Feasibility and Acceptability of Home-Based Exercise Snacking and Tai Chi Snacking Delivered Remotely to Self-Isolating Older Adults During COVID-19

The purpose of this study was to examine the feasibility and acceptability of remotely delivered, home-based exercise programs on physical function and well-being in self-isolating older adults during the COVID-19 pandemic. In a four-arm randomized controlled trial, 63 participants (aged 65 years and older) were allocated to one of three home-based daily (2 × 10-min) exercise interventions (exercise snacking, tai chi snacking, and combination) or control (UK National Health Service Web pages). Functional assessments were conducted via video call at baseline and 4-week follow-up. A web-based survey assessed the acceptability of each exercise program and secondary psychological/well-being outcomes. Ecological momentary assessment data, collected in Weeks 1 and 4, explored feeling states as antecedents and consequences of exercise. All intervention groups saw increased physical function at follow-up and displayed good adherence with exercise snacking considered the most acceptable program. Multilevel models revealed reciprocal associations between feelings of energy and exercise engagement. Further studies are needed with larger, more diverse demographic samples.</p

Exercise strategies to protect against the impact of short-term reduced physical activity on muscle function and markers of health in older men:study protocol for a randomised controlled trial

BACKGROUND: Muscles get smaller and weaker as we age and become more vulnerable to atrophy when physical activity is reduced or removed. This research is designed to investigate the potentially protective effects of two separate exercise strategies against loss in skeletal muscle function and size, and other key indices of health, following 14 days of reduced physical activity in older men. METHODS: Three groups of 10 older men (aged 65–80 years) will undertake 2 weeks of reduced activity by decreasing daily steps from more than 3500 to less than 1500 (using pedometers to record step count). Two of the three groups will then undertake additional exercise interventions, either: 4 weeks of progressive resistance training prior to the step-reduction intervention (PT-group), or home-based ‘exercise snacking’ three times per day during the step-reduction intervention (ES-group). The third group undertaking only the step-reduction intervention (control) will provide a comparison against which to assess the effectiveness of the protective exercise strategies. Pre and post step-reduction assessments of muscle function, standing balance, anthropometry and muscle architecture will be taken. Pre and post step-reduction in postprandial metabolic control, resting systemic inflammation, adipose inflammation, oxidative stress, immune function, sleep quality, dietary habits, and quality of life will be measured. The stress response to exercise, and signalling protein and gene expression for muscle protein synthesis and breakdown following an acute bout of exercise will also be assessed pre and post step-reduction. Rates of muscle protein synthesis and adipose triglyceride turnover during the step-reduction intervention will be measured using stable isotope methodology. All participants will then undertake 2 weeks of supervised resistance training with the aim of regaining any deficit from baseline in muscle function and size. DISCUSSION: This study aims to identify exercise strategies that could be implemented to protect against loss of muscle power during 2 weeks of reduced activity in older men, and to improve understanding of the way in which a short-term reduction in physical activity impacts upon muscle function and health. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02495727 (Initial registration: 25 June 2015

Myths and Methodologies:Standardisation in human physiology research—should we control the controllables?

The premise of research in human physiology is to explore a multifaceted system whilst identifying one or a few outcomes of interest. Therefore, the control of potentially confounding variables requires careful thought regarding the extent of control and complexity of standardisation. One common factor to control prior to testing is diet, as food and fluid provision may deviate from participants’ habitual diets, yet a self‐report and replication method can be flawed by under‐reporting. Researchers may also need to consider standardisation of physical activity, whether it be through familiarisation trials, wash‐out periods, or guidance on levels of physical activity to be achieved before trials. In terms of pharmacological agents, the ethical implications of standardisation require researchers to carefully consider how medications, caffeine consumption and oral contraceptive prescriptions may affect the study. For research in females, it should be considered whether standardisation between‐ or within‐participants in regards to menstrual cycle phase is most relevant. The timing of measurements relative to various other daily events is relevant to all physiological research and so it can be important to standardise when measurements are made. This review summarises the areas of standardisation which we hope will be considered useful to anyone involved in human physiology research, including when and how one can apply standardisation to various contexts

Exercise snacking to improve physical function in pre-frail older adult memory clinic patients: a 28-day pilot study

Abstract Background Finding innovative yet feasible ways of preventing physical and cognitive decline in those at risk is a critical global challenge, with exercise being championed as a key precursor to robust health in later life. Exercise snacking, here defined as short bouts of sporadic [muscle-strengthening] exercise, is one such strategy designed to overcome typical participation barriers observed in older adults. This study examined the acceptability of exercise snacking amongst pre-frail older adults and explored the efficacy of this approach in improving physical function. Methods In this single group design, 21 pre-frail outpatients with mild-cognitive impairment were recruited from a UK memory clinic. To be eligible, participants were aged ≥ 65-years who scored 3–8 (inclusive) on the short physical performance battery (SPPB) and were not regularly engaging in sport or exercise. Participants completed a 28-day, twice daily, exercise snacking intervention, consisting of five muscle-strengthening exercises, with the aim being to complete as many repetitions as possible of each exercise in a minute. Acceptability of the intervention was measured quantitatively and qualitatively using a survey and topic guide informed by the Theoretical Framework of Acceptability. Pre- and post-intervention physical function was measured using the SPPB, timed up-and-go (TUG), and 60s standing balance and sit-to-stand tests. Results Eighteen participants provided follow-up data and showed 85% adherence to the exercise snacking intervention, measured as the proportion of all sessions completed out of a possible 56. Participants rated the intervention as highly acceptable (4.6/5) suggesting it supported their self-efficacy (4.3/5) was enjoyable (4.1/5) and had a low burden (2.1/5). Qualitative findings suggested the ease of use, flexibility of the programme, and perceived effectiveness was important, and particularly useful for non-exercisers. Changes in SPPB score (8(1) vs. 9(3), p < 0.01), TUG (11.32(4.02) vs. 9.18(5.25) seconds, p < 0.01) and in the 60-second sit-to-stand test (17 ± 5 vs. 23 ± 7 repetitions, p < 0.01) were seen between baseline and follow-up. Conclusions Exercise snacking is an acceptable and potentially efficacious format of exercise for pre-frail memory clinic attendees who are at heightened risk of falling and frailty. Large scale randomised controlled trials are required to confirm whether exercise snacking is effective in the short and long term. ClinicalTrials.gov registration NCT05439252 (30/06/2022

Habitual physical activity levels do not predict leg strength and power in healthy, active older adults.

Physical activity is considered crucial in attenuating losses in strength and power associated with ageing. However, in well-functioning, active older adults the relationship between habitual physical activity and muscle function is surprisingly unclear. Leg press velocity, force, and power, were compared between 50 older and 30 younger healthy individuals, and associations with habitual physical activity explored. An incremental power test was performed on a pneumatic leg press, with theoretical maximum velocity, force, and power calculated. Vastus lateralis muscle thickness was measured by ultrasound, and participants wore a combined accelerometer and heart rate monitor for 6-days of free-living. Older individuals produced lower absolute maximum velocity, force, and power, than younger individuals. When accounting for smaller muscle size, older individual's maximum force and power remained markedly lower. Both groups were active, however using age specific thresholds for classifying physical activity, the older individuals engaged in twice the amount of moderate-to-vigorous physical activity in comparison to the younger individuals. There were no associations between any characteristics of muscle function and physical activity. These data support that the ability to generate force and power deteriorates with age, however habitual physical activity levels do not explain inter-individual differences in muscle function in active older individuals

The Effect of Age on Technique Variability and Outcome Variability during a Leg Press.

The aim of this study was to determine the effect of aging on power generation and joint coordination during a leg press, in order to increase understanding of how functional movements are affected during the aging process. 44 older and 24 younger adults performed eight sub-maximal power repetitions on a seated leg press dynamometer. Peak power and velocity (at 40% maximum resistance) were measured along with the coordination (coupling angle) of the lower limb joints using the vector coding technique. The younger adults produced significantly greater peak power than the older adults (mean ± SD; 762 W ± 245 vs 361 W ± 162, p < 0.01) and at higher peak velocities (mean ± SD; 1.37 m/s ± 0.05 vs 1.00 m/s ± 0.06, p < 0.01). The older adults produced less consistent values of peak power than younger adults, evidenced by a higher coefficient of variation (mean ± SD; 7.6% ± 5.2 vs 5.0% ± 3.0, p < 0.01), however, there was significantly less variability in the coupling angles displayed by the older adults compared to the younger adults (mean ± SD; 2.0° ± 1.1 vs 3.5° ± 2.7, p < 0.01 (ankle-knee); 1.7° ± 0.6 vs 4.1° ± 3.0, p < 0.01 (knee-hip)). The results of this study demonstrate that older adults display higher outcome variability but lower variability in technique (coordination). The more rigid movement strategies displayed by the older adults potentially reflects an increased risk of overuse injury due to repetitive demands on the same structures, or the reduced ability to respond to unexpected situations due to a lack of flexibility in joint control

Exercise strategies to protect against the impact of short-term reduced physical activity on muscle function and markers of health in older men:study protocol for a randomised controlled trial

Background: Muscles get smaller and weaker as we age and become more vulnerable to atrophy when physical activity is reduced or removed. This research is designed to investigate the potentially protective effects of two separate exercise strategies against loss in skeletal muscle function and size, and other key indices of health, following 14 days of reduced physical activity in older men.Methods: Three groups of 10 older men (aged 65–80 years) will undertake 2 weeks of reduced activity by decreasing daily steps from more than 3500 to less than 1500 (using pedometers to record step count). Two of the three groups will then undertake additional exercise interventions, either: 4 weeks of progressive resistance training prior to the step-reduction intervention (PT-group), or home-based ‘exercise snacking’ three times per day during the step-reduction intervention (ES-group). The third group undertaking only the step-reduction intervention (control) will provide a comparison against which to assess the effectiveness of the protective exercise strategies. Pre and post step- reduction assessments of muscle function, standing balance, anthropometry and muscle architecture will be taken. Pre and post step-reduction in postprandial metabolic control, resting systemic inflammation, adipose inflammation, oxidative stress, immune function, sleep quality, dietary habits, and quality of life will be measured. The stress response to exercise, and signalling protein and gene expression for muscle protein synthesis and breakdown following an acute bout of exercise will also be assessed pre and post step-reduction. Rates of muscle protein synthesis and adipose triglyceride turnover during the step-reduction intervention will be measured using stable isotope methodology. All participants will then undertake 2 weeks of supervised resistance training with the aim of regaining any deficit from baseline in muscle function and size.Discussion: This study aims to identify exercise strategies that could be implemented to protect against loss of muscle power during 2 weeks of reduced activity in older men, and to improve understanding of the way in which a short-term reduction in physical activity impacts upon muscle function and health

Schematic representation of Vector Coding.

<p>Schematic representation of Vector Coding.</p

Relative force and power are significantly lower in healthy older individuals than younger individuals.

<p>Mean ± SD extrapolated peak force (F_max:VL) and interpolated peak power (P_max:VL) relative to vastus lateralis muscle thickness for 65–80 vs 20–35 yr olds. The older individuals are represented by circles and the younger individuals by squares. **denotes significant difference between age groups (<i>P</i> < 0.01).</p