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Clara Suemi da Costa Rosa, Danilo Yuzo Nishimoto, Ismael Forte Freitas Júnior, Emmanuel Gomes Ciolac and Henrique Luiz Monteiro

Background:

Patients on hemodialysis (HD) report lower physical activity (PA) levels. We analyzed factors associated with low levels of PA in patients with chronic kidney disease (CKD) and compared PA on HD day and non-HD.

Methods:

79 patients wore an accelerometer and were classified according to time spent on moderate-to-vigorous PA (MVPA). Demographic data, BMI, comorbidities, clinical status, and health-related quality of life (HRQoL) were checked for association with PA. In addition, PA level was compared between days of HD and non-HD.

Results:

Accelerometer compliance was 78.5% [33 men and 29 women (53.96 ± 15.71 yrs) were included in analysis]. 35.5% of sample achieved ≥150min/week on MVPA. Lower MVPA was associated with older age (OR = 5.80, 95% CI = 1.11 to 30.19, P = .04), and lower score of physical function HRQoL (OR = 4.33, 95% CI = 1.23 to 15.23, P = .02). In addition, patients spent 9.73% more time on sedentary behavior, 38.9% less on light PA and 74.9% less on MVPA on HD day versus non-HD day.

Conclusion:

Age and physical function HRQoL were the main factors associated to lower PA levels. In addition, lower time spent on PA during HD day suggest that strategies for increasing physical activity levels during HD day such exercising during HD session could help CKD patients to reach current PA recommendations.

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Ikuyo Imayama, Catherine M. Alfano, Caitlin E. Mason, Chiachi Wang, Liren Xiao, Catherine Duggan, Kristin L. Campbell, Karen E. Foster-Schubert, Ching-Yun Wang and Anne McTiernan

Background:

Regular exercise increases exercise self-efficacy and health-related quality of life (HRQOL); however, the mechanisms are unknown. We examined the associations of exercise adherence and physiological improvements with changes in exercise self-efficacy and HRQOL.

Methods:

Middle-aged adults (N = 202) were randomized to 12 months aerobic exercise (360 minutes/week) or control. Weight, waist circumference, percent body fat, cardiopulmonary fitness, HRQOL (SF-36), and exercise self-efficacy were assessed at baseline and 12 months. Adherence was measured in minutes/day from activity logs.

Results:

Exercise adherence was associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (P trend ≤ 0.05). Increased fitness was associated with improved physical functioning, bodily pain and general health scores (P trend ≤ 0.04). Reduced weight and percent body fat were associated with improved physical functioning, general health, and bodily pain scores (P trend < 0.05). Decreased waist circumference was associated with improved bodily pain and general health but with reduced role-emotional scores (Ptrend ≤ 0.05). High exercise adherence, increased cardiopulmonary fitness and reduced weight, waist circumference and percent body fat were associated with increased exercise self-efficacy (P trend < 0.02).

Conclusions:

Monitoring adherence and tailoring exercise programs to induce changes in cardiopulmonary fitness and body composition may lead to greater improvements in HRQOL and self-efficacy that could promote exercise maintenance.

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Philipe de Souto Barreto, Anne-Marie Ferrandez and Bérengère Saliba-Serre

Background:

Participation bias in exercise studies is poorly understood among older adults. This study was aimed at looking into whether older persons who volunteer to participate in an exercise study differ from nonvolunteers.

Methods:

A self-reported questionnaire on physical activity and general health was mailed out to 1000 persons, aged 60 or over, who were covered by the medical insurance of the French National Education System. Among them, 535 answered it and sent it back. Two hundred and thirty-three persons (age 69.7 ±7.6, 65.7% women) said they would volunteer to participate in an exercise study and 270 (age 71.7 ±8.8, 62.2% women) did not.

Results:

Volunteers were younger and more educated than nonvolunteers, but they did not differ in sex. They had less physical function decline and higher volumes of physical activity than nonvolunteers. Compared with volunteers, nonvolunteers had a worse self-reported health and suffered more frequently from chronic pain. Multiple logistic regressions showed that good self-reported health, absence of chronic pain, and lower levels of physical function decline were associated with volunteering to participate in an exercise study.

Conclusions:

Volunteers were fitter and healthier than nonvolunteers. Therefore, caution must be taken when generalizing the results of exercise intervention studies.

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Ruth E. Taylor-Piliae, Kathryn A. Newell, Rise Cherin, Martin J. Lee, Abby C. King and William L. Haskell

Objective:

To compare the effects of Tai Chi (TC, n = 37) and Western exercise (WE, n = 39) with an attention-control group (C, n = 56) on physical and cognitive functioning in healthy adults age 69 ± 5.8 yr, in a 2-phase randomized trial.

Methods:

TC and WE involved combined class and home-based protocols. Physical functioning included balance, strength, flexibility, and cardiorespiratory endurance. Cognitive functioning included semantic fluency and digit-span tests. Data were analyzed using intention-to-treat analysis.

Results:

At 6 mo, WE had greater improvements in upper body flexibility (F = 4.67, p = .01) than TC and C. TC had greater improvements in balance (F = 3.36, p = .04) and a cognitive-function measure (F = 7.75, p < .001) than WE and C. The differential cognitive-function improvements observed in TC were maintained through 12 mo.

Conclusion:

The TC and WE interventions resulted in differential improvements in physical functioning among generally healthy older adults. TC led to improvement in an indicator of cognitive functioning that was maintained through 12 mo.

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Jack M. Guralnik, Suzanne Leveille, Stefano Volpato, Marcia S. Marx and Jiska Cohen-Mansfield

Epidemiological studies have demonstrated that, using objective performance measures of physical functioning, disability risk can be predicted in nondisabled older adults. This makes it possible to recruit a nondisabled but at-risk population for clinical trials of disability prevention. Successful disability prevention in this population, for example through an exercise program, would have a major public health impact. To enhance the development of exercise interventions in this group it would be valuable to have additional information not available from existing epidemiologic studies. This report examines the evidence that functional limitations preceding disability can be identified in a community-dwelling population and that it is feasible to recruit these people into studies. It introduces a series of articles examining the characteristics of this population: motivators and barriers to exercise, exercise habits and preferences, the impact of positive and negative affect, and the impact of pain and functional limitations on attitudes toward exercise.

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Christopher A. Shields, David M. Paskevich and Lawrence R. Brawley

This article presents three studies representing the development stages of a theoretically driven measure employed to assess the frequency of use of the self-presentational strategy of self-handicapping in exercise contexts (Self-Handicapping Exercise Questionnaire: SHEQ). First a pilot study was conducted to examine the nature of the phenomenology of self-handicaps reported in exercise settings. Study 2 involved item creation, item trimming, and model confirmation. Study 3 concerned factorial validation, cross-validating the self-handicapping measure created in the second study. The outcome was a 20-item measure assessing self-handicapping claims in exercise. The results of both model-testing studies indicated three unique and stable factors addressing self-handicapping claims about making exercise a routine, training in an exercise facility, and healthy physical functioning. Self-handicapping responses were not moderated by gender, age, or exercise setting. Further use and development of the SHEQ is discussed.

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Joanna S. Kostka, Jan W. Czernicki and Tomasz J. Kostka

We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (υopt) to physical functioning in 28 women aged 50–87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, υopt, and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and υopt than to strength. Functional gains obtained with rehabilitation were not related to changes in power or υopt, and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis.

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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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Chiung-ju Liu, Leah Y. Jones, Alyssa R. M. Formyduval and Daniel O. Clark

The purpose of this feasibility study was to evaluate the 3-Step Workout for Life program, a 10-week exercise program that included moderate-intensity muscle strength training followed by task-oriented training. Fourteen participants completed the program (mean age = 73 years; SD = 6.83). The Box and Block test (Z = −2.24, p = .03) and the 30-s chair stand test (Z = −2.21, p = .03) indicate improved physical functioning of the upper and lower extremities. More importantly, results of the function component from the Late-Life Function and Disability Instrument (Z = −2.04, p = .04) and motor skills scale from the Assessment of Motor and Process Skills (Z = −2.97, p = .003) indicate subjective and objective improvements on performing activities of daily living. Supplementing moderate-intensity muscle strength exercise with taskoriented training components is feasible. Preliminary data support the effectiveness of 3-Step Workout for Life in reducing late-life disability.

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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.