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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).

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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.

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Anners Lerdal, Elin Hannevig Celius and Gunn Pedersen

Background:

Participants who completed a 3-month prescribed individualized exercise program in groups were followed-up prospectively. The aims were to describe the characteristics of the participants, their health-related quality of life (HRQoL) and physical fitness at baseline, at completion and at 12-month follow-up, and to identify predictors of HRQoL and physical fitness at completion and at 12-month follow-up.

Methods:

A 1-group follow-up design was used. Data were collected from records of 163 attendees at a municipality-sponsored health center in Norway. HRQoL was measured by self-report using the COOP/WONCA questionnaire. Physical fitness was estimated from the results of a 2-km walk test.

Results:

Of the 163 participants referred to the clinic, 130 (79.8%) were women and 33 were (20.2%) men. Participants who completed were older than those who dropped out. The participants showed clinical improvement in physical fitness and all health-related quality life domains (d > 0.53) at the completion of the program and in physical functioning, mental health, performance of daily activities, overall health, and perceived improved health after 12 months (d > 0.36).

Conclusions:

Participation in group-based prescribed exercise program for 3 months may improve physical fitness and HRQoL significantly in short and long terms.

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Takashi Kamijo and Masami Murakami

Background:

Lifestyle-related diseases among middle-age and elderly people have become serious problems. Underlying causes might be related to the changes in the lifestyle including the absence of regular physical exercise.

Methods:

To clarify the significance of regular physical exercise to prevent lifestyle-related diseases, we studied motor functions and blood chemistry examinations in middle-age and elderly women (over 40 years old) who performed regular physical exercise for 2 years (exercise group) and those who initially did not (control group).

Results:

In study 1, VO2max significantly increased in the exercise group compared with the control group in the under 60 years old groups. In the over 60 years old groups, VO2max, foot balance, and HDL-cholesterol significantly increased. Plasma glucose at 120 minutes after the 75 g oral glucose tolerance test, fasting insulin, homeostasis model assessment (HOMA-R), and high sensitivity C-reactive protein (hsCRP) significantly decreased in the exercise group compared with the control group. In study 2, a 1-year exercise program significantly improved physical functions and biochemical markers in the control group.

Conclusion:

These results suggest that regular physical exercise might help to maintain sound motor functions and decrease insulin resistance and a risk for arteriosclerosis.

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Katherine S. Hall and Edward McAuley

Background:

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.

Methods:

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.

Results:

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.

Conclusions:

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.

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Nancy Margaret Salbach, Jo-Anne Howe, Karen Brunton, Kathryn Salisbury and Lorene Bodiam

Background:

The purpose of this article is to describe the development and evaluation of a task-oriented group exercise program, delivered through a municipal recreation program, for community-dwelling people with neurological conditions.

Methods:

Physical therapists (PTs) at a rehabilitation hospital partnered with a municipal recreation provider to develop and evaluate a 12-week exercise program for people with stroke, acquired brain injury, and multiple sclerosis at 2 community centers. Fitness instructors who were trained and supported by PTs taught 1-hour exercise classes twice a week. In a program evaluation of the safety, feasibility and effects of the program, standardized measures of physical function were administered before and after the program.

Results:

Fourteen individuals (mean age: 63 years) participated and attended 92% of exercise classes, on average. Two minor adverse events occurred during 293 attendances. Improvement in mean score on all measures was observed. In people with stroke, a statistically significant improvement in mean Berg Balance Scale (mean ± SD change = 3 ± 2 points, P = .016, n = 7) and 6-minute walk test scores (change = 26 ± 26 m, P = .017, n = 9) was observed.

Conclusions:

This model of exercise delivery provides people with neurological conditions with access to a safe, feasible and potentially beneficial exercise program in the community.

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Patrick J. O’Connor, Amanda L. Caravalho, Eric C. Freese and Kirk J. Cureton

Compounds found in the skins of grapes, including catechins, quercetin, and resveratrol, have been added to the diet of rodents and improved run time to exhaustion, fitness, and skeletal-muscle mitochondrial function. It is unknown if such effects occur in humans. The purpose of this experiment was to investigate whether 6 wk of daily grape consumption influenced maximal oxygen uptake (VO2max), work capacity, mood, perceived health status, inflammation, pain, and arm-function responses to a mild eccentric-exercise-induced arm-muscle injury. Forty recreationally active young adults were randomly assigned to consume a grape or placebo drink for 45 consecutive days. Before and after 42 d of supplementation, assessments were made of treadmill-running VO2max, work capacity (treadmill performance time), mood (Profile of Mood States), and perceived health status (SF-36 Health Survey). The day after posttreatment treadmill tests were completed, 18 high-intensity eccentric actions of the nondominant elbow flexors were performed. Arm-muscle inflammation, pain, and function (isometric strength and range of motion) were measured before and on 2 consecutive days after the eccentric exercise. Mixed-model ANOVA showed no significant effect of grape consumption on any of the outcomes. Six weeks of supplemental grape consumption by recreationally active young adults has no effect on VO2max, work capacity, mood, perceived health status, inflammation, pain, or physical-function responses to a mild injury induced by eccentric exercise.

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NiCole R. Keith, Daniel O. Clark, Timothy E. Stump, Douglas K. Miller and Christopher M. Callahan

Background:

An accurate physical fitness survey could be useful in research and clinical care.

Purpose:

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.

Methods:

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.

Results:

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.

Conclusion:

Initial evaluation supports the SRFit survey’s validity and reliability.

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William R. Sukala, Rachel Page, Chris Lonsdale, Isabelle Lys, David Rowlands, Jeremy Krebs, Murray Leikis and Birinder Singh Cheema

Background:

To evaluate the differential effect of 2, group-based exercise modalities on quality of life (QoL) in indigenous Polynesian peoples with type 2 diabetes (T2DM) and visceral obesity.

Methods:

Participants were randomized to resistance training or aerobic training performed 3 times per for 16 weeks. The Short-Form 36 was administered at baseline and post intervention to assess 8 domains and physical and mental component scales (PCS and MCS) of QoL.

Results:

With the exception of Mental Health and MCS, all scores were lower at baseline than general population norms. Significant improvements were documented in several QoL scores in each group post intervention. No group × time interactions were noted. Pooled analyses of the total cohort indicated significantly improved Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Role-Emotional, PCS and MCS. Adaptation ranged from 5%−22%, and demonstrated a moderate-to-large effect (Cohen’s d = 0.64−1.29). All measures of QoL increased to near equivalent, or greater than general norms.

Conclusion:

Exercise, regardless of specific modality, can improve many aspects of QoL in this population. Robust trials are required to investigate factors mediating improvements in QoL, and create greater advocacy for exercise as a QoL intervention in this and other indigenous populations with T2DM.

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Matthew P. Ford, Laurie A. Malone, Harrison C. Walker, Ildiko Nyikos, Rama Yelisetty and C. Scott Bickel

Background:

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.

Methods:

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.

Results:

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.

Conclusions:

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.