Effects of a 24-Week Low-Cost Multicomponent Exercise Program on Health-Related Functional Fitness in the Community-Dwelling Aged and Older Adults.

Background and Objectives: This study aimed to examine the effects of a low-cost multicomponent exercise program on health-related functional fitness in the community-dwelling aged and older adults. As a second objective, this study compared the exercise program between aged adults (<65 years) and those considered elderly (≥65 years). Materials and Methods: Forty-eight participants were included in the exercise program, and their mean age was 64.73 years (±5.93 years). The Senior Fitness Tests were performed by each participant. A dynamometer was used to assess hand grip strength, and body composition was assessed considering the body mass index. Paired-sample t test was used to compare data at baseline and after the exercise program, considering the total sample. Afterwards, a 2 × 2 analysis of variance was used to examine differences within and between groups. Results: Statistically significant improvements in the chair stand (t = -14.06; p < 0.001; d = 0.42), arm curl (t = -12.10; p < 0.001; d = 0.58), 2 min step test (t = -9.41; p < 0.001; d = 0.24), timed up and go test (t = 5.60; p < 0.001; d = 0.19), and hand grip strength (t = -3.33; p < 0.001; d = 0.15) were observed. There were also significant differences in the back scratch (t = -6.68; p < 0.001; d = 0.18) and chair sit and reach test (t = 5.04; p < 0.001; d = 0.05), as well as body mass index (p < 0.05). No significant differences were found between groups (p > 0.05). Conclusion: This study provides evidence that a 24-week low-cost community-based exercise program can improve functional fitness in aged and in older adults. The exercise program supplied the necessary data to construct further randomized controlled trials that can be performed in the community in an environmentally sustainable fashion and applied, not only to the elderly, but also to those transitioning to this age group.

The impact of an exercise intervention using low-cost equipment on functional fitness in the community-dwelling older adults: A pilot study.

Exercise interventions have shown significant improvements in the older adult population regarding functional and cognitive capacity. However, much research has applied exercise protocols that are expensive both for research and participation. Thus, high investments that are made are currently not ecologically efficient. The aim of the study was to determine whether the impact of a 20-week multicomponent exercise intervention using low-cost material could improve physical fitness in community-dwelling older adults. We tested the feasibility of this three times per week exercise protocol using an inclusive approach. Eligibility criteria included age ≥65 years, the ability to stand and walk with or without assistive devices, being physically inactive; medical clearance, and living in the community. Outcomes were muscle resistance measured using the chair-stand test for lower limbs, cardiorespiratory capacity measured using the 6-min walk test, and agility and balance using the Timed-up and Go test. Flexibility was measured using the chair sit and reach for lower limbs and the back scratch for upper limbs using the dominant leg and arm, respectively. Hand grip strength was measured using a dynamometer. Thirty participants (n = 30) were recruited and included in the intention-to-treat analysis. The mean age of participants was 70 years (±3.62 years), 100% were Caucasians, and 50% were female. There was a significant trend toward a clinically important improvement in the chair-stand (t = -5.23; p < 0.001; d = 0.36), arm curl (t = -5.21; p < 0.001; d = 0.74), 6-min walk test (t = -4.69; p = <0.001; d = 0.77), timed-up and go test (t = 8.788; p < 0.001; d = 1.18), and hand grip strength (t = 2.846; p = 0.009; d = 0.23). There were also differences in the back scratch (t = 2.243; p = 0.035; d = 0.29) and chair sit and reach test (t = -3.380; p < 0.001; d = 0.15). This pilot study has provided preliminary evidence that a 20-week community-based low-cost exercise program may be effective in improving overall functional fitness in older people. The pilot trial has provided the necessary data to design future randomized-controlled trials that can be implemented in the community in an ecological feasible manner.

Assessment in Sport and Exercise Psychology: Considerations and Recommendations for Translation and Validation of Questionnaires.

Translating and validating measurement instruments in sport and exercise psychology is not an easy task. Rather, it is a task that requires effort and time, for the process is not limited to a simple translation to translate words from one language to another, just in order to make valid and reliable measure. All researchers should be aware that the only proper way is to adopt rigorous and robust methodologies to conduct the process from the preliminary stage of translation to reaching the validation stage of the psychological variable. Only so is it possible to avoid creating fragile and inadequate psychological assessment instruments that can jeopardize the entire investigation to be held with its use. Thus, the main objective of this work is to promote reflection and discussion on the subject by presenting some considerations and recommendations about translation and validation of questionnaires for psychological assessment applied to sport and exercise domain.

Exercise Promotion: Reviewing the Importance of Health Professionals' Interpersonal Behaviors on Exercisers' Basic Psychological Needs.

Previous studies have investigated the impact of exercisers' perceptions of health professionals' interpersonal behaviors on exercisers' exercise adherence. From these studies, there is increased interest in developing and evaluating programs to improve health professionals' communication skills and interpersonal behavior. In this narrative review, we provide examples of self-determination theory and newer modifications to it, discuss the empirical conditions that foster optimal exerciser motivation, consider the antecedent factors influencing health professionals' behaviors, and offer practical suggestions to health professionals seeking to promote regular exercise practice. Since exercisers perceive and differentiate health professionals' need-supportive, need-thwarting, and need-passive behaviors, health professionals who can critically and consciously distinguish these different types of behavior are more likely to foster supportive climates and suppress the use of need-thwarting and need-indifferent behaviors. The interpersonal interaction between health professionals and exercisers strongly influences how exercisers will regulate their behavior toward persistent exercise.

The Basic Psychological Need Satisfaction and Frustration Scale in Exercise (BPNSFS-E): Validity, Reliability, and Gender Invariance in Portuguese Exercisers.

The aim of this study was to translate and validate the Basic Psychological Need Satisfaction and Frustration Scale for Portuguese exercisers. In addition, we sought to analyze gender invariance. We collected data from two independent samples of Portuguese respondents-a calibration sample with 316 participants and a validation sample with 632 participants. Results from confirmatory factor analysis supported the original six-factor model in both the calibration sample, χ2(237) = 471.814, χ2/df = 1.99; B-S p < .001, Comparative Fit Index = .935, Tucker-Lewis Index =.924, standard mean root square residual = .047, root mean square error of approximation = .057 (90% confidence interval = [.050, .065]), and the validation sample, χ2(237) = 571.796, χ2/df = 2.41; B-S p < .001, Comparative Fit Index = .948, Tucker-Lewis Index = .940, standard mean root square residual = .038, root mean square error of approximation = .047 (90% confidence interval = [.042, .052]). Moreover, our analysis revealed acceptable internal consistency, convergent and discriminant validity of the translated version, and invariance between the two samples and between genders, as differences across latent means showed that magnitude effects were trivial between samples and between male and female exercisers. These results support the use of the adapted scale among both male and female exercisers.

Rating Scales and Performance-based Measures for Assessment of Functional Ability in Huntington's Disease: Critique and Recommendations.

Limitation of functional ability is a major feature of Huntington's disease (HD). The International Parkinson and Movement Disorder Society (MDS) commissioned the appraisal of the use and clinimetric properties of clinical measures of functional ability that have been applied in HD studies and trials to date, to make recommendations regarding their use based on standardized criteria. After a systematic literature search, we included a total of 29 clinical measures grouped into two categories: (1) performance-based measures (e.g., balance, walking, and reaching/grasping), and (2) rating scales. Three performance-based measures are rated as "recommended": the Tinetti Mobility Test for screening of fall risk and for severity assessment of mobility in patients with manifest HD (up to stage III); the Berg Balance Scale for severity of balance impairment; and the Six-Minute Walk Test for assessment of walking endurance (severity) in HD subjects with preserved ambulation. No rating scale targeting functional ability reached a "recommended" status either for screening or severity measurement. The main challenges identified in this review include applying widely accepted conceptual frameworks to the identified measures, the lack of validation of clinical measures to detect change over time, and absence of validated measures for upper limb function. Furthermore, measures of capacity or ability to perform activities of daily living had ceiling effects in people with early and pre-manifest HD. We recommend that the MDS prioritize the development of new scales that capture small, but meaningful changes in function over time for outcome assessment in clinical trials, particularly in earlier stages of HD.

Fifteen Years of Clinical Trials in Huntington's Disease: A Very Low Clinical Drug Development Success Rate.

BACKGROUND: Drug development in Huntington's disease (HD) is particularly challenging, and only two compounds are approved by the FDA. It is therefore essential to appraise drug development programs in order to understand the reasons for their failure during the early stages of development. OBJECTIVES: To describe the landscape of HD therapeutic development and critically explore the causes of compound attrition in the different stages of drug development, from phase 1 to phase 4. METHODS: All HD clinical trials registered in the WHO International Clinical Trials Search Portal, from inception to May 2017, were analyzed. Two independent authors selected and extracted data. Success rate in a trial phase was calculated as the number of compounds that progressed to the next trial phase divided by the number of compounds in that phase. The overall success rate was calculated as the ratio between the number of compounds that receive regulatory approval and the total number of compounds. RESULTS: Ninety-nine trials assessing 41 compounds and eleven non-pharmacological interventions (devices and cell therapies) were identified. Twenty-four (24.2%) were phase 1 trials, 46 (46.5%) phase 2, 20 (20.2%) phase 3, and two (2.0%) phase 4. Sixty trials (60.6%) received industry sponsorship. The most frequently studied compounds were creatine, latrepirdine and pridopidine. The mean number of participants enrolled was 92.0 and the length of treatment was 262.9 days, and both increased from phase 1 to phase 3 trials. The success rate was 25.0% from phase 1 to phase 2, 19.4% from phase 2 to phase 3, and 14.3% from phase 3 to approval. The overall success rate was 3.5%. CONCLUSIONS: Although HD is a rare condition, 99 HD trials were identified in a comprehensive clinical trial registry. We found a low success rate at earlier phases of drug-development and a very low trial success rate at later phases. There is a significant gap between drug discovery and development success rates that warrants careful appraisal and improvement.