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.
Melissa Moore, Jeni Warburton, Paul D. O’Halloran, Nora Shields and Kingsley
Seung-uk Ko, Gerald J. Jerome, Eleanor M. Simonsick and Luigi Ferrucci
subtle deteriorations in physical function. Several studies have examined obstacle crossing, but none have explicitly examined risk of falls in well-functioning older adults. Older adults have been found to take shorter steps and to have more narrow step width when crossing obstacles than younger adults
Shanelle Sorbello, Vu Quang Do, Anna Palagyi and Lisa Keay
) is an assessment of physical function shown to be predictive of falls risk ( Veronese et al., 2014 ), disability in activities of daily living, and nursing home admission ( Guralnik et al., 1994 ). Investigating the relationship between SPPB scores and vision impairment may aid in understanding the
Lotta Palmberg, Erja Portegijs, Taina Rantanen, Eeva Aartolahti, Anne Viljanen, Mirja Hirvensalo and Merja Rantakokko
). Previous findings show that going outdoors into the neighborhood at least once a week can help to maintain physical function among frail older people ( Shimada et al., 2010 ), but going outdoors daily increases the probability of positive health outcomes even further ( Jacobs et al., 2008 ). We studied
Shannon L. Mihalko and Edward McAuley
The purpose of the present investigation was to examine (a) the effects of upper body high-intensity strength training on muscular strength, activities of daily living (ADLs), and subjective well-being within an aging population, and (b) whether changes in strength were related to subsequent changes in subjective well-being and ADLs. The main effects of the training program were significant for all five individual muscle groups examined, indicating that subjects who participated in the strength program had greater increases in muscular strength than did controls. There was limited support for the contention that strength training enhances subjective well-being and ADLs in older adults. Strength gains were related to moderate reductions in negative affect, greater satisfaction with life, and higher ADLs. Findings are discussed in terms of design and measurement improvements, the need to focus research efforts on multiple components of fitness in relation to subjective well-being, and relations among strength and ADLs in the elderly.
Mark G. Davis, Kenneth R. Fox, Afroditi Stathi, Tanya Trayers, Janice L. Thompson and Ashley R. Cooper
The relationship of objectively measured sedentary time (ST), frequency of breaks in ST, and lower extremity function (LEF) was investigated in a diverse sample aged ≥ 70 years (n = 217). Physical activity (PA) was assessed by accelerometry deriving moderate-vigorous PA (MVPA) minutes per registered hour (MVPA min · hr−1), registered ST (ST min · hr−1), and breaks in ST min · hr−1 (breaks · hr−1). LEF was assessed by the Short Physical Performance Battery. Univariate associations with overall LEF were MVPA (r = .523), ST (r = −.499), and breaks (r = .389). Adjusted linear regression including MVPA min · hr−1, ST min · hr−1, and breaks · hr−1 explained 41.5% of LEF variance. Each additional break · hr−1 was associated with 0.58 point increase in LEF. Breaks and MVPA had strongest independent associations with LEF. Promoting regular breaks might be useful in maintaining or increasing LEF and later life independence. This novel finding is important for the design of effective lifestyle interventions targeting older adults.
Anna Mulasso, Mattia Roppolo, Monica Emma Liubicich, Michele Settanni and Emanuela Rabaglietti
The aim of this study was to assess the direct and indirect effects of a multicomponent exercise (MCE) program on mobility and balance in institutionalized older people. One hundred and twelve subjects (85 women; 83.0 years on average; SD = 7.5) were included in the study, and divided into a MCE-group (MCE-G) and a control group (CG) according to matching techniques. The MCE-G consisted of a 9-month program featuring range-of-motion, strength, and balance exercises performed in small groups. The CG received routine medical and nursing care. The timed up-and-go test and Tinetti Performance-Oriented Mobility Assessment balance subscale were administered at baseline and postintervention. After controlling for physical baseline value, age, sex, residential care facilities, and body mass index, the MCE-G showed positive effects both on mobility (p < .001) and balance (p = .001). The role of balance as mediator in the relationship between participation to the MCE program and mobility was demonstrated.
Danielle R. Bouchard, K. Ashlee McGuire, Lance Davidson and Robert Ross
One hundred forty-six abdominally obese adults age 60–80 yr were studied to investigate the interaction between cardiorespiratory fitness (CRF) and obesity on functional limitation. Obesity was determined by fat mass (FM), CRF was determined by a maximal treadmill test, and functional limitation was based on 4 different tasks that are predictive of subsequent disability. Both FM (r = –.34, p ≤ .01) and CRF (r = .54, p ≤ .01) were independently associated with functional limitation in bivariate analysis. After further control for sex, age, and the interaction term (CRF × FM), FM was no longer independently associated with functional limitation (p = .10). Analyses were also based on sex-specific tertiles of FM and CRF. The referent group demonstrated significantly lower functional limitation than the low-CRF/low-FM and the low-CRF/high-FM groups (both p ≤ .05). These results highlight the value of recommending exercise for abdominally obese adults.
Trudy L. Moore-Harrison, Mary Ann Johnson, Mary Ellen Quinn and M. Elaine Cress
This study examined the feasibility of implementing the EnhanceFitness Program (formerly Lifetime Fitness Program), an evidence-based exercise program, at congregate-meal sites that generally serve low-income older adults.
A 12-week aerobic and strength training exercise program was held at senior centers 3 times a week.
The mean age of the 31 participants was 73.5 years ± 6.7 years (60–86). Participants’ compliance with attending the exercise class was 74%. Paired t tests were used to evaluate change after the intervention. Three out of six components of the Senior Fitness Test increased significantly after the exercise intervention (P < .003). Three out of the eight self-reported health concepts of the SF-36 demonstrated significant improvement after the exercise intervention (P < .003).
These data indicate that an evidence-based exercise program can be successfully implemented in this population.
Kristin Musselman and Brenda Brouwer
This study examined gender differences in balance, gait, and muscle performance in seniors and identified gender-specific factors contributing to physical performance. Forty (20 men, 20 women) healthy, community-dwelling seniors (74.5 ± 5.3 years) participated. Limits of stability, gait speed, lower limb flexor and extensor isokinetic concentric peak torques, self-reported activity level, and balance confidence were measured. No gender differences were detected in gait speed, limits of stability when normalized to height, activity level, or balance confidence (p ≥ .188). Women were weaker than men (p ≤ .007), even after controlling for weight and body-mass index, suggesting that other gender-related factors contribute to strength. Gender accounted for 18–46% of the variance in strength and served as a modifier of the relationship between activity level and strength in some muscle groups. The primary factors relating to gender-specific strength was activity level in men and body weight in women.