Should physical activity programs be tailored when older adults have compromised function?

Dept. of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
Journal of aging and physical activity (Impact Factor: 1.41). 07/2009; 17(3):294-306.
Source: PubMed

ABSTRACT The purpose of this study was to determine whether a walking program supplemented by tasks designed to challenge balance and mobility (WALK+) could improve physical function more than a traditional walking program (WALK) in older adults at risk for mobility disability. 31 community-dwelling older adults (M +/- SD age = 76 +/- 5 yr; Short Physical Performance Battery [SPPB] score = 8.4 +/- 1.7) were randomized to treatment. Both interventions were 18 sessions (1 hr, 3x/wk) and progressive in intensity and duration. Physical function was assessed using the SPPB and the 400-m-walk time. A subset of participants in the WALK group who had relatively lower baseline function showed only small improvement in their SPPB scores after the intervention (0.3 +/- 0.5), whereas a subset of participants in the WALK+ group with low baseline function showed substantial improvement in their SPPB scores (2.2 +/- 0.7). These preliminary data underscore the potential importance of tailoring interventions for older adults based on baseline levels of physical function.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To investigate effects of interventions to promote long-term participation in physical activity (PA) on measures of frequency, duration or intensity of PA at three months or longer in community dwelling stroke survivors. Data Sources Medline, CINAHL and PsycINFO between 1987 and December 2012. Search terms included “physical activity, exercise promotion”; “stroke”; “behaviour change interventions” and synonyms. Study Selection Randomised controlled trials or comparison studies involving stroke survivors, with follow-up of > 3 months, examining interventions to increase long-term participation in PA. Data Extraction PRISMA guidelines informed data extraction. Risk of bias was assessed using the Cochrane Collaboration tool. Two reviewers independently reviewed abstracts and extracted data. Data Synthesis Of 2,888 studies, 11 involving 1,704 participants were included. Risk of bias occurred in randomisation methods and blinding. Limited data and study heterogeneity meant data pooling was not possible. Odds ratios and continuous data as weighted mean differences were however calculated using fixed-effect models and 95% confidence intervals. Two intervention types were identified: individualised tailored counselling with or without supervised exercise (n=6 studies) and supervised exercise with advice (n=5). Three studies illustrated increased odds of meeting recommended PA levels and participation in PA at 12 months following tailored counselling (p<0.05). Two studies showed improved step count at three months with supervised exercise only (p<0.05), however PA levels had declined by three months. Tailored home exercise was the only predominantly exercise based intervention to demonstrate higher PA participation at 12 months. Conclusions This study provides some evidence that tailored counselling alone or with tailored supervised exercise improves long-term PA participation and functional exercise capacity after stroke better than tailored supervised exercise with general advice only. Interventions to improve participation in physical activity should incorporate PA specific tailored counselling based on sound behavioural theory to promote long-term participation in PA.
    Archives of physical medicine and rehabilitation 05/2014; DOI:10.1016/j.apmr.2013.12.016 · 2.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Considerable research over the past decade has garnered support for the notion that the mind is both embodied and relational. Jointly, these terms imply that the brain, physical attributes of the self, and features of our interpersonal relationships and of the environments in which we live jointly regulate energy and information flow; they codetermine how we think, feel, and behave both individually and collectively. In addition to direct experience, evidence supports the view that stimuli embedded within past memories trigger multimodal simulations throughout the body and brain to literally recreate lived experience. In this paper, we review empirical support for the concept of an embodied and relational mind and then reflect on the implications of this perspective for clinical interventions in aging individuals and populations. Data suggest that environmental influences literally "get under the skin" with aging; that musculoskeletal and visceral sensations become more prominent in activities of the mind due to aging biological systems and chronic disease. We argue that conceiving the mind as embodied and relational will grow scientific inquiry in aging, transform how we think about the self-system and well-being, and lead us to rethink health promotion interventions aimed at aging individuals and populations.
    Clinical Interventions in Aging 06/2013; 8:657-65. DOI:10.2147/CIA.S44797 · 1.82 Impact Factor
  • Source


Available from
Jun 11, 2014