Adiposity, lean mass, and physical activity (PA) are known to influence physical function in older adults, although the independent influences are not completely characterized. Older adults (N = 156, M age = 68.9 ± 6.7 yr, 85 men) were assessed for body composition via dual-energy X-ray absorptiometry, PA by accelerometer, and physical function via timed up-and-go (UP&GO), 30-s chair stand, 6-min walk (6-min WALK), and Star-Excursion Balance Test. In the absence of percentage-body-fat by PA interactions (p > .05), main effects existed such that a higher percentage body fat was associated with poorer performance in UP&GO, 30-s chair stand, and 6-min WALK (p < .05). No significant main effects were found for PA and functional performance. Adiposity explains 4.6–11.4% in physical functional variance (p < .05). Preventing increases in adiposity with age may help older adults maintain functional independence.
Christie L. Ward, Rudy J. Valentine and Ellen M. Evans
Chad R. Straight, Leah R. Dorfman, Kathryn E. Cottell, Julie M. Krol, Ingrid E. Lofgren and Matthew J. Delmonico
Community-based interventions that incorporate resistance training (RT) and dietary changes have not been extensively studied in overweight and obese older adults. The purpose of this investigation was to determine the effects of a community-based RT and dietary intervention on physical function and body composition in overweight and obese older adults.
Ninety-five overweight and obese (BMI = 33.4 ± 4.0 kg/m2) older adults aged 55–80 years completed an 8-week RT and dietary intervention at 4 Rhode Island senior centers. Participants performed RT twice-weekly using resistance tubing, dumbbells, and ankle weights. Participants also attended 1 weekly dietary counseling session on a modified Dietary Approaches to Stop Hypertension diet. Outcome measurements included anthropometrics, body composition, and physical function.
There were small changes in body mass (–1.0 ± 1.8 kg, P < .001), waist circumference (–5.2 ± 3.8 cm, P < .001), and percent body fat (–0.5 ± 1.4%, P < .001). In addition, significant improvements were observed in knee extensor torque (+7.9 ± 19.1 N-m, P < .001), handgrip strength (+1.2 ± 2.5 kg, P < .001), and 8-foot up-and-go test time (–0.56 ± 0.89 s, P < .001).
Community-based RT and dietary modifications can improve body composition, muscle strength, and physical function in overweight and obese older adults. Future investigations should determine if this intervention is effective for long-term changes.
Anthony P. Marsh, W. Jack Rejeski, Stacy L. Hutton, Cristal L. Brown, Edward Ip and Jack M. Guralnik
Lateral mobility is integral to many activities of daily living involving transfer from one position to another. The objective of this study was to develop and evaluate the validity and test–retest reliability of a lateral-mobility (LATMOB) task for older adults. Measurements of lateral mobility, balance, and strength and self-reported and performance-based physical functioning were obtained in 63 women and 77 men ≥50 years of age. The LATMOB task was significantly correlated with age, knee-extensor strength, grip strength, functional reach, and one-leg-stance time. Test–retest reliability of the task was excellent. The LATMOB task was highly correlated with the car task. Balance was significantly correlated with time to get into and out of a car and performance on the LATMOB task. The LATMOB task was significantly correlated with the Short Physical Performance Battery score. The LATMOB task is valid and reliable, but additional work is needed to assess its sensitivity to change and predictive validity.
Sarah L. West, Adam Gassas, Tal Schechter, R. Maarten Egeler, Paul C. Nathan and Greg D. Wells
Hematopoietic stem-cell transplant (SCT) is increasingly used to treat children with cancer, and survival following SCT is improving. One predominant consequence of childhood cancer therapy is increased physical morbidity, which is worse in pediatric SCT recipients compared with children treated with chemotherapy or radiation alone. There are many factors that contribute to exercise intolerance and reduced physical function during the pretransplant, peritransplant, and posttransplant phases. These include side effects from chemotherapy or radiation, excessive immobility due to bed rest, infections, the negative effects of immunosuppressants, and graft vs host disease, all of which can impair cardiorespiratory fitness, muscle strength, and muscle function. Few studies have investigated the effects of exercise in childhood SCT recipients. In a small number of published studies, exercise interventions have been demonstrated to improve cardiorespiratory fitness, preserve or increase muscle mass, and improve muscle strength in children following SCT. The use of exercise as medicine may be a noninvasive and nonpharmaceutical treatment to target physical complications post-SCT. Researchers and health-care professionals should work together to develop exercise prescription guidelines for this unique and important population.
Charlotte H. Worm, Esther Vad, Lis Puggaard, Henrik Støvring, Jens Lauritsen and Jakob Kragstrup
The purpose of this study was to determine the effects of a multicomponent exercise program on basic daily functions and muscle strength in community-dwelling frail older people. The randomized, controlled study comprised 46 community-dwelling frail older people (above 74 years of age and not able to leave their home without mobility aids). For 12 weeks the intervention group (n = 22) was transported to 2 class-based exercise sessions each week. Assessment of physical function was obtained using Berg's Balance Scale and a walking test. Self-reported functional ability was assessed through SF-36. Maximal oxygen uptake and maximal voluntary contraction of the shoulders' abductors were measured. The intervention group had a significant improvement in balance, muscle strength, walking function, and self-assessed functional ability compared with the control group. This study demonstrates that multicomponent exercise has a significant effect on basic daily functions and muscle strength in community-dwelling frail older people and might improve their ability to live an independent life.
Anthony P. Marsh, Michael E. Miller, W. Jack Rejeski, Stacy L. Hutton and Stephen B. Kritchevsky
It is unclear whether strength training (ST) or power training (PT) is the more effective intervention at improving muscle strength and power and physical function in older adults. The authors compared the effects of lower extremity PT with those of ST on muscle strength and power in 45 older adults (74.8 ± 5.7 yr) with self-reported difficulty in common daily activities. Participants were randomized to 1 of 3 treatment groups: PT, ST, or wait-list control. PT and ST trained 3 times/wk for 12 wk using knee-extension (KE) and leg-press (LP) machines at ~70% of 1-repetition maximum (1RM). For PT, the concentric phase of the KE and LP was completed “as fast as possible,” whereas for ST the concentric phase was 2–3 s. Both PT and ST paused briefly at the midpoint of the movement and completed the eccentric phase of the movement in 2–3 s. PT and ST groups showed significant improvements in KE and LP 1RM compared with the control group. Maximum KE and LP power increased approximately twofold in PT compared with ST. At 12 wk, compared with control, maximum KE and LP power were significantly increased for the PT group but not for the ST group. In older adults with compromised function, PT leads to similar increases in strength and larger increases in power than ST.
Eeva Aartolahti, Sirpa Hartikainen, Eija Lönnroos and Arja Häkkinen
This study was conducted to determine the characteristics of health and physical function that are associated with not starting strength and balance training (SBT). The study population consisted of 339 community-dwelling individuals (75–98 years, 72% female). As part of a population-based intervention study they received comprehensive geriatric assessment, physical activity counseling, and had the opportunity to take part in SBT at the gym once a week. Compared with the SBT-adopters, the nonadopters (n = 157, 46%) were older and less physically active, had more comorbidities and lower cognitive abilities, more often had sedative load of drugs or were at the risk of malnutrition, had lower grip strength and more instrumental activities of daily living (IADL) difficulties, and displayed weaker performance in Berg Balance Scale and Timed Up and Go assessments. In multivariate models, higher age, impaired cognition, and lower grip strength were independently associated with nonadoption. In the future, more individually-tailored interventions are needed to overcome the factors that prevent exercise initiation.
Jo-Ana D. Chase, Lorraine J. Phillips and Marybeth Brown
The purpose of this systematic review and meta-analysis was to determine the effects of supervised resistance and/or aerobic training physical activity interventions on performance-based measures of physical functioning among community-dwelling older adults, and to identify factors impacting intervention effectiveness. Diverse search strategies were used to identify eligible studies. Standardized mean difference effect sizes (d, ES) were synthesized using a random effects model. Moderator analyses were conducted using subgroup analyses and meta-regression. Twenty-eight studies were included. Moderator analyses were limited by inconsistent reporting of sample and intervention characteristics. The overall mean ES was 0.45 (k = 38, p ≤ .01), representing a clinically meaningful reduction of 0.92 s in the Timed Up and Go for treatment versus control. More minutes per week (p < .01) and longer intervention session duration (p < .01) were associated with larger effects. Interventions were especially effective among frail participants (d = 1.09). Future research should clearly describe sample and intervention characteristics and incorporate frail populations.
Roger J. Paxton, Caitlin Feldman-Kothe, Megan K. Trabert, Leah N. Hitchcock, Raoul F. Reiser II and Brian L. Tracy
The purpose was to determine the effect of peripheral neuropathy (PN) on motor output variability for ankle muscles of older adults, and the relation between ankle motor variability and postural stability in PN patients.
Older adults with (O-PN) and without PN (O), and young adults (Y) underwent assessment of standing postural stability and ankle muscle force steadiness.
O-PN displayed impaired ankle muscle force control and postural stability compared with O and Y groups. For O-PN, the amplitude of plantarflexor force fluctuations was moderately correlated with postural stability under no-vision conditions (r = .54, p = .01).
The correlation of variations in ankle force with postural stability in PN suggests a contribution of ankle muscle dyscontrol to the postural instability that impacts physical function for older adults with PN.
Melissa Moore, Jeni Warburton, Paul D. O’Halloran, Nora Shields and Kingsley
The purpose of this systematic review was to assess the characteristics and effectiveness of community-based interventions designed to increase physical activity participation in older adults (aged 65 years or more) living in rural or regional areas. Relevant peer-reviewed literature was obtained, using four primary electronic search engines, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The initial search identified 4,690 articles. After removal of duplicates and excluded articles, seven articles were included in the review. Few consistencies existed between intervention types, duration, outcome measures, and follow-up. Results provide some evidence to support the effectiveness of community-based interventions that include low- to moderate-intensity exercise to increase physical activity, physical function, and psychological state. However, without more rigorous studies it is difficult to identify the most critical characteristics of community-based interventions for older adults in rural and regional settings.