The Functional Effects of Physical Exercise Training in Frail Older People

Department of Public and Occupational Health, VU University Medical Center, Amsterdam, the Netherlands.
Sports Medicine (Impact Factor: 5.04). 02/2008; 38(9):781-93. DOI: 10.2165/00007256-200838090-00006
Source: PubMed

ABSTRACT This systematic review describes the effect of exercise training on physical performance in frail older people. Randomized controlled trials were identified from searches in PubMed, EMBASE and CENTRAL from January 1995 through August 2007. Two reviewers independently screened the trials for eligibility, rated their quality, and extracted data. Randomized controlled trials that examined the effects on performance-based measures of physical function among frail older adults were included. The systematic search identified 20 studies, examining 23 different exercise programmes. The methodological quality score (0-9) of the trials ranged from 2 to 7 points. Sixteen of the studies were scored as high quality. There was a large variety in the studies concerning sample size, degree of frailty, types of interventions and types of assessments. The majority of the programmes were facility-based, group-exercise programmes that were performed three times a week for 45-60 minutes. The intervention programmes comprised resistance training (n = 9), Tai Chi training (n = 2), or multi-component training (n = 12). Six of the total selected 20 studies did not find a beneficial exercise effect on functional performance. This systematic review suggests that older adults with different levels of abilities can improve their functional performance by regular exercise training. To determine the most appropriate design of the exercise programme (type, intensity, frequency and duration of exercise) for functional improvement or prevention of loss of function, more high-quality trials are needed in which different training protocols are compared.

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    • "These results and other several lines of evidence suggest that the primary BMS associated with neuropathic disorder might be peripheral, central or mixed depending on the individual [17] [24]. Thus, although a variety of pain interventions have been developed and their effectiveness have been investigated , the dropout rate in pain management has always been high and a matter of concern [27] [42]. Poor attendance rates and poor compliance with interventions are factors contributing to the unsatisfactory effect of pain management interventions. "
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    ABSTRACT: Please cite this article in press as: Naganawa T, et al. Effect of motivational interviewing on medication non-adherence for patients with chronic intraoral pain. J Oral Maxillofac Surg Med Pathol (2015), http://dx. a b s t r a c t Motivational interviewing (MI) is a technique for helping clients to recognize and address their problems. This approach is useful for clients who are reluctant to change or who are ambivalent about changing their behaviors. We describe a case of medication non-adherence in a patient with chronic intraoral neuropathic pain. A 54-year-old man visited the Tokyo Women's Medical University Hospital with spontaneous pain on the gingiva and tongue. Although, pharmacotherapy was initiated, pain management was inadequate. The patient was unwilling to take any more medications (medication non-adherence) because of his previous experience, where the medications prescribed were non-effective in controlling his pain. MI was performed for his ambivalent condition (unwilling to take medicine vs. willing to achieve pain relief). The patient's behavior changed after three MI sessions, and then 2 weeks of pharma-cotherapy (amitriptyline, 10 mg/day) decreased the pain score from 8 to 4 on the numerical rating scale (0–10). Another 8 weeks on amitriptyline at 20 mg/day further improved pain score from 4 to 0. MI may be effective as a psychological approach for addressing non-adherence to medication in the management of chronic intraoral pain.
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    • "que se requiere . Hay casos donde una función cognitiva responde a un tipo de ejercicio y no a otro ( Angevaren , Aufdemkampe , Verhaar , Aleman y Vanhees , 2008 ) . Además , se han reportado estudios con resultados inconsistentes , con problemas metodológicos que no permiten establecer una suficiente relación clínica o estadística significativa ( Chin et al . , 2008 ; Smith et al . , 2013 ) ."
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    • "Experts predominantly working in the healthcare sector stressed the importance of progression for all users of CBE – whether it is to standing exercise programmes or a progressively challenging seated programme. Progressively challenging programmes are supported by evidence of effective exercise for frail older people [17] and identify that if delivered appropriately CBE can be underpinned by the principles of exercise for frail older people [18]. "
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    ABSTRACT: Background: Chair based exercise (CBE) is suggested to engage older people with compromised health and mobility in an accessible form of exercise. A systematic review looking at the benefits of CBE for older people identified a lack of clarity regarding a definition, delivery, purpose and benefits. This study aimed to utilise expert consensus to define CBE for older people and develop a core set of principles to guide practice and future research. Methods: The framework for consensus was constructed through a team workshop identifying 42 statements within 7 domains. A four round electronic Delphi study with multi-disciplinary health care experts was undertaken. Statements were rated using a 5 point Likert scale of agreement and free text responses. A threshold of 70% agreement was used to determine consensus. Free text responses were analysed thematically. Between rounds a number of strategies (e.g., amended wording of statements, generation and removal of statements) were used to move towards consensus. Results: 16 experts agreed on 46 statements over four rounds of consultation (Round 1: 22 accepted, 3 removed, 5 new and 17 modified; Round 2: 16 accepted, 0 removed, 4 new and 6 modified; Round 3: 4 accepted, 2 removed, 0 new and 4 modified; Round 4: 4 accepted, 0 removed, 0 new, 0 modified).Statements were accepted in all seven domains: the definition of CBE (5), intended users (3), potential benefits (8), structure (12), format (8), risk management (7) and evaluation (3).The agreed definition of CBE had five components: 1. CBE is primarily a seated exercise programme; 2. The purpose of using a chair is to promote stability in both sitting and standing; 3. CBE should be considered as part of a continuum of exercise for frail older people where progression is encouraged; 4. CBE should be used flexibly to respond to the changing needs of frail older people; and 5. Where possible CBE should be used as a starting point to progress to standing programmes. Conclusions: Consensus has been reached on a definition and a set of principles governing CBE for older people; this provides clarity for implementation and future research about CBE.
    BMC Geriatrics 05/2014; 14(1-1):65. DOI:10.1186/1471-2318-14-65 · 1.68 Impact Factor
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