The Effectiveness of Exercise Interventions for the Management of Frailty: A Systematic Review

This systematic review examines the effectiveness of current exercise interventions for the management of frailty. Eight electronic databases were searched for randomized controlled trials that identified their participants as “frail” either in the title, abstract, and/or text and included exercise as an independent component of the intervention. Three of the 47 included studies utilized a validated definition of frailty to categorize participants. Emerging evidence suggests that exercise has a positive impact on some physical determinants and on all functional ability outcomes reported in this systematic review. Exercise programs that optimize the health of frail older adults seem to be different from those recommended for healthy older adults. There was a paucity of evidence to characterize the most beneficial exercise program for this population. However, multicomponent training interventions, of long duration (≥5 months), performed three times per week, for 30–45 minutes per session, generally had superior outcomes than other exercise programs. In conclusion, structured exercise training seems to have a positive impact on frail older adults and may be used for the management of frailty

Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach

Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally

Sedentary Behavior and Physical Activity Are Independent Predictors of Successful Aging in Middle-Aged and Older Adults

Background. Sedentary behavior is emerging as an important risk factor for poor health. Physical activity has proven to be important in determining overall successful aging (SA) among older adults; however, no data exists on the influence of sedentary behavior on SA. The purpose of this analysis was to determine whether there is an association between sedentary behavior and successful aging, independent of physical activity levels. Methods. 9,478 older (M = 4,245; F = 5,233) and 10,060 middle-aged (M = 4.621; F = 5,439) adults from the Healthy Aging cycle of the Canadian Community Health Survey were analyzed. Multivariate logistic regressions were conducted with SA and its three components as outcomes while physical activity and sedentary behavior were entered as main exposures. Results. Among older adults, compared to those who were sedentary (4 hours or more/day), those who were moderately (2–4 hours/day) and least sedentary (<2 hours/day) were 38% (OR: 1.38; CI: 1.12–1.69) and 43% (OR: 1.43; CI: 1.23–1.67) more likely to age successfully, respectively. Among middle-aged adults, those who were least sedentary were 43% (OR: 1.43; CI: 1.25–1.63) more likely to age successfully. Conclusions. These novel findings suggest that sedentary activities are significantly associated with lower odds of SA among middle-aged and older adults, potentially in a dose-dependent manner

Perceptions of Exercise Screening Among Older Adults

Background: Pre-physical activity screening is important for older adults’ participating in physical activity. Unfortunately, many older adults face barriers to exercise participation and thus, may not complete proper physical activity screening. The purpose of this project was to conduct a thematic analysis of perceptions and experiences of community-dwelling older adults regarding pre-physical activity screening (i.e., Get Active Questionnaire (GAQ) and a standardized exercise stress test). Methods: A convenience sample of adults (male n=58, female n=54) aged 75 ±7 years living in the City of London, Ontario was used. Participants completed a treadmill stress test and the GAQ at a research laboratory for community-based referrals. One week later, participants completed the GAQ again and were asked questions by a research assistant about their perceptions of the screening process. Results: Thematic analysis of the responses was conducted. The results indicated that older adults view physical activity screening as acceptable, but not always necessary. Also, the experiences expressed by this sample of older adults indicated that physical activity screening can contribute to continued confidence (through reassurance) and can contribute to increased motivation (through yearly fitness results) in exercise participation. Conclusions: Older adults may perceive screening as supportive in exercise adoption, if screening is simple, convenient and supports older adults’ motivation and confidence to exercise.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Flexibility of Older Adults Aged 55–86 Years and the Influence of Physical Activity

Cross-sectional age-related differences in flexibility of older adults aged 55–86 years of varying activity levels were examined. Shoulder abduction and hip flexion flexibility measurements were obtained from 436 individuals (205 men, 71±9 years; 231 women, 72±8 years). Total physical activity was assessed using the Minnesota Leisure-Time Physical Activity Questionnaire. Shoulder abduction showed a significant decline averaging 5 degrees/decade in men and 6 degrees/decade in women. Piecewise linear regression showed an accelerated decline in men starting at the age of 71 years of 0.80 degrees/year, whereas in women the onset of decline (0.74 degrees/year) was 63 years. Men and women showed a significant decline in hip flexion (men: 6 degrees/decade; women: 7 degrees/decade). Piecewise linear regression revealed a rate of decline of 1.16 degrees/year beginning at 71 years in men and in women a single linear decline of 0.66 degrees/year. Multiple regression analysis showed that age and physical activity accounted for only 9% of the variance in hip flexion in women and 10% in men, with age but not physical activity remaining significant. Similarly for shoulder abduction, age was significant but not physical activity, in a model that described 8% of the variance for both sexes

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This systematic review examines the effectiveness of current exercise interventions for the management of frailty. Eight electronic databases were searched for randomized controlled trials that identified their participants as &quot;frail&quot; either in the title, abstract, and/or text and included exercise as an independent component of the intervention. Three of the 47 included studies utilized a validated definition of frailty to categorize participants. Emerging evidence suggests that exercise has a positive impact on some physical determinants and on all functional ability outcomes reported in this systematic review. Exercise programs that optimize the health of frail older adults seem to be different from those recommended for healthy older adults. There was a paucity of evidence to characterize the most beneficial exercise program for this population. However, multicomponent training interventions, of long duration (≥5 months), performed three times per week, for 30-45 minutes per session, generally had superior outcomes than other exercise programs. In conclusion, structured exercise training seems to have a positive impact on frail older adults and may be used for the management of frailty

Development of a physical literacy model for older adults – a consensus process by the collaborative working group on physical literacy for older Canadians

Background: Arguably the uptake and usability of the physical activity (PA) guidelines for older adults has not been effective with only 12% of this population meeting the minimum guidelines to maintain health. Health promoters must consider innovative ways to increase PA adoption and long-term sustainability. Physical literacy (PL) is emerging as a promising strategy to increase lifelong PA participation in younger age-groups, yet there is relatively little evidence of PL being used to support older adults in achieving the PA guidelines. Methods: An iterative and mixed-methods consensus development process was utilized over a series of six informed processes and meetings to develop a model of physical literacy for adults aged 65 years and older. Results: A multi-disciplinary collaborative working group (n = 9) from diverse practice settings across Canada, and representative and reflective of the full range of key elements of PL, was assembled. Three consensus meetings and two Delphi surveys, using an international cohort of 65 expert researchers, practitioners, non-government organizations and older adults, was conducted. 45% responded on the first round and consensus was achieved; however, we elected to run a second survey to support our results. With 79% response rate, there was consensus to support the new PL model for older adults. Conclusion: Older adults are a unique group who have yet to be exposed to PL as a means to promote long-term PA participation. This new PL model uses an ecological approach to integrate PL into the lifestyles of most older adults. Understanding the interactions between components and elements that facilitate PL will ultimately provide a new and effective tool to target PA promotion and adherence for all older Canadians.Health and Social Development, Faculty of (Okanagan)Non UBCHealth and Exercise Sciences, School of (Okanagan)ReviewedFacult