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.     

The gallon-jug shelf-transfer test: an instrument to evaluate deteriorating function in older adults

This study examined the validity, reliability, and discriminatory capacity of the gallon-jug shelf-transfer (GJST) test. Six hundred fifty-three independent-living older adults (463 women age 72.9 +/- 7.0 years, 190 men age 74.3 +/- 6.7 years) participated. Participants moved five 1-gallon jugs (approximately 3.9 kg) from a knee-high to a shoulder-high shelf as quickly as possible. The GJST showed an exponential performance decline with age, and there were significant correlations between the GJST and common functional tests (p<.001). High within-day and between-days reliability was detected. The test also detected differences resulting from training status (p<.01) and training protocols (p<.05). The GJST is a valid, reliable, inexpensive, safe, and easily administered clinical test for identifying physically vulnerable elders who could benefit from interventions such as exercise to improve their physical capacities and maintain independence.     

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.     

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.     

The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 +/- 40 to 141 +/- 53 W (p < .01); dynamic balance increased 48%, from 22.3 +/- 7.9 to 33.1 +/- 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 +/- 1.32 to 6.54 +/- 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.     

Why older Australians participate in exercise and sport

Research on variables that encourage older adults to exercise is limited. This study was carried out to identify the participation motives of older Australians involved in regular exercise and sport. The 815 participants (399 men, 416 women) ranged in age from 55 to 93 years (M = 63.6, SD = 7.8) and were participating in their activities of choice at least once per week. All participants completed the Participation Motivation Questionnaire for Older Adults. The most common exercise/sport activities that participants were involved in were walking, golf, lawn bowls, tennis, and swimming. The most highly reported motives for participation were to keep healthy, liking the activity, to improve fitness, and to maintain joint mobility. Principal-components analysis of the questionnaire revealed 6 factors: social, fitness, recognition, challenge/benefits, medical, and involvement. Analyses of variance showed significant differences in reasons for participation in exercise and sport based on gender, age, education level, and occupation.     

Comparison of two methods of measuring physical activity in South African older adults

The aim of this study was to assess the validity and reliability of the Yale Physical Activity Survey (YPAS) and the short version of the International Physical Activity Questionnaire (IPAQ) in older South African adults. The YPAS includes measures of weekly energy expenditure (EE) for housework, yard work, caregiving, exercise, and recreation. The IPAQ measures total time and EE during vigorous and moderate activity, walking, and sitting. The instruments were administered twice for test-retest reliability (men, n = 52, 68 +/- 5.4 years, and women, n = 70, 66 +/- 5.8 years). Data for criterion validity were obtained from accelerometers. YPAS reliability ranged from r = .44 to.80 for men and r = .59 to .99 for women (p < .0001). IPAQ reliability was lower for men (r = .29 to .76) than for women (r = .46 to .77). Criterion validity of the YPAS was .31 to .54 for men and .26 to .29 for women. The YPAS and short IPAQ had comparable results for reliability and criterion validity.     

Rate of perceived exertion as a tool to monitor cycling exercise intensity in older adults

The purpose of this study was to determine the efficacy of rate of perceived exertion (RPE) to monitor exercise intensity in older adults. Middle-aged (46.9 +/- 7.0 years, n = 24) and older women (75.5 +/- 3.8 years, n = 29) performed a graded maximal exercise test on a cycle ergometer while RPE, oxygen uptake, heart rate, and blood lactate levels were measured. The Pearson's product moment correlation coefficient between RPE and oxygen uptake for each stage of the graded exercise test was calculated for each participant. The mean coefficient for the older group (r =.954) was similar to that of middle-aged group (r =.963). The autocorrelation coefficient was much lower (r =.411) in the older group than in the middle-aged group (r =.871). Variability in RPE through the graded exercise test was similar between the two groups. In conclusion, RPE was strongly associated with oxygen uptake in the older group. These results indicate that RPE is effective in monitoring exercise intensity in older adults.     

Testing the efficacy of the theory of planned behavior to explain strength training in older adults

The purpose of this study was to use the constructs of the theory of planned behavior (TPB) to gain a better understanding of the factors influencing older adults' participation in strength training. Two hundred men and women age 55 years and older were purposely sampled from seniors' centers in Ontario Canada. Participants completed a TPB questionnaire and reported their current physical activity participation. It was hypothesized that perceived behavioral control followed by attitude would be the strongest determinants of strength-training intentions and that intention would be the strongest determinant of strength-training behavior. Regression analyses revealed that subjective norm and perceived behavioral control explained 42% of the variance in intention and intention explained 40% of the variance in behavior. Gender and current strength-training participation did not significantly moderate the relationship between the TPB variables. The results suggest that interventions targeting subjective norm and perceived control might be helpful in promoting strength-training behavior among older adults.     

Anabolic responses to resistance training in older men and women: a brief review

Resistance training has been shown to be the most effective exercise mode to induce anabolic adaptations in older men and women. Advances in imaging techniques and histochemistry have increased the ability to detect such changes, confirming the high level of adaptability that remains in aging skeletal muscle. This brief review presents a summary of the resistance-training studies that directly compare chronic anabolic responses to training in older (>60 years) men and women. Sixteen studies are summarized, most of which indicate similar relative anabolic responses between older men and women after resistance training. Relatively small sample sizes in most of the interventions limited their ability to detect significant sex differences and should be considered when interpreting these studies. Future research should incorporate larger sample sizes with multiple measurement time points for anabolic responses.     

Social physique anxiety, obligation to exercise, and exercise choices among college students

OBJECTIVE: The authors examined relationships among social physique anxiety, obligation to exercise, and exercise choices. PARTICIPANTS AND METHODS: College students (N = 337; 200 women, 137 men) volunteered to complete 3 questionnaires: the Social Physique Anxiety Scale (SPAS), Obligatory Exercise Questionnaire (OEQ), and Physical Activity Specification Survey (PASS). RESULTS: On the SPAS, men (M score = 31.9 +/- 8.8) differed from women (M score = 37.3 +/- 8.3; p = .001). Men (M score = 43.0 +/- 9.9) and women (M score = 43.0 +/- 9.6) responded similarly (p = .94) on the OEQ. There was no interaction between sex and exercise level on the SPAS or OEQ. When separated by low, medium, and high SPAS scores, neither OEQ nor exercise scores differed. CONCLUSIONS: Obligation to exercise appears to be similar for both sexes. Women, however, appear to have higher levels of anxiety regarding how others evaluate their physique than do men. The combination of level of activity and sex do not appear to be associated with social physique anxiety or obligation to exercise.     

Aging, physical activity, and hormones in women--a review

Women experience significant changes in endocrine function during aging. Decreasing levels of anabolic hormones may be associated with musculoskeletal atrophy and decrease in function that is observed in older women and, as a result, there has been an increase in the use of pharmacological hormone therapies. It is difficult to distinguish, however, between physiological changes that are truly age related and those that are associated with lifestyle factors such as physical activity participation. Some research has shown that circulating levels of anabolic hormones such as DHEA(S) and IGF-I in older women are related to physical activity, muscle function, and aerobic power. Exercise-intervention studies have generally shown that increasing age blunts the acute hormonal response to exercise, although this might be explained by a lower exercise intensity in older women. There have been relatively few studies that examine hormonal adaptations to exercise training. Physical activity might have an effect on hormone action as a result of changes in protein carriers and receptors, and future research needs to clarify the effect of age and exercise on these other components of the endocrine system. The value and safety of hormone supplements must be examined, especially when used in combination with an exercise program.     

Pilot study comparing physical and psychological responses in medical qigong and walking

Identifying alternative exercise modalities in an effort to stimulate and promote participation in physical activity, especially among older adults, is a critical health consideration. The purpose of this study was to compare physiological and psychological responses to medical qigong with self-paced brisk walking. Older women (55-79 years) performed 22 min of either qigong or walking on two separate days. During exercise performance, heart rate and ratings of perceived exertion were assessed. Psychological affect, blood pressure, and pulse rate were assessed before and after the exercise bouts. Heart-rate data indicated that both forms of exercise were at a moderate level of intensity. In addition, similar values were found for the physiological and psychological variables as a function of the two forms of exercise. Therefore, it was concluded that this form of medical qigong can be considered a moderate-intensity physical activity that should have both physiological and psychological benefits for older women.     

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.     

Incremental exercise tests in master athletes and untrained older adults

This study aimed to analyze the impact of step-duration protocols, 1-min vs. 3-min, on cardiorespiratory responses to exercise, whatever the aerobic-fitness level of sedentary (65.5 +/- 2.3 years, n = 8) or highly fit (63.1 +/- 3.2 years, n = 19) participants. Heart rate and VO2 at the first and second ventilatory thresholds (VT1 ,VT2) and maximal exercise were not significantly different between the two protocols. In master athletes, the 3-min protocol elicited significantly lower ventilation at VT2 and maximal exercise (p < .01). In the latter, breathlessness was also lower at maximal exercise (p < .05) than in sedentary participants. In trained or sedentary older adults, VT1, VT2, and were not influenced by stage duration. According to the lower breathlessness and ventilation, however, the 3-min step protocol could be more appropriate in master athletes. In untrained participants, because the cardiorespiratory responses were similar with the two incremental exercise tests, either of them could be used.     

Bicycle ergometry in subacute-stroke survivors: feasibility, safety, and exercise performance

This study evaluated the feasibility, safety, and findings from a protocol for exercise-bicycle ergometry in subacute-stroke survivors. Of 117 eligible candidates, 14 could not perform the test and 3 discontinued because of cardiac safety criteria. In the 100 completed tests, peak heart rate was 116 +/- 19.1 beats/min; peak VO(2) was 11.4 +/- 3.7 ml x kg x min(-1), peak METs were 3.3 +/- 0.91, exercise duration was 5.1 +/- 2.84 min, and Borg score was 14 +/- 2.6. Among 71 tests, anaerobic threshold was achieved in 3.0 +/- 1.7 min with a VO(2) of 8.6 +/- 1.7 ml x kg x min(-1). After screening, this protocol is feasible and safe in subacute-stroke survivors with mild to moderate deficits. These stroke survivors have severely limited functional exercise capacity. Research and clinical practice in stroke rehabilitation should incorporate more comprehensive evaluation and treatment of endurance limitations.     

The Health Belief Model and the Contraceptive Behavior of College Women: Implications for Health Education

Abstract

“The Incidence of Primary Cardiac Arrest During Vigorous Exercise,” David S. Siscovick, et al. To examine the risk of primary cardiac arrest during vigorous exercise, we interviewed the wives of 133 men without known prior heart disease who had had primary cardiac arrest. Cases were classified according to their activity at the time of cardiac arrest and the amount of their habitual vigorous activity. From interviews with wives of a random sample of healthy men, we estimated the amount of time members of the community spent in vigorous activity.

Among men with low levels of habitual activity, the relative risk of cardiac arrest during exercise compared with that of other times was 56 (95% confidence limits, 23 to 131). The risk during exercise among men at the highest level of habitual activity was also elevated, but only by a factor of 5 (95% confidence limits, 2 to 14). However, among the habitually vigorous men, the overall risk of cardiac arrest—i.e., during and not during vigorous activity—was only 40% that of the sedentary men (95% confidence limits, 0.23 to 0.67).

Although the risk of primary cardiac arrest is transiently increased during vigorous exercise, habitual vigorous exercise is associated with an overall decreased risk of primary cardiac arrest. (New England Journal of Medicine 1984;311:874-7.)

“Osteoporosis in Women with Anorexia Nervosa,” Nancy A. Rigotti, et al. Because estrogen deficiency predisposes to osteoporosis, we assessed the skeletal mass of women with anorexia nervosa, using direct photon absorptiometry to measure radial bone density in 18 anorectic women and 28 normal controls. The patients with anorexia had significantly reduced mean bone density as compared with the controls (0.64 ±0.06 vs. 0.72 ±0.04 g per square centimeter, P < 0.001). Vertebral compression fractures developed in two patients, and bone biopsy in one of them demonstrated osteoporosis. Bone density in the patients was not related to the estradiol level (r = 0.02). Levels of parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal despite low calcium intakes.

The patients with anorexia who reported a high physical activity level had a greater bone density than the patients who were less active (P < 0.001); this difference could not be accounted for by differences in age, relative weight, duration of illness, or serum estradiol levels. The bone density of physically active patients did not differ from that of active or sedentary controls.

We conclude that women with anorexia nervosa have a reduced bone mass due to osteoporosis, but that a high level of physical activity may protect their skeletons. (New England Journal of Medicine 1984;311:1601-6.)     

Physical activity, exercise, and sedentary behavior in college students

The authors examined the relationship between physical activity, exercise, and sedentary behaviors in 493 college students who were enrolled in 10 conditioning activity classes and had completed questionnaires at the beginning of the course. They analyzed sedentary activities and indicators of participation in exercise and physical activity by demographic variables. Surveyed men reported greater participation in physical activity and exercise than did women, and they also spent more time watching television/videos and using the computer. Older students were more likely to report more computer use, whereas younger students scored higher on several physical activity indicators. Of the sedentary behaviors, only computer use for men and television watching for women were negatively correlated with exercise and physical activity. In addition to accessibility and reinforcing properties of sedentary activities, the gender-related relationships between sedentary and active behaviors should be considered in designing interventions to promote exercise in this population.     

Yearlong physical activity and health-related quality of life in older Japanese adults: the Nakanojo Study

We hypothesized that the health-related quality of life (HRQOL) would be poorer in physically inactive older adults. This was tested in a sample of 73 male and 108 female free-living healthy Japanese participants, age 65-85 years. We measured accelerometer step counts and their metabolic equivalents (METs) throughout each 24-hr period for 1 year. At the end of the year, HRQOL was assessed. Physical activity was grouped into quartiles. HRQOL was poorer in the lowest quartiles of participants with respect to both step count and duration of activity >3 METs; however, our sample showed no better HRQOL in those participants exceeding minimum standards of daily physical activity, corresponding to counts of around 5,500 and 4,500 steps/day and durations of around 13 and 14 min/day in men and women, respectively. Causation cannot be demonstrated from this cross-sectional study, but nevertheless we suggest that elderly individuals should be encouraged to meet such standards of habitual physical activity.