Prospective associations between systolic blood pressure, serum cholesterol, and physical activity behaviour and the development of cardiovascular disease.

AIMS: To systematically appraise and summarise meta-analyses of longitudinal studies to determine the effect size, and quality and certainty of the evidence summaries for systolic blood pressure (SBP), serum cholesterol, and physical activity behaviour in developing cardiovascular disease (CVD). METHODS AND RESULTS: An umbrella review was conducted by searching MEDLINE, Embase, and Scopus databases. Eligible meta-analyses were longitudinal studies investigating the association between SBP, serum cholesterol, or physical activity behaviour on CVD development. Summary risk estimates were extracted. Quality and certainty of the evidence summaries of included records were performed using AMSTAR 2 and GRADE, respectively. Forty-one eligible records were found of which thirteen related to SBP, five to cholesterol, and twenty-three to physical activity behaviour. The quality and certainty of the evidence summaries were variable, with most studies rating 'low'. Reported risk estimates for the risk of developing CVD ranged from: no change to a 68% decreased risk for lower SBP; a 21% increased risk to a 44% decreased risk for lower cholesterol; and a 1% decreased risk to a 56% decreased risk for higher physical activity levels. CONCLUSIONS: There were strong associations with CVD risk at the meta-analysis level for all three exposures, with a proportionally greater number of meta-analyses and primary studies for physical activity than SBP or serum cholesterol. Given the number of meta-analyses and similar CVD risk reductions and certainty of evidence associated with physical activity behaviour, there is a strong case for its routine assessment alongside SBP and serum cholesterol in primary CVD prevention.

Resistance Band Exercise: An Effective Strategy to Reverse Cardiometabolic Disorders in Women With Osteosarcopenic Obesity.

We designed to evaluate the effects of resistance elastic band exercises (REBEs) on cardiometabolic/obesity-related biomarkers in older females with osteosarcopenic obesity. Sixty-three patients (aged 65-80 years) with osteosarcopenic obesity and a body mass index exceeding 30 kg/m2 were enrolled in the study. The participants were randomly assigned to either an experimental group (REBE, n = 32) or a usual care group (n = 31). The experimental group completed a 12-week REBE program, three times a week and 60 min per session. There were decreases in lipid accumulation product (p = .033), visceral adipose index (p = .001), triglyceride-glucose-body mass index (p = .034), and atherogenic index of plasma (p = .028) in the experimental group compared with the usual care group. Our findings highlight the importance of an REBE program in improving combined cardiometabolic/obesity-related indices in older women with osteosarcopenic obesity. The incorporation of an REBE program may benefit individuals who are unable to tolerate or participate in more strenuous exercise programs.

Physical activity interventions in older people with cancer: A review of systematic reviews.

INTRODUCTION: Whilst there has been a wealth of research on benefits of physical activity (PA) in people with cancer, with three published reviews of reviews, no review of reviews has focused on older adults (65 years or older) who may have unique biological characteristics and barriers. We summarised PA effectiveness from reviews where majority of study participants were 65 years or older. METHODS: Six databases were searched for systematic reviews of randomised controlled studies (RCTs)/quasi-RCTs examining any type of PA in reviews where majority of study participants were aged 65 years or older. Two reviewers conducted the search and analysis according to PRISMA and JBI guidelines. RESULTS: Fifteen reviews involving 76 different primary studies (5404 participants) were included. The majority (3827; 71%) had prostate cancer. PA was associated with benefits across multiple physical outcomes (muscle mass, functional performance, strength), improved fatigue and health service outcomes. In contrast to younger adults, there was no improvement in anxiety and mixed findings for quality of life and depression. CONCLUSION: PA is associated with multiple benefits in older adults with cancer, with some differences compared to younger individuals which may reflect biological or behavioural determinants. Future research should focus on mechanisms underlying PA effectiveness and underrepresented populations.

Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis.

OBJECTIVE: To assess whether physically active yoga is superior to waitlist control, treatment as usual and attention control in alleviating depressive symptoms in people with a diagnosed mental disorder recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM). DESIGN: Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DATA SOURCES: Data were obtained from online databases (MEDLINE, EMBASE, PsychINFO, CENTRAL, EMCARE, PEDro). The search and collection of eligible studies was conducted up to 14 May 2019 (PROSPERO registration No CRD42018090441). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included randomised controlled trials with a yoga intervention comprising ≥50% physical activity in adults with a recognised diagnosed mental disorder according to DSM-3, 4 or 5. RESULTS: 19 studies were included in the review (1080 participants) and 13 studies were included in the meta-analysis (632 participants). Disorders of depression, post-traumatic stress, schizophrenia, anxiety, alcohol dependence and bipolar were included. Yoga showed greater reductions in depressive symptoms than waitlist, treatment as usual and attention control (standardised mean difference=0.41; 95% CI -0.65 to -0.17; p<0.001). Greater reductions in depressive symptoms were associated with higher frequency of yoga sessions per week (ß=-0.44, p<0.01).

Approaches to determining occlusion pressure for blood flow restricted exercise training: Systematic review.

Low-intensity exercise with blood flow restriction (BFR) is an increasingly common method of improving muscular strength and hypertrophy, and improving aerobic fitness, in clinical and athletic populations. The aim of this systematic review was to describe common approaches to determining occlusion pressures for BFR exercise. A comprehensive literature search yielded 1389 results, of which 129 were included. Studies were predominantly randomised control trials (86.7%) with modest sample sizes (average number of 11.4 ± 6.2 participants per BFR group/s) of young adults (average age of 34.6 ± 17.9). Five different approaches for determining occlusion pressure were identified: arbitrary pressures (56.6%), percentage of limb occlusion pressure (25.6%), brachial systolic blood pressure (10.9%), perceived tightness (3.9%) and other (3%). From 2016 to 2018, the number of published papers using a percentage of limb occlusion pressure increased yearly, paralleling a decrease use of arbitrary pressures. Of the studies included in this review, the most common approach to determining occlusion pressure was using a non-individualised, arbitrary pressure. Given the safety concerns associated with arbitrary pressures, continual dissemination regarding the optimal applications of BFR for safety and efficacy is required.

Water-Based Interventions for People With Neurological Disability, Autism, and Intellectual Disability: A Scoping Review.

The purpose of this study was to produce a descriptive overview of the types of water-based interventions for people with neurological disability, autism, and intellectual disability and to determine how outcomes have been evaluated. Literature was searched through MEDLINE, EMBASE, Ovid Emcare, SPORTDiscus, Google Scholar, and Google. One hundred fifty-three papers met the inclusion criteria, 115 hydrotherapy, 62 swimming, 18 SCUBA (self-contained underwater breathing apparatus), and 18 other water-based interventions. Common conditions included cerebral palsy, spinal cord injury, Parkinson's disease, and intellectual disability. Fifty-four papers explored physical outcomes, 36 psychosocial outcomes, and 24 both physical and psychosocial outcomes, with 180 different outcome measures reported. Overall, there is a lack of high-quality evidence for all intervention types. This review provides a broad picture of water-based interventions and associated research. Future research, guided by this scoping review, will allow a greater understanding of the potential benefits for people with neurological disability, autism, and intellectual disability.

Self-reported physical activity levels of the 2017 Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference delegates and their exercise referral practices.

Background: Physical activity (PA) significantly improves physical health and clinical symptoms across mental disorders. Accredited Exercise Physiologists (AEPs) are trained to lead PA interventions for people with mental illness, but referrals to AEPs are low.Aims: To determine the knowledge and attitudes of delegates attending the 2017 Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference toward physical health monitoring and exercise interventions for people with mental illness.Methods: A cross-sectional survey of RANZCP delegates investigated knowledge and attitudes toward PA for people with mental illness, self-reported PA, and their understanding of AEP's role within mental health settings. A subgroup of delegates underwent fitness assessments.Results: Seventy-three delegates completed surveys and 24 underwent fitness assessments. Delegates demonstrated good knowledge regarding associations between PA and cardiovascular disease risk. Delegates were less knowledgeable of AEP's role within mental health settings. Forty-six participants (63%) did not meet the Australian recommended guidelines for PA. No association between referrals to AEPs and self-reported PA or fitness measures were evident.Conclusions: Promoting PA participation for mental health professionals, coupled with education on the important role AEPs play in the multidisciplinary treatment of mental health consumers is vital to improve health outcomes for this vulnerable group.

Diagnostic sensitivity of 2-day cardiopulmonary exercise testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

BACKGROUND: There are no known objective biomarkers to assist with the diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A small number of studies have shown that ME/CFS patients exhibit an earlier onset of ventilatory threshold (VT) on the second of two cardiopulmonary exercise tests (CPET) performed on consecutive days. However, cut-off values which could be used to differentiate between ME/CFS patients have not been established. METHODS: 16 ME/CFS patients and 10 healthy controls underwent CPET on a cycle-ergometer on 2-consecutive days. Heart rate (HR), ventilation, ratings of perceived exertion (RPE) and work rate (WR) were assessed on both days. RESULTS: WR at VT decreased from day 1 to day 2 and by a greater magnitude in ME/CFS patients (p < 0.01 group × time interaction). No interaction effects were found for any other parameters. ROC curve analysis of the percentage change in WR at VT revealed decreases of - 6.3% to - 9.8% provided optimal sensitivity and specificity respectively for distinguishing between patients with ME/CFS and controls. CONCLUSION: The decrease in WR at VT of 6.3-9.8% on the 2nd day of consecutive-day CPET may represent an objective biomarker that can be used to assist with the diagnosis of ME/CFS.

Correction to: The effect of functional overreaching on parameters of autonomic heart rate regulation.

The original version of this article unfortunately contained a mistake. The presentation of Equation was incorrect.

What is the effect of aerobic exercise intensity on cardiorespiratory fitness in those undergoing cardiac rehabilitation? A systematic review with meta-analysis.

OBJECTIVE: Assess the role of exercise intensity on changes in cardiorespiratory fitness (CRF) in patients with cardiac conditions attending exercise-based cardiac rehabilitation. DESIGN: Systematic review with meta-analysis. DATA SOURCES: MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO and Web of Science. ELIGIBILITY CRITERIA FOR SELECTION: Studies assessing change in CRF (reported as peak oxygen uptake; V̇O2peak) in patients post myocardial infarction and revascularisation, following exercise-based cardiac rehabilitation. Studies establishing V̇O2peak via symptom-limited exercise test with ventilatory gas analysis and reported intensity of exercise during rehabilitation were included. Studies with mean ejection fraction <40% were excluded. RESULTS: 128 studies including 13 220 patients were included. Interventions were classified as moderate, moderate-to-vigorous or vigorous intensity based on published recommendations. Moderate and moderate-to-vigorous-intensity interventions were associated with a moderate increase in relative V̇O2peak (standardised mean difference±95% CI=0.94±0.30 and 0.93±0.17, respectively), and vigorous-intensity exercise with a large increase (1.10±0.25). Moderate and vigorous-intensity interventions were associated with moderate improvements in absoluteV̇O2peak (0.63±0.34 and 0.93±0.20, respectively), whereas moderate-to-vigorous-intensity interventions elicited a large effect (1.27±0.75). Large heterogeneity among studies was observed for all analyses. Subgroup analyses yielded statistically significant, but inconsistent, improvements in CRF. CONCLUSION: Engagement in exercise-based cardiac rehabilitation was associated with significant improvements in both absolute and relative V̇O2peak. Although exercise of vigorous intensity produced the greatest pooled effect for change in relative V̇O2peak, differences in pooled effects between intensities could not be considered clinically meaningful. REGISTRATION: Prospero CRD42016035638.

A randomised controlled trial of movement quality-focused exercise versus traditional resistance exercise for improving movement quality and physical performance in trained adults.

The aim of this trial was to compare an eight-week individual movement quality versus traditional resistance training intervention on movement quality and physical performance. Forty-six trained adults were randomised to a movement quality-focused training (MQ) or a traditional resistance training (TRAD) group, and performed two individualised training sessions per week, for 8 weeks. Session-RPE (sRPE) was obtained from each session. Measures of movement quality (MovementSCREEN and Functional Movement Screen (FMS)) and physical performance were performed pre- and post-intervention. All measures improved significantly in both groups (3-14.5%, p = <0.005). The between-group difference in MovementSCREEN composite score was not statistically significant (0.3, 95% CI -3.4, 4.1, p = 0.852). However, change in FMS composite was significantly greater in MQ (1.3, 95% CI 0.8, 1.8, p < 0.001). There were no significant between-group differences in physical performance (p = 0.060-0.960). The mean sRPE was significantly lower in MQ (5.25, SD 1.2) compared to TRAD (6.6 SD 1.0, p = <0.001). Thus, although movement quality scores were not distinctly greater in the MQ group, a movement quality specific intervention caused comparable improvements in physical performance compared to traditional resistance training but at lower perceived training intensity.

The roles of exercise professionals in the health care system: A comparison between Australia and China.

Physical inactivity is identified by the World Health Organisation as the fourth risk factor for global mortality and has major implications on the prevalence of non-communicable diseases and general health of the populations. There has been substantial evidence indicating that adequate levels of physical activity, such as prescribed exercise, can be an effective intervention for prevention and treatment of many chronic health conditions, as well as for improvement of mental health, quality of life and well-being. Many countries in the world have developed policies and guidelines for promotion of participation in physical activity and application of prescribed exercise as a means of intervention for chronic health conditions. Subsequently, the roles of exercise professionals in the community and health care system who provide services to the general community members, individuals with various health conditions, as well as elite athletes, and their professional training, qualifications and standards need to be defined and implemented. This article provides a preliminary comparison of the exercise professionals and their current roles in the community and health care systems between Australia and China (including mainland, Taiwan and Hong Kong, as they have different health care systems), aiming to promote the recognition of exercise professionals in the health care systems, and facilitate the global development of the exercise-related professions, for a healthier world.

A Case Study of Exercise Adherence during Stereotactic Ablative Radiotherapy Treatment in a Previously Active Male with Metastatic Renal Cell Carcinoma.

Stereotactic Ablative Radiotherapy (SABR) is increasingly replacing thoracotomy for resection of lung cancers and oligometastatic lung lesions but it is not known whether exercise can be maintained during SABR, the major side-effect of which is fatigue. This case study describes a 57-year-old male who exercised regularly (above American College of Sports Medicine minimum weekly exercise guidelines) and continued to exercise during SABR for a renal cell metastasis in his left lung. His exercise program included 5x60-minute moderate intensity aerobic exercise sessions and 3x45-minute resistance exercise sessions per week for 12 weeks post-treatment. Cardiorespiratory fitness and strength, as well as self-reported fatigue, depression, anxiety, physical wellbeing and sleep quality were assessed at baseline and fortnightly. Exercise adherence was 98% and no adverse events occurred. Fatigue was elevated from Weeks 2-8, which adversely impacted exercise intensity perception. Minimal changes were observed in cardiorespiratory fitness, depression, anxiety and sleep quality, but strength decreased, and physical wellbeing was improved above baseline levels. This is the first reported clinical case of exercise during SABR for a lung carcinoma. The data suggest that exercise may be feasible for patients undergoing SABR and may improve physical wellbeing. Larger controlled studies are needed to confirm these findings.

Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials.

OBJECTIVE: To systematically appraise and summarise meta-analyses investigating the effect of exercise compared with a control condition on health outcomes in cancer survivors. DESIGN: Umbrella review of intervention systematic reviews. DATA SOURCES: Web of Science, Scopus, Cochrane Library, CINAHL and MEDLINE databases were searched using a predefined search strategy. ELIGIBILITY CRITERIA: Eligible meta-analyses compared health outcomes between cancer survivors participating in an exercise intervention and a control condition. Health outcomes were cardiovascular fitness, muscle strength, health-related quality of life, cancer-related fatigue and depression. Pooled effect estimates from each meta-analysis were quantified using standardised mean differences and considered trivial (<0.20), small (0.20-0.49), moderate (0.50-0.79) and large (≥0.80). Findings were summarised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: There were 65 eligible articles that reported a total of 140 independent meta-analyses. 139/140 meta-analyses suggested a beneficial effect of exercise. The beneficial effect was statistically significant in 104 (75%) meta-analyses. Most effect sizes were moderate for cardiovascular fitness and muscle strength and small for cancer-related fatigue, health-related quality of life and depression. The quality of evidence was variable according to the GRADE scale, with most studies rated low or moderate quality. Median incidence of exercise-related adverse events was 3.5%. CONCLUSION: Exercise likely has an important role in helping to manage physical function, mental health, general well-being and quality of life in people undergoing and recovering from cancer and side effects of treatment. PROSPERO REGISTRATION NUMBER: CRD42015020194.

The effect of functional overreaching on parameters of autonomic heart rate regulation.

PURPOSE: Correlations between fatigue-induced changes in performance and maximal rate of HR increase (rHRI) may be affected by differing assessment workloads. This study evaluated the effect of assessing rHRI at different workloads on performance tracking, and compared this with HR variability (HRV) and HR recovery (HRR). METHODS: Performance [5-min cycling time trial (5TT)], rHRI (at multiple workloads), HRV and HRR were assessed in 12 male cyclists following 1 week of light training (LT), 2 weeks of heavy training (HT) and a 10-day taper (T). RESULTS: 5TT very likely decreased after HT (effect size ± 90% confidence interval = -0.75 ± 0.41), and almost certainly increased after T (1.15 ± 0.48). rHRI at 200 W likely increased at HT (0.70 ± 0.60), and then likely decreased at T (-0.50 ± 0.70). rHRI at 120 and 160 W was unchanged. Pre-exercise HR during rHRI assessments at 120 W and 160 W likely decreased after HT (≤-0.39 ± 0.14), and correlations between these changes and rHRI were large to very large (r = -0.67 ± 0.31 and r = -0.78 ± 0.23). When controlling for pre-exercise HR, rHRI at 120 W very likely slowed after HT (-0.72 ± 0.44), and was moderately correlated with 5TT (r = 0.35 ± 0.32). RMSSD likely increased at HT (0.75 ± 0.49) and likely decreased at T (-0.49 ± 0.49). HRR following 5TT likely increased at HT (0.84 ± 0.31) and then likely decreased at T (-0.81 ± 0.35). CONCLUSIONS: When controlling for pre-exercise HR, rHRI assessment at 120 W most sensitively tracked performance. Increased RMSSD following HT indicated heightened parasympathetic modulation in fatigued athletes. HRR was only sensitive to changes in training status when assessed after maximal exercise, which may limit its practical applicability.

Maximal rate of heart rate increase correlates with fatigue/recovery status in female cyclists.

PURPOSE: Being able to identify how an athlete is responding to training would be useful to optimise adaptation and performance. The maximal rate of heart rate increase (rHRI), a marker of heart rate acceleration has been shown to correlate with performance changes in response to changes in training load in male athletes; however, it has not been established if it also correlates with performance changes in female athletes. METHODS: rHRI and cycling performance were assessed in six female cyclists following 7 days of light training (LT), 14 days of heavy training (HT) and a 10 day taper period. rHRI was the first derivative maximum of a sigmoidal curve fit to R-R data recorded during 5 min of cycling at 100 W. Cycling performance was assessed as work done (kJ) during time-trials of 5 (5TT) and 60 (60TT) min duration. RESULTS: 5TT was possibly decreased at HT (ES ± 90% confidence interval = - 0.16 ± 0.25; p = 0.60), while, 5TT and 60TT very likely to almost certainly increased from HT to taper (ES = 0.71 ± 0.24; p = 0.007 and ES = 0.42 ± 0.19; p = 0.02, respectively). Large within-subject correlations were found between rHRI, and 5TT (r = 0.65 ± 0.37; p = 0.02) and 60TT (r = 0.70 ± 0.31; p = 0.008). CONCLUSIONS: rHRI during the transition from rest to light exercise correlates with training induced-changes in exercise performance in females, suggesting that rHRI may be a useful monitoring tool for female athletes.

Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

Validity of a perceptually-regulated step test protocol for assessing cardiorespiratory fitness in healthy adults.

PURPOSE: To determine whether maximal oxygen uptake (VO2max) could be predicted accurately and reliably from a 2-step, perceptually-regulated exercise test (PRET) in healthy adults. METHODS: Sixteen participants (31.7 ± 11.3 years, 3 females) completed three PRETs (separated by 24-72 h) and one maximal, perceptually-regulated, graded exercise test (PRETmax) on a motorized treadmill. Oxygen uptake (VO2) and heart rate (HR) were recorded during each test. VO2 values for RPE range 9-15 were extrapolated to RPE 20 and age-predicted maximal HR (HRmax) using individual linear regression analysis to predict VO2max values compared to measured VO2max. RESULTS: VO2 and HR values were consistent between each of four RPE levels of the PRET. ICC values ranged between 0.76 and 0.85. Predicted VO2max from both methods were lower than measured VO2max (p < 0.01). Limits of agreement (LoA) for measured (41.4 ± 5.3 ml kg-1 min-1) versus predicted VO2max from each of the three PRETs using RPE20 were -1.2 ± 15.6, -1.0 ± 7.2 and -2.1 ± 5.5 and for HRmax were -1.8 ± 4.2; -2.6 ± 4.2 and -2.4 ± 4.4 ml kg-1 min-1 for PRET 1, 2 and 3, respectively. CONCLUSIONS: The step PRET elicited significant and reliable increases in VO2 across the four RPE levels, but under-estimated treadmill VO2max. However, there was better agreement between measured and predicted VO2max when extrapolated to HRmax. As evidence indicates the underestimation of VO2max is explained by the difference in the mode of exercise, the step PRET provides a simple and convenient test of cardiorespiratory fitness.

Prioritising restorative care programs in light of current age care reform.

BACKGROUND: Short-term restorative care (STRC) aims to reduce the demand for long-term aged care services through 8 weeks of intensive, multidisciplinary services designed to enhance the independence of community-dwelling older Australians at risk of functional decline. Evidence surrounding the effectiveness and feasibility of STRC is limited. OBJECTIVE: This study aimed to examine the effectiveness of an existing exercise-based STRC model and help inform successful service delivery to maximise participant outcomes nationally. METHODS: An observational cohort study was conducted to evaluate the potential benefits accrued by community-dwelling older adults accessing Southern Cross Care's current exercise-based STRC model in Adelaide, South Australia. Program effectiveness was determined via improvements in outcome measures specific to functional decline risk factors from baseline (Week 0) to discharge (Week 8). RESULTS: Results demonstrated significant improvements (p < 0.001) in participants' (n = 62) lower extremity function (44.9%), depressive symptoms (52.4%), anxiety (45.8%), frailty stage (57.9%), independence in activities of daily living (17.3%) and health-related quality of life (24.0%). No significant change was found for grip strength or BMI post-intervention. The most frequent services were exercise-based (54.3% of total services), with participants receiving an average of two to three exercise services per week. CONCLUSIONS: An exercise-based STRC model is an effective mechanism to reverse functional decline and associated risk factors among community-dwelling older Australians. Adoption of multidisciplinary intervention as a standardised STRC service model could help improve client outcomes nationally and offset expected increases in community and long-term aged care demand.