Exercise and physical activity for older adults American College of Sport Medicine Position Stand Med Sci Sports Exerc 2009 41 1510 1530 10.1249/MSS.0b013e3181a0c95c
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Article: Exercise and physical activity for older adults American College of Sport Medicine Position Stand Med Sci Sports Exerc 2009 41 1510 1530 10.1249/MSS.0b013e3181a0c95c
- SourceAvailable from: Mylène Aubertin-Leheudre
[Show abstract] [Hide abstract] ABSTRACT: Background: Maintaining a physically active lifestyle promotes general health. Recent studies have demonstrated that patients with Parkinson's disease (PD) fail to meet the suggested levels of physical activity and that targeted interventions do not always improve this behavior. One validated treatment for motor symptoms in PD is subthalamic stimulation (STN DBS). Objective: Assess whether motor symptom improvement following STN DBS translated into increased physical activity behavior. Methods: Twenty-two patients with PD scheduled for STN DBS filled-out the Phone-FITT physical activity questionnaire and the SF-36 quality of life questionnaire prior to surgery and 6 to 9 months postoperatively. Data were compared to age- and gender-matched healthy controls. Results: Our results demonstrate that PD patients' quality of life is significantly lower than healthy controls. While STN DBS improves motor symptoms in the intermediate term, it only improves some aspects of quality of life related to physical function. Furthermore, STN DBS did not modify physical activity behavior measured by the Phone-FITT, whether for household or recreational activities. Conclusion: The current study demonstrates that the motor improvements observed after STN DBS do not lead to systematic improvements in all aspects of quality of life or increased levels of physical activity. This highlights the need to develop and implement intervention strategies to promote an active lifestyle in this population, even if clinical improvement is evident following surgery.
- "The current results also support the previously demonstrated notion that patients are not physically active and fail to meet the daily recommendation of physical activity [21, 26–29]. It is well known that participation in physical activity improves mobility in healthy elderly   and disabled elderly individuals , which in turn may improve QoL. Therefore more emphasis should be placed on improving the physical activity behavior of PD patients. "
[Show abstract] [Hide abstract] ABSTRACT: The purpose of this cross-sectional study was to examine the changes in the temporal parameters measured during the performance of the Step Test, to evaluate the relationship between age and these measurements and to determine their relationships to aerobic endurance, muscular strength and mobility in a sample of older adults. Eighty-eight older adults (mean age = 73.0 years SD = 5.4) participated in the study. During the Step Test, we collected measurements of the following temporal parameters using the Optojump system: step number, support time and executive time. We also evaluated the performance of the Six-Minute Walk Test, the 30-Second Chair Rise Test and the Timed Up and Go Test. We observed a significant decrease in the step number and an increase in the support time and executive time (p = .001) during each minute of the test. The results revealed that the relationship between age and Step Test performance was attenuated when we controlled for potential confounding variables. Controlling for age, gender and BMI, variance in support time during the Step Test was accounted for by variance in 30-Second Chair Rise Test performance (partial r = -.224). Moreover, variance in executive time was accounted for by variance in 30-Second Chair Rise Test (partial r = .234) and Timed Up and Go Test performance (partial r = -.259). Understanding the factors that are associated with the performance of the Step Test may provide new insights into the development of specific intervention programs for older adults.
- "These findings may be related to the fact that in older adults, the stepping task is a destabilising skill  and is linked with functional decline . Due to the decline in physiological reserves and in physical capacities , older adults require more support time and executive time, and consequentially, a decrease in the step number performance occurs. This may appear to reflect a compensatory strategy to maintain balance and safety , probably for counteracting the adverse fatigue effects and the potential risk factors . "
[Show abstract] [Hide abstract] ABSTRACT: Background Exercise and adequate self-management capacity may be important strategies in the management of venous leg ulcers. However, it remains unclear if exercise improves the healing rates of venous leg ulcers and if a self-management exercise program based on self-efficacy theory is well adhered to. Method/design This is a randomised controlled in adults with venous leg ulcers to determine the effectiveness of a self-efficacy based exercise intervention. Participants with venous leg ulcers are recruited from 3 clinical sites in Australia. After collection of baseline data, participants are randomised to either an intervention group or control group. The control group receive usual care, as recommended by evidence based guidelines. The intervention group receive an individualised program of calf muscle exercises and walking. The twelve week exercise program integrates multiple elements, including up to six telephone delivered behavioural coaching and goal setting sessions, supported by written materials, a pedometer and two follow-up booster calls if required. Participants are encouraged to seek social support among their friends, self-monitor their weekly steps and lower limb exercises. The control group are supported by a generic information sheet that the intervention group also receive encouraging lower limb exercises, a pedometer for self-management and phone calls at the same time points as the intervention group. The primary outcome is the healing rates of venous leg ulcers which are assessed at fortnightly clinic appointments. Secondary outcomes, assessed at baseline and 12 weeks: functional ability (range of ankle motion and Tinetti gait and balance score), quality of life and self-management scores. Discussion This study seeks to address a significant gap in current wound management practice by providing evidence for the effectiveness of a home-based exercise program for adults with venous leg ulcers. Theory-driven, evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact in improving the management of people with venous leg ulcers. Information gained from this study will provide much needed information on management of this chronic disease to promote health and independence in this population. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612000475842.
- "Lower limb resistance exercises (5–6 sessions/week) are strongly encouraged, as strength training has benefits of improving the capacity of the calf muscle pump to return blood to the heart and lower venous hypertension [25,26] and is consistent with exercise guidelines for older adults . In the exercise intervention booklet, participants are provided with detailed pictures and instructions, and guidelines on the number of sets and repetitions of each exercise, along with options for progression. "