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.     

Validation of the OMNI-cycle scale of perceived exertion in the elderly

This study examined the concurrent and construct validity of the OMNI-Cycle Rating of Perceived Exertion (RPE) Scale, using elderly men and women. Seventy-six participants performed a load-incremented cycle-ergometer exercise test. Concurrent validity was determined by correlating OMNI-RPE responses with oxygen uptake, relative peak oxygen uptake, pulmonary ventilation, heart rate, respiratory rate, and respiratory-exchange ratio during a load-incremented cycle-ergometer protocol. Construct validity was established by correlating RPE derived from the OMNI-Cycle Scale with RPE from the Borg (6-20) Scale. Multilevel, mixed linear-regression models indicated that OMNI-RPE distributed as a significant (p < .05) positive linear function (r = .81-.92) for all physiological measures. OMNI-RPE was positively (p < .01) and linearly related to Borg-RPE in elderly men (r = .97) and women (r = .96). This study demonstrates both concurrent and construct validity of the OMNI-Cycle RPE Scale. These findings support the use of this scaling metric with elderly men and women to estimate RPE during cycle-ergometer 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.     

Older women's cardiovascular responses to deep-water running

The aim of the study was to examine submaximal and maximal physiological responses and perceived exertion during deep-water running with a vest compared with the responses during treadmill running in healthy elderly women. Eleven healthy women 70 +/- 2 years old participated. On two different occasions they performed a graded maximal exercise test on a treadmill on land and a graded maximal exercise test in water wearing a vest. At maximal work the oxygen uptake was 29% lower (p < .05), the heart rate was 8% lower (p < .05), and the ventilation was 16% lower (p < .05) during deep-water running than during treadmill running. During submaximal absolute work the heart rate was higher during deep-water running than during treadmill running for the elderly women. The participants had lower maximal oxygen uptake, heart rate, ventilation, respiratory-exchange ratio, and rate of perceived exertion during maximal deep-water running with a vest than during maximal treadmill running. These responses were, however, higher during submaximal deep-water running than during treadmill running.     

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.     

Energy expenditure during physically interactive video game playing in male college students with different playing experience

OBJECTIVE: Researchers have yet to explore the effect of physically interactive video game playing on energy expenditure, despite its potential for meeting current minimal daily activity and energy expenditure recommendations. PARTICIPANTS AND METHODS: Nineteen male college students -- 12 experienced Dance Dance Revolution (DDR) players and 7 inexperienced players -- completed maximal oxygen uptake assessments and a 30-minute DDR gaming session. The authors recorded heart rate (HR), rating of perceived exertion (RPE), respiratory exchange rate (RER), oxygen consumption (VO2), and total steps (TS30). RESULTS: Experienced participants showed higher exercise HR, RPE, RER, VO2, total and relative energy expenditure, exercise intensity, TS30, and average steps per minute, and less time and steps to expend 150 kilocalories (p < .05). CONCLUSIONS: Participants with greater playing experience can work at higher intensities, promoting greater energy expenditure.     

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.     

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.     

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.     

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.     

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.     

Relationship between balance and gait stability in healthy older adults

Age-related adaptations during walking create a more stable walking pattern, which is less effective for forward progression and might be related to balance deficiencies. This study determined the relationship between walking stability and measures of balance in older adults. Seventeen older and 20 young adults performed the Berg Balance Test (BBT) and walked 10 m. Walking velocity (WV) and cadence were measured, and a gait-stability ratio (GSR) was calculated. Higher GSR indicated that a greater portion of the gait cycle was spent in double-limb support. Age-group comparisons established declines in BBT scores and WV and increases in GSR with age. Significant relationships were identified for BBT Item 12 (alternate stepping on a stool) with WV (r =.58, r(2) =.34) and GSR (r = -.74, r(2) =.54). The correlation of BBT Item 12 with GSR was stronger than with WV (p <.05). Results indicated a strong relationship between increased gait stability and decreased balance for a dynamic weight-shifting task. Therefore, GSR is a better indicator of balance deficits during walking than is WV alone.     

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.     

Misconceptions about strength exercise among older adults

The purposes of this study were to determine current opinions of strength exercise among older adults and whether knowledge of recommended protocols differs between strength-exercise participants and nonparticipants. One hundred twenty-nine older adults (77.5 +/- 8.6 years) responded to questions about their opinions, experiences, and knowledge of strength-exercise recommendations. Some misconceptions were identified in the sample, with 48.4% of participants responding "no" to "strength training increases muscle mass," 45% responding "no" to "increasing weight is more important than number of repetitions for building strength," and 37% responding that walking is more effective than lifting weights at building muscle strength. The number of correct responses was related to the number of years in school (semipartial r(2)= .046). More education is needed about the benefits and recommendations to ensure proper use of current strength-exercise protocols among older adults.     

Energy Expenditure During Physically Interactive Video Game Playing in Male College Students With Different Playing Experience

Objective: Researchers have yet to explore the effect of physically interactive video game playing on energy expenditure, despite its potential for meeting current minimal daily activity and energy expenditure recommendations. Participants and Methods: Nineteen male college students-12 experienced Dance Dance Revolution (DDR) players and 7 inexperienced players- completed maximal oxygen uptake assessments and a 30-minute DDR gaming session. The authors recorded heart rate (HR), rating of perceived exertion (RPE), respiratory exchange rate (RER), oxygen consumption (VO₂), and total steps (TS₃₀). Results: Experienced participants showed higher exercise HR, RPE, RER, VO₂, total and relative energy expenditure, exercise intensity, TS₃₀, and average steps per minute, and less time and steps to expend 150 kilocalories (p < .05). Conclusions: Participants with greater playing experience can work at higher intensities, promoting greater energy expenditure.     

Disparities in Access to Health Care Among Middle-Aged and Older Adults with Disabilities

Disability is increasing among middle-aged adults and, reversing earlier trends, increasing among older adults as well. Disability is experienced disproportionately by Black and lower socioeconomic status (SES) individuals. We used Medical Expenditure Panel Survey data to examine health care disparities in access to health care for middle-aged (31 to 64 years of age) and older (65+ years of age) adults with disabilities by race and ethnicity, education, and income (n = 13,174). Using logistic regression, we examined three measures of potential (e.g., usual source of care), and three measures of realized (e.g., counseling related to smoking) access. Middle-aged and older minority individuals with disabilities had lower relative risks of having usual sources of care and higher relative risks of having suboptimal usual sources of care (e.g., a place rather than a person) than White adults with disabilities. There were SES effects observed for middle-aged adults with disabilities across most measures that were, for certain measures, more pronounced than SES effects among older adults with disabilities. These findings are important, since health resources (e.g., a usual source of care) may mediate relations among disability, morbidity, and mortality. Policy actions that may mitigate the disparities we observed include financial incentives to support access to an optimal usual source of care and mechanisms to foster behavioral interventions related to smoking and exercise. Ensuring that these actions address the specific concerns of individuals with disabilities, such as physical accessibility and provider cultural competency, is essential.     

Reliability and validity of responses to submaximal all-extremity semirecumbent exercise in older adults

Although popular in clinical settings, little is known about the utility of all-extremity semirecumbent exercise machines for research. Twenty-one community-dwelling older adults performed two exercise trials (three 4-min stages at increasing workloads) to evaluate the reliability and validity of exercise responses to submaximal all-extremity semirecumbent exercise (BioStep). Exercise responses were measured directly (Cosmed K4b2) and indirectly through software on the BioStep. Test-retest reliability (ICC2,1) was moderate to high across all three stages for directly measured METs (.92, .87, and .88) and HR (.91, .83, and .86). Concurrent criterion validity between the K4b2 and BioStep MET values was moderate to very good across the three stages on both Day 1 (r = .86, .71, and .83) and Day 2 (r = .73, .87, and .72). All-extremity semirecumbent submaximal exercise elicited reliable and valid responses in our sample of older adults and thus can be considered a viable exercise mode.     

Barriers to exercise behavior among older adults: a focus-group study

Longer life expectancy, rapid population growth, and low exercise-participation rates of adults 65 and older justify the need for better understanding of older adults' exercise behavior. The objectives of this focus-group study were to determine barriers to the exercise behavior of older adults. Six focus groups, three with exercisers and three with nonexercisers, were conducted at various sites throughout Rhode Island. The majority (n = 57) of the 66 individuals who participated were women, and all stated that they were 65 and older. Results from the focus-group data identified 13 barriers to exercise behavior. The most significant barriers mentioned by nonexercisers were fear of falling, inertia, and negative affect. Exercisers identified inertia, time constraints, and physical ailments as being the most significant barriers to exercise. Implications from these focus-group data can be useful in the development of exercise interventions for older adults, which could increase exercise participation.     

Reliability and validity of the Outcome Expectations for Exercise Scale-2

Development of a reliable and valid measure of outcome expectations for exercise for older adults will help establish the relationship between outcome expectations and exercise and facilitate the development of interventions to increase physical activity in older adults. The purpose of this study was to test the reliability and validity of the Outcome Expectations for Exercise-2 Scale (OEE-2), a 13-item measure with two subscales: positive OEE (POEE) and negative OEE (NOEE). The OEE-2 scale was given to 161 residents in a continuing-care retirement community. There was some evidence of validity based on confirmatory factor analysis, Rasch-analysis INFIT and OUTFIT statistics, and convergent validity and test criterion relationships. There was some evidence for reliability of the OEE-2 based on alpha coefficients, person- and item-separation reliability indexes, and R(2)values. Based on analyses, suggested revisions are provided for future use of the OEE-2. Although ongoing reliability and validity testing are needed, the OEE-2 scale can be used to identify older adults with low outcome expectations for exercise, and interventions can then be implemented to strengthen these expectations and improve exercise behavior.