responses to typical isometric (ISO) and isokinetic (90 degrees /s) eccentric (ECC) resistance-training protocols in older adults. Twenty healthy older adults (74 +/- 5 years old) performed randomly ordered ISO and isokinetic ECC exercise (3 sets of 10 repetitions) at a target intensity of 100 % of their peak ISO torque value. Heart rate and systolic (SBP) and diastolic (DBP) blood pressures were recorded continuously, and mean arterial pressure (MAP) and rate-pressure product (RPP) were calculated. ECC peak torque (139 +/- 33 N. m) was significantly greater than ISO peak torque (115 +/- 26 N. m; p <.001). All variables increased significantly (p <.001) during both ISO and ECC exercise. Changes in SBP, DBP, MAP, and RPP were significantly greater during ISO exercise than during ECC exercise (p <.001). Clinically, an isokinetic ECC exercise program enables older adults to work at the same torque output with less cardiovascular stress than ISO exercise.     

Outcomes of a multicomponent physical activity program for sedentary, community-dwelling older adults

This single-group repeated-measures pilot study evaluated the effects of a 10-wk, multicomponent, best-practice exercise program on physical activity, performance of activities of daily living (ADLs), physical performance, and depression in community-dwelling older adults from low-income households (N = 15). Comparison of pretest and posttest scores using a one-tailed paired-samples t test showed improvement (p < .05) for 2 of 3 ADL domains on the Activity Measure-Post Acute Care and for 6 physical-performance measures of the Senior Fitness Test. Repeated-measures ANOVA revealed significant main effects for 3 of 8 physical activity measures using the Yale Physical Activity Scale. Retention rate was 78.9%, and the adherence rate for group sessions was 89.7%. Results suggest that participation in a multicomponent, best-practice physical activity program may positively affect sedentary, community-dwelling older adults' physical activity, ADL performance, and physical performance.     

Improvements in functional capacity from Nordic walking: a randomized-controlled trial among elderly people

This study examined the effects of an instructed structured Nordic walking (NW) exercise program on the functional capacity of older sedentary people. Volunteers were randomly assigned to an NW group (68.2 ± 3.8 yr old) or control group (69.9 ± 3.0 yr old). Before and at the end of the 9-wk intervention, functional tests and 2-dimensional ground-reaction-force (GRF) patterns of normal (1.40 m/s) and fast (1.94 m/s) walking speeds were measured. The intervention included a 60-min supervised NW session on an inside track twice a week for 9 wk. The mean changes in functional tests differed between groups significantly. Gait analyses showed no significant differences between the groups on any GRF parameters for walking speed either before or after the intervention. The study showed that NW has favorable effects on functional capacity in older people and is a suitable form of exercise for them.     

Sex-dependent associations between daily physical activity and leg exercise blood pressure responses

The authors examined interindividual and sex-specific variation in systolic (SBP) and diastolic (DBP) blood pressure responses to graded leg-extension exercise in healthy older (60-78 yr) women (n = 21) and men (n = 19). Maximal oxygen uptake (VO2max), body composition, physical activity (accelerometry), and vascular function were measured to identify predictors of exercise BP. Neither VO2max nor activity counts were associated with the rise in SBP or DBP during exercise in men. The strongest predictors of these responses in men were age (SBP: r2 = .19, p = .05) and peak exercise leg vasodilation (DBP: r2 = -.21, p < .05). In women, the modest relationship observed between VO2max and exercise BP was abolished after adjusting for central adiposity and activity counts (best predictors, cumulative r2 = .53, p < .05, for both SBP and DBP). These results suggest that determinants of variation in submaximal exercise BP responses among older adults are sex specific, with daily physical activity influencing these responses in women but not men.     

Individual progress toward self-selected goals among older adults enrolled in a physical activity counseling intervention

The purpose of this study was to examine what happens to goals over the course of a physical activity counseling trial in older veterans. At baseline, participants (N = 313) identified 1 health-related goal and 1 walking goal for their participation in the study and rated where they perceived themselves to be relative to that goal at the current time. They rated their current status on these same goals again at 6 and 12 mo. Growth-curve analyses were used to examine longitudinal change in perceived goal status. Although both the intervention and control groups demonstrated improvement in their perceived proximity to their health-related and walking goals (L = 1.19, p < .001), the rates of change were significantly greater in the intervention group (β = -.30, p < .05). Our results demonstrate that this physical activity counseling intervention had a positive impact on self-selected goals over the course of the intervention.     

Exercise can improve speed of behavior in older drivers

The main aim of this research was to study the effects of a specific exercise program on the speed of behavior of older adults during on-the-road driving. Twenty-six drivers (55-78 yr old) were randomly assigned to either an exercise group or a control group. The exercise program (3 sessions of 60 min/wk for 8 wk) incorporated tasks that induced the participants to respond quickly to challenging situations. On-the-road driving tasks (under single- and dual-task conditions) included measures of simple and choice reaction time, movement time, and response time. Significant positive effects were found at follow-up resulting from participation in the exercise program: Improvements were found for several measures in all driving tasks, and a composite score reflected a better general drivers' speed of behavior. These results show that exercise can enhance speed of behavior in older drivers and should therefore be promoted.     

Older adults' exercise behavior: roles of selected constructs of social-cognitive theory

Exercise is consistently related to physical and psychological health benefits in older adults. Bandura's social-cognitive theory (SCT) is one theoretical perspective on understanding and predicting exercise behavior. Thus, the authors examined whether three SCT variables-self-efficacy, self-regulation, and outcome-expectancy value-predicted older adults' (N = 98) exercise behavior. Bivariate analyses revealed that regular exercise was associated with being male, White, and married; having higher income, education, and self-efficacy; using self-regulation skills; and having favorable outcome-expectancy values (p < .05). In a simultaneous multivariate model, however, self-regulation (p = .0097) was the only variable independently associated with regular exercise. Thus, exercise interventions targeting older adults should include components aimed at increasing the use of self-regulation strategies.     

Effects of vibration exercise on muscle performance and mobility in an older population

This study was designed to investigate the effects of vibration on muscle performance and mobility in a healthy, untrained, older population. Forty-three participants (23 men, 20 women, 66-85 y old) performed tests of sit-to-stand (STS), 5- and 10-m fast walk, timed up-and-go test, stair mobility, and strength. Participants were randomly assigned to a vibration group, an exercise-withoutvibration group, or a control group. Training consisted of 3 sessions/wk for 2 mo. After training, the vibration and exercise groups showed improved STS (12.4%, 10.2%), 5-m fast walk (3.0%, 3.7%), and knee-extension strength (8.1%, 7.2%) compared with the control (p < 0.05). Even though vibration training improved lower limb strength, it did not appear to have a facilitatory effect on functional-performance tasks compared with the exercise-without-vibration group. Comparable mobility and performance changes between the experimental groups suggest that improvements are linked with greater knee-extension strength and largely attributed to the unloaded squats performed by both exercise groups.     

The effects of respiratory-muscle training on exercise in older women

This research examined the effects of respiratory-muscle (RM) training on RM function and exercise performance in older women. Twenty-six women (60-69 yr of age) were assessed for spirometry, RM strength (maximal inspiratory and expiratory pressure), inspiratory-muscle endurance, and walking performance to a perceived exertion rating of "hard." They were randomly allocated to a threshold RM training group (RMT) or a nonexercising control group (CON) for 8 wk.After training, the 22% (inspiratory) and 30% (expiratory) improvements in RM strength in the RMT group were significantly higher than in the CON group (p < .05). The RMT group also displayed several significant performance improvements, including improved within-group treadmill performance time (12%) and reductions in submaximal heart rate (5%), percentage of maximum voluntary ventilation (16%), and perceived exertion for breathing (8%). RM training appears to improve RM function in older women. Furthermore, these improvements appear to be related to improved submaximal exercise performance.     

Effects of exercise training with weighted vests on bone turnover and isokinetic strength in postmenopausal women

The effects of 12 wk of exercise training using weighted vests on bone turnover and isokinetic strength were evaluated in postmenopausal women randomly assigned as exercisers (EX; n = 9) or controls (CON; n = 7). Training included 3 multimodal exercise sessions per wk wearing weighted vests. The vest load was progressively increased each wk to a maximum of 15% of body weight. Bone turnover was determined from resting levels of serum osteocalcin and NTx. Knee and ankle strength were measured at 60 degrees/s and 180 degrees/s using an isokinetic dynamometer. After 12 wk, NTx decreased by 14.5% (P 相似文献   

Neighborhood and individual factors in activity in older adults: results from the neighborhood and senior health study

This study examined whether features of the built environment and residents' perceptions of neighborhood walkability, safety, and social cohesion were associated with self-reported physical activity (PA) and community-based activity among a sample of 190 older adults (mean age 74) residing in 8 Denver neighborhoods. Neighborhood walking audits were conducted to assess walkability and social capital. In multilevel analyses, a few walkability variables including curb cuts, crosswalks, and density of retail predicted greater frequency of walking for errands (p < .05), but mean frequency of walking for errands for this sample was low (<1/wk). Contrary to expectations, total PA and community-based activity were highest in neighborhoods with fewer walkability variables but higher respondent perceptions of safety and social cohesion (p < .01). For seniors, the importance of characteristics of the built environment in promoting PA and general activity engagement might be secondary to attributes of the social environment that promote safety and social cohesion.     

Factors associated with exercise participation in adults with arthritis

Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis. Using a cross-sectional design, sociodemographic, health-related, and psychosocial variables were collected from community-dwelling individuals with arthritis (N = 141). Associations with exercise level were examined with bivariate statistics (ANOVAs, chi-squares) and logistic-regression analyses. Exercisers were less likely than nonexercisers and insufficiently active people to report that arthritis negatively affected their physical and social functioning, and they reported more positive affect and greater self-efficacy (p < .05). Exercisers also reported less pain than nonexercisers (p < .05). In multiple logistic-regression analyses, self-efficacy and physical limitations remained independent predictors of exercise. The results suggest the need to target exercise self-efficacy when designing exercise interventions. Results also suggest the need to tailor exercise programs to individuals' physical limitations.     

Community exercise program for older adults recovering from hip fracture: a pilot study

Community-based rehabilitative exercise programs might be an effective means to improve functional outcomes for hip-fracture patients. The purpose of this study was to evaluate the effectiveness of a community exercise program (CEP) for older adults recovering from hip fracture. Twenty-five older adults (mean age 80.0 +/- 6.0 years; 24 women; 71 +/- 23 days post-hip fracture) participated in this pilot study (17 exercise, 8 control). The CEP involved functional stepping and lower extremity-strengthening exercises. Control participants received only standard outpatient therapy. Measures of functional mobility, balance confidence, falls efficacy, lower extremity strength, and daily physical activity were evaluated at baseline and at 16 weeks. Improvements for self-reported physical activity, mobility, balance, and knee-extensor strength were observed for the CEP group. This study demonstrated that a CEP is beneficial for community-dwelling older adults post-hip fracture.