D Popkema

Once a week is not enough: Effects of a widely implemented group based exercise programme for older adults; a randomised controlled trial

Objectives: To determine the effects of gymnastics on the health related quality of life (HRQoL) and functional status of independently living people, aged 65 to 80 years. Gymnastics formed part of the More Exercise for Seniors (MBvO in Dutch) programme, a group based exercise programme for older adults in the Netherlands. It has been widely implemented since 1980. Design: Randomised controlled trial with pretest and post-test measurements. Intervention: The exercise programme given by experienced instructors lasted 10 weeks and was given weekly (MBvO1; n = 125, six groups) or twice weekly (MBvO2; n = 68, six groups). The control group (n = 193) was offered a health education programme. Setting: Community dwelling of older people, with a comparatively low level of fitness as assessed with the Groningen Fitness test for the Elderly. Results: No significant effects were found on the HRQoL (Vitality Plus Scale, TAAQoL, and RAND-36) and the functional status (Physical Performance Test and the Groningen Activity Restriction Scale). The MBvO2 group, with a low level of physical activity at baseline, showed the only improvement found on the Vitality Plus Scale (F = 4.53; p = 0.01). Conclusions: MBvO gymnastics once a week did not provide benefits in HRQoL and functional status after 10 weeks. However, participants with a low level of physical activity may benefit from MBvO gymnastics if they participate twice a week. To improve the health of the general public, sedentary older adults should be recruited and encouraged to combine MBvO with the health enhancing physical activity guidelines.

Reliability and validity of a twelve-minute walking test for coronary heart disease patients

This study examined the reliability and validity of a 12-min. walking test for coronary heart disease patients. CHD patients (28 men, 18 women) were recruited out of 86 CHD patients of the Martini Hospital Groningen, The Netherlands. 46 CHD patients (age M = 66.0 yr., SD = 6.8) participated in the reliability study and 24 (age M = 62.0 yr., SD = 9.2) in the validity study. A test-retest analysis showed a satisfactory Bland-Altman plot and an intraclass coefficient of .98. The Pearson correlation between the score on the test and the VO2 peak was .77. This test gives a reliable and valid assessment of cardiorespiratory fitness of CHD patients.

Meer bewegen voor Ouderen gymnastiek: verslag van een evaluatiestudie.

SummarySince 1980, More Exercise for Seniors (MBvO in Dutch) has provided a number of special physical activities for the elderly. The aim is to improve social participation and integration, and to prevent a need for care. Despite the fact that MBvO has been active for more than 25 years, and weekly 300,000 people participate in gymnastics, swimming, dancing, etc, no effect on fitness and health has been proven to date.The study was carried out in two regions: Drenthe and Zuid-Holland. Using the GALM (Groningen Active Living Model) method, 4600 independently living people aged 65 years and older were asked to participate in a motor fitness test. Of the 721 people who participated, 386 (the least fit) were invited to take part in the study. They were than randomly divided into an experimental and a control group. The experimental group did gymnastics once or twice a week. The control group received a health educational program.Assessments were carried out at pretest and posttest (10 weeks). In the groups offered MBvO gymnastics once a week, no effects were found on subjective health, physical performance or quality of life and only minor effects on physical fitness. In the groups offered MBvO gymnastics twice a week, some beneficial quality of life effects were found in the least physically active people at baseline.It is recommended that the frequency and intensity of the regular MBvO gymnastics should be increased, to emphasize the importance of health education, and that relatively inactive and older individuals (70+) should be recruited.SamenvattingIn deze studie zijn de effecten van Meer Bewegen voor Ouderen (MBvO) gymnastiek onderzocht. Met behulp van de GALM methodiek zijn 4.600 zelfstandig wonende ouderen van 65 jaar tot 80 in Drenthe en Zuid-Holland benaderd; 721 personen deden mee, waarvan 386 personen (de minst fitten) zijn uitgenodigd voor het onderzoek. Vervolgens is gerandomiseerd in een experimentele (n=193) en een controlegroep (n=193). MBvO- gymnastiek is zowel 1 maal (n=125, 6 groepen) als 2 maal per week (n=68, 6 groepen) aangeboden. De controlegroep kreeg een voorlichtingsprogramma. In de voor- en nameting (na 10 weken) is bij alle deelnemers de fitheid (GFO), subjectieve gezondheidsstatus (Rand-36) kwaliteit van leven (TAAQOL,VPS) , zelfredzaamheid (GARS) en functionele status (PPT) onderzocht.Na 10 weken zijn geen effecten gevonden op subjectieve gezondheid, kwaliteit van leven, zelfredzaamheid en functionele status en slechts een klein effect op beenkracht. Twee maal per week MBvO-gymnastiek gaf een klein positief effect op de kwaliteit van leven bij de van tevoren minst actieve ouderen.Aanbevolen wordt om de frequentie of intensiteit van de reguliere MBvO-gymnastiek te verhogen, meer voorlichting te geven over het belang van een actieve leefstijl en bij de werving de nadruk te leggen op de minst actieve en oudere ouderen (70+).

Gezondheidsgerelateerde fitheid van sedentaire senioren in Nederland

SummaryThe assessment of fitness is a component of a national project aimed at the enhancement of physical avtivity among sedentary older adults, aged 55-65 year in the Netherlands. Deterioration in physical functioning may be improved through an exercise programme. Research showed that enhancement of physical activity results in improved fitness, increased functional ability and health-related quality of life. Scientific results of the association between exercise and physical fitness in older adults is not sufficiently evidence-based in the Netherlands. In order to support health policy interventions 5.584 fitness tests of sedentary older adults were analyzed. The fitness was assessed by the Groninger Fitnesstest for Elderly (GFE).The analysis of physical fitness in sedentary older adults showed a lower fitness status among the age group 55-65 of age and women. Health risk factors such as overweight and having a chronic disease explained 88% of the variance between a low fitness and a high fitness profile.SamenvattingIn het kader van de landelijke uitvoering van een bewegingsstimuleringsproject voor sedentaire senioren in de leeftijd van 55-65 jaar, wordt voorafgaand aan deelname, de fitheid van de deelnemers getest. Het onderhouden, behouden en zo mogelijk bevorderen van fitheid door het stimuleren van lichamelijke activiteit levert naast gezondheidswinst ook positieve effecten voor de zelfredzaamheid op. Tot nu toe ontbrak er kennis over de fitheidstatus van sedentaire senioren in Nederland. Om hierin inzicht te krijgen is een analyse uitgevoerd naar de resultaten van 5.584 fitheidstesten van sedentaire senioren uit 51 gemeenten, die hebben deelgenomen aan het bewegingsstimuleringsproject. De fitheid is gemeten met behulp van de Groninger Fitheidtest voor Ouderen (GFO).De analyse van de fitheid bij sedentaire senioren leidt tot de conclusie dat ze, in vergelijking tot eenzelfde leeftijdsgroep uit de Nederlandse bevolking, een slechtere fitheidstoestand hebben en dat vrouwen wat betreft motorische fitheid aanzienlijk minder fit zijn dan mannen. Bovendien verklaren overgewicht en chronische aandoeningen samen voor 88% het verschil in motorische fitheid bij sedentaire ouderen.