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A Qualitative Exploration of Perceptions of a Digital Intervention to Promote Physical Activity in Older Adults

Sebastien Pollet, James Denison-Day, Katherine Bradbury, Rosie Essery, Elisabeth Grey, Max Western, Fiona Mowbray, Kirsten A. Smith, Joanna Slodkowska-Barabasz, Nanette Mutrie, Paul Little, and Lucy Yardley

Purpose: This study explored participant views of a web-based physical activity intervention for older adults and examined how they resonate with the key principles that guided intervention development. Methods: Qualitative interviews were carried out with 52 older adults. A deductive qualitative analysis approach was taken, based around the intervention’s key principles. Results: Participants expressed mostly positive views of the intervention features, broadly confirming the appropriateness of the key principles, which were to: (a) encourage intrinsic motivation for physical activity, (b) minimize the risk of users receiving activity suggestions that are inappropriate or unsafe, (c) offer users choice regarding the activities they engage with and build confidence to undertake more activity, and (d) minimize the cognitive load and need to engage with the intervention website. The findings also identified ways in which content could be improved to further increase acceptability. Conclusion: This study illustrates how using the person-based approach has enabled the identification and implementation of features that older adults appreciate.

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“Someone’s Got My Back”: Older People’s Experience of the Coaching for Healthy Ageing Program for Promoting Physical Activity and Preventing Falls

Abby Haynes, Catherine Sherrington, Geraldine Wallbank, David Lester, Allison Tong, Dafna Merom, Chris Rissel, and Anne Tiedemann

The Coaching for Healthy Ageing trial evaluated the impact on physical activity (PA) and falls based on a year-long intervention in which participants aged 60+ receive a home visit, regular health coaching by physiotherapists, and a free activity monitor. This interview study describes the participants’ experiences of the intervention and ideas for improvement. The authors sampled purposively for maximum variation in experiences. The data were analyzed thematically by two researchers. Most of the 32 participants reported that the intervention increased PA levels, embedded activities, and generated positivity about PA. They were motivated by quantified PA feedback, self-directed goals, and person-centered coaching. Social connectivity motivated some, but the intervention did not support this well. The intervention structure allowed participants to trial and embed activities. Autonomy and relatedness were emphasized and should be included in future program theory. The authors identified synergistic effects, likely “essential ingredients,” and potential areas for improving this and similar interventions.

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Tai Chi for the Prevention of Falls Among Older Adults: A Critical Analysis of the Evidence

Samuel R. Nyman

Despite interest as to the benefits of Tai Chi, there remains a controversy over its effectiveness as an exercise intervention for preventing falls among older adults. This review synthesizes the evidence base with a focus on meta-analyses and randomized controlled trials with community-dwelling older adults. It provides a critical lens on the evidence and quality of the trials. High-quality evidence suggests that Tai Chi is an effective intervention for preventing falls in community settings; however, there is unclear evidence for long-term care facilities and an absence of evidence for hospital settings. When compared directly with other exercise interventions, Tai Chi may offer a superior strategy for reducing falls through its benefits on cognitive functioning. Using data from the current Cochrane review, a new synthesis is presented suggesting that 71–81% of community-dwelling older adults are adherent to class-based Tai Chi interventions. The practical opportunities and challenges for practitioners are discussed.

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Effects of Enriched Physical Activity Environments on Balance and Fall Prevention in Older Adults: A Scoping Review

Mohsen Shafizadeh, Jane Manson, Sally Fowler-Davis, Khalid Ali, Anna C. Lowe, Judy Stevenson, Shahab Parvinpour, and Keith Davids

The incidence of falling, due to aging, is related to both personal and environmental factors. There is a clear need to understand the nature of the major risk factors and design features of a safe and navigable living environment for potential fallers. The aim of this scoping review was to identify studies that have examined the effectiveness of environments, which promote physical activity and have an impact on falls prevention. Selected studies were identified and categorized into four main topics: built environment, environment modifications, enriched environments, and task constraints. The results of this analysis showed that there are a limited number of studies aiming to enhance dynamic postural stability and fall prevention through designing more functional environments. This scoping review study suggests that the design of interventions and the evaluation of an environment to support fall prevention are topics for future research.

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Bicycling Exercise Helps Maintain a Youthful Metabolic Cost of Walking in Older Adults

Daniel H. Aslan, Joshua M. Collette, and Justus D. Ortega

The decline of walking performance is a key determinant of morbidity among older adults. Healthy older adults have been shown to have a 15–20% lower walking economy compared with young adults. However, older adults who run for exercise have a higher walking economy compared with older adults who walk for exercise. Yet, it remains unclear if other aerobic exercises yield similar improvements on walking economy. The purpose of this study was to determine if regular bicycling exercise affects walking economy in older adults. We measured metabolic rate while 33 older adult “bicyclists” or “walkers” and 16 young adults walked on a level treadmill at four speeds between (0.75–1.75 m/s). Across the range of speeds, older bicyclists had a 9–17% greater walking economy compared with older walkers (p = .009). In conclusion, bicycling exercise mitigates the age-related deterioration of walking economy, whereas walking for exercise has a minimal effect on improving walking economy.

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Changes in Strength, Mobility, and Body Composition Following Self-Selected Exercise in Older Adults

Ashley A. Herda, Brianna D. McKay, Trent J. Herda, Pablo B. Costa, Jeffrey R. Stout, and Joel T. Cramer

The purpose of this trial was to examine the effects of self-selected exercise intensities plus either whey protein or placebo supplementation on vital signs, body composition, bone mineral density, muscle strength, and mobility in older adults. A total of 101 participants aged 55 years and older (males [n = 34] and females [n = 67]) were evaluated before and after 12 weeks of self-selected, free-weight resistance exercise plus 30 min of self-paced walking three times per week. The participants were randomized into two groups: whey protein (n = 46) or placebo (n = 55). Three-way mixed factorial analyses of variance were used to test for mean differences for each variable. The 12 weeks of self-selected, self-paced exercise intensities improved resting heart rate, fat-free mass, percent body fat, handgrip strength, bench press strength, leg press strength, and all mobility measurements (p < .05) in males and females despite supplementation status. This suggests that additional protein in well-fed healthy older adults does not enhance the benefit of exercise.

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REducing SEDENTary Behavior Among Mild to Moderate Cognitively Impaired Assisted Living Residents: A Pilot Randomized Controlled Trial (RESEDENT Study)

K. Dillon and Harry Prapavessis

Older adults in assisted living spend most of their day in sedentary behaviors, which may be detrimental to cognitive function. The primary purpose of this pilot study was to assess the feasibility of using a prompting device to reduce sitting time with light walking among older adults with mild to moderate cognitive impairment residing in an assisted living setting. A secondary purpose was to examine the effectiveness of the intervention on the residents’ cognitive function, physical function, and quality of life. The participants (n = 25, mean age = 86.7 [5.3] years) were assigned in clusters into a two-arm 10-week single-site pilot randomized controlled trial. The intervention group was prompted with a watch to interrupt sedentary behaviors and partake in 10 min of light physical activity (i.e., walking) three times a day after a meal. The assessments included hip-worn accelerometers (Actical) and diaries, the Alzheimer’s disease assessment scale—cognitive, Timed Up and Go, and the short-form 36 health survey. Adherence was high, as there were no dropouts, and over 70% of the participants completed over 80% of the prescribed physical activity bouts. Significant effects favoring the intervention were shown for all outcomes.

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A Qualitative Exploration of Immigrant Muslim Older Adults’ Experiences and Perceptions of Physical Activity

Jordana Salma, Allyson Jones, Savera Aziz Ali, Bukola Salami, and Shelby Yamamoto

Physical activity is essential for healthy aging; however, there has been little exploration of physical activity in Muslim older immigrants in Canada. Over one million Canadians identify as Muslim, the majority is first-generation immigrants, with increasing cohorts entering older age. A community-based participatory research project on healthy aging was conducted with 68 older adults and community members from South Asian, Arab, and African Muslim ethnocultural communities in a Canadian urban center. A combination of individual interviews and focus groups discussions were completed, followed by thematic analysis of data. Participating community groups emphasized the importance of physical activity in older age and prioritized the need for physical activity programs. The four themes highlight Muslim older immigrants’ perspectives on physical activity in Canada: (a) values and approaches to staying active; (b) health factors: pain and health limitations; (c) social factors: culture, religion, and belonging; and (d) environmental factors: safety and accessibility.

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Effectiveness of Tai Chi on Balance Improvement in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis

Stefano Palermi, Anna M. Sacco, Immacolata Belviso, Nastasia Marino, Francesco Gambardella, Carlo Loiacono, and Felice Sirico

Balance impairments are a relevant problem in patients with diabetes, and interventions to manage this issue represent a public health need. This study reviewed the literature about the effectiveness of Tai Chi on balance improvement in patients with type 2 diabetes. Springerlink, MEDLINE, PubMed, CINAHL, Web of Science, Scopus, and Cochrane CENTRAL databases were screened. Randomized and nonrandomized controlled trials assessing balance in patients with type 2 diabetes enrolled in a Tai Chi program were considered eligible. Four studies were included in qualitative synthesis and in quantitative analysis (three randomized controlled trials and one pretest–posttest quasi-experimental study). Evidence supporting Tai Chi to improve balance in patients with type 2 diabetes was found (effect size: 0.52; 95% confidence interval [0.20, 0.84]); however, the analysis relied on a small number of studies, which raises concerns about the risk of bias. In conclusion, the results support the benefits of Tai Chi intervention to improve balance in patients with type 2 diabetes.

Open access

Exploring Active Travel and Leisure-Time Physical Activity Relationships With Cognition Among Older Adults

Madhura Phansikar and Sean P. Mullen

Leisure-time physical activity (LTPA) is known to benefit cognition among older adults, but the impact of active travel is unclear. To explore this relationship, data from the 2011–2014 National Health and Nutritional Examination Survey (N = 2,702; mean age = 70) were retrieved on the self-reported frequency and duration of active travel (walking/cycling for transport, >20 min), LTPA engagement (e.g., sport), and three cognitive outcomes. Four groups were created according to physical activity guidelines (600 metabolic equivalent of task/week): inactive (n = 1,790), active travelers (n = 210), engaging in LTPA (n = 579), and engaging in both (n = 123). Analysis of covariance (and follow-up comparisons) revealed a significant main effect for each cognition variable, after adjusting for the covariates, indicating that those engaging in LTPA performed the best. Although correlational, these findings suggest that LTPA engagement may be important for cognition among older adults, but active travel did not provide added benefit.