Synchronous Group-Based Online Exercise Programs for Older Adults Living in the Community: A Scoping Review.

Older adults are the least physically active group with specific barriers to regular exercise, and online exercise programs could overcome some of those barriers. This scoping review aimed to describe the characteristics of supervised group-based synchronous online exercise programs for older adults living in the community, their feasibility, acceptability, and potential benefits. MEDLINE (Ovid), Embase, SPORTDiscus, and the Cumulative Index to Nursing and Allied Health Literature were searched until November 2022. The included studies met the following criteria: participants aged 50 years and above, a minimum of a 6-week group-based supervised and synchronous intervention, and original articles available in English. Eighteen articles were included, with 1,178 participants (67% female, average age of 71 [57-93] years), most (83%) published in the past 3 years. From the limited reported studies, delivering supervised, synchronous online exercise programs (one to three times/week, between 8 and 32 weeks) for older adults living in the community seems feasible, accepted, and can improve physical function.

Resistance Training on an Outdoor Exercise Structure Improves Lower-Body Relative Strength in Older Adults.

Improving relative strength is important for maintaining functionality with age, and outdoor exercise structures could be useful to facilitate this. A total of 29 adults aged 65+ participated in a non-randomized crossover study with a 6-week control followed by a 6-week resistance training intervention on an outdoor exercise structure (3x/week). Relative strength (predicted maximal leg press/lower body lean mass [Dual-energy X-ray Absorptiometry]) and physical function variables were measured at baseline, post-control, and post-intervention. Represented as median (25th-75th), lower body relative strength improved from 7.91 (7.01-9.35) post-control to 8.50 (7.99-9.72) post-intervention (p = .002) in study completers (n = 17). Maximum leg press (p = .002), 30-second chair stand (p < .001), one-leg stance (p = .011), and maximum chest press (p = .009) also improved significantly during the intervention. There were no significant changes in aerobic activity, grip strength, lean mass, or muscle power. This study demonstrates that there could be potential relative strength benefits associated with the use of outdoor exercise structures in older adults.

Impact of Outdoor Play Structures on Moderate to Vigorous Physical Activity in Children during Recess: A Comparative Study.

BACKGROUND/OBJECTIVES: It is believed that outdoor play structures lead to more physical activity for kids during school recess. However, the intensity of this activity remains unknown. This study explored whether access to outdoor play structures during recess interferes with children's physical activity levels. METHODS: Forty-one children (8-10 years old) accessed play structures during the afternoon recess but not in the morning for one entire week. To control for temperature differences, the same number of participants from another school who did not access playground structures were invited to participate. Moderate to Vigorous Physical Activity (MVPA) was determined using heart rate reserve. Heart rate was recorded using the Fitbit Inspire 2 (San Francisco, CA, USA) for at least three full school days. Wilcoxon signed-rank and Mann-Whitney U tests analyzed within- and between-group differences. RESULTS: The findings show no difference in MVPA when accessing or not accessing outdoor play structures, both within groups [(n = 37) median (25th-75th) 16 min (7-30) vs. 14 min (5-22)] and between groups [(n = 22) 16 min (7-26)]. The weekly MVPA for all participants (n = 59) [172 min (117-282)] was the strongest variable associated with MVPA during recess [t(df) = 5.40 (38), 95% CI 0.04-0.09, p < 0.001]. CONCLUSION: accessibility to outdoor play structures does not increase MVPA during recess in children aged 8 to 10. Therefore, schools may need various options for children to play during recess, allowing them to accumulate MVPA.

Increasing aerobic exercise intensity fails to consistently improve the glycemic response in people living with prediabetes or type 2 diabetes mellitus: the INTENSITY trial.

Some individuals with prediabetes or type 2 diabetes mellitus (T2DM) who engage in exercise will not experience the anticipated improvements in glycemic control, referred to as non-responders. Increasing exercise intensity may improve the proportion of individuals who become responders. The objectives were to (i) identify responders and non-responders based on changes in glycated hemoglobin (HbA1c) in individuals with prediabetes or T2DM following 16 weeks of aerobic exercise; (ii) investigate if increasing exercise intensity enhances the responders' status for individuals not previously responding favourably to the intervention. Participants (n = 40; age = 58.0 years (52.0-66.0); HbA1c = 7.0% (6.0-7.2)) engaged in a two-phase, randomized study design. During phase one, participants performed 16 weeks of treadmill-based, supervised, aerobic exercise at 4.5 metabolic equivalents (METs) for 150 min per week. Thereafter, participants were categorized as responders, non-responders, or unclear based on the 90% confidence interval above, below, or crossing a 0.3% reduction in HbA1c. For phase two, participants were randomized to a maintained intensity (4.5 METs) or increased intensity (6.0 METs) group for 12 weeks. Following phase one, two (4.1%) participants were categorized as responders, four (8.2%) as non-responders, and 43 (87.7%) as unclear. Following phase two, two from the increased intensity group and one from the maintained intensity group experienced an improvement in response categorization. There were no significant between or within group (maintained vs. increased) differences in HbA1c. For most people with prediabetes or T2DM, increasing exercise intensity by 1.5 METs does not improve response categorization.

Does type 2 diabetes duration influence the effectiveness of an aerobic exercise intervention: Results from the INTENSITY study.

BACKGROUND: Studies suggest that longer durations of T2DM increase the risk of T2DM complications and premature mortality. However, whether T2DM duration impacts the efficacy of an aerobic exercise intervention is unclear. OBJECTIVE: The purpose of this study was: 1) to compare changes in body composition, cardiorespiratory fitness, and glycemia between individuals with short- and long-duration T2DM after aerobic exercise and 2) to determine whether these changes were associated with changes in glycemia by T2DM duration. METHODS: A secondary analysis of the INTENSITY study (NCT03787836), including thirty-four adults (≥19 years) with T2DM who participated in 28 weeks of aerobic exercise training for 150 minutes per week at a moderate-to-vigorous intensity (4.5 to 6.0 metabolic equivalents (METs)). Using pre-established cut-points, participants were categorized into two groups 1) short-duration T2DM (<5 years) or 2) long-duration T2DM (≥5 years). Glycemia was measured by glycated hemoglobin (HbA1c), body composition by BodPod, and cardiorespiratory fitness by a measure of peak oxygen consumption (VO2peak). All measurements were performed at baseline, 16 weeks, and 28 weeks. RESULTS: Participants in the short-duration T2DM group experienced decreases in fat mass (kg) (p = 0.03), HbA1c (p = 0.05), and an increased relative VO2peak (p = 0.01). Those with long-duration T2DM experienced decreases in fat mass (kg) (p = 0.02) and HbA1c (p <0.001) and increased fat-free mass (p = 0.02). No significant differences were observed between groups in any outcomes. Changes in fat mass (r = 0.54, p = 0.02), and body fat percentage (r = 0.50, p = 0.02) were significantly associated with the change in HbA1c in those with a long-duration T2DM only. CONCLUSION: Our results suggest T2DM duration did not differently impact the efficacy of a 28-week aerobic exercise intervention. However, changes in body composition were associated with better glycemia in individuals with longer T2DM duration only.

Association between changes in habitual stepping activity and cognition in older adults.

Advancing age is associated with declines in cognitive function. Although physical activity is thought to protect against this decline, it is unclear how a short-term uptake in daily steps or a decline in day-to-day step variability may contribute to cognition among older adults. We tested associations between changes in step counts, day-to-day step variability and executive cognitive functions among older adults taking part in a physical activity intervention. Thirty-seven older adults (33 females; 71.4 ± 6.3 years) completed a 10-week personalized physical activity intervention. Participants wore a Fitbit to measure daily step counts throughout the study. They also completed a computerized Stroop task before and after the intervention. Average step counts and step count variability via average-real-variability (ARV) were determined. Compared to pre-intervention, step counts increased (p < 0.001) and step variability decreased post-intervention (p = 0.04). Models describing the changes in step counts and ARV over the 10-weeks were cubic (both, p < 0.04). Reaction times during the simple (p = 0.002) and switching (p = 0.04) conditions were faster post-intervention. Change in step variability was positively associated with the change in reaction time for the switching condition (ß = 0.029, p = 0.002). On average, a reduction in day-to-day step variability was associated with improvements in cognitive flexibility.

Association between physical fitness and executive functions in cognitively healthy female older adults: a cross-sectional study.

Cardiovascular endurance and muscular fitness seem to impact specific cognitive components in older females. However, it remains uncertain whether these relate to executive functions or if these correlations are limited to specific physical fitness indicators. This study aimed to determine the association between specific physical fitness components and executive functions in community-dwelling older females. Thirty-five cognitively healthy community-dwelling older females (71.5 ± 5.7 years) underwent a series of physical fitness tests. These included the handgrip strength test (HGT), the 6-min walk test (6MWT), the 8-foot up-and-go test (8FUGT), and the chair stand test (CST). Participants also completed trail A and trail B of the cognitive trail making test. Results showed that trail B reaction time had a negative association with both HGT (r = - 0.502; p = 0.002) and 6MWT (r = - 0.543; p < 0.001). Together, the HGT and 6MWT results explained 39% of the variation in trail B reaction times: HGT accounted for 18% and 6MWT for 21%. Better scores on the 6MWT and HGT-but not on the 8FUGT and CST-correlated with enhanced executive function in cognitively healthy community-dwelling older females. The results of this study underscore the importance of specific physical assessments, like the 6MWT and HGT, as potential indicators of executive function, offering targeted strategies for maintaining cognitive health in aging females.