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Falls Prevention: Adherence, Fear of Falling, Assessment, and Intervention

Ellen Freiberger

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Implementation of an Evidence-Based, Tai Ji Quan Fall Prevention Program in Rural West Virginia Churches: A RE-AIM Evaluation

Dina L. Jones, Terry Kit Selfe, Sijin Wen, Jennifer L. Eicher, Sara Wilcox, and Corrie Mancinelli

This study implemented a 16-week Tai Ji Quan: Moving for Better Balance® intervention for older adults in churches in hard-to-reach, medically underserved, rural communities, and evaluated the process using the RE-AIM Framework. Community-dwelling adults, aged 55 years, or older, were eligible. Data (N = 237) were collected at baseline, 16 weeks, and 32 weeks on falls efficacy, depression, physical/mental health-related quality of life, aerobic activity, gait speed, mobility, balance, and leg strength. Generalized/linear mixed models determined if outcomes improved. Eighteen churches sponsored 16 classes. Church adoption was 94%, instructor adoption was 86%, reach was 90%, and fidelity was good/fair. All outcomes improved except physical health-related quality of life and gait speed. Thirty-six percent of participants, 28% of churches, and 37% of instructors continued Tai Ji Quan: Moving for Better Balance at 32 weeks. Compared with two prior RE-AIM evaluations, adoption and reach rates, improvements in outcomes, and satisfaction were comparable; attendance, program completion, and continuation rates were lower.

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The Diversity of Qualitative Research Approaches and Foci on Aging and Physical Activity—Celebrating 20 Years!

Rylee A. Dionigi, Maria Horne, Anne-Marie Hill, and Mary Ann Kluge

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Erratum. Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review

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Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review

Andrew Powell

Increasing the physical activity (PA) levels of inactive older adults to promote healthy aging and to reduce preventable health conditions is a public health priority. However, there remains uncertainty on what constitutes the most important components and characteristics of effective PA interventions for older adults, and previous research has largely focused on the cognitive and behavioral strategies they adopt to increase uptake and adherence to PA. This narrative review puts forward the novel idea, with supporting evidence, that the strength, quality, and collaborative nature of the professional–client relationship, a concept drawn from the field of psychotherapy and known as therapeutic alliance, may be a vital and foundational element of effective PA interventions. This article will offer a new understanding, and a new direction of research to aid the future conceptualization, design, and development of interventions that aim to increase the PA levels of older adults.

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Trade-Off Between Maximal Power Output and Fatigue Resistance of the Knee Extensors for Older Men

Ryota Akagi, Yuta Nomura, Chiho Kawashima, Mari Ito, Kosuke Oba, Yuma Tsuchiya, Geoffrey A. Power, and Kosuke Hirata

This study investigated associations of fatigue resistance determined by an exercise-induced decrease in neuromuscular power with prefatigue neuromuscular strength and power of the knee extensors in 31 older men (65–88 years). A fatigue task consisted of 50 consecutive maximal effort isotonic knee extensions (resistance: 20% of prefatigue isometric maximal voluntary contraction torque) over a 70° range of motion. The average of the peak power values calculated from the 46th to 50th contractions during the fatigue task was normalized to the prefatigue peak power value, which was defined as neuromuscular fatigue resistance. Neuromuscular fatigue resistance was negatively associated with prefatigue maximal power output (r = −.530) but not with prefatigue maximal voluntary contraction torque (r = −.252). This result highlights a trade-off between prefatigue maximal power output and neuromuscular fatigue resistance, implying that an improvement in maximal power output might have a negative impact on neuromuscular fatigue resistance.

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Outdoor Community Ambulation Interventions to Improve Physical and Mental Health in Older Adults: A Systematic Review and Meta-Analysis

Dominika Bhatia, Nancy M. Salbach, Olayinka Akinrolie, Kyla Alsbury-Nealy, Renato Barbosa dos Santos, Parvin Eftekhar, Hal Loewen, Erica Nekolaichuk, Chelsea Scheller, Rebecca Schorr, Stephanie Scodras, and Ruth Barclay

Limited community ambulation, defined as independent mobility outside the home, predicts adverse outcomes in older adults. We performed a systematic review and meta-analysis to examine outdoor community ambulation intervention effectiveness in older adults. We searched six databases until October 2021. Studies with an evaluative research objective, older adult population, and outdoor community ambulation interventions were eligible. After reviewing 23,172 records, five studies were included. The meta-analysis found no significant difference in walking endurance and depression outcomes between outdoor community ambulation and comparison interventions. For outcomes not suitable for meta-analysis, studies showed no significant difference in walking activity, anxiety, and general and health-related quality of life, and possible improvements in gait speed and lower extremity function and strength. Most evidence was of low to very low certainty. Considering the limited evidence base, the design, implementation, and evaluation of outdoor community ambulation interventions in older adults should be prioritized in primary research.

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Necessity of Considering Sex of Participants in Research: Observations Drawn From Resistance Training Studies of Older Adults

Dana M. Ghareeb, Owen D. Harris, and Jennifer M. Jakobi

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Journal of Aging and Physical Activity Celebrates Its 30th Year With a Virtual Special Issue: Reflections on the First 30 Years From the Editors

Wojtek Chodzko-Zajko, Debra J. Rose, Diane E. Whaley, Philip D. Chilibeck, and Samuel R. Nyman

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How Much Time in Sedentary Behavior Should Be Reduced to Decrease Fear of Falling and Falls in Community-Dwelling Older Adults?

Jaquelini Betta Canever, Ana Lúcia Danielewicz, Amanda Aparecida Oliveira Leopoldino, Maruí Weber Corseuil, and Núbia Carelli Pereira de Avelar

Fear of falling and history of falls are frequent situations in older adults, which can be aggravated by sedentary behavior (SB). The objective was to establish SB cutoff values which discriminate falls and fear of falling in older adults and verify the association between these conditions. This was a cross-sectional study including 308 community-dwelling older adults. The SB was assessed by International Physical Activity Questionnaire. The outcomes were history of falling in the last 12 months and fear of falling (higher or equal than 23 points in Falls Efficacy Scale International—Brazil). The cutoff points found were >4.14 (area under curve = 0.60, 95% confidence intervals [CIs] [0.54, 0.65]) and >3.90 hr per day (area under curve = 0.59, 95% CI [0.53, 0.64]) for fear of falling and history of falls, respectively. Older adults with SB had 1.71 (95% CI [1.03, 2.84]) and 1.75 (95% CI [1.06, 2.89]) greater odds of having greater fear of falling and suffering falls, respectively.