Experiences of Habitual Physical Activity in Maintaining Roles and Functioning among Older Adults: A Qualitative Study

Physically active older adults have reduced risk of functional restrictions and role limitations. Several aspects may interrelate and influence habitual physical activity (PA). However, older adults’ own perspectives towards their PA need to be addressed. The aim of this study was to explore the experiences of habitual physical activity in maintaining roles and functioning among older adult Palestinians ≥60 years.Data were collected through in-depth interviews based on a narrative approach. Seventeen participants were recruited (aged 64–84 years). Data were analyzed using a narrative interpretative method. Findings.Three central narratives were identified, “keepmoving, stay healthy,” “social connectedness, amotive to stay active,” and “adapting strategies to age-related changes.” Conclusion. Habitual physical activity was perceived as an important factor to maintain functioning and to preserve active roles in older adults.Walking was the most prominent pattern of physical activity and it was viewed as a vital tool to maintain functioning among the older adults. Social connectedness was considered as a contributing factor to the status of staying active. To adapt the process of age-related changes in a context to stay active, the participants have used different adapting strategies, including protective strategy, awareness of own capabilities, and modifying or adopting new roles.The authors thank all the participants for their valuable contributions to this study

Ambulatory Function and Perception of Confidence in Persons with Stroke with a Custom-Made Hinged versus a Standard Ankle Foot Orthosis

Objective. The aim was to compare walking with an individually designed dynamic hinged ankle foot orthosis (DAFO) and a standard carbon composite ankle foot orthosis (C-AFO). Methods. Twelve participants, mean age 56 years (range 26–72), with hemiparesis due to stroke were included in the study. During the six-minute walk test (6MW), walking velocity, the Physiological Cost Index (PCI), and the degree of experienced exertion were measured with a DAFO and C-AFO, respectively, followed by a Stairs Test velocity and perceived confidence was rated. Results. The mean differences in favor for the DAFO were in 6MW 24.3 m (95% confidence interval [CI] 4.90, 43.76), PCI −0.09 beats/m (95% CI −0.27, 0.95), velocity 0.04 m/s (95% CI −0.01, 0.097), and in the Stairs Test −11.8 s (95% CI −19.05, −4.48). All participants except one perceived the degree of experienced exertion lower and felt more confident when walking with the DAFO. Conclusions. Wearing a DAFO resulted in longer walking distance and faster stair climbing compared to walking with a C-AFO. Eleven of twelve participants felt more confident with the DAFO, which may be more important than speed and distance and the most important reason for prescribing an AFO

Association between physical activity and physical functioning in community-dwelling older adults

Aim: To evaluate the association between level of physical activity (PA) and physical functioning among community-dwelling older adults. Methods: A total of 176 older adults were assessed with a PA socio-cultural adapted questionnaire (PA-SCAQ), the participants were categorized into three PA groups (low, moderate and high). Physical functioning was examined by using: Hand Grip Strength (HGS), Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB). Statistical analyses were performed to determine differences between the groups according to age, gender and PA level. Spearman’s correlation was used to examine the association between the PA level and physical functioning values. Major findings: Older adults who participated in moderate-intensity aerobic PA for 150 min/week have recorded higher values of physical functioning than older adults who were classified as low physically active (p<0.001). PA levels were positively correlated with HGS and SPPB and negatively correlated with TUG (p<0.001). Conclusion: There were strong associations between higher levels of PA and levels of physical functioning (p<0.001). Moderate to high level of PA may contribute to maintain physical functioning among community-dwelling older adults.We thank all participants and centres that participated in this study. Many thanks to all colleagues of physiotherapists for their support throughout the study, especially in the recruitment process of the participants

Physical Activity, Ambulation, and Motor Impairment Late after Stroke

Objective. To assess walking capacity and physical activity using clinical measures and to explore their relationships with motor impairment late after stroke. Subjects. A nonrandomised sample of 22 men and 9 women with a mean age of 60 years, 7–10 years after stroke. Methods. Fugl-Meyer Assessment, maximum walking speed, 6 min walk test, perceived exertion, and heart rate were measured, and the Physiological Cost Index was calculated. Physical activity was reported using The Physical Activity Scale for the Elderly. Results. Mean (SD) 6 min walking distance was 352 (±136) m, and Physiological Cost Index was 0.60 (±0.41). Self-reported physical activity was 70% of the reference. Motor impairment correlated with walking capacity but not with the physical activity level. Conclusion. It may be essential to enhance physical activity even late after stroke since in fairly young subjects both walking capacity and the physical activity level were lower than the reference

Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study

BACKGROUND: Development of reliable and objective evaluation methods is required, particularly for natural and goal-oriented upper-extremity tasks. Three-dimensional imaging measurement techniques have turned out to be a powerful tool for a quantitative and qualitative assessment of multijoint movements. The purpose of this study was to develop and test a method of three-dimensional motion analysis for the activity "drinking from a glass" and describe the drinking task with kinematic variables in control subjects. METHODS: A protocol was developed for the drinking activity including the set-up of cameras and positions of the markers and the subject. The drinking task included reaching, forward transport with glass, drinking, back transport and returning the hand to the initial position. An optoelectronic system was used for the three-dimensional kinematic motion capture. Movement times, velocities, joint angles and interjoint coordination for shoulder and elbow were computed and analyzed for twenty control subjects. Test-retest consistency was evaluated for six subjects. RESULTS: The test protocol showed good consistency in test-retest. Phase definitions for the drinking task were defined and verified. Descriptive kinematic variables were obtained for movement times, positions, velocities and joint angles for shoulder and elbow joint. Interjoint coordination between shoulder and elbow joint in reaching phase showed a high correlation. CONCLUSION: This study provides a detailed description of the three-dimensional kinematic analysis of the drinking task. Our approach to investigate and analyze a goal-oriented daily activity has a great clinical potential. Consequently, the next step is to use and test this protocol on persons with impairments and disabilities from upper extremities

Physical performance, pain and pool exercise in individuals with late effects of polio

The overall purpose of the studies was to obtain knowledge about physical performance and related factors in individuals with late effects of polio. The specific aims were to provide a description of pain and how it is related to the effects of polio and the physical activity of the individual; to evaluate physical performance, the effect of reduced muscle strength on walking performance, and to study the impact of pool exercise. The subjects included in the studies comprised 234 individuals, 146 women and 88 men. They had all been to a first visit at the polio unit at Sahlgrenska University Hospital. The overall inclusion criteria were experience of the late effects of polio and being a walker with or without devices.Study I: Presence and intensity of pain and pain characteristics were assessed in thirty-two individuals, and were correlated to the level of physical exertion, muscle strength in the knee extensors during 30 m walking, and to the level of distress as measured by the Nottingham Health Profile (NHP). Pain was most common due to physical activity during leisure time. Cramping pain was the most common type of pain in the lower limbs regardless of polio affection or not. In the trunk and upper limbs aching was most marked. The level of pain intensity correlated positively to the level of physical exertion, to walking speed and to five of six dimensions in NHP, but not to the degree of muscle weakness. Study II: Another 32 individuals were recruited for this study. An exercise test on a bicycle ergometer was performed, and isokinetic muscle strength in knee extensors and knee flexors were measured. A strong correlation was found between the muscle measurements with peak workload and peak oxygen uptake from the exercise test. Individuals with weak muscles and low peak heart rate would benefit from peripheral muscle endurance training, and those with relatively stronger muscles from a general aerobic exercise program.Study III: The 234 individuals with late effects of polio were included and 143 clinically healthy subjects were used for comparison. The values from eight strength measurements were transformed into an index. The index was used together with spontaneous and maximal walking speed from 30 m walking, to develop a model for analysis of non-linear regression. A specific strength threshold could not be identified, but rather a gradual flattening of the curve. The asymptote for maximal walking was higher in the healthy group than in the group with late effects of polio, but it occurred at approximately the same strength index. A high BMI lowered the asymptote for both groups. In the polio-group those walking with assistive devices were slower walkers.Study IV: A general dynamic five months exercise program in heated water was studied. There were no differences in peak workload, peak VO2, and peak heart rate after training compared to a control group. At the same workload after training, the heart rate was significantly lowered for the training group compared to the controls. A reduction of pain experience was seen in the training group. No negative effects were seen.Study V: To gain an understanding of the participants experiences of the training in water an interview study was carried out and analysed according to the phenomenographic approach. Fourteen different categories appeared focusing on three different aspects of exercising in water: the self, the training situation and the world around. The self includes the body, the mind or the body related to the mind. The training situation includes the group, the water or the leader and the world around situations outside the training situation.Conclusions: The experience of pain was related to physical activity in daily life. Decreased muscle function was a major factor negatively influencing physical performance as shown in the ergometer test and in walking capacity. Evidence was provided for a non-linear relationship between walking speed and muscle strength in both healthy subjects and in persons with late effects of polio. Exercise training in water resulted in a lower heart rate at submaximal workload and less experience of pain. The training was experienced as being good for the body, but also influenced both self-confidence and sociality

Perspectives of Older Adults on Aging Well: A Focus Group Study

Background. With increasing number of older adults worldwide, promoting health and well-being becomes a priority for aging well. Well-being and physical and mental health are closely related, and this relation may become more vital at older ages as it may contribute to aging well. The state of well-being is a multifaceted phenomenon that refers to an individual’s subjective feelings, and exploring perspectives of older adults on aging well is developing to be an important area of research. Therefore, the aim of this study was to explore perceptions on aging well among older adult Palestinians ≥60 years. Methods. A qualitative research design in the context of focus group discussions was used; seven focus groups were conducted including fifty-six participants (aged 63–81 years). Data were analyzed using a qualitative interpretative thematic approach described by Braun and Clarke. Results. Three major themes were identified, “sense of well-being,” “having good physical health,” and “preserving good mental health.” The participants perceived that aging well is influenced by positive feelings such as being joyous, staying independent, having a life purpose, self-possessed contentment, and financially secured, in addition to be socially engaged and enjoying good physical and mental health. Conclusion. This study contributes to get a better insight concerning older adults’ perspectives on aging well. Enhancing physically active lifestyle, participation in social and leisure activities, healthy eating habits, having a purpose in life, and being intellectually engaged are all contributing factors to aging well. Vital factors are to be considered in developing strategic health and rehabilitative plans for promoting aging well among older adults