Are interventions effective in improving the ability of older adults to rise from the floor independently? A mixed method systematic review.

Purpose: To review available evidence on older people's ability to get up off the floor independently and determine the effectiveness of interventions to improve older adults' ability to rise from the floor.Materials and methods: Seven databases were searched between January 1975 and June 2018. Eligibility criteria included: people aged ≥60; interventions to improve strength/function including ability to get up off the floor (for intervention studies); comparison groups (for randomized and nonrandomized controlled trials); outcome: quantitative or qualitative evaluation of ability to get up off the floor. Selection of the studies was undertaken in three stages: (1) titles and abstracts were scanned by one reviewer, (2) full abstract screening by one reviewer, and (3) articles read in full by two reviewers. Results of all articles are summarized and randomized controlled trials (RCT) (where possible) were analyzed by meta-analysis to determine intervention effectiveness.Results: Forty-one studies met inclusion criteria. For each of the RCTs that utilized resistance training and/or teaching the skill, a reduction in time to get up off the floor were reported. However, meta-analyses of all RCT interventions indicated no significant change in time for older people to get up off the floor independently with intervention (MD: -0.43[-1.38, 0.51]). Sub-analyses of interventions utilizing resistance training showed an improvement trending towards significance (MD: -0.81[-1.72, 0.09]). Heterogeneity between studies was high, therefore results should be viewed with some caution.Conclusions: Resistance training interventions may improve older people's ability to rise from the floor unassisted. However, knowledge of specific techniques to get up and the effect of simply practicing the task of getting off the floor need to be further explored.Implication for rehabilitationOne in three older people living in the community fall each yearOne aspect of falling that is often overlooked is whether the older person can get themselves up off the floor independently or do they have to wait for assistance.Interventions that include resistance training may help the older person to be able to get up by themselves.

Physical activity programs for older people in the community receiving home care services: systematic review and meta-analysis.

The proportion of older adults is increasing around the world and most wish to live in their home until they die. To achieve this, many will require services in the home to remain living independently. To maintain function (ie, strength, balance, and endurance), physical activity needs to be undertaken on a regular basis, and is essential as a person ages. Unfortunately, as people age there is a tendency to reduce activity levels, which often leads to loss of function and frailty, and the need for home care services. This updated systematic review includes a mix of study methodologies and meta-analysis, and investigated the effectiveness of physical activity/exercise interventions for older adults receiving home care services. Eighteen studies including ten randomized controlled trials meeting the selection criteria were identified. Many of the studies were multi-factorial interventions with the majority reporting aims beyond solely trying to improve the physical function of home care clients. The meta-analysis showed limited evidence for effectiveness of physical activity for older adults receiving home care services. Future exercise/physical activity studies working with home care populations should consider focusing solely on physical improvements, and need to include a process evaluation of the intervention to gain a better understanding of the association between adherence to the exercise program and other factors influencing effectiveness.

Trends in substance references in Australian top 20 songs between 1990 and 2015.

INTRODUCTION AND AIMS: This study examined references to alcohol and other drugs in top 20 songs over the last quarter of a century to explore the potential for popular music to constitute a barometer for changes occurring in youth consumption of alcohol and other substances. DESIGN AND METHODS: The online Australian Recording Industry Association charts resource was accessed to identify the top 20 songs for the period 1990 to 2015 inclusive. The lyrics of the identified songs were imported into NVivo11 for coding and analysis. Two coders analysed each song by line unit and a third coder assisted in resolving any coding discrepancies. RESULTS: Of the 508 discrete songs, 74 (15%) featured references to alcohol, tobacco and/or illicit drugs. Substance mentions increased over time such that the second half of the study period accounted for three-quarters of all references. The peak period for mentions was 2008-2012, with 2010 exhibiting an especially high prevalence rate for alcohol references. There was a marked decline in alcohol mentions between 2010 and 2013. The rate at which female artists referred to alcohol increased sharply until 2010 and then decreased. DISCUSSION AND CONCLUSIONS: Patterns in substance mentions in top 20 songs in more recent years may reflect broader social trends that influence youth substance use. As such, monitoring music lyrics may assist researchers to better understand forces underlying patterns of youth substance use.

What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: There is strong research evidence for falls prevention among older people in the community setting, although most is from Western countries. Differences between countries (eg sunlight exposure, diet, environment, exercise preferences) may influence the success of implementing falls prevention approaches in Asian countries that have been shown to be effective elsewhere in the world. The aim of this review is to evaluate the scope and effectiveness of falls prevention randomized controlled trials (RCTs) from the Asian region. METHOD: RCTs investigating falls prevention interventions conducted in Asian countries from (i) the most recent (2012) Cochrane community setting falls prevention review, and (ii) subsequent published RCTs meeting the same criteria were identified, classified and grouped according to the ProFANE intervention classification. Characteristics of included trials were extracted from both the Cochrane review and original publications. Where ≥2 studies investigated an intervention type in the Asian region, a meta-analysis was performed. RESULTS: Fifteen of 159 RCTs in the Cochrane review were conducted in the Asian region (9%), and a further 11 recent RCTs conducted in Asia were identified (total 26 Asian studies: median 160 participants, mean age:75.1, female:71.9%). Exercise (15 RCTs) and home assessment/modification (n = 2) were the only single interventions with ≥2 RCTs. Intervention types with ≥1 effective RCT in reducing fall outcomes were exercise (6 effective), home modification (1 effective), and medication (vitamin D) (1 effective). One multiple and one multifactorial intervention also had positive falls outcomes. Meta-analysis of exercise interventions identified significant benefit (number of fallers: Odds Ratio 0.43 [0.34,0.53]; number of falls: 0.35 [0.21,0.57]; and number of fallers injured: 0.50 [0.35,0.71]); but multifactorial interventions did not reach significance (number of fallers OR = 0.57 [0.23,1.44]). CONCLUSION: There is a small but growing research base of falls prevention RCTs from Asian countries, with exercise approaches being most researched and effective. For other interventions shown to be effective elsewhere, consideration of local issues is required to ensure that research and programs implemented in these countries are effective, and relevant to the local context, people, and health system. There is also a need for further high quality, appropriately powered falls prevention trials in Asian countries.

A Typology of Factors Influencing Seniors' Participation in Strength Training in Gyms and Fitness Centers.

Older people are less likely to engage in strength training than their younger counterparts, despite the substantial benefits of this form of exercise for preventing and addressing age-related physical decline. In many countries, strength training programs are available for older people yet are undersubscribed. The aim of this study was to identify the factors influencing older people's participation in strength training at gyms and fitness centers to provide insights into potentially effective recruitment and retention strategies for this population. A total of 79 individuals from four stakeholder groups (seniors, fitness center instructors and managers, health practitioners, and those involved in policy) were interviewed to identify and explicate relevant factors. A detailed typology was developed that provides insights into potential strategies at five ecological system levels: intrapersonal, interpersonal, organizational, social, and policy. The typology can be used as a tool for identifying opportunities to encourage strength training participation among older people.

Effectiveness of peers in delivering programs or motivating older people to increase their participation in physical activity: Systematic review and meta-analysis.

The objective of this systematic review and meta-analysis was to evaluate the effectiveness of peers to deliver programs or encourage older people to be physically active and improve physical outcomes. Peer reviewed articles published in English between January 1976 and June 2016, retrieved from six databases according to the predefined inclusion criteria were included. Where possible results were pooled and meta-analyses conducted. Eighteen articles were included in the review, a total of 3,492 intervention participants, average age 66.5 years and 67.1% were female. Overall, study quality was medium to high. Interventions mainly included resistance, flexibility and cardiovascular training, however there was one aquatic exercise group. Eight studies were delivered by peers and five utilised peer support, which included advice and being positive but was not directly linked to an exercise intervention. While 16 of the 18 studies reported improvement in levels of physical activity and/or noted physical benefits by peer involvement, the meta-analyses findings supported the control groups for the six-minute-walk-test and the timed-up-and-go test. Findings from this review suggest exercise programs involving peers can promote and maintain adherence to exercise programs. However, results were inconclusive as to whether peers have a positive effect on improving older people's physical function.

Why do seniors leave resistance training programs?

PURPOSE: The proportion of the population, that is older, is growing at a faster rate than other age groups. Physical activity is important for older people because it assists in living independently. Participating in resistance training on a regular basis (twice weekly) is recommended for older people; yet, fewer than 15% of people over 60 years achieve this level. The aim of this article was to investigate the factors contributing to older people's decisions to stop participation in a resistance training program. PARTICIPANTS AND METHODS: Participants were older people who had chosen to participate in a structured resistance training program specifically designed for seniors and then after a period of time discontinued. This population received a questionnaire in the mail focused on factors contributing to their cessation of resistance training exercise. Qualitative results were analyzed using inductive content analysis. RESULTS: Fifty-six survey responses were received (average age 71.5 years, SD =9.0; 79% females). Injury, illness, and holidaying were the main reasons for ceasing participation. A small but important number of responses (11%) reported that they considered they were not provided with sufficient support during the resistance training programs. CONCLUSIONS: To attract and retain their senior clients, the results indicate that program organizers need to provide tailored support to return to resistance training after injury and offer flexible and individualized services that accommodate older people's life choices in retirement.

Dysmobility syndrome: current perspectives.

BACKGROUND: A new term, dysmobility syndrome, has recently been described as a new approach to identify older people at risk of poor health outcomes. The aim was to undertake a systematic review of the existing research literature on dysmobility syndrome. METHOD: All articles reporting dysmobility syndrome were identified in a systematic review of Medline (Proquest), CINAHL, PubMed, PsycInfo, EMBASE, and Scopus databases. Key characteristics of identified studies were extracted and summarized. RESULTS: The systematic review identified five papers (three cross-sectional, one case control, and one longitudinal study). No intervention studies were identified. Prevalence of dysmobility syndrome varied between studies (22%-34% in three of the studies). Dysmobility syndrome was shown to be associated with reduced function, increased falls and fractures, and a longitudinal study showed its significant association with mortality. CONCLUSION: Early research on dysmobility syndrome indicates that it may be a useful classification approach to identify older people at risk of adverse health outcomes and to target for early interventions. Future research needs to standardize the optimal mix of measures and cut points, and investigate whether balance performance may be a more useful factor than history of falls for dysmobility syndrome.

Identifying motivators and barriers to older community-dwelling people participating in resistance training: A cross-sectional study.

Participation rates of older people in resistance training (RT) are low despite increasing research showing many health benefits. To increase the number of older people participating in RT it is important to know what would motivate people to become involved, what motivates those who participate to continue, and the factors preventing many older people from commencing participation. To investigate these issues, a questionnaire was mailed to three groups of older people: (1) those receiving home care services, (2) members of a peak non-government seniors' organisation and (3) those participating in a specific gym-based RT programme. In total, 1327 questionnaires were returned (response rate = 42.5%). To feel good physically and mentally were the main reasons motivating participation among all three groups, and falls prevention was identified as an important motivator for the home care respondents. Pain, injury and illness were the main barriers to participating, or continuing to participate. However, medical advice was a factor influencing participation commencement. The results suggest organisations providing RT programmes for older people should tailor the promotion and delivery of programmes to address key motivators and barriers specific to each group to increase the proportion of older people initiating and continuing to engage in RT.

Motivators and Barriers for Older People Participating in Resistance Training: A Systematic Review.

Regular participation in resistance training is important for older people to maintain their health and independence, yet participation rates are low. The study aimed to identify motivators and barriers to older people participating in resistance training. A systematic review was conducted including quantitative, qualitative, and mixed-method studies. Searches generated 15,920 citations from six databases, with 14 studies (n = 1,937 participants) included. In total, 92 motivators and 24 barriers were identified. Motivators specific to participating in resistance training included preventing deterioration (disability), reducing risk of falls, building (toning) muscles, feeling more alert, and better concentration. Looking too muscular and thinking participation increased the risk of having a heart attack, stroke, or death, despite the minimal likelihood of these occurring, were barriers. The analysis indicates that increasing participation in resistance training among older people should focus on the specific benefits valued by older people and the dissemination of accurate information to counter misperceptions.