Online Group-exercises for Older Adults of Different Physical Abilities

In this paper we describe the design and validation of a virtual fitness environment aiming at keeping older adults physically and socially active. We target particularly older adults who are socially more isolated, physically less active, and with less chances of training in a gym. The virtual fitness environment, namely Gymcentral, was designed to enable and motivate older adults to follow personalised exercises from home, with a (heterogeneous) group of remote friends and under the remote supervision of a Coach. We take the training activity as an opportunity to create social interactions, by complementing training features with social instruments. Finally, we report on the feasibility and effectiveness of the virtual environment, as well as its effects on the usage and social interactions, from an intervention study in Trento, Ital

Measuring the Use of the Active and Assisted Living Prototype CARIMO for Home Care Service Users: Evaluation Framework and Results

To address the challenges of aging societies, various information and communication technology (ICT)-based systems for older people have been developed in recent years. Currently, the evaluation of these so-called active and assisted living (AAL) systems usually focuses on the analyses of usability and acceptance, while some also assess their impact. Little is known about the actual take-up of these assistive technologies. This paper presents a framework for measuring the take-up by analyzing the actual usage of AAL systems. This evaluation framework covers detailed information regarding the entire process including usage data logging, data preparation, and usage data analysis. We applied the framework on the AAL prototype CARIMO for measuring its take-up during an eight-month field trial in Austria and Italy. The framework was designed to guide systematic, comparable, and reproducible usage data evaluation in the AAL field; however, the general applicability of the framework has yet to be validated

Reducing fall risk with combined motor and cognitive training in elderly fallers

Background. Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. Methods. In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). Results. Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention. Conclusions. This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.Peer ReviewedPostprint (published version

The appeal of the Functional Fitness MOT to older adults and health professionals in an outpatient setting: a mixed-method feasibility study

Purpose: To understand the views and perceptions regarding the Functional Fitness MOT (FFMOT), a battery of functional tests followed by a brief motivational interview, of both the older people undergoing it and the health professionals delivering it. Patients and methods: Physically inactive older adults (n=29) underwent the FFMOT and subsequently attended focus groups to share their perceptions of it and to discuss the barriers, motivators, health behavior change, and scope to improve physical activity (PA) levels. PA levels were recorded at baseline and again at 12 weeks together with a post-intervention questionnaire concerning behavior change. Participating physiotherapists and technical instructors were interviewed. Results: Most participants felt they had learned about their abilities and comparisons with their peers, had a change in perception about the importance of good balance and strength, and felt the FFMOT helped raise their awareness of local and self-directed physical activity opportunities. Most felt their awareness of the need for PA had not changed, but 25% of participants started a new organized PA opportunity. The health professionals perceived the FFMOT as being easy to administer, educating, and motivating for participants to increase their PA. Space, time, finances, and insecurity about having the necessary skills to conduct the FFMOTs were seen as barriers in implementing the FFMOT in daily practice. Conclusion: Over half of those offered the FFMOT accepted it, suggesting it is appealing. However, most participants felt they were already active enough and that their awareness of the need for PA had not changed. There were positive perceptions of the FFMOT from both professionals and older people, but both felt the FFMOT could be held in a community venue. The overall findings suggest that the FFMOT is feasible in the clinical setting, but its effectiveness has yet to be determined

Technology use in everyday life: Implications for designing for older users

This study examines the experience and attitudes of older adults towards technology and how they compare with younger age groups. Two hundred and thirty seven participants completed an extensive questionnaire exploring their daily lifestyle, use of technology, attitudes towards technology, and perceived difficulty of household devices. The main findings from the study were; (1) there was a strong motivation to learn or to continue learning to use computers by the older group; (2) social connectedness influenced how the older group used or would like to use technology and also why some preferred not to use it; and finally (3) there was an age-related increase in perceived difficulty for many household devices, however some devices maintained intergenerational usability. These finding can be used to inform the design of future intergenerational household technologies

Exercise for falls prevention in community-dwelling older adults: Trial and participant characteristics, interventions and bias in clinical trials from a systematic review

IntroductionThere is strong evidence that exercise prevents falls in community-dwelling older people. This review summarises trial and participant characteristics, intervention contents and study quality of 108 randomised trials evaluating exercise interventions for falls prevention in community-dwelling older adults.MethodsMEDLINE, EMBASE, CENTRAL and three other databases sourced randomised controlled trials of exercise as a single intervention to prevent falls in community-dwelling adults aged 60+ years to May 2018.Results108 trials with 146 intervention arms and 23 407 participants were included. Trials were undertaken in 25 countries, 90% of trials had predominantly female participants and 56% had elevated falls risk as an inclusion criterion. In 72% of trial interventions attendance rates exceeded 50% and/or 75% of participants attended 50% or more sessions. Characteristics of the trials within the three types of intervention programme that reduced falls were: (1) balance and functional training interventions lasting on average 25 weeks (IQR 16–52), 39% group based, 63% individually tailored; (2) Tai Chi interventions lasting on average 20 weeks (IQR 15–43), 71% group based, 7% tailored; (3) programmes with multiple types of exercise lasting on average 26 weeks (IQR 12–52), 54% group based, 75% tailored. Only 35% of trials had low risk of bias for allocation concealment, and 53% for attrition bias.ConclusionsThe characteristics of effective exercise interventions can guide clinicians and programme providers in developing optimal interventions based on current best evidence. Future trials should minimise likely sources of bias and comply with reporting guidelines

Acute Effects of Exercise on Cognitive Performances of Older Adults

Accelerating rates of structural decline become evident during the third and fourth decades of human life, with disproportionate degeneration occurring in the frontal, parietal, and temporal brain lobes. As the structure of the brain declines, a broad array of cognitive processes involving memory, decision making, and selective attention are reduced as well (Raz 2000, Park et al. 2001). Cardiovascular exercise has been associated with improved cognitive functioning in aging humans, suggesting that increased vascular supply enhances availability of oxygen, nutrients, and other physical entities to nourish the brain. Previous experimentation on older adults revealed significant positive effects of exercise on a variety of memory types following participation in a program six or more months in duration (Colcombe 2003, Kramer et al.1999). The primary focus of this study was to test the effects of acute aerobic exercise on cognitive functioning of adults over the age of 60. A second purpose was to determine that the positive neurological effects of exercise can start taking place immediately. The hypothesis is that memory retention, mental processing speed, and selective attention would acutely improve in the participants after they had exercised, in comparison to their cognitive state prior to exercise. Cognitive performances both before and after exercise were tested using the Stroop test. All participants completed the post-exercise test with improved scores (p=0.000) indicating an increase in cognitive ability, relating exercise and improved cognitive function

Are the attitudes of exercise instructors who work with older adults influenced by training and personal characteristics?

Little is known about the relationship between attitudes and characteristics of instructors and uptake and adherence of older people to exercise classes. This article explores these issues.Methods:The authors surveyed 731 UK exercise instructors with specialist older adult exercise qualifications. A questionnaire investigated instructors’ characteristics and attitudes toward older adults’ participation in exercise.Results:For mostly seated classes, EXTEND qualification (B = 0.36, p = .005) had a positive effect on instructors’ attitudes. Later Life Training qualification (B = −2.80, p = .003), clinical background (B = −3.99, p = .005), and delivering classes in National Health Services (B = −3.12, p &lt; .001), leisure centers (B = −2.75, p = .002), or nursing homes (B = −2.29, p = .005) had a negative effect on attitudes. For mostly standing classes, experience (B = 0.20, p = .003) and delivering in leisure centers (B = 0.46, p = .032) had a positive and clinical background (B = −1.78, p = .018) had a negative effect on instructors’ attitudes.Conclusions:Most instructors have positive attitudes, but training and work context can influence attitudes toward older people’s participation in exercise classes both positively and negatively.</jats:sec