Functional fitness and physical independence in later years: cut-off values and validation.

BACKGROUND: To establish and validate the criterion-referenced standards of functional fitness in predicting physical independence in 80 + years. METHODS: A group of 2,749 older community dwellers (60-84 years) were recruited, and 2,050 were identified with moderate-to-high independent living ability according to the proposed minimum composite physical function score. The Senior Fitness Test battery was applied to measure functional fitness at five-year intervals. The declining rate for each fitness dimension was calculated based on the differences between any two adjacent age groups and was adjusted according to the reported degradation rate differences between the cross-sectional and longitudinal studies. RESULTS: The age-and-sex-specific criterion-referenced standards were identified for muscle strength, cardiovascular endurance, and dynamic balance that older adults should possess at 60-79 to maintain independent living abilities. Moderate to high consistency (k = 0.622-0.650) and associations (φ = 0.641-0.694) were found between the predicted physical independence by criterion-referenced standards of functional fitness and the results from the composite physical function scale. Moreover, the predicted independent living abilities in later years from the criterion-referenced standards of functional fitness showed high test-retest reliability (Pa = 0.90-0.96). CONCLUSION: The criterion-referenced standards for functional fitness are valid and reliable to predict independent living abilities in later years, and provide the threshold to identify the limitations in physical fitness and detect the risks of functional disabilities among older adults in an early stage.

Translation, validity and reliability of the fall risk scale for older adults.

INTRODUCTION: Falls in older adults are a common and serious threat to health and functional independence. It can cause psychological distress, inability to participate in activities of daily living, brain injury, fractures, and even death. The aim was to analyze the psychometric properties of the self-assessed fall risk scale (FRS) that measures the risk of falls in older adults in a central region of Chile, as well as to verify the concurrent validity against functional fitness tests. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out in 222 older adults (OA) [34 males and 188 females] with an age range of 65 to 85 years. The 13-item self-perceived fall risk scale (FRS) was validated. Anthropometric measures (weight, height and waist circumference) were assessed. Five functional fitness tests were measured (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test). Validation was performed by construct validation [(exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)] and concurrent validity. RESULTS: The EFA revealed 4 factors in the FRS scale [1: fear of falling (variance 27.1%), 2: use of assistive devices (variance 10.6%), 3: loss of sensation (variance 9.3%), and 4: limited mobility (variance 8.3%)]. Factor loadings ranged from ∼ 0.50 to 0.83 across the 4 components. The Kaiser-Meyer Olkin sample adequacy test (KMO) reflected adequate adequacy (KMO = 0.79, chi-square (X2) = 498.806, gl = 78, p = 0.00). The CFA showed a satisfactory final fit [chi-square (X2) = 126.748, Root mean squared error of approximation (RMSEA) = 0.042, Tucker-Lewis Index (TLI) = 0.946, Comparative fit index (CFI) = 0.935 y Normed fit index (NFI) = 0.90. The relationships between the FRS scale and functional fitness tests (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test) ranged from low to moderate (r= -0.23 to 0.41). CONCLUSION: The FRS scale showed acceptable validity and reliability in older adults in central region of Chile. It is expected that this scale will be useful for assessing fall risk in clinical and epidemiological settings in the aging Chilean population.

Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial.

BACKGROUND: Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment. METHODS: A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively. RESULTS: There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise. CONCLUSIONS: Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment. TRIAL REGISTRATION: This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).

Functional fitness of adults with Down syndrome: a longitudinal study.

BACKGROUND: Individuals with Down syndrome (DS) are born with and develop many health-related complications. The purpose of this study was to determine the longitudinal functional fitness profile of adults with DS. METHODS: The functional fitness of adults with DS was tested twice, 12 years apart. Sixty-six adults with DS were tested for body mass, stature and 10 functional fitness tests. Data were categorised according to gender and age-specific categories. RESULTS: Static balance, shoulder flexibility, trunk strength and aerobic capacity deteriorated significantly with medium to large effect sizes for both DS men and women (most age categories). For women, dynamic balance deteriorated significantly, and for men, leg- and upper body-strength deteriorated significantly. CONCLUSIONS: Practitioners working in the field of adapted physical activity should take cognisance of the functional fitness ageing profile of adults with DS and timeously develop habitual physical activity interventions to reduce the effect of accelerated ageing experienced by this population.

Feasibility of home-based exercise training during adjuvant treatment for metastatic castrate-resistant prostate cancer patients treated with an androgen receptor pathway inhibitor (EXACT).

BACKGROUND: Exercise is an effective adjuvant therapy that can alleviate treatment-related toxicities for men with prostate cancer (PC). However, the feasibility of delivering exercise training to men with advanced disease and the wider impact on clinical outcomes remain unknown. The purpose of the EXACT trial was to determine the feasibility and effects of home-based exercise training in men with metastatic castrate-resistant prostate cancer (mCRPC). METHODS: Patients with mCRPC receiving ADT + an androgen receptor pathway inhibitor (ARPI) were prescribed 12 weeks of home-based, remotely monitored, moderate intensity, aerobic and resistance exercise. Feasibility was assessed using recruitment, retention and adherence rates. Safety and adverse events were monitored throughout, with functional and patient-reported outcomes captured at baseline, post-intervention and at 3-month follow-up. RESULTS: From the 117 screened, 49 were deemed eligible and approached, with 30 patients providing informed consent (61% recruitment rate). Of those who consented, 28 patients completed baseline assessments, with 24 patients completing the intervention and 22 completing follow-up (retention rates: 86% and 79% respectively). Task completion was excellent throughout, with no intervention-related adverse events recorded. Self-reported adherence to the overall intervention was 82%. Exercise training decreased mean body mass (-1.5%), improved functional fitness (> 10%) and improved several patient-reported outcomes including clinically meaningful changes in fatigue (p = 0.042), FACT-G (p = 0.054) and FACT-P (p = 0.083), all with moderate effect sizes. CONCLUSION: Home-based exercise training, with weekly remote monitoring, was feasible and safe for men with mCRPC being treated with an ARPI. Given that treatment-related toxicities accumulate throughout the course of treatment, and as a result, negatively impact functional fitness and health-related quality of life (HRQoL), it was positive that exercise training improved or prevented a decline in these clinically important variables and could better equip patients for future treatment. Collectively, these preliminary feasibility findings support the need for a definitive, larger RCT, which downstream may lead to the inclusion of home-based exercise training as part of adjuvant care for mCRPC.

A Web-Delivered, Clinician-Led Group Exercise Intervention for Older Adults With Type 2 Diabetes: Single-Arm Pre-Post Intervention.

BACKGROUND: The COVID-19 pandemic created unprecedented shifts in the way health programs and services are delivered. A national lockdown to prevent the spread of COVID-19 in Australia was introduced in March 2020. This lockdown included the closure of exercise clinics, fitness centers, and other community spaces, which, before the pandemic, were used to deliver Beat It. Beat It is an 8-week in-person, community-based, and clinician-led group exercise and education program for adults self-managing diabetes. To continue offering Beat It, it was adapted from an in-person program to a fully web-based supervised group exercise program for adults with type 2 diabetes (T2DM). OBJECTIVE: This study aims to assess whether the Beat It Online program produced comparable health outcomes to the Beat It in-person program in terms of improving physical fitness (muscular strength and power, aerobic endurance, balance, and flexibility) and waist circumference in older adults with T2DM. METHODS: Australians with T2DM who were aged ≥60 years were included. They were enrolled in Beat It Online, a twice-weekly supervised group exercise and education program conducted via videoconference over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. The adaptations to Beat It are reported using the Model for Adaptation, Design, and Impact, including the type of changes (what, where, when, and for whom), the criteria for making those changes (why and how), and the intended and unintended outcomes. The intended outcomes were comparable functional fitness as well as physical and mental health improvements across demographics and socioeconomic status. RESULTS: A total of 171 adults (mean 71, SD 5.6 years; n=54, 31.6% male) with T2DM were included in the study, with 40.4% (n=69) residing in lower socioeconomic areas. On the completion of the 8-week program, significant improvements in waist circumference, aerobic capacity, muscular strength, flexibility, and balance were observed in both male and female participants (all P<.001). The Model for Adaptation, Design, and Impact reports on 9 clinical, practical, and technical aspects of Beat It that were adapted for web-based delivery. CONCLUSIONS: This study found that Beat It Online was just as effective as the in-person program. This adapted program produced comparable health benefits across demographics and socioeconomic status. This study offers important findings for practitioners and policy makers seeking to maintain independence of older people with T2DM, reversing frailty and maximizing functional and physical fitness, while improving overall quality of life. Beat It Online offers a flexible and inclusive solution with significant physical and mental health benefits to individuals. Further evaluation of Beat It (both in-person and Online) adapted for culturally and linguistically diverse communities will provide greater insights into the efficacy of this promising program.

Effects of 24-week basketball programme on body composition and functional fitness on adults with Down syndrome.

BACKGROUND: The body index [body mass, body mass index (BMI), waist circumference and waist-height ratio] and functional fitness (aerobic capacity, muscular strength, balance, flexibility and functional ability) of people with Down syndrome (DS) are substantially lower than those in the general population, as DS has an overall negative impact on health. AIMS: This study explored the effect of a 24-week basketball training programme on the body composition and functional fitness of adults with DS. METHODS AND PROCEDURE OUTCOMES: Twenty-two adults with DS (24 ± 6 years; 25 ± 4 kg/m2 ) were randomly allocated to the experimental (n = 11, 67.04 kg) and control groups (n = 11, 69.36 kg). The experimental group performed 24 weeks of basketball programme training (3 times per week, 60 min per session), while the control group maintained their daily activities without any special physical training. Body composition and functional fitness parameters were measured before and after the intervention. To evaluate the differences between groups, an analysis of covariance (ANCOVA) was used while controlling for differences at baseline. RESULTS: Hip circumference and waist-height ratio were statistically different at baseline between the intervention and control groups. After the 24-week basketball training programme, the results showed significant differences between the exercise and control groups for hip circumference, body mass, BMI, waist circumference, hip circumference, waist-height ratio, flexibility, aerobic capacity, static and dynamic balance, balance and basketball functional ability (P < 0.05). The exercise group showed significant improvements in all variables of body composition and functional fitness (P < 0.05) except for the waist-hip ratio. There was no statistical significance between all physical composition and functional health variables in the control group except for the standing long jump (P > 0.05), with effect sizes ranging from small to large. CONCLUSIONS AND IMPLICATIONS: The basketball training programme improved body composition and functional fitness of adults with DS.

Effects of Vitality Acupunch exercise on functional fitness and activities of daily living among probable sarcopenic older adults in residential facilities.

PURPOSE: To test the effects of a Vitality Acupunch exercise program on the functional fitness and the ability to perform the activities of daily living (ADL) among older adults with probable sarcopenia in residential facilities. DESIGN: This was a cluster-randomized controlled trial. A total of 12 long-term care facilities randomly assigned to the intervention and control groups with 1:1 allocation ratio. Among them, 114 older adults with probable sarcopenia participated at baseline and were allocated to either the intervention or control group according to the facility where they resided in. Of these, 103 older adults completed the study. METHODS: The intervention group (n = 52) underwent the Vitality Acupunch exercise program three times a week, each lasting 40 min, for 6 months while the control group (n = 51) performed its routine daily activities. FINDINGS: The functional fitness and ADL of the intervention group significantly improved at each time point (all p < 0.001), while the control group showed a significant decreasing trend. Except the lower limb muscular endurance, the functional fitness and ADL of the intervention group significantly improved compared to the control group at T1, and the improvements were still significant at T2. CONCLUSIONS: Functional fitness and the ability to perform ADL in older adults with probable sarcopenia were significantly improved after receiving the Vitality Acupunch exercises. CLINICAL RELEVANCE: An exercise that integrates the meridian theory and exercise concepts effectively improves functional fitness in probable sarcopenic older adults. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov (NCT04504786). The trial was first posted on August 7, 2020. This part of the data was collected from August 2020 to March 2021.

30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors.

INTRODUCTION: After hospitalization, early detection of musculoskeletal sequelae might help healthcare professionals to improve and individualize treatment, accelerating recovery after COVID-19. The objective was to determine the association between the 30s sit-to-stand muscle power (30s-STS) and cross-sectional area of the chest muscles (pectoralis) in COVID-19 survivors. METHOD: This cross-sectional study collected routine data from COVID-19 survivors one month after hospitalization: 1) a chest computed tomography (CT) scan and 2) a functional capacity test (30s-STS). The pectoralis muscle area (PMA) was measured from axial CT images. For each gender, patients were categorized into tertiles based on PMA. The 30s-STS was performed to determine the leg extension power. The allometric and relative STS power were calculated as absolute 30s-STS power normalized to height squared and body mass. The two-way ANOVA was used to compare the gender-stratified tertiles of 30s-STS power variants. RESULTS: Fifty-eight COVID-19 survivors were included (mean age 61.2 ± 12.9 years, 30/28 (51.7%/48.3%) men/women). The two-way ANOVA showed significant differences between the PMA tertiles in absolute STS power (p = .002) and allometric STS power (p = .001). There were no significant gender x PMA tertile interactions (all variables p > .05). The high tertile of PMA showed a higher allometric STS power compared to the low and middle tertile, p = .002 and p = .004, respectively. Absolute STS power and allometric STS power had a moderate correlation with the PMA, r = 0.519 (p < .001) and r = 0.458 (p < .001) respectively. CONCLUSION: The 30s-STS power is associated with pectoralis muscle thickness in both male and female COVID-19 survivors. Thus, this test may indicate global muscle-wasting and may be used as a screening tool for lower extremity functional capacity in the early stages of rehabilitation planning in COVID-19 survivors.

Effects of a 24-Week Exercise Program on Functional Fitness, Oxidative Stress, and Salivary Cortisol Levels in Elderly Subjects.

Background and Objectives: Aging is a biological and irreversible process characterized by physiological alterations resulting in a progressive decline in biological functions, decreased resistance or adaptability to stress, and increased disease susceptibility. A decline in functional fitness, imbalance between pro- and antioxidant capacity, and/or hormonal dysregulation adversely impact physical capacity, emotional status, and overall quality of life, especially within the elderly population. On the other hand, regular physical activity is considered an effective strategy to prevent and reduce those changes associated with primary aging and concurrent chronic disease, while slowing age-related physical degeneration. However, there is still limited evidence-based information regarding both the intensity and interval of effective interventions on physical functioning in older adults. Thus, the aim of the study was to assess the effects of a 24-week regular multimodal exercise program on functional fitness, oxidative stress, salivary cortisol level, and self-perceived quality of life in a group of eighteen physically active elderly subjects (mean age 72.8 ± 7.5 years). Materials and Methods: A set of anthropometric and physical measurements (grip strength, chair sit to stand, sit and reach and back scratch) assessing the functional fitness performance were evaluated. Moreover, biochemical markers (derived-reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) tests, and salivary cortisol levels) and the EuroQoL 5-Dimension 3-Level (EuroQoL 5-D 3-L) self-perceived questionnaire of quality of life were measured before and after the intervention program. All measurements were normally distributed as assessed by D'Agostino and Pearson's omnibus normality test. Student's t-tests were used to evaluate the differences in all the parameters measured at baseline (T0) and after the 24-week physical program (T1). Results: The results showed that an age-tailored structured intervention exercise program (1 h per session, twice per week, for 24 weeks) was effective in improving flexibility and other biomechanical parameters, such as muscle strength and the dynamic balance fitness component, which are key to performing daily tasks independently. Moreover, biochemical analyses demonstrate that the proposed intervention program has beneficial effects on the balance between plasma ROS production and their neutralization. Conclusions: The results confirm the benefits of regular physical activity in older adults resulting in improved physical strength and flexibility in the functional fitness parameters, and in regulating anti- and pro-oxidant activity and cortisol (stress hormone) levels.

Exercise as a countermeasure for latent viral reactivation during long duration space flight.

Latent viral reactivation is a commonly reported manifestation of immune system dysregulation during spaceflight. As physical fitness and exercise training have been shown to benefit multiple arms of the immune system, we hypothesized that higher levels of preflight physical fitness and/or maintaining fitness during a mission would protect astronauts from latent viral reactivation. Standardized tests of maximal strength, muscular endurance, flexibility, and cardiorespiratory fitness (CRF) were performed in 22 international space station (ISS) crewmembers before and after a ~6-month mission. Reactivation of cytomegalovirus (CMV), Epstein-Barr virus (EBV), and varicella zoster virus (VZV) was determined in crewmembers and ground-based controls before, during, and after spaceflight. Crewmembers with higher CRF before spaceflight had a 29% reduced risk of latent viral reactivation compared to crew with lower CRF. Higher preflight upper body muscular endurance was associated with a 39% reduced risk of viral reactivation, a longer time to viral reactivation, and lower peak viral DNA concentrations, particularly for EBV and VZV. Latent viral reactivation rates were highest in crew with lower preflight CRF and higher levels of CRF deconditioning on return to Earth. We conclude that physical fitness may protect astronauts from latent viral reactivation during long duration spaceflight missions.

Sex- and age-specific normative values for handgrip strength and components of the Senior Fitness Test in community-dwelling older adults aged 65-75 years in Germany: results from the OUTDOOR ACTIVE study.

BACKGROUND: Physical fitness is a key component of independent living and healthy ageing. For the measurement of physical fitness in older adults, the Senior Fitness Test is a commonly used tool. The objective of this study is to calculate sex- and age-specific normative values for handgrip strength and components of the Senior Fitness Test for older adults (65-75 years) in Germany. METHODS: Cross-sectional data of 1657 community-dwelling older adults residing in Bremen, Germany (53% female) were included in this study. Physical fitness was assessed using the following measurements of the Senior Fitness Test battery: 30s-chair stand test, 2 min-step test, sit-and-reach test, and back scratch test. In addition, handgrip strength was measured using a Saehan DHD-3 digital hand dynamometer SH1003. Sex- and age specific normative values were calculated for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th, and 99th percentile using the GAMLSS method. RESULTS: The normative values show differences dependent on sex and age. For handgrip strength, the 30s-chair stand test and the 2 min-step test, normative values were higher for men, while women reached higher values in the sit-and-reach test and the back scratch test. For both, men and women, normative values declined with age. CONCLUSIONS: This study provides sex- and age-specific normative values for handgrip strength and components of the Senior Fitness Test for older adults in Germany. They might be useful for future research and for the application in practice.

Associations of sleep duration with physical fitness performance and self-perception of health: a cross-sectional study of Taiwanese adults aged 23-45.

BACKGROUND: The relationship between sleep duration and physical fitness is one aspect of sleep health. Potential factors associated with sleep duration interfere with physical fitness performance, but the impact trends on physical fitness indicators remain unclear. METHODS: This study examined associations between sleep duration and physical fitness among young to middle-aged adults in Taiwan. A total of 42,781 Taiwanese adults aged 23-45 participated in the National Physical Fitness Examination Survey 2013 (NPFES-2013) in Taiwan between October 2013 and March 2014. A standardized structural questionnaire was used to record participants' sleep duration, which was stratified as short (< 6 h/day (h/d)), moderate (6-7 h/d; 7-8 h/d; 8-9 h), and long (≥ 9 h/d) sleep duration groups. Physical fitness was assessed based on four components: body composition (body mass index [BMI], waist-to-height ratio [WHtR], and waist-to-hip ratio [WHR]), muscle strength and endurance (1-min bent-leg sit-up test [BS]), flexibility (sit-and-reach test [SR]), and cardiorespiratory endurance index (3-min step test [CEI]). RESULTS: By using analysis of covariance (ANCOVA), after sex grouping and age adjustment, we observed that sleep duration was significantly associated with obesity, functional fitness, and self-perception of health. The sleep duration for low obesity-related values (BMI, WHtR, and WHR) for men was 7-9 h/d, and that for women was 7-8 h/d. Sleeping more than 8 h/d showed poor functional fitness performances (BS and SR). For both sexes, sleep duration of 8-9 h/d was the optimal sleep duration for self-perceptions of health. CONCLUSIONS: Our research found that there were wide and different associations of sleep duration with physical fitness and self-perception of health among Taiwanese adults aged 23-45, and there were differences in these associated manifestations between men and women. This study could be of great importance in regional public health management in Taiwan, and provide inspirations for clinical research on physical fitness.

Associations between functional fitness and walking speed in older adults.

This cross-sectional study aimed to explore 1) the overall associations between functional fitness and walking speed in older adults and 2) the key functional fitness parameters affecting older adults' walking speeds. A total of 242 apparently healthy older adults finished a 6-m walking speed test at both usual walking speed (UWS) and maximum walking speed (MWS). Functional fitness was assessed using the Senior Fitness Test battery. The results revealed significantly moderate correlations of functional fitness with UWS (r = 0.380) and MWS (r = 0.436). Both age (UWS = -0.332, MWS = -0.324) and dynamic balance and agility (UWS = 0.329, MWS = 0.411) were key indicators of both UWS and MWS. In addition, gender (r = 0.090), aerobic endurance (r = 0.326), and lower body flexibility (r = 0.183) were key fitness indicators of MWS in older adults.

Muscle Mass and Muscle Strength Relationships to Balance: The Role of Age and Physical Activity.

OBJECTIVE: To investigate the relations of balance to muscle mass (MM) and muscle strength (MS), depending on age and physical activity, which is of particular importance to functional independence in older people. METHODS: This cross-sectional study included 802 volunteers (69.82 ± 5.60 years). The Fullerton Advanced Balance scale was used to assess balance and a composite score, including arm curl and chair stand tests for assessing MS. MM was estimated by dual-energy X-ray absorptiometry and physical activity by questionnaire. RESULTS: Greater MM (r = .26, p < .001) and MS (r = .53, p < .001) were positively correlated to balance. The old-old adults and less active individuals attained lower balance. Notably, moderation and subsequent simple slope analyses revealed that the relations of balance, MM, and MS were larger in less active and the old-old adults. CONCLUSIONS: The old-old and less active adults were more prone to muscle weakness and balance impairments. Tailored interventions should particularly consider these vulnerable groups.

[Lower Extremity Exercise Improves Functional Fitness, Physiological Indexes, Exercise Self-Efficacy, Sleep Quality, and Mental Health in Middle-Aged and Older Individuals].

BACKGROUND: Middle-aged and older individuals suffer from skeletal muscle loss due to aging, increasing the risk of sarcopenia. Muscular dystrophy reduces lower-extremity muscle endurance. The annual incidence of falls in the community is about 30-40%. Falls contribute to disability and fractures, affect quality of life, reduce mental health, and, in severe cases, result in death. Therefore, preventing lower limb muscle weakness in middle-aged and older individuals should be taken seriously. PURPOSE: The purpose of this study was to promote community health with a focus on older, community-dwelling individuals. The effects of a lower-extremity exercise intervention on middle-aged and older individuals in terms of improving functional fitness, physiological indexes, exercise self-efficacy, sleep quality, and mental health were explored. METHODS: This study used convenience sampling to recruit community residents over 55 years old as participants, with 50 participants assigned to the control group and to the experimental group, respectively. The experimental group participated in a 50-min lower extremity exercise intervention three times a week for 12 weeks. Differences in functional fitness, basic physiological index, exercise self-efficacy, sleep quality, and mental health variables between the two groups were assessed at the conclusion of the intervention. RESULTS: The lower-extremity muscle exercise program significantly improved functional fitness, physiological indexes, exercise self-efficacy, sleep quality, and overall mental health status in the experimental group, as compared to the control group (p < .05). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: It is recommended that the concept and application of lower extremity movement intervention should be popularized among middle-aged and older individuals to promote physical and mental health, prevent the decline and loss of lower extremity muscle strength, and help realize healthy aging goals.

The relationship between the level of physical activity, independence in daily activities, and life quality and satisfaction in women over 80 living in rural areas - a pilot study.

BACKGROUND: Better medicine and health care steadily increases the human life expectancy. Growing number of elderly people and the imbalance of population structure will affect many fields of life, including social security system, joborientation and culture. Therefore it is crucial that the elderly maintain not only good physical health but keep the ability to self-care as long as possible, stay functionally fit and express satisfaction of life in all domains. OBJECTIVE: This study aims to analyse the factors that affect the quality of life in different domains (physical, psychological, social and environmental), like the independence in performing everyday life activities and the level of physical activity of women above 80 years old, living in own households. MATERIALS AND METHODS: The study was performed from March to August 2015 in Opole, Lower Silesia and Silesia voivodeship, mosty in rural areas, on 67 women, age above 80 (average 82.9), who filled the standarized questionnaires of life quality (WHOQOL-BREF), physical activity (IPAQ), and self-maintenance in daily living (IADL, Lawton scale). RESULTS: The results show that the life satisfaction of women above 80 years old living in own households in rural areas is highest in the social and environmental domains, while is the lowest in physical health domain. There is a strong positive correlation between the level of physical activity, the level of self-maintenance and the life quality in four of its domains. CONCLUSIONS: Self-maintenance and higher level of physical fitness, which are the components of functional fitness, positively correlate with self-assesed life-satisfaction in all domains. It is crucial to stress the importance of physical activity in seniors, preferably in way of dedicated exercising of moderate and high intensity, that will bring benefits not only in domain of physical health but in overall well-being and higher life-satisfaction, the significant factors in healthy ageing.

Targeting the psychosocial and functional fitness challenges of older adults with hearing loss: a participatory approach to adaptation of the walk and talk for your life program.

OBJECTIVE: Explore the acceptability of a socialisation, health education and falls prevention programme (Walk and Talk for Your Life: WTL) as an adjunct to group auditory rehabilitation (GAR) and how it might be adapted for older adults with hearing loss (HL). DESIGN: Content theme analysis (CTA) of guided interviews explored the experience of HL, the acceptability of a WTL programme and suggestions on how to adapt the WTL programme to better suit the needs of older adults with HL. STUDY SAMPLE: Twenty-eight (20 women, 8 men) adults (>55 years of age) with HL were interviewed. Seventeen had participated in past WTL programmes and eleven were sampled from the community. RESULTS: Interviewees reported difficulty socialising and a tendency to withdraw from social interactions. Addition of GAR to a WTL programme was found to be highly acceptable. Interviewees suggested that to best suit their needs, sessions should take place in a location with optimal acoustics; include small groups integrating hearing-impaired and hearing-intact participants; include appropriate speaking ground rules; and include an option for partner involvement. CONCLUSIONS: The adapted WTL programme provides a holistic and unique approach to the treatment of HL that has the potential to positively impact the hearing-impaired elderly.

Effects of Functional-Task Training on Older Adults With Alzheimer's Disease.

The aim of this study was to verify the effects of functional-task training on cognitive function, activities of daily living (ADL) performance, and functional fitness in community-dwelling older adults with diagnosis of Alzheimer's disease (AD). A total of 57 participants (22 functional-task training group [FTG], 21 social gathering group [SGG], 14 control group [CG]) were recruited. Participants in both intervention groups carried out three 1-hr sessions per week of a functional-task program and social gathering activities for 12 weeks. Significant improvements were observed in executive functions (TMT, t-test, p = .03) in the SGG and in upper limb strength (arm curl, t-test, p = .01) in the FTG. Functional-task training has no significant effect on cognitive function, ADL, and functional fitness among people with AD, although it may contribute to slowing down the process of deterioration this illness causes.

[Improvement of physical and functional fitness in patients hospitalized at a geriatric ward depending on the duration of kinesitherapy].

OBJECTIVE: Introduction: Physical and functional fitness plays the key role in an independent, quality life of patients. Primarily, it prevents deterioration of health and loss of independence. Our degree of physical fitness depends on us and determines our old age life. There has been lots of scientific research into physical and functional fitness and its role in disease prevention and maintaining independence. With physical and functional fitness, older people have the chance to maintain their functional independence and improve quality of life. The aim: To evaluate the effect of duration of kinesitherapy on the improvement of physical and functional fitness in patients hospitalized at a geriatric ward. PATIENTS AND METHODS: Material and methods: The study involved 40 randomly selected, old-age patients hospitalized at a geriatric ward. All the patients took part in the study two times - both before and after kinesitherapy. The study was carried out on the basis of selected elements of comprehensive geriatric assessment. ADL and IADL tests were used for each patient to assess both basic and complex aspects of life functions. To assess physical fitness, SPPB (Short Physical Performance Battery) tests were employed. RESULTS: Results: The results show that the longer of kinesitherapy process, the better improvement of functional and physical fitness. CONCLUSION: Conclusions: The test showed that patients who had underwent kinesitherapeutic intervention for more than four days at the ward had better results. To sum up, it can be concluded that quick implementation of kinesitherapy, thus making the kinesitherapy process longer, significantly improves patients' fitness.