Search Results

You are looking at 1 - 8 of 8 items for

  • Author: K. John Fisher x
Clear All Modify Search
Restricted access

Fuzhong Li and K. John Fisher

Objectives:

This study examined the relationship between physical activity and self-rated health in older adults at both the neighborhood level and the resident level.

Methods:

A multilevel design was used that involved neighborhoods as the primary sampling unit and residents nested within each neighborhood. Residents (N = 582, mean age = 73.99 years, SD = 6.26) from 56 neighborhoods in Portland, Oregon, were surveyed on neighborhood physical activity and health status.

Results:

Multilevel path analysis showed a positive relationship between physical activity and health status at the neighborhood level. In addition, perceptions of neighborhood social cohesion, proximity to physical activity facilities, safety for walking, and importance of physical activity involvement, were positively related to high levels of physical activity. At the resident level, education and walking efficacy were positively associated with physical activity.

Conclusions:

The results provide evidence that neighborhood-level physical activity is positively linked to neighborhood-level self-rated health in older adults.

Restricted access

Fuzhong Li, K. John Fisher, Peter Harmer and Machiko Shirai

Low-impact exercise that appeals to elderly adults and can be done almost anywhere provides both societal and individual benefits. One such program is Tai Chi, a traditional Chinese dancelike conditioning exercise. The article presents an easily adopted and adapted 8-form Tai Chi program (Easy Tai Chi) designed for older adults or individuals with mobility challenges or physical impairments. Derived from a simplified 24-form Yang-style Tai Chi, it stresses postural control and body-limb rotational movements. Easy Tai Chi can be performed either standing or sitting, depending on the physical and functional limitations of participants. Preliminary data indicate a number of health benefits of Easy Tai Chi compared with a traditional exercise program. Although subject to further empirical evaluation, Easy Tai Chi can be applied in research settings to investigate prevention or amelioration of hypokinetic diseases and in clinical settings to treat physically frail seniors or others with functional impairments of the musculoskeletal or cardiovascular system.

Restricted access

Fuzhong Li, Peter Harmer, Nicole L. Wilson and K. John Fisher

This study examined the effect of cobblestone-mat walking on health-related outcomes in older adults. Participants (mean age 72.6, N=40) were randomized into either an 8-week cobblestone-mat walking activity (n = 22) or a control group (n = 18). Cobblestone-mat walking entailed three 45-min sessions per week. Primary outcomes included SF-12 (mental, physical), instrumental activities of daily living (IADLs), psychophysical well-being, daytime sleepiness, and pain. Secondary outcomes included resting blood pressure and perceived control of falls. The walkers experienced significantly improved SF-12 scores, IADLs, and psychophysical well-being and significantly reduced daytime sleepiness and pain. They also reported significantly improved perceptions of control over falls. A significant between-groups difference in resting diastolic blood pressure was observed, with reductions in the walkers. A significant within-group reduction in systolic blood pressure was observed in the walkers only. The data indicate that cobblestone-mat walking can significantly improve health-related outcomes in older adults.

Restricted access

K. John Fisher, Fuzhong Li, Yvonne Michael and Minot Cleveland

There is a need for greater understanding of setting-specific influences on physical activity to complement the predominant research paradigm of individual-centered influences on physical activity. In this study, the authors used a cross-sectional multilevel analysis to examine a range of neighborhood-level characteristics and the extent to which they were associated with variation in self-reported physical activity among older adults. The sample consisted of 582 community-dwelling residents age 65 years and older (M = 73.99 years, SD = 6.25) recruited from 56 neighborhoods in Portland, OR. Information collected from participants and neighborhood data from objective sources formed a two-level data structure. These hierarchical data (i.e., individuals nested within neighborhoods) were subjected to multilevel structural-equation-modeling analyses. Results showed that neighborhood social cohesion, in conjunction with other neighborhood-level factors, was significantly associated with increased levels of neighborhood physical activity. Overall, neighborhood-level variables jointly accounted for a substantial variation in neighborhood physical activity when controlling for individual-level variables.

Restricted access

Fuzhong Li, K. John Fisher and Ross C. Brownson

The article reports on a multilevel analysis conducted to examine change in neighborhood walking activity over a 12-month period in a community-based sample of 28 neighborhoods of 303 older adults age 65 and over. The study employed a multilevel (residents nested within neighborhoods) and longitudinal (4 repeated measures over 1 year) design and a multilevel analysis of change and predictors of change in neighborhood walking activity. Results indicated a significant neighborhood effect, with neighborhood-level walking characterized by a downward trajectory over time. Inclusion of baseline variables using selected perceived neighborhood-level social- and physical-environment measures indicated that neighborhoods with safe walking environments and access to physical activity facilities had lower rates of decline in walking activity. The findings provide preliminary evidence of neighborhood-level change and predictors of change in walking activity in older adults. They also suggest the importance of analyzing change in physical activity in older adults from a multilevel or macrolevel framework.

Restricted access

Fuzhong Li, Peter Harmer, K. John Fisher, Junheng Xu, Kathleen Fitzgerald and Naruepon Vongjaturapat

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson’s disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.

Restricted access

Fuzhong Li, K. John Fisher, Adrian Bauman, Marcia G. Ory, Wojtek Chodzko-Zajko, Peter Harmer, Mark Bosworth and Minot Cleveland

Over the past few years, attention has been drawn to the importance of neighborhood influences on physical activity behavior and the need to consider a multilevel analysis involving not only individual-level variables but also social-and physical-environment variables at the neighborhood level in explaining individual differences in physical activity outcomes. This new paradigm raises a series of issues concerning systems of influence observed at different hierarchical levels (e.g., individuals, neighborhoods) and variables that can be defined at each level. This article reviews research literature and discusses substantive, operational, and statistical issues in studies involving multilevel influences on middle-aged and older adults’ physical activity. To encourage multilevel research, the authors propose a model that focuses attention on multiple levels of influence and the interaction among variables characterizing individuals, among variables characterizing neighborhoods, and across both levels. They conclude that a multilevel perspective is needed to increase understanding of the multiple influences on physical activity.

Restricted access

Fuzhong Li, Peter Harmer, Karin A. Mack, David Sleet, K. John Fisher, Melvin A. Kohn, Lisa M. Millet, Junheng Xu, Tingzhong Yang, Beth Sutton and Yvaughn Tompkins

Background:

This study was designed to develop an evidence- and community-based falls prevention program—Tai Chi: Moving for Better Balance.

Methods:

A mixed qualitative and quantitative approach was used to develop a package of materials for program implementation and evaluation. The developmental work was conducted in 2 communities in the Pacific Northwest. Participants included a panel of experts, senior service program managers or activity coordinators, and older adults. Outcome measures involved program feasibility and satisfaction.

Results:

Through an iterative process, a program package was developed. The package contained an implementation plan and class training materials (ie, instructor’s manual, videotape, and user’s guidebook). Pilot testing of program materials showed that the content was appropriate for the targeted users (community-living older adults) and providers (local senior service organizations). A feasibility survey indicated interest and support from users and providers for program implementation. A 2-week pilot evaluation showed that the program implementation was feasible and evidenced good class attendance, high participant satisfaction, and interest in continuing Tai Chi.

Conclusions:

The package of materials developed in this study provides a solid foundation for larger scale implementation and evaluation of the program in community settings.