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Volume 32 (2024): Issue 4 (Aug 2024)

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Acute Effects of Cadence-Controlled Walking on Cognition and Vascular Function in Physically Inactive Older Adults: A Randomized Crossover Study

Peixuan Zheng, Hayley V. MacDonald, Mark T. Richardson, Kaiwen Man, Ian M. McDonough, and Elroy J. Aguiar

Background: Cadence-controlled walking may be a desirable approach for older adults to self-monitor exercise intensity and achieve physical activity guidelines. We examined the acute effects of cadence-controlled walking on cognition and vascular function in physically inactive older adults. Methods: In a randomized crossover design, 26 participants (65% females, 67.8 ± 11.3 years) underwent 30-min acute exercise (walking at 100 steps/min) and control (sitting) conditions. We measured cognition, central blood pressure (BP), and arterial stiffness before, and immediately, after each condition. Results: We observed significant Time × Condition interactions in the Flanker Inhibitory Control and Attention (Flanker) test and Dimensional Change Card Sort (DCCS) test scores, and in central systolic BP, central pulse pressure, and carotid to femoral pulse wave velocity (p < .05). The Flanker and DCCS scores significantly increased after walking (d = 0.4 and 0.5, respectively), but not after sitting. Central systolic BP, central pulse pressure, and carotid to femoral pulse wave velocity significantly increased after sitting but remained unchanged after acute walking (d = 0.4–0.2), with p-values < .05. After walking, significant correlations were observed between DCCS and diastolic BP and central pulse pressure change scores and change scores in central pulse wave velocity, Flanker, and DCCS (r s = −0.45 to −0.52). Conclusion: These findings suggest that a single bout of cadence-controlled walking elicited an immediate improvement in cognition and might have mitigated increases in arterial stiffness and central BP observed in the seated control condition. Further research is needed to examine the association between cognition and vascular function following acute exercise compared to control conditions. Significance: Our findings may have practical implications for developing daily physical activity recommendations for improving the cognitive health for successful aging.

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Dosed Failure Increases Older Adult’s Motivation for an Exergame

Nick Kluft, Jeroen B.J. Smeets, and Katinka van der Kooij

We investigated whether dosed failure motivates older adults to perform more repetitions in an exergame that involves hitting targets with stepping movements. The effect of dosed failure was studied in a within-participants design in which all participants performed this exergame in both a Standard condition, in which one never fails, and in a Dosed Failure condition, in which we introduced about 30% failures. The order of conditions (Standard First or Dosed Failure first) was chosen randomly for each participant. Results showed that participants performed more repetitions in the Dosed Failure condition compared with the Standard condition, while play duration and subjective motivation at the moment of quitting did not differ. This shows that dosed failure motivated older adults to put a greater amount of effort to perform the exercise without affecting play duration or subjective motivation.

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Community Group-Based Physical Activity Programs for Immigrant Older Adults: A Systematic Realist Review

Jordana Salma, Alesia Au, Sonam Ali, Stephanie Chamberlain, John C. Spence, Allyson Jones, Megan Kennedy, Hongmei Tong, Salima Meherali, Philile Mngomezulu, and Rachel Flynn

Physical activity program interventions often lack sensitivity to the needs of older immigrant adults. The objective of this systematic realist review is to explain how, why, for whom, and under which circumstances community group-based physical activity programs work for immigrant older adults. The initial program theory was developed using prior research, team expertise, social cognitive theory, and knowledge user consultations. The program theory was tested and refined via a systematic review of the literature. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Library, Sports Medicine and Education Index, and SPORTDiscus. A total of 22 sources of evidence met inclusion criteria and included intervention studies, systematic reviews, and a discussion paper. Intervention studies were appraised using the Mixed Methods Appraisal Tool. The final program theory constituted eight context–mechanism–outcome configurations that highlight the importance of facilitator characteristics, access to safe spaces, group dynamics, and social support. A limitation was the small number and variable quality of included evidence. Physical activity programs that target immigrant older adults must strengthen physical and psychological safety and maximize opportunities for role modeling and socialization. This research was supported by the Alberta Health Services Seniors Health Strategic Clinical Network and is registered in PROSPERO (ID#258179).

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“There’s a Lifestyle, an Appreciation, a Beauty”: An Interpretative Phenomenological Analysis of Masters Rowers

Jason Rich, Pamela Beach, and Heidi K. Byrne

Masters rowing has seen a measurable increase in participation, with masters rowers engaged in the sport for competition, health, and recreation reasons. Unlike other masters sports, masters rowing has a unique high level of synchronous, cooperative, and interdependent elements. To better understand the benefits and challenges of participation in competitive masters rowing, the purpose of this study was to explore the lived experiences of competitive masters rowers. Twelve competitive masters rowers were recruited and interviewed. Utilizing an interpretative phenomenological analysis approach to guide data collection, analysis, and interpretation, the analysis revealed four major themes: navigating community relationships, finding a reason to row, growing opportunities, and seeking considerate coaches. Utilizing self-determination theory as a framework for interpreting the findings, the identified themes illustrate the varying motivations, needs, and preferences of competitive masters rowers, as well as how their experiences are influenced by their coaches and peers. Efforts should be made by masters rowing coaches and administrators to better understand the needs of their athletes to ensure the maximum benefits of participation, commitment, and enjoyment of the sport.

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A Novel Behavioral Intervention to Enhance Physical Activity for Older Veterans in a Skilled Nursing Facility

Julie A. Stutzbach, Kristine S. Hare, Allison M. Gustavson, Danielle L. Derlein, Andrea L. Kellogg, and Jennifer E. Stevens-Lapsley

Physical activity levels during skilled nursing facility (SNF) rehabilitation fall far below what is needed for successful community living and to prevent adverse events. This feasibility study’s purpose was to evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention designed to improve physical activity in patients admitted to SNFs for short-term rehabilitation. High-Intensity Rehabilitation plus Mobility combined a high-intensity (i.e., high weight, low repetition), progressive (increasing in difficulty over time), and functional resistance rehabilitation intervention with a behavioral economics-based physical activity program. The behavioral economics component included five mobility sessions/week with structured goal setting, gamification, and loss aversion (the idea that people are more likely to change a behavior in response to a potential loss over a potential gain). SNF physical therapists, occupational therapists, and a mobility coach implemented the High-Intensity Rehabilitation plus Mobility protocol with older Veterans (n = 18) from a single SNF. Participants demonstrated high adherence to the mobility protocol and were highly satisfied with their rehabilitation. Treatment fidelity scores for clinicians were ≥95%. We did not observe a hypothesized 40% improvement in step counts or time spent upright. However, High-Intensity Rehabilitation plus Mobility participants made clinically important improvements in short physical performance battery scores and gait speed from admission to discharge that were qualitatively similar to or slightly higher than historical cohorts from the same SNF that had received usual care or high-intensity rehabilitation alone. These results suggest a structured physical activity program can be feasibly combined with high-intensity rehabilitation for SNF residents following a hospital stay.

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

Frederico M. Baptista, Rosa Andias, Nelson P. Rocha, and Anabela G. Silva

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

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Exploring the Lived Experiences of Physical Activity in Community-Dwelling Adults Living With Dementia and Their Carers

Joanna Blackwell and Mo Ray

People living with dementia have the same right to well-being as anyone else, including physical activity. Yet, physical activity levels among people with dementia are lower than in the general population, and while the physical activity health benefits are well established, little is known about how people living with dementia experience physical activity. To explore these physical activity experiences, we visited six community settings in one English county and conducted informal interviews with 18 people who were either living with dementia and community dwelling (n = 4), caring for or who had cared for someone with dementia (n = 10), or providing a support service for people living with dementia and their carers (n = 4). Findings highlight both the challenges and facilitators presented by organized groups, service provider skills and qualities, and environmental factors. Additionally, these factors were influential in shaping the physical activity experience of people living with dementia. The findings may be relevant for people providing or planning support services, commissioners, policymakers, and researchers.

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Active Learning Through Video Conferencing to Maintain Physical Activity Among Older Adults: A Pilot Randomized Controlled Trial

Kazuki Uemura, Tsukasa Kamitani, Atsuya Watanabe, Hiroshi Okamoto, Kenshi Saho, and Minoru Yamada

This randomized pilot trial investigated the feasibility of an active learning physical activity intervention through video conferencing and its preliminary effects. Participants comprised community-dwelling older adults who could use e-mail. The intervention group underwent a 12-week active learning intervention via video conferencing to promote a healthy lifestyle, particularly physical activity. The control group received information via e-mail once per week. The amount of physical activity and sedentary behavior was measured using an accelerometer at baseline, postintervention, and 24-week postintervention (36 weeks). Of the 31 participants, 29 were eligible and randomized into two groups (15 for the intervention and 14 for the control). Adherence to the intervention was 83%–100% (mean, 97%). Compared with the control group, the intervention group showed moderate maintenance effects on total physical activity and sedentary behavior at 36 weeks. Active learning physical activity intervention through video conferencing was found to be feasible and contributed to the prevention of physical activity decline in older adults.

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Volume 32 (2024): Issue 3 (Jun 2024)