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

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Volume 18 (2024): Issue 2 (Jun 2024)

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Effect of Protein Supplementation Combined With Resistance Training in Gait Speed in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Juan Li, Yahai Wang, Fang Liu, and Yu Miao

Background: We aimed to evaluate the effectiveness of the combination of protein supplementation and resistance training (RT), compared with RT alone or combined with a placebo, in improving gait speed. Methods: We searched PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases, and 18 randomized controlled trials with 1,147 older participants were included for meta-analysis. Data were pooled as the effect sizes (Hedges’ g) with 95% confidence interval (CI) of the gait speed (in meters per second). The random-effect meta-analysis, subgroup analyses, meta-regression, and sensitivity analysis were conducted. Results: The combination of protein supplementation and RT significantly improved gait speed (Hedges’ g: 0.52 m/s, 95% confidence interval [0.17, 0.86], p = .005; I 2  = 86.5%) compared with the RT alone. The subgroup analyses revealed that the significant improvement in gait speed postprotein intervention plus RT was observed only in participants who consumed protein after RT (Hedges’ g: 0.90 m/s, 95% confidence interval [0.46, 1.33], p = .001; I 2  = 79.6%). The pooled result did not significantly change after excluding any single study at one time or excluding smaller studies with large effect sizes. Conclusions: Protein supplementation combined with RT could significantly improve the gait speed of older adults compared with RT alone. This positive effect is more pronounced in people who consume protein after RT.

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“Now I Am Walking Toward Health”: A Qualitative Study About the Outcomes of Physical Activity Participation That Matter to Older Adults

Peter J. Young, Christine Wallsworth, Hitika Gosal, and Dawn C. Mackey

Background/Objectives: Randomized controlled trials that deliver physical activity interventions have demonstrated benefits for older adults across numerous health outcomes. However, too little attention has been directed to ensuring that such trials are measuring patient-relevant outcomes. To support outcome selection for future trials, the objective of this study was to understand what outcomes related to their physical activity participation older adults find important. Methods: We conducted 12 semistructured interviews with adults aged 65 years and older and analyzed interview transcripts with a reflexive thematic analysis. Results: Older adults desired diverse outcomes from their physical activity participation, ranging from generic (e.g., quality of life) to specific (e.g., leg strength). Relevant outcomes were classified under five themes: physical, clinical, social, psychological, and overarching, each with respective subthemes. Conclusions: The outcomes that older adults found important were plentiful and rooted in a desire to improve their quality of life. Some of the outcome themes have been reported frequently in past trials (e.g., physical), but others have not (e.g., social). Future researchers should be aware of, and responsive to, the priorities of older adults when designing trials and defining outcomes. Significance/Implications: This study will help to improve outcome selection for future trials of physical activity with older adults. In alignment with a patient-oriented research philosophy, this study will also ground future outcome selection in the priorities of older adults.

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Association Between Depressive Symptoms, Cognitive Status, and the Dual-Task Performance Index in Older Adults: A Cross-Sectional Study

Fabiane de Oliveira Brauner, Mariana Oliveira, Daiane Oliveira Hausen, Aniuska Schiavo, Gustavo Balbinot, and Régis Gemerasca Mestriner

The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23 years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26–74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive–motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults.

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Follow the Arrows: Using a Co-Created Causal Loop Diagram to Explore Leverage Points to Strengthen Population Physical Activity Promotion in British Columbia, Canada

Lori Baugh Littlejohns, Geoffrey McKee, Drona Rasali, Daniel Naiman, Jennafer Mee, Tanya Osborne, Phuc Dang, Meghan Winters, Scott A. Lear, Diane Nelson, Steve McGinley, and Guy Faulkner

Background: Population physical activity promotion (PPAP) is one of the most effective noncommunicable disease prevention strategies, yet coordination is lacking around the world. Whole-of-system approaches and complex systems methods are called for to advance PPAP. This paper reports on a project which (1) used an Attributes Framework with system mapping (group model building and causal loop diagramming of feedback loops) and (2) identified potential leverage points to address the challenge of effective coordination of multisectoral PPAP in British Columbia. Methods: Key findings from stakeholder interviews and workshops described the current system for PPAP in terms of attributes and dimensions in the framework. These were translated into variables and used in group model building. Participants prioritized the importance of variables to address the coordination challenge and then created causal loop diagrams in 3 small groups. One collective causal loop diagram was created, and top priority variables and associated feedback loops were highlighted to explore potential leverage points. Results: Leverage points included the relationships and feedback loops among priority variables: political leadership, visible policy support and governance, connectivity for knowledge translation, collaborative multisector grants, multisector collaboration, and integrating co-benefits. Leveraging and altering “vicious” cyclical patterns to increase coordinated multisector PPAP are key. Conclusions: The Attributes Framework, group model building and causal loop diagrams, and emergent feedback loops were useful to explore potential leverage points to address the challenge of multisectoral coordination of PPAP. Future research could apply the same methods in other jurisdictions and compare and contrast resultant frameworks, variables, feedback loops, and leverage points.

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Investigating the Effect of a Multicomponent Exercise Program on Adropin, Endothelial Function, Insulin Resistance, and Sleep Quality in Overweight Older Adults (a Link With Physiological Indexes and Sleep Quality): Results of a Randomized Controlled Study

Elham Ghasemi and Kazem Cheraghbirjandi

The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p = .01), nitric oxide (p = .01), and maximal oxygen uptake (VO2max; p = .002) increased, and glucose (p = .001), insulin (p = .001), insulin resistance (p = .01), systolic blood pressure (p = .01), and sleep disorders (p = .01) decreased significantly. Also, Pearson’s test results showed a significant inverse relationship between adropin level (p = .01 and r = −.55) and glucose (p = .01 and r = −.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults.

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Self-Care and Emotional Competence in Supervision: Helping Clinical Sport Psychology Trainees Foster Professional Well-Being

Erin N.J. Haugen and Kristin Hoff

Within clinical sport psychology (CSP), there is increased attention on factors designed to enhance professional well-being, such as self-care, for practitioners. Emotional competence is a relatively new supervision topic despite it being an ethical imperative within clinical/counseling and sport psychology. CSP trainees deal with stressors that could threaten professional well-being and are complicated by ethical challenges within the sport ecosystem. The purpose of this article is to describe self-care and emotional competence as they relate to the professional well-being of CSP trainees. We offer practical applications for supervisors to consider adopting in their work with trainees. Overall, it is of vital importance that those in CSP attend to their well-being, and we call upon the CSP field to be more intentional about integrating well-being factors into the supervision relationship.

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Criterion Validity of Commonly Used Sedentary Behavior Questionnaires to Measure Total Sedentary Time in Adults

Madeline E. Shivgulam, Derek S. Kimmerly, and Myles W. O’Brien

Background: Self-report questionnaires are a fast and cost-efficient method to determine habitual sedentary time (sitting/lying time while awake), but their accuracy versus thigh-worn accelerometry (criterion), which can distinguish between sitting and standing postures, is unclear. While the validity of sedentary questionnaires has previously been evaluated, they have not been investigated simultaneously in the same sample population. We tested the hypothesis that common sedentary questionnaires underpredict habitual sedentary time compared with an objective, monitor-based assessment. Methods: Ninety-three participants (30 ± 18 years, 59 females) wore the activPAL inclinometer on the midthigh 24 hr per day for 6.9 ± 0.4 days and completed the SIT-Q, Sedentary Behavior Questionnaire (SBQ), International Physical Activity Questionnaire (IPAQ), and Physical Activity and Sedentary Behavior Questionnaire (PASB-Q). Results: In comparison to the activPAL (9.9 ± 1.9 hr/day), the SIT-Q measured more time (12.9 ± 5.4 hr/day), but the SBQ (7.5 ± 3.3 hr/day), IPAQ (7.4 ± 3.0 hr/day), and PASB-Q (6.6 ± 3.0 hr/day) measured less time (all p < .001). The SIT-Q was positively and weakly correlated (ρ = .230 [95% confidence interval: .020, .422], p = .028) with the activPAL, but the SBQ, IPAQ, and PASB-Q were not (all ps > .760). Equivalence testing demonstrated poor equivalence for the SIT-Q (±40%), SBQ (±31%), IPAQ (±36%), and PASB-Q (±29%). The SIT-Q (β = −1.36), SBQ (β = −0.97), and IPAQ (β = −0.78) exhibited a negative proportional bias (all ps < .002). Conclusions: In summary, the SIT-Q, SBQ, IPAQ, and PASB-Q demonstrated poor validity. Researchers and health promoters should be cautious when implementing these self-report sedentary time questionnaires, as they may not reflect the true sedentary activity and negatively impact study results.

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Effects of Detraining on Physical Capacity and Its Relationship With Depressive Symptoms, Quality of Life and Sedentary Behavior in Community-Dwelling Older Adults: A Longitudinal Study

Gabriela Cassemiliano, Ana C.S. Farche, Stefany Lee, Paulo G. Rossi, Laura B. Message, Tainara R. dos Santos, Vinícius R.S. Santos, and Anielle C.M. Takahashi

Background: Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL). Objective: To evaluate the effects of detraining, in the pandemic, on physical capacity and its relationship with DS, QoL, and SB of community-dwelling older adults. Methods: The physical capacity (static balance, dynamic balance, and lower limb and handgrip strength) of 35 participants was assessed prepandemic and after 18 and 24 months of the pandemic. DS, QoL, and SB were evaluated only at 18-month period. The analysis of variance for repeated measures or the Friedman and Pearson or Spearman tests were used for statistical analysis. Results: There was a decline in dynamic balance (p < .001) and strength in the lower limbs (p < .001) in the first 18 months, as well as maintenance in the following 6 months. The reduction in dynamic balance during the 18 months of the pandemic was associated with greater DS (p = .015; r = .414) and worse QoL (p = .024; r = −.381) in this period. More time spent on SB (p = .024; r = .386) in the 18th month was associated with worse dynamic balance in the following 6 months. Conclusion: Detraining in the pandemic setting led to long-lasting harmful effects, which can last for 2 years, on the physical capacity of community-dwelling older adults. Implication: Our findings highlight how periods of detraining can interfere in physical and mental health of older adults.