Functional tasks exercise improves daily function in older women

Ageing is characterised by a reduction in physical reserve, the physiological capacity in excess of that needed for daily activities, that provides a margin of safety that absorbs age- or disease-related changes without a loss in function. When physical capacity falls below the ability required for the performance of daily tasks, functional limitations and a loss of independence may occur. Approximately 20% of people between 65 and 75 years of age report problems with activities of daily living (ADLs), a proportion which increases to 48% in people older than 85. Exercise studies and exercise promotion for older adults offer the potential for improving the performance of daily activities and quality of life. However, the results of current exercise programmes are limited and inconsistent. The University Medical Center (UMC) Utrecht developed an exercise programme focusing on functional tasks of everyday life, tasks that are affected early in the ageing process. The aim of the studies described in this thesis was to study the difference in effect between functional tasks exercises and resistance strength exercises on the physical functional performance and health-related quality of life of older community-dwelling women. A pilot study with 24 community-dwelling, medically stable women (mean age 74.6 ?4.8) demonstrated that both exercise programmes were feasible and well tolerated by women over the age of 70 years and living in the community. Ninety-eight healthy women aged 70 and older were randomly assigned to either the function group (n = 33), the resistance group (n = 34) or a control group (n = 31). Participants attended exercise classes three times a week for 12 weeks. Functional task performance (ADAP test), isometric knee extensor strength (IKES), handgrip strength, isometric elbow flexor strength (IEFS) and leg extension power were measured at baseline, at the end of training (at 3 months) and 6 months after the end of training (at 9 months). The ADAP assessment of daily activity performance (ADAP) test includes 16 common tasks, such as transferring laundry and boarding a bus, performed at maximal effort. proved to be reliable and valid for measuring the performance of daily activities by community-dwelling older women. The ADAP total score increased more in the function group than in the resistance group or the control group. The ADAP total score of the resistance group did not change compared with the control group. In contrast, IKES and IEFS increased significantly in the resistance group compared with the function group and the control group. Six months after the end of training, the increase in ADAP scores were sustained in the function group, whereas the strength gains of the resistance group had disappeared. Physical activity scores demonstrated that functional tasks exercises may positively influence daily habits more than resistance training, which means that older individuals may continue exercising and thus maintain the effects of exercise. Functional tasks exercises are more effective in improving physical functional performance than common resistance strength exercises and the effects are preserved for longer than the gain in muscle strength achieved with resistance exercises

The Prevention and Reactivation Care Program: intervention fidelity matters.

The Prevention and Reactivation Care Program (PReCaP) entails an innovative multidisciplinary, integrated and goal oriented approach aimed at reducing hospital related functional decline among elderly patients. Despite calls for process evaluation as an essential component of clinical trials in the geriatric care field, studies assessing fidelity lag behind the number of effect studies. The threefold purpose of this study was (1) to systematically assess intervention fidelity of the hospital phase of the PReCaP in the first year of the intervention delivery; (2) to improve our understanding of the moderating factors and modifications affecting intervention fidelity; and (3) to explore the feasibility of the PReCaP fidelity assessment in view of the modifications. Based on the PReCaP description we developed a fidelity instrument incorporating nineteen (n=19) intervention components. A combination of data collection methods was utilized, i.e. data collection from patient records and individual Goal Attainment Scaling care plans, in-depth interviews with stakeholders, and non-participant observations. Descriptive analysis was performed to obtain levels of fidelity of each of the nineteen PReCaP components. Moderating factors were identified by using the Conceptual Framework for Implementation Fidelity. Ten of the nineteen intervention components were always or often delivered to the group of twenty elderly patients. Moderating factors, suc

The relationship between older adults' self-management abilities, well-being and depression

This study aimed to identify the relationship between self-management abilities, well-being and depression. Our study was conducted among older adults (>65 years of age) who were vulnerable to loss of function after hospital discharge. Three months after hospital admission, 296/456 patients (65 % response rate) were interviewed in their homes. The 30-item Self-Management Ability Scale was used to measure six self-management abilities: taking initiative, investing in resources for long-term benefits, taking care of a variety of resources, taking care of resource multifunctionality, being self-efficacious and having a positive frame of mind. Well-being was measured with the Social Production Function (SPF) Instrument for the Level of Well-being (SPF-IL) and Cantril's ladder. The Geriatric Depre

Oefentherapie bij ouderen, keuzes te over

Eens te meer wordt hiermee het belang van de oudere cliënt voor de toekomst van de fysiotherapie benadrukt. Cijfers van het Centraal Bureau voor de Statistiek (cbs ) wijzen uit dat personen ouder dan 65 jaar regelmatig door de huisarts, verpleeghuisarts en geriater naar de fysiotherapeut worden verwezen om de fysieke activiteit te verhogen met als doel de functionele capaciteit te vergroten, herstellen en/of behouden. Ouderen zijn hiermee nu al de grootste groep consumenten van de fysiotherapeut (22,5% van de eerstelijns consulten) en naar verwachting zal dit aandeel alleen maar toenemen. Ook in politiek Den Haag is men doordrongen van het belang van een actieve levensstijl tot op hoge leeftijd

Ouderen in beweging! in Hillesluis

Speeltuinen zijn een uitstekende plek voor ouderen om te bewegen en niet meer alleen het domein van kinderen. TNO evalueerde in opdracht van de gemeente Rotterdam en speeltoestellenfabrikant Yalp sport & spel een kleine groep ouderen die gedurende tien weken een trainingsprogramma volgden op speeltoestellen in Speeltuin Hillesluis te Rotterdam. De balans en coördinatie van de deelnemende ouderen verbeterde en de angst om te vallen verminderde. De ouderen waren zo gemotiveerd dat zij na afloop zelf zijn blijven doortrainen. Bijna de helft van de Nederlandse ouderen beweegt onvoldoende. Mogelijkheden om in de eigen buurt actief te bewegen, ontbreken vaak. De deelgemeente Feijenoord te Rotterdam heeft een oplossing gevonden: speelplekken voor ouderen. Onder begeleiding van Sportfysiotherapie Spanjersberg hebben dertien ouderen vanaf oktober vorig jaar tien weken lang intensief getraind op de diverse speeltoestellen in Speeltuin Hillesluis. Zowel trainers als de ouderen zijn enthousiast over deze nieuwe manier van actief zijn. De ouderen misten nauwelijks een trainingssessie. Ze zijn zelfs zo gemotiveerd dat zij na afloop zijn blijven doortrainen. Het trainingsprogramma, dat ontwikkeld is door Sportfysiotherapie Spanjersberg in samenwerking met TNO, kan de balans van ouderen verbeteren en de angst om te vallen verminderen. Om de effectiviteit van het programma daadwerkelijk aan te tonen is onderzoek op een grotere schaal nodig met een grotere groep deelnemers. De speeltoestellen in Hillesluis zijn van de Finse speeltoestellenfabrikant Lappset en worden in Nederland op de markt gezet door Yalp. Lappset heeft het concept van een speelterrein ontwikkeld waar drie generaties bij elkaar komen. Een speelplaats waar naast kinderen ook ouders en grootouders gebruik maken van de speeltoestellen. Het gebruik van openbare speelplekken en de Lappset speeltoestellen bieden een nieuwe, goedkope en eenvoudige mogelijkheid om beweegprogramma's voor ouderen aan te bieden