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William P. Berg and Brian A. Lapp

The purpose of this study was to examine the effect of a practical resistance training program for the lower extremities on mobility in independent, community-dwelling older adults. Twenty-two volunteers with a mean age of 72.9 years underwent two identical pretests 1 month apart. Lower extremity strength, locomotor stability, preferred gait velocity, and step lime in obstacle clearance were assessed. Participants then engaged in an 8-week resistance training program for the lower extremities using adjustable ankle weights. Following a posttest, a repeated-measures ANOVA was used to determine whether changes in strength and mobility when the treatment was interjected differed from when it was not. Results indicated that the training had a limited effect on strength and no effect on mobility. The feasibility of practical resistance training interventions to counteract muscle weakness and associated immobility in independent older adults is discussed.

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Ann-Charlotte Grahn Kronhed, Claes Möller, Boel Olsson and Margareta Möller

This study evaluated a balance-training program’s influence in healthy older adults. Fifteen community-dwelling participants aged 70–75 years were randomized to an exercise group, and 15 gender- and age-matched participants, to a control group. The 9-week training program comprised ordinary-life balance, vestibular-habituation, and ball exercises and station training. Clinical balance tests were conducted before and after training. Tests that showed significant improvement in the exercise group after the intervention included standing on the right leg with eyes closed, standing on the right leg and the left leg while turning the head and walking 30 m. Significant between-group differences were found at posttest. A significant decrease was seen in the control group in the walking-forward test, and this change was significantly different between groups. The study indicates that balance performance in healthy older adults might be improved by balance training including exercises that stimulate multiple sensory systems and their central integration.

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Nicole Kahle and Michael A. Tevald

To determine the effect of core muscle strengthening on balance in community-dwelling older adults, 24 healthy men and women between 65 and 85 years old were randomized to either exercise (EX; n = 12) or control (CON; n = 12) groups. The exercise group performed a core strengthening home exercise program thrice weekly for 6 wk. Core muscle (curl-up test), functional reach (FR) and Star Excursion Balance Test (SEBT) were assessed at baseline and follow-up. There were no group differences at baseline. At follow-up, EX exhibited significantly greater improvements in curl-up (Cohen’s d = 4.4), FR (1.3), and SEBT (>1.9 for all directions) than CON. The change in curl-up was significantly correlated with the change in FR (r = .44, p = .03) and SEBT (r > .61, p ≤ .002). These results suggest that core strengthening should be part of a comprehensive balance-training program for older adults.

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Narcís Gusi, Josue Prieto, Pedro R. Olivares, Serafin Delgado, Fabian Quesada and Clarencio Cebrián

A cross-sectional descriptive study was designed to obtain normative age-specific fitness scores for the general population of community-dwelling older adults in Spain. In total, 6,449 participants (5,610 women and 839 men) age 60–99 yr who lived in the region of Extremadura were recruited. Compared with the cohorts of similar studies in other countries, this cohort had more physically inactive elderly participants and participants with a higher body-fat percentage. All test results declined as age increased. Sex differences in the age-related decline in fat and body mass were observed. Women scored better in the flexibility tests, and men performed better in the other tests. These data may be highly useful for the age-specific assessment of the fitness performance of older adults and the design of programs that promote functional ability in older adults.

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Rebecca L. Vivrette, Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson and B. Josea Kramer

Objective:

To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.

Methods:

Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.

Results:

Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.

Implications:

An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.

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Ro DiBrezzo, Barbara B. Shadden, Blake H. Raybon and Melissa Powers

Loss of balance and falling are critical concerns for older adults. Physical activity can improve balance and decrease the risk of falling. The purpose of this study was to evaluate a simple, low-cost exercise program for community-dwelling older adults. Sixteen senior adults were evaluated using the Senior Fitness Test for measures of functional strength, aerobic endurance, dynamic balance and agility, and flexibility. In addition, measures of height, weight, resting blood pressure, blood lipids, and cognitive function were obtained. Participants then attended a 10-week exercise class including stretching, strengthening, and balance-training exercises. At the completion of the program, significant improvements were observed in tests measuring dynamic balance and agility, lower and upper extremity strength, and upper extremity flexibility. The results indicate that exercise programs such as this are an effective, low-cost solution to improving health and factors that affect falling risk among older adults.

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Jiska Cohen-Mansfield, Marcia S. Marx and Jack M. Guralnik

This study aimed to ascertain perceived barriers and motivators to exercise in people age 74–85 and to clarify the meaning of these barriers and motivators by examining participant characteristics that relate to them. 324 community-dwelling participants age 74–85 completed a health questionnaire that included items on barriers and motivators to exercise, as well as questions on demographic variables, health, and exercise. Selected participants then completed a physical-performance battery to measure functional performance. Barriers and motivators were related internally, as well as to many other factors including pain and depressed affect on the Geriatric Depression Scale. The findings suggest a need for individualized and comprehensive approaches to the presentation of exercise programs. Health interventions are needed that will address both physical pain and depressed affect and explain the importance of exercise even in the presence of health problems. An understanding of the context of reported barriers and motivators is necessary for correct interpretation and program development.

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Martin G. Jorgensen, Uffe Laessoe, Carsten Hendriksen, Ole B.F. Nielsen and Per Aagaard

The aims of the current study were to examine the intrarater intersession reproducibility of the Nintendo Wii agility and stillness tests and explore the concurrent validity in relation to gold-standard force-plate analysis. Within-day intersession reproducibility was examined in 30 older adults (age 71.8 ± 5.1 yr). No systematic test–retest differences were found for the Wii stillness test; however, the Wii agility test scores differed systematically between test sessions (p < .05). The Wii stillness test yielded a test–retest ICC of .86 (95% CI 0.74–0.93), CV of 6.4%, LOA of 11.0, and LOA% of 17.9%. Likewise for the Wii agility test ICC was .73 (95% CI 0.50-0.86), CV 5.3%, LOA 1.8, and LOA% of 14.6%. Wii stillness scores correlated to force plate measures (r = .65–.82, p < .01), reflecting moderate to excellent validity. In conclusion, it appears that the Wii stillness test represents a low-cost, objective, reproducible, and valid test of undisturbed postural balance in community-dwelling older adults.

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Jannique G.Z. van Uffelen, Marijke J.M. Chinapaw, Marijke Hopman-Rock and Willem van Mechelen

This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty participants did not start a program; median attendance in the other 122 participants was 71%. Small but significant associations were observed between attendance and memory in the MI-WP and general cognition in the LI-AP. Associations were no longer significant when both groups were analyzed together. Intensity, assessed using percentage of heart-rate reserve and the Borg scale, equaled intended intensity for both programs. Aerobic fitness improved significantly in participants in the MI-WP. In conclusion, cognition was not clearly associated with attendance in the 62 participants starting the MI-WP, and average attendance was good. The intensity was feasible for participants who continued the MI-WP. The findings support the proposal that regular moderate-intensity walking improves aerobic fitness in adults with MCI.

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Daisuke Koizumi, Nicole L. Rogers, Michael E. Rogers, Mohammod M. Islam, Masanobu Kusunoki and Nobuo Takeshima

Background:

Although many Japanese older adults spend more than an hour each day walking for exercise, the intensity is often lower than the minimum level associated with various health benefits. The purpose of this study was to evaluate the efficacy of a lifestyle physical activity intervention on improving quantity and quality of daily physical activity (DPA) as well as cardiorespiratory endurance in community-dwelling older women.

Methods:

68 women (60–78 yr of age) were randomly assigned to either a lifestyle physical activity intervention group (LIFE) or control group. During the 12-wk intervention, feedback based on accelerometer DPA data (number of daily steps (STEPS) and time spent performing daily moderate intensity physical activity (MPA) was provided to each participant in LIFE every two weeks. Cardiorespiratory endurance was evaluated using the 12-Minute Walk Test (12-MW).

Results:

Following the 12-wk intervention, significant group interactions were observed for STEPS, MPA, and cardiorespiratory endurance. LIFE increased STEPS by 16%, MPA by 53%, and the distance walked during the 12-MW by 10%.

Conclusions:

Promotion of DPA using accelerometers can significantly improve quantity and quality of daily physical activity as well as cardiorespiratory endurance in older women.