Avatar-based three-dimensional technology is a new approach to improve physical function in older adults. The aim of this study was to use three-dimensional video gaming technology in virtual reality training to improve postural balance and lower extremity strength in a population of community-dwelling older adults. The experimental group participated in the virtual reality training program for 60 min, twice a week, for 6 weeks. Both experimental and control groups were given three times for falls prevention education at the first, third, and fifth weeks. The experimental group showed significant improvements not only in static and dynamic postural balance but also lower extremity strength (p < .05). Furthermore, the experimental group was improved to overall parameters compared with the control group (p < .05). Therefore, three-dimensional video gaming technology might be beneficial for improving postural balance and lower extremity strength in community-dwelling older adults.
Yongwoo Lee, Wonjae Choi, Kyeongjin Lee, Changho Song and Seungwon Lee
Anni Rava, Anu Pihlak, Jaan Ereline, Helena Gapeyeva, Tatjana Kums, Priit Purge, Jaak Jürimäe and Mati Pääsuke
The purpose of this study was to evaluate the differences in body composition, neuromuscular performance, and mobility in healthy, regularly exercising and inactive older women, and examine the relationship between skeletal muscle indices and mobility. Overall, 32 healthy older women participated. They were divided into groups according to their physical activity history as regularly exercising (n = 22) and inactive (n = 10) women. Body composition, hand grip strength, leg extensor muscle strength, rapid force development, power output, and mobility indices were assessed. Regularly exercising women had lower fat mass and higher values for leg extensor muscle strength and muscle quality, and also for mobility. Leg extensor muscle strength and power output during vertical jumping and appendicular lean mass per unit of body mass were associated with mobility in healthy older women. It was concluded that long-term regular exercising may have beneficial effects on body composition and physical function in older women.
Justin W.L. Keogh, Andrew Kilding, Philippa Pidgeon, Linda Ashley and Dawn Gillis
Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B–level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults’ lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.
Kimberly Hannam, Kevin Deere, Sue Worrall, April Hartley and Jon H. Tobias
The purpose of this study was to establish the feasibility of using an aerobics class to produce potentially bone protective vertical impacts of ≥ 4g in older adults and to determine whether impacts can be predicted by physical function. Participants recruited from older adult exercise classes completed an SF-12 questionnaire, short physical performance battery, and an aerobics class with seven different components, performed at low and high intensity. Maximum g and jerk values were identified for each activity. Forty-one participants (mean 69 years) were included. Mean maximal values approached or exceeded the 4g threshold for four of the seven exercises. In multivariate analyses, age (−0.53; −0.77, −0.28) (standardized beta coefficient; 95% CI) and 4-m walk time (−0.39; −0.63, −0.16) were inversely related to maximum g. Aerobics classes can be used to produce relatively high vertical accelerations in older individuals, although the outcome is strongly dependent on age and physical function.
Matthew P. Ford, Laurie A. Malone, Harrison C. Walker, Ildiko Nyikos, Rama Yelisetty and C. Scott Bickel
UPDRS and PDQ-39 are reliable and valid assessments of quality of life and physical function in persons with Parkinson’s disease (PD). However, these measures were not designed to track day-to-day or week-to-week changes in community activity in persons with PD.
Twelve individuals with PD (stage 1 to 3, Hoehn and Yahr) who were active members of a health and wellness facility were recruited for this study. Investigators collected health history information, asked questions about the amount and frequency of weekly exercise, and assessed motor symptoms and ADL skills using the UPDRS, and provided participants with Step Activity Monitor (SAM). SAM data were collected for a continuous 7-day period.
Participants averaged 8996 steps/day, had an average of 322 minutes of step activity per day, but were inactive (minIA) 77% of their time per day. On the days that participants visited the health and wellness facility they took an average of 802 more steps with 12 minutes more activity per day.
A SAM can be used to capture activity levels in persons with PD. These pilot data indicate that persons with mild to moderate PD can achieve step activity levels similar to healthy older adults.
NiCole R. Keith, Daniel O. Clark, Timothy E. Stump, Douglas K. Miller and Christopher M. Callahan
An accurate physical fitness survey could be useful in research and clinical care.
To estimate the validity and reliability of a Self-Reported Fitness (SRFit) survey; an instrument that estimates muscular fitness, flexibility, cardiovascular endurance, BMI, and body composition (BC) in adults ≥ 40 years of age.
201 participants completed the SF-36 Physical Function Subscale, International Physical Activity Questionnaire (IPAQ), Older Adults’ Desire for Physical Competence Scale (Rejeski), the SRFit survey, and the Rikli and Jones Senior Fitness Test. BC, height and weight were measured. SRFit survey items described BC, BMI, and Senior Fitness Test movements. Correlations between the Senior Fitness Test and the SRFit survey assessed concurrent validity. Cronbach’s Alpha measured internal consistency within each SRFit domain. SRFit domain scores were compared with SF-36, IPAQ, and Rejeski survey scores to assess construct validity. Intraclass correlations evaluated test-retest reliability.
Correlations between SRFit and the Senior Fitness Test domains ranged from 0.35 to 0.79. Cronbach’s Alpha scores were .75 to .85. Correlations between SRFit and other survey scores were –0.23 to 0.72 and in the expected direction. Intraclass correlation coefficients were 0.79 to 0.93. All P-values were 0.001.
Initial evaluation supports the SRFit survey’s validity and reliability.
Katherine S. Hall and Edward McAuley
Few studies have examined physical activity behavior and its associated outcomes in older adults living in retirement communities. Guided by the disablement model and social cognitive theory, we tested a cross-sectional model in which physical activity was hypothesized to influence disability indirectly through self-efficacy, functional performance, and functional limitations.
One hundred six older men and women residing in independent-living (ILF) assisted-living (ALF) facilities completed self-report measures of self-efficacy, function, and disability. Objective assessments of physical activity and functional performance were conducted using waist-mounted accelerometers and the short physical performance battery (SPPB), respectively. Path analysis was used to examine the proposed associations among constructs.
Older adults who were more active were also more efficacious and had better physical function and fewer functional limitations. Only higher levels of self-efficacy were associated with less disability. The effects of individual-level covariates were also examined.
This cross-sectional study is among the first to examine the associations between physical activity, function, and disability among older adults residing in ILFs and ALFs. Future research addressing the physical and psychological needs of this growing population is warranted.
George J. Salem, Sean P. Flanagan, Man-Ying Wang, Joo-Eun Song, Stanley P. Azen and Gail A. Greendale
Stepping activities when wearing a weighted vest may enhance physical function in older persons. Using 3 weighted-vest resistance dosages, this study characterized the lower-extremity joint biomechanics associated with stepping activities in elders. Twenty healthy community-dwelling older adults, ages 74.5 ± 4.5 yrs, performed 3 trials of forward step-up and lateral step-up exercises while wearing a weighted vest which added 0% body weight (BW), 5% BW, or 10% BW. They performed these activities on a force platform while instrumented for biomechanical analysis. Repeated-measures ANOVA was used to evaluate the differences in ankle, knee, and hip maximum joint angles, peak net joint moments, joint powers, and impulses among both steping activities and the 3 loading conditions. Findings indicated that the 5% BW vest increased the kinetic output associated with the exercise activities at all three lower-extremity joints. These increases ranged from 5.9% for peak hip power to 12.5% for knee extensor impulse. The application of an additional 5% BW resistance did not affect peak joint moments or powers, but it did increase the joint impulses by 4–11%. Comparisons between exercise activities, across the 3 loading conditions, indicated that forward stepping preferentially targeted the hip extensors while lateral stepping targeted the plantar flexors; both activities equally targeted the knee extensors. Weighted-vest loads of 5% and 10% BW substantially increased the mechanical demand on the knee extensors, hip extensors (forward stepping), and ankle plantar flexors (lateral stepping).
Silvia Aranda-García, Albert Busquets, Antoni Planas, Joan A. Prat-Subirana and Rosa M. Angulo-Barroso
Gait speed is related to physical function in older adults. This cross-sectional study examined the best predictors of maximal gait speed (MGS) among physical abilities, and general factors in healthy, rural community-dwelling older adults.
MGS, muscle strength, and postural sway were measured in 55 community-dwelling participants (age, 72.1 ± 6.8, range 61–87 years; 72.7% women). Two stepwise regressions were used to find MGS predictors in two models: physical abilities and global.
Strength of knee extensors with 60° of knee flexion (KStrength60°) and maximal distance in the anterior-posterior direction with eyes closed explained 50.2% of MGS variance (p < .05) in the physical abilities model. KStrength60°, age, and level of physical activity explained 63.9% of MGS variance (p < .05) in the global model.
Regardless of the model, KStrength60° was the best predictor of MGS in rural female older adults. Future research should examine the generalization of these findings to rural male older adults.
Kristen M. Beavers, Fang-Chi Hsu, Monica C. Serra, Veronica Yank, Marco Pahor and Barbara J. Nicklas
Observational studies show a relationship between elevated serum uric acid (UA) and better physical performance and muscle function. The purpose of this paper was to determine whether regular participation in an exercise intervention, known to improve physical functioning, would result in increased serum UA. For this study, 424 older adults at risk for physical disability were randomized to participate in either a 12-mo moderate-intensity physical activity (PA) or a successful aging (SA) health education intervention. UA was measured at baseline, 6, and 12 mo (n = 368, 341, and 332, respectively). Baseline UA levels were 6.03 ± 1.52 mg/dl and 5.94 ± 1.55 mg/dl in the PA and SA groups, respectively. The adjusted mean UA at month 12 was 4.8% (0.24 mg/dl) higher in the PA compared with the SA group (p = .028). Compared with a health education intervention, a 1-yr PA intervention results in a modest increase in systemic concentration of UA in older adults at risk for mobility disability.