The peer experience for older people encouraging other older people to engage in resistance training: A qualitative study

Resistance training (RT) can maintain and improve physical and mental health in 2 older adults, but this population has low levels of participation in RT. Linking older people 3 already participating in RT (i.e. peers) with those who have not may promote and maintain 4 adherence to RT participation. This qualitative study explored the experience of peers in 5 encouraging participation in RT among older community-dwelling adults. Data were collected 6 using focus groups, researcher observations, and semi-structured interviews. Thematic 7 analysis was conducted. Older people (n=8) who had engaged in RT for at least two months 8 prior to recruitment, participated as peers. They each provided peer support for between one 9 and four RT participants for six weeks. The peer role was perceived by peers as potentially 10 leading to a relationship which was of benefit to both parties. Peers reported that helping and 11 supporting others was a positive experience and raised their own self-efficacy. Difficulty 12 initiating contact and differing expectations of peers and RT participants were viewed as 13 challenges. Peer-mentoring could help to promote RT participation among older adults. 1

The Effect of Moderate +Gz on Cervical Muscle Strength of RAAF Trainee Pilots Flying PC-9 Aircraft

External stimulus/loading initiates adaptations within skeletal muscle. Whilst performing flying manoeuvres under +Gz it has been previously found that the cervical area has the highest loading. The purpose of this study was to examine cervical muscle response to moderate +Gz force (+4-6Gz) loading generated during RAAF pilot training. Cervical muscle strength was monitored in nine RAAF pilots completing an eight-month flight training course and ten controls matched for gender, age, height and weight. Cervical muscle strength and range of movement were measured at baseline and at eight months using the Multi-Cervical Rehabilitation Unit (Hanoun, Canada). Also measured, using EMG, was the activation of sternocleidomastoid and erector spinae muscles for a test pilot during simulated flight training. The statistical procedure used was a comparison in the difference between the pilots and control subjects for baseline and post-testing in neck strength and range of movement using an unpaired t-test. Statistical significance was accepted at

Organisational effectiveness in selected grass roots sport clubs in Western Australia

Grass roots sport clubs are the foundation for sport in Australia, they cater for mass participation across all ages and are predominantly managed by volunteers. The benefits of being involved in sport and in particular a sport club, both from a health and social capital perspective are well documented (Houlihan & Green, 2006; Hoye & Nicholson, 2008; Stewart, Nicholson, Smith, & Westerbeek, 2004). Australian governments at every level, provide funding for sport to support these benefits and often directly to sport clubs. Yet there is little published research on what makes a grass roots sport club effective (Koski, 1995), particularly in Australia. Organisational effectiveness is difficult to define, is constantly changing and usually requires the organisation to determine what is to be measured for effectiveness (Cameron, 1986b). Due to the difficulty in defining organisational effectiveness, researchers began to develop models, which are used to measure the effectiveness of an organisation rather than define it. These models can be onedimensional or multi-dimensional in nature. However, limitations exist with this method of determining organisational effectiveness, because the criteria of effectiveness is predetermined and may not be specific to the organisation/s needs (Kent & Weese, 2000)

Balance on the Brain: a randomised controlled trial evaluating the effect of a multimodal exercise programme on physical performance, falls, quality of life and cognition for people with mild cognitive impairment—study protocol

This project is funded by the National Health and Medical Research Council (NHMRC) (Investigator Grant--APP1174739) and Curtin University.Introduction Exercise and physical activity have been shown to improve cognition for people living with mild cognitive impairment (MCI). There is strong evidence for the benefits of aerobic exercise and medium evidence for participating in regular strength training for people with MCI. However, people living with MCI fall two times as often as those without cognitive impairment and the evidence is currently unknown as to whether balance training for people with MCI is beneficial, as has been demonstrated for older people without cognitive impairment. The aim of this study is to determine whether a balance-focused multimodal exercise intervention improves balance and reduces falls for people with MCI, compared with a control group receiving usual care. Methods and analysis This single blind randomised controlled trial (Balance on the Brain) will be offered to 396 people with MCI living in the community. The multimodal exercise intervention consists of two balance programmes and a walking programme to be delivered by physiotherapists over a 6-month intervention period. All participants will be followed up over 12 months (for the intervention group, this involves 6-month intervention and 6-month maintenance). The primary outcomes are (1) balance performance and (2) rate of falls. Physical performance, levels of physical activity and sedentary behaviour, quality of life and cognition are secondary outcomes. A health economic analysis will be undertaken to evaluate the cost-effectiveness of the intervention compared with usual care. Ethics and dissemination Ethics approval has been received from the South Metropolitan Health Service Human Research Ethics Committee (HREC), Curtin University HREC and the Western Australia Department of Health HREC; and approval has been received to obtain data for health costings from Services Australia. The results will be disseminated through peer-review publications, conference presentations and online platforms.National Health and Medical Research Council (NHMRC) of Australia APP1174739Curtin Universit

Do peers increase older adults\u27 participation in strength training? Pilot randomized trial

Fewer than 20% of older adults participate in strength training (ST). Barriers to ST participation include not knowing where to go or not having someone to go with. To address these barriers, the authors provided older adults with a peer (older person already participating in ST) to support their engagement. The aim of this pilot randomized controlled trial was to determine whether older adults who were provided with a peer when participating in ST were more likely to be participating in ST 4 weeks postintervention, compared with those receiving ST alone. Fifty-one ST participants were recruited; 40 completed the intervention and postintervention data collection (78.4%). Providing peer support with ST did not significantly increase ST participation (p = .775). However, both groups made significant improvements over time in lower-limb strength and mobility. Participants in either group who continued the ST program (55%) had made additional significant improvements in lower-limb strength and mobility

A Systematic Review of Physical Activity Programs for Older People Receiving Home Care Services

The proportion of older people living in our communities is rising and to live independently some require assistance from home care services. Physical activity can improve and maintain function, strength and balance, which is important for those receiving home care. This study reviewed the evidence on physical activity/exercise interventions trialled with older people receiving a home care service. A systematic review of studies published from January 1982 to September 2012, from five databases, was undertaken. Inclusion criteria were: aged 65+ years; community dwelling; no dementia diagnosis; receiving home care services; and a physical activity/exercise program. Eight articles were included and results show there were few consistencies between intervention types, groups, outcome measures and follow-up. Study quality was mixed. Future studies should include pragmatic randomized controlled trials involving home care practitioners and their clients to gain “real world” knowledge of what interventions are effective and can be delivered within this setting

Physical activity preferences of older home care clients

Background - Physical activity contributes to an older person's health and well-being by maintaining strength, balance and mobility, all of which are important for older people who wish to remain living in their home for as long as possible. It is therefore essential that community nurses and those working with home care clients promote being physically active. To do this effectively requires an understanding of the type of physical activity older home care clients prefer to engage in. Aim - The aims of this study were to identify the physical activity preferences of older people who received a home care service and to determine whether being physically active is important to this population. Methods - Twenty older home care clients were interviewed using a semi-structured interview schedule. Data were analysed using a descriptive qualitative methodology. Results - Walking, housework and gardening were identified as the activities of choice. The majority of interviewees suggested that it was important to be physically active. Conclusion - Structured exercise programmes are not the activity of choice for older home care clients. Therefore, when community nurses and allied health workers promote physical activity to their clients, they should suggest activities such as walking, housework and gardening and also endorse the benefits of physical activity for well-being and staying independent. Implication for practice - Health and community nurses and organisations should routinely encourage home care clients to increase their activity levels, especially utilising those activities they most enjoy

Dysmobility syndrome: Current perspectives

Background: A new term, dysmobility syndrome, has recently been described as a new approach to identify older people at risk of poor health outcomes. The aim was to undertake a systematic review of the existing research literature on dysmobility syndrome. Method: All articles reporting dysmobility syndrome were identified in a systematic review of Medline (Proquest), CINAHL, PubMed, PsycInfo, EMBASE, and Scopus databases. Key characteristics of identified studies were extracted and summarized. Results: The systematic review identified five papers (three cross-sectional, one case control, and one longitudinal study). No intervention studies were identified. Prevalence of dysmobility syndrome varied between studies (22%–34% in three of the studies). Dysmobility syndrome was shown to be associated with reduced function, increased falls and fractures, and a longitudinal study showed its significant association with mortality. Conclusion: Early research on dysmobility syndrome indicates that it may be a useful classification approach to identify older people at risk of adverse health outcomes and to target for early interventions. Future research needs to standardize the optimal mix of measures and cut points, and investigate whether balance performance may be a more useful factor than history of falls for dysmobility syndrome. © 2017 Hill et al

Factors predicting falls and mobility outcomes in patients with stroke returning home after rehabilitation who are at risk of falling

Objective: To identify factors predicting falls and limited mobility in people with stroke at 12 months after returning home from rehabilitation. Design: Observational cohort study with 12-month follow-up. Setting: Community. Participants: People with stroke (N=144) and increased falls risk discharged home from rehabilitation. Interventions: Not applicable. Main Outcome Measures: Falls were measured using monthly calendars completed by participants, and mobility was assessed using gait speed over 5m (high mobility: >0.8m/s vs low mobility: ≤0.8m/s). Both measures were assessed at 12 months postdischarge. Demographics and functional measures, including balance, strength, visual or spatial deficits, disability, physical activity level, executive function, functional independence, and falls risk, were analyzed to determine factors significantly predicting falls and mobility levels after 12 months. Results: Those assessed as being at high falls risk (Falls Risk for Older People in the Community [FROP-Com] score≥19) were 4.5 times more likely to fall by 12 months (odds ratio [OR], 4.506; 95% confidence interval [CI], 1.71–11.86; P=.002). Factors significantly associated with lower usual gait speed (≤0.8m/s) at 12 months in the multivariable analysis were age (OR, 1.07; 95% CI, 1.01–1.14; P=.033), physical activity (OR, 1.09; 95% CI, 1.03–1.17, P=.007), and functional mobility (OR, .83; 95% CI, .75–.93; P=.001). Conclusions: Several factors predicted falls and limited mobility for patients with stroke 12 months after rehabilitation discharge. These results suggest that clinicians should include assessment of falls risk (FROP-Com), physical activity, and dual-task Timed Up and Go test during rehabilitation to identify those most at risk of falling and experiencing limited mobility outcomes at 12 months, and target these areas during inpatient and outpatient rehabilitation to optimize long-term outcomes

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: study protocol for a pragmatic randomised controlled trial

BACKGROUND: Restorative home care services help older people maximise their independence using a multidimensional approach. They usually include an exercise program designed to improve the older person’s strength, balance and function. The types of programs currently offered require allocation of time during the day to complete specific exercises. This is not how the majority of home care clients prefer to be active and may be one of the reasons that few older people do the exercises regularly and continue the exercises post discharge. This paper describes the study protocol to test whether a Lifestyle Functional Exercise (LiFE) program: 1) is undertaken more often; 2) is more likely to be continued over the longer term; and, 3) will result in greater functional gains compared to a standard exercise program for older people receiving a restorative home care service.METHODS/DESIGN: Design: A pragmatic randomised controlled trial (RCT) design was employed with two study arms: LiFE program (intervention) and the current exercise program (control). Setting: Silver Chain, a health and community care organisation in Perth, Western Australia. Participants: One hundred and fifty restorative home care clients, aged 65 years and older. Measurements: The primary outcome is a composite measure incorporating balance, strength and mobility. Other outcome measures include: physical functioning, falls efficacy, and levels of disability and functioning.DISCUSSION: If LiFE is more effective than the current exercise program, the evidence will be presented to the service management accompanied by the recommendation that it be adopted as the generic exercise program to be used within the restorative home care service