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Allison Naber, Whitney Lucas Molitor, Andy Farriell, Kara Honius and Brooke Poppe

This study aimed to determine the feasibility of an occupational therapy intervention to address sedentary behavior and pain among older adults residing in assisted living facilities. A single group pretest and posttest design was implemented using the Sedentary Behavior Questionnaire, actigraphy technology, and daily activity logs to measure sedentary behavior. The Short-Form McGill Pain Questionnaire was used to assess pain. Occupational therapy intervention focused on individualized goals related to participation in meaningful physical activities, which were established in collaboration with the participant and were tracked for 3 weeks. A total of 12 participants were recruited for this study. The mean number of steps and daily calories burned over the course of a week increased by 3,058.3 steps (30.82%) and 57.64 calories (19.96%), respectively. Individualized goal setting may have a positive impact on the reduction of pain and increasing activity levels among older adults residing in assisted living facilities.

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Melissa E. Hay and Denise M. Connelly

Physical inactivity and chronic back pain are prevalent among older adults; however, there are individuals who persist in exercising despite daily pain. This research explored the meaning of exercise in the lives of older adults with chronic back pain. Hermeneutic phenomenology, valuing everyday experiences and highlighting meaning, was employed. Individual in-depth interviews with 10 adults aged 65 years and older gathered rich descriptions of their experiences. Data collection and analyses were iterative processes. The experience of exercise was inextricably connected with older adults’ chronic back pain. The essence of embodied relief from pain offered by exercise was considered through themes reflecting the restoration of existential coherence—enjoying exercise experiences, social engagement, gratitude, learned latitudes, maintaining mobility, and aging. Understanding that older adults can live in their bodies pain-free for some time with regular physical activity may endorse adherence to exercise participation for maintained or improved well-being.

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Sharon Hetherington, Paul Swinton, Tim Henwood, Justin Keogh, Paul Gardiner, Anthony Tuckett, Kevin Rouse and Tracy Comans

In this article, the authors assessed the cost-effectiveness of center-based exercise training for older Australians. The participants were recipients of in-home care services, and they completed 24 weeks of progressive resistance plus balance training. Transport was offered to all participants. A stepped-wedge randomized control trial produced pre-, post-, and follow-up outcomes and cost data, which were used to calculate incremental cost-effectiveness ratios per quality-adjusted life year gained. Analyses were conducted from a health provider perspective and from a government perspective. From a health-service provider perspective, the direct cost of program provision was $303 per person, with transport adding an additional $1,920 per person. The incremental cost–utility ratio of the program relative to usual care was $70,540 per quality-adjusted life year over 6 months, decreasing to $37,816 per quality-adjusted life year over 12 months. The findings suggest that Muscling Up Against Disability offers good value for the money within commonly accepted threshold values.

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Ece Acar, Tamer Çankaya and Serkan Öner

Trunk muscles are required for safety of movement in aging. The authors aimed to investigate the relationship between trunk muscle thickness and the static postural balance in older adults. A total of 31 females and 23 males with a mean age of 73.39 ± 6.09 completed the study. The thickness of the trunk muscles was determined with ultrasound imaging. Postural balance was assessed with force plate. There was a positive weak correlation between right and left upper rectus abdominis muscle thickness and anterior stability area (p < .05, r > .3). The negative and moderate correlation was determined between the left lower rectus abdominis and the perturbated stability sway value (p < .01, r > .5). The increase in trunk muscle thickness in older adults increases the postural stability area and decreases the postural sway especially in the mediolateral direction.

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Chevelle M.A. Davis, Tetine L. Sentell, Juliana Fernandes de Souza Barbosa, Alban Ylli, Carmen-Lucia Curcio and Catherine M. Pirkle

Physical activity (PA) among older adults is understudied in middle-income countries. The authors examined the associations of factors across levels of the social ecological model (individual, interpersonal, organizational, and community) with older adults meeting guidelines of 150 min of moderate- to vigorous-intensity PA per week through walking in three middle-income countries: Albania (n = 387), Colombia (n = 404), and Brazil (n = 402). Using 2012 International Mobility in Aging Study data, multivariate logistic regression models identified the following significant associations with meeting PA guidelines through walking (a) individual level: depression (odds ratio [OR] = 0.62, 95% confidence interval, CI [0.45, 0.86]), being female (OR = 0.74, 95% CI [0.56, 0.998]), and high relative education (OR = 1.79, 95% CI [1.33, 2.41]) and (b) interpersonal level: high life partner (OR = 1.38, 95% CI [1.04, 1.83]) and friend social ties (OR = 1.39, 95% CI [1.05, 1.83]). While individual and interpersonal variables were associated with meeting PA guidelines, community-level social and environmental variables were not.

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Johanna Popp, Nanna Notthoff and Lisa Marie Warner

Older adults process and remember positive information relatively better than negative information, compared with younger adults; this is known as the positivity effect. This study examined whether older adults compared with younger adults also respond differently to positively and negatively framed questionnaire items. Participants (N = 275; age = 18–81 years) were randomly assigned to a positively or negatively framed version of a self-efficacy for physical activity questionnaire. Self-efficacy, physical activity intentions, and planned physical activity in the following week were regressed on experimental group and age, controlling for baseline physical activity and covariates. A significant Age × Frame interaction showed that item framing made a difference in planned physical activity for the oldest age group (+350 min compared with the youngest group). This study provides initial support for the positivity effect in item framing on physical activity plans, but not on intentions or self-efficacy. Item framing should be taken into consideration for accurate measurement, but could also be a simple intervention approach.

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Quinn Malone, Steven Passmore and Michele Maiers

Different techniques used to analyze and reduce accelerometer data may impact its interpretation. To determine which variables were impacted by changing analysis parameters, the authors performed a secondary analysis of data gained from a clinical trial conducted on older adults (aged ≥65 years; M = 71.1 and SD = 5.3; n = 100) with neck and back disabilities and compared the effects of two different cut- point sets (Matthews and Freedson sets) commonly used to analyze older adult accelerometry data. The Matthews set was found to assign significantly greater moderate-to-vigorous physical activity per day than the Freedson set in all comparisons. This suggests that, if moderate-to-vigorous physical activity per unit time is a primary outcome measure, the choice of which analysis method is used should be carefully considered. Further results from analyses of dependent variables, time in moderate-to-vigorous physical activity bouts of >10 min/day, mean bout length, and number of bouts per day are discussed.

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Andreas Heissel, Anou Pietrek, Michael A. Rapp, Stephan Heinzel and Geoffrey Williams

The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach’s alpha was found to be high (α = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant’s perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.

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Shirley M. Bluethmann, Wayne Foo, Renate M. Winkels, Scherezade K. Mama and Kathryn H. Schmitz

Purpose: (a) To describe the relationship of multimorbidity and physical activity (PA) in cancer survivors and (b) to explore perceived disability and PA in middle-aged and older survivors. Methods: The authors analyzed the data from cancer survivors (N = 566), identified using the Pennsylvania Cancer Registry, who responded to a Behavioral Risk Factor Surveillance System-derived questionnaire. They created age groups (e.g., 45–54 years, 55–64 years, 65–74 years, and 75 years and older) and calculated a composite score of eight common comorbidities (e.g., chronic obstructive pulmonary disease, heart disease) to assess multimorbidity. Logistic regression was used to estimate the association of demographic and behavioral/clinical risk factors (e.g., multimorbidity, perceived disability, body mass index) with PA. Results: Most respondents were females (62%), older (mean age = 68 years) and represented diverse cancer sites, including breast (n = 132), colorectal (n = 102), gynecologic (n = 106), prostate (n = 111), and lung (n = 80). PA participation was mixed; 44% of survivors reported achieving >150 min of aerobic PA, but half of lung and 37% of gynecologic survivors reported no PA (0 min/week). Higher multimorbidity (odds ratio = 0.82, confidence  interval [0.69, 0.98], p < .05), obesity (odds ratio = 0.51, confidence  interval [0.30, 0.86], p < .05), and perceived disability (odds ratio = 0.49, confidence  interval [0.32, 0.77], p < .001) were negatively associated with PA participation. Strength training was suboptimal across all survivors. Conclusion: Most older survivors experienced comorbid conditions, and this was associated with less PA. Survivors who perceived themselves as disabled or who were obese were half as likely as others to participate in PA. This suggests an increasing need to address both physical and psychological limitations in designing PA interventions for real-world needs. Exercise interventions that address the unique needs of older survivors for multimorbidity, obesity, and perceived disability may strengthen opportunities for PA.

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Nicolas Hobson, Sherry L. Dupuis, Lora M. Giangregorio and Laura E. Middleton

Persons with mild cognitive impairment (MCI) and early dementia are often physically inactive, despite associated benefits. This study explored the barriers, facilitators, and preferences for exercise among persons living with MCI/early dementia. The authors conducted 2 focus groups among persons living with MCI/early dementia (n = 4, 6 participants) and 2 focus groups among care partners (n = 3, 4 participants). The transcripts were analyzed using thematic analysis, guided by the social-ecological model. Three themes emerged, reinforcing motivation to exercise, managing changes to cognitive and physical health, and variable perceptions of dementia, each with influences from individual, care partner, and community levels. Low intrinsic motivation, poor physical/cognitive health, and stigma restricted the exercise among persons living with MCI/early dementia. The care partners motivated their partners and provided company and transportation to exercise. People with MCI/early dementia also indicated poor access to exercise providers and exercise opportunities that met their needs and preferences was a barrier to exercise participation. Knowledge translation research should develop exercise interventions at the individual, social, and community levels.