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Guillaume Lamotte, Elizabeth Skender, Miriam R. Rafferty, Fabian J. David, Steve Sadowsky and Daniel M. Corcos

Objective:

This paper reviews the therapeutically beneficial effects of progressive resistance exercise training (PRET) on motor and nonmotor symptoms in Parkinson's disease (PD).

Methods:

First, we perform a systematic review of the literature on the effects of PRET on motor signs of PD, functional outcomes, quality of life, and patient perceived improvement, strength, and cognition in PD. Second, we perform a meta-analysis on the motor section of the UPDRS. Finally, we discuss the results of our review and we identify current knowledge gaps regarding PRET in PD.

Conclusion:

This systematic review synthesizes evidence that PRET can improve strength and motor signs of Parkinsonism in PD and may also be beneficial for physical function in individuals with PD. Further research is needed to explore the effects of PRET on nonmotor symptoms such as depression, cognitive impairment, autonomic nervous system dysfunction, and quality of life in individuals with PD.

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Jitka Jancova-Vseteckova, Martin Bobak, Ruzena Kubinova, Nada Capkova, Anne Peasey, Michael G. Marmot and Hynek Pikhart

Background:

The aim was to examine the association of objective measures of physical functioning (PF) with education and material circumstances and the decline in PF with age by socioeconomic position (SEP).

Methods:

In 3,205 subjects (60–75 years) from the Czech Republic, we assessed relationship between PF, SEP, and age. Linear regression was used to assess PF measures and SEP measures.

Results:

Cross-sectional decline in PF by age was similar in all individuals. Differences between SEP groups were similar across age groups, except for the difference in walk speed by material circumstances in men—bigger at older ages (p = .004). Men and women with the highest education were about 2 s faster at the chair rise test than those with the lowest education.

Discussion:

Findings suggest strong educational gradient in PF, an inconsistent role of self-assessed material circumstances, and virtually no interaction of SEP with the cross-sectional decline in PF by age.

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Lorraine J. Phillips and Marcia Flesner

This qualitative study investigated individual and situational factors influencing physical activity (PA) practices of elders in residential-care/assisted-living (RC/ AL) communities. This article describes the results of focus-group interviews involving 47 residents across 6 RC/AL settings. Thematic analysis revealed 6 themes: staying active, past PA experiences, value of PA, barriers to PA, strategies to facilitate PA, and support needs to promote PA. Staying active meant walking indoors and out, attending chair-exercise programs, performing professionally prescribed home exercises, and using available exercise equipment. Past PA experiences shaped current preferences and practices. Participants agreed that exercise helped maintain physical functioning but recounted cognitive and situational barriers to PA. Lack of dedicated exercise space and short corridors hampered efforts to stay active. Participants wished for individualized home exercise programs and supervised exercise sessions. Future research should examine the extent to which the physical environment and PA programming in RC/AL communities affect elders’ PA.

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Kathleen Benjamin, Nancy C. Edwards and Virendra K. Bharti

For seniors, an inactive lifestyle can result in declines in mental and physical functioning, loss of independence, and poorer quality of life. This cross-sectional descriptive study examined theory-of-planned-behavior, health-status, and sociodemographic predictors on exercise intention and behavior among 109 older and physically frail adults. Significant predictors of being a high versus a low active were a strong intention to continue exercising, positive indirect attitudes about exercise, and having been advised by a doctor to exercise. Findings indicate that a strong intention to continue exercising differentiates between those who report low levels and those who report high levels of physical activity. The results also highlight the salience of physician’s advice for seniors to exercise.

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Dori E. Rosenberg, Jacqueline Kerr, James F. Sallis, Gregory J. Norman, Karen Calfas and Kevin Patrick

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.

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Lisa M. Warner, Jochen P. Ziegelmann, Benjamin Schüz, Susanne Wurm and Ralf Schwarzer

The purpose of the current study was to examine whether the effects of social support on physical exercise in older adults depend on individual perceptions of self-efficacy. Three hundred nine older German adults (age 65–85) were assessed at 3 points in time (3 months apart). In hierarchical-regression analyses, support received from friends and exercise self-efficacy were specified as predictors of exercise frequency while baseline exercise, sex, age, and physical functioning were controlled for. Besides main effects of self-efficacy and social support, an interaction between social support and self-efficacy emerged. People with low self-efficacy were less likely to be active in spite of having social support. People with low support were less likely to be active even if they were high in self-efficacy. This points to the importance of both social support and self-efficacy and implies that these resources could be targets of interventions to increase older adults’ exercise.

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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.

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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.

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Yongwoo Lee, Wonjae Choi, Kyeongjin Lee, Changho Song and Seungwon Lee

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.

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Dusa Marn-Vukadinovic and Helena Jamnik

Context:

Valid patient-based outcome instruments are necessary for comprehensive patient care that focuses on all aspects of health, from impairments to participation restrictions.

Objective:

To validate the Slovenian translation of Medical Outcome Survey (MOS) Short Form Health Survey (SF-36) and to assess relations among various knee measurements, activity tested with Oxford Knee Score (OKS) and health-related quality of life as estimated with SF-36 domains.

Design:

Descriptive validation study.

Setting:

Isokinetic laboratory in outpatient rehabilitation unit.

Participants:

101 subjects after unilateral sport knee injury.

Interventions:

All subjects completed the SF-36 and OKS, and isokinetic knee-muscle strength output at 60°/s was determined in 78 participants. Within a 3-d period, 43 subjects completed the SF-36 and OKS questionnaires again.

Main Outcome Measures:

Reliability testing included internal consistency and test–retest reliability. Correlations between SF-36 subscales and OKS were calculated to assess construct validity, and correlation between SF-36 subscales and muscle strength was calculated to assess concurrent validity.

Results:

Chronbach α was above .78 for all SF-36 subscales. ICCs ranged from .80 to .93. The correlation between OKS and the physical-functioning subscale, showing convergent construct validity, was higher (r = .83, P < .01) than between OKS and mental health (r = .50, P < .01), showing divergent construct validity. Knee-extensor weakness negatively correlated with physical-functioning (r = −.59, P < .01) and social-functioning (r = −.43, P < .01) subscales.

Conclusions:

The Slovenian translation of the SF-36 is a reliable and valuable tool. The relationships between knee-muscle strength and activity and between knee-muscle strength and SF-36 subscales in patients after sport knee injury were established.