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Diane E. Adamo, Neil B. Alexander and Susan H. Brown

Our understanding of age-related declines in upper limb proprioceptive abilities is limited. Furthermore, the extent to which physical activity might ameliorate age-related changes in proprioception is not known. Upper limb proprioceptive acuity was examined in young and older (active and sedentary) right-handed adults using a wrist-position-matching task that varied in terms of processing demands. Older individuals were also classified according to their participation in tasks specific to the upper limb. Errors were greater for older than younger individuals. Older sedentary adults showed greater errors and performed movements less smoothly than older active adults. The nonspecific group showed greater errors and longer movement times than the upper-limb-specific group. In older adults, decreased ability to perceive limb position may be related to a sedentary lifestyle and declines associated with memory and transfer of proprioceptive information. Performing tasks specific to the upper limbs may reduce age-related declines in proprioception.

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Kimberlee A. Gretebeck, Caroline S. Blaum, Tisha Moore, Roger Brown, Andrzej Galecki, Debra Strasburg, Shu Chen and Neil B. Alexander

Background: Diabetes-related disability occurs in approximately two-thirds of older adults with diabetes and is associated with loss of independence, increased health care resource utilization, and sedentary lifestyle. The objective of this randomized controlled trial was to determine the effect of a center-based functional circuit exercise training intervention followed by a 10-week customized home-based program in improving mobility function in sedentary older adults with diabetes. Methods: Participants (n = 111; mean age 70.5 [7.1] y; mean body mass index 32.7 [5.9] kg/m2) were randomized to either a moderate-intensity functional circuit training (FCT) plus 10-week home program to optimize physical activity (FCT-PA) primary intervention or one of 2 comparison groups (FCT plus health education [FCT-HE] or flexibility and toning plus health education [FT-HE]). Results: Compared with FT-HE, FCT-PA improvements in comfortable gait speed of 0.1 m/s (P < .05) and 6-minute walk of 80 ft were consistent with estimates of clinically meaningful change. At 20 weeks, controlling for 10-week outcomes, improvements were found between groups for comfortable gait speed (FCT-PA vs FT-HE and FCT-HE vs FT-HE) and 6-minute walk (FCT-PA vs FCT-HE). Conclusions: Functional exercise training can improve mobility in overweight/obese older adults with diabetes and related comorbidities. Future studies should evaluate intervention sustainability and adaptations for those with more severe mobility impairments.

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Taís L. Almeida, Neil B. Alexander, Linda V. Nyquist, Marcos L. Montagnini, Angela C.S. Santos, Giselle H.P. Rodrigues, Carlos E. Negrão, Ivani C. Trombetta and Mauricio Wajngarten

Few studies have evaluated the benefit of providing exercise to underprivileged older adults at risk for falls. Economically and educationally disadvantaged older adults with previous falls (mean age 79.06, SD = 4.55) were randomized to 4 mo of multimodal exercise provided as fully supervised center-based (FS, n = 45), minimally supervised home-based (MS, n = 42), or to nonexercise controls (C, n = 32). Comparing groups on the mean change in fall-relevant mobility task performance between baseline and 4 mo and compared with the change in C, both FS and MS had significantly greater reduction in timed up-and-go, F(2,73) = 5.82, p = .004, η2 p = .14, and increase in tandem-walk speed, F(2,73) = 7.71, p < .001 η2 p = .17. Change in performance did not statistically differ between FS and MS. In community-dwelling economically and educationally disadvantaged older adults with a history of falls, minimally supervised home-based and fully supervised center-based exercise programs may be equally effective in improving fall-relevant functional mobility.