A Judo-Based Exercise Program to Reduce Falls and Frailty Risk in Community-Dwelling Older Adults: A Feasibility Study.

OBJECTIVES: This study aimed to explore the feasibility (including recruitment, safety and adherence) and the effects of a twice weekly supervised Judo-based exercise program over eight weeks on mobility, balance, physical performance, quality of life, fear of falling and physical activity (including by frailty status) in community-dwelling older people aged ≥65 years. DESIGN: Pre-post study. PARTICIPANTS: A total of 17 participants (mean age 74.3±6.2; range 66-87 years; 76.5% female). INTERVENTION: A Judo-based exercise program conducted twice weekly for 60 minutes per session over eight weeks. MEASUREMENTS: Pre and post assessments included the Timed Up and Go (TUG); the Berg Balance Scale (BBS); the Short Physical Performance Battery (SPPB); the Short Form Health Survey-36 (SF-36); the Falls Efficiency Scale International (FES-I); and an ActivPal accelerometer to measure participants' physical activity. RESULTS: Most participants had low (≤3) Charlson's Comorbidity Index scores (n=17, 100%), were well nourished (n=16, 94.1%), not sarcopenic (n=16, 94.1%), and not cognitively impaired (n=13, 76.5%), anxious or depressed (n=14, 82.4%). Ten participants (58.8%) were non-frail and seven were pre-frail (41.2%). Significant improvements (p<0.05) were seen for mobility (TUG), balance (BBS) and physical performance (SPPB). Pre-frail participants showed greater improvement in mobility (TUG) than non-frail participants (p=0.020). No changes (p≥0.05) were seen in quality of life, fear of falling, or physical activity. Participants' adherence (i.e., attending sessions) was high (i.e., ≥81.2%). No serious adverse events or withdrawals were reported. CONCLUSION: Findings suggest that the eight week Judo-based exercise program can be delivered safely to older adults aged ≥65 years, including those at-risk of frailty, as long as there is close supervision with individualisation of the program in response to emergent health symptoms and the program is conducted on requisite Judo mats. This Judo-based exercise program is effective in improving physical function with potential to prevent falls and frailty risk.

The Sustained Impact of a Medical School-Based Physical Activity Module on Interns' Perceived Competence in Advising Older Adults about Exercise.

The study aimed to examine the sustained impact of a 1.5-hour medical school-based physical activity (PA) module on interns' perceived competence and importance in advising older adults about exercise. The modified Exercise and Physical Activity Competence Questionnaire (EPACQ) was administered in 2017 (CG: control group) and 2018 (IG: intervention group) two years post-course. The perceived competence of both, CG (n=23) and IG (n=18), decreased significantly over two years (p≤0.05) with no difference between the groups (p>0.05). However, 72.2% (n=13) of the interns who attended the PA module still felt competent in advising older adults about exercise (4.21±0.66) compared to 47.8% (n=11) of the CG (3.89±0.67). The perceived importance decreased significantly in both groups (p≤0.05) with no difference between the groups (p>0.05). However, both groups still perceived exercise for older people as important (CG:4.55±0.61; IG:4.83±0.47). Subsequently, continued professional development is likely to be a key requirement for ensuring sustainability over time.

Anorexia of Aging - An Updated Short Review.

The anorexia of aging affects approximately a quarter of older people and is a major contributor to the development of under-nutrition and many other adverse health outcomes in older people. Despite the high prevalence, the anorexia of aging is frequently overlooked by clinicians and, of even more concern, it is commonly accepted as inevitable and a part of 'normal' aging. Early identification of risk coupled with efforts to mitigate these risks through appropriate interventions might stem the deleterious consequences of the anorexia of aging. This review aims to provide an update on the current knowledge base whilst making some practical suggestions that may be of use in clinical practice. Interventions such as exercise and good nutrition remain the preferred treatment while pharmacological options, whilst they continue to be trialed, are not currently recommended for routine clinical use.

Educating Medical Students in Counselling Older Adults about Exercise: The Impact of a Physical Activity Module.

BACKGROUND: Exercise courses during medical school contribute to medical students' confidence in promoting physical activity to their patients. However, there is still a lack of uniform physical activity education across medical school curricula to equip medical students with the necessary skills and knowledge to counsel their patients about exercise. OBJECTIVE: To determine the effects of a 1.5-hour physical activity module including a one-hour exercise tutorial combined with a 30-minute practical counselling session on senior medical students' perceptions of the importance of exercise and their perceived competence in advising older people about exercise. DESIGN: Pre-post survey. SETTING: University campus. PARTICIPANTS: 161 senior medical students taking part in the Queen Elizabeth Hospital Geriatric Medicine course in 2015 (control group) and 2016 (intervention group). MEASUREMENT: The modified Exercise and Physical Activity Competence Questionnaire (EPACQ) was administered before and after a 4.5-week Geriatric Medicine Course. Scores ranged from 1 (not important or competent) to 6 (very important or competent). The independent T-Test and repeated-measures ANOVA was used to determine differences between intervention and control group. RESULTS: Medical students perceived exercise-related skills to be highly important (score ≥4) in both the intervention (4.85 ± 0.37) and control group (4.78 ± 0.67), pre-course. The overall perceived importance could not be significantly increased by the physical activity module (P=0.082). The physical activity module, however, improved medical students' perceived competence in six out of ten exercise-related skills, and increased their overall perceived competence in counselling older people about exercise (P<0.001). CONCLUSION: A 1.5-hour physical activity module improves senior medical students' perceived competence in counselling older people about exercise. This research proves that little teaching space is needed to impact positively on medical students' exercise counselling abilities.

The Feasibility of Standardised Geriatric Assessment Tools and Physical Exercises in Frail Older Adults.

Geriatric assessment tools are applicable to the general geriatric population; however, their feasibility in frail older adults is yet to be determined. The study aimed to determine the feasibility of standardised geriatric assessment tools and physical exercises in hospitalised frail older adults. Various assessment tools including the FRAIL Screen, the Charlson Comorbidity Index, the SF-36, the Trail Making Test (TMT), the Rapid Cognitive Screen, the Self Mini Nutritional Assessment (MNA-SF) and the Lawton iADL as well as standard physical exercises were assessed using observational protocols. The FRAIL Screen, MNA-SF, Rapid Cognitive Screen, Lawton iADL and the physical exercises were deemed to be feasible with only minor comprehension, execution and safety issues. The TMT was not considered to be feasible and the SF-36 should be replaced by its shorter form, the SF-12. In order to ensure the validity of these findings a study with a larger sample size should be undertaken.