Mohammod M. Islam

Water-based exercise improves health- related aspects of fitness in older women

PURPOSE The purpose of this study was to determine the physiological responses of elderly women to a well-rounded exercise program performed in water (WEX). METHODS The participants (60-75 yr of age) were randomly divided into a training (TR) group (N = 15) and a control group (N = 15). The TR group participated in a 12-wk supervised WEX program, 70 min x day(-1), 3 d x wk(-1). The WEX consisted of 20 min of warm-up and stretching exercise, 10 min of resistance exercise, 30 min of endurance-type exercise (walking and dancing), and 10 min of cool-down exercise. RESULTS The WEX led to an increase (P < 0.05) in peak VO2 (12%) and VO2 at lactate threshold (20%). Muscular strength evaluated by a hydraulic resistance machine increased significantly at resistance dial setting 8 (slow) for knee extension (8%), knee flexion (13%), chest press (7%) and pull (11%), shoulder press (4%) and pull (6%), and back extension (6%). Vertical jump (9%), side-stepping agility (22%), trunk extension (11%), and FEV1.0 (7%) also increased significantly. There was a significant decrease in skin-fold thickness (-8%), low-density lipoprotein (LDL) cholesterol (-17%), and total cholesterol (-11%). There were no significant changes in these variables in the control group. CONCLUSION These results indicate that WEX elicits significant improvements in cardiorespiratory fitness, muscular strength, body fat, and total cholesterol in older adult women. Water-based exercise appears to be a very safe and beneficial mode of exercise that can be performed as part of a well-rounded exercise program.

Methods to assess and improve the physical parameters associated with fall risk in older adults.

BACKGROUND Falls are common among older adults. Many physical parameters including reduced postural stability, decreased dynamic balance, gait disorders, strength deficits, difficulty standing from a chair, and other impairments have been shown to be strongly associated with fall risk in the elderly. ASSESSMENTS To identify those at risk for falls, tools that accurately measure physical performance parameters associated with falls are essential. Several tools are available to measure these parameters including clinical evaluations, functional performance tests, and questionnaires. The article describes many of the tools that can be used to evaluate the physical parameters associated with fall risk in older adults. CONCLUSIONS The described instruments can help in identifying those who are most likely to fall, and those who would benefit from targeted interventions. The final part of the article includes a brief discussion of the potential role of exercise training interventions to improve these physical parameters and prevent falls.

Threshold of lower body muscular strength necessary to perform ADL independently in community-dwelling older adults

Objective: To determine the thresholds of lower extremity muscle strength below which performing activities of daily living (ADL) is impaired in older adults. Design: Cross-sectional. Setting: Community. Subjects: Forty-nine older adults (81—89 years) were divided into an independent group (n = 25) who needed no assistance and a dependent group (n = 24) who needed assistance to perform ADL. Interventions: Not applicable. Main measures: Functional independence measures to determine level of disability and muscular strength of hip flexors, hip extensors, knee flexors, knee extensors and ankle dorsiflexors assessed by a hand-held dynamometer (HHD). Muscle groups were tested separately for each leg and values were averaged for the two legs. A ratio of maximal muscular strength to body weight was calculated by dividing the muscular strength (N) by body weight (kg). Results: Muscular strength thresholds to perform ADL independently were 2.3 N/kg for hip flexors, 1.7 N/kg for hip extensors, 0.7 N/kg for knee flexors, 2.8 N/kg for knee extensors and 2.8 N/kg for ankle dorsiflexors. Conclusion: The thresholds of lower extremity muscle strength below which assistance is required to perform ADL in community-dwelling older adults were identified. Furthermore, results indicate that the muscular strength of hip extensors is more important in performing ADL than other muscles of the lower extremities.

Pattern of age-associated decline of static and dynamic balance in community-dwelling older women

Falling is the leading cause of injury‐related deaths in older adults, and a loss of balance is often the precursor to a fall. However, little is known about the rate at which balance declines with age. The objective of the present study was to determine whether there is an age‐associated decline in static (SB) and/or dynamic (DB) balance in community‐dwelling older women.

Effects of Customized Balance Exercises on Older Women Whose Balance Ability Has Deteriorated With Age

Falls represent a major public health problem for older adults, and loss of balance (LOS) abilities is one of the primary causes of falls. Previous studies have shown that balance training is effective in improving physical function and decreasing risk of falls. However, little attention has been given specifically to balance training in older adults with very poor balance. The purpose of this study was to determine the effect of a 12-week customized balance exercise program on LOS for community-dwelling older women with poor balance ability. Twenty-four older women with poor balance (composite maximum excursion [MXEcomp] score of less than 70% based on Limits of Stability) were divided into an exercise group and control group. After 12 weeks of balance exercises, mean MXEcomp improved (p < .05) from 58.6% to 79.0% in the exercise group. EPEcomp (composite endpoint excursion), RTcomp (composite reaction time), SVcomp3 (composite sway velocity on thick foam with the eyes open), UG (up and go) also improved, but the functional reach and other static balance indexes did not change. These results indicated that balance training allows older adults with poor balance to improve dynamic balance ability and potentially reduce risk for falls.

Effects of Combined Balance and Resistance Exercise on Reducing Knee Pain in Community-Dwelling Older Adults

ABSTRACT The effects of a combined balance and resistance exercise program on knee joint pain (KJP) in community-dwelling older adults were determined. Twenty-eight participants with KJP were divided into an exercise group (EXG: n = 14, 77 ± 4 year) and a control group (n = 14, 77 ± 4 year). The EXG participated in 12 weeks of community-based training. The training program consisted of balance exercise and lower body resistance exercise using body weight. The EXG demonstrated significant improvements in KJP (46%), lower extremity muscular strength (5–26%), Chair Stand (27%), Up and Go (9%), and Functional Reach (17%).

Effects of Hydraulic-resistance Exercise on Strength and Power in Untrained Healthy Older Adults

Lee, S, Islam, MM, Rogers, ME, Kusunoki, M, Okada, A, and Takeshima, N. Effects of hydraulic-resistance exercise on strength and power in untrained healthy older adults. J Strength Cond Res 25(4): 1089-1097, 2011-The purpose of this study was to determine the efficacy of hydraulic-resistance exercise (HDRE) in improving strength and power in healthy older adults. Thirty-nine older adults (68.6 ± 4.9 years; 15 men, 24 women) were divided into a training group or control group (CON). Hydraulic-resistance exercise consisted of a 12-week supervised program, 50 min·d−1, 3 d·wk−1. Hydraulic-resistance exercise was used for 10 exercises: Chest press and pull, shoulder press and pull, low back flexion and extension squat, leg adduction/abduction, leg press, and elbow extension/flexion. The number of the sets and the hydraulic-resistance dial setting (D) were gradually increased in 3 stages during the 12-week program. Strength, rating of perceived exertion, and relative intensity during exercise increased significantly from stage to stage whereas repetition velocity decreased. Total work was higher in the second stage compared with the first but lower in the final stage because of reduced repetitions. Peak torque at D2 and D11 increased (p < 0.05) for knee extension (58 and 9%) and flexion (94 and 21%), chest press (35 and 12%) and pull (29 and 14%), shoulder press (14 and 18%) and pull (75 and 18%), and low back flexion (59 and 46%) and extension (84 and 34%). Peak power at D2 and D11 also increased (p < 0.05) for knee extension (140 and 26%) and flexion (96 and 36%), chest press (54 and 28%) and pull (62 and 23%), shoulder press (55 and 31%) and pull (159 and 30%), and low back flexion (177 and 127%) and extension (104 and 66%). There were no significant changes in the CON. Hydraulic-resistance exercise elicits significant improvements in strength and power in older adults. Therefore, HDRE is an effective form of resistance training that provides benefits using low and moderate intensity of training for older adults.

Threshold of chair stand power necessary to perform activities of daily living independently in community-dwelling older women

Purpose:To determine (1) the reproducibility of measurements of chair stand mean power (CSMP), (2) the relationships of CSMP with age, height, body mass, and body mass index, and (3) to identify the threshold of CSMP below which performing activities of daily living (ADL) is limited in older women. Methods:Eighty-seven older women (70-88 years) were divided into an independent group (n = 48) who needed no assistance and a dependent group (n = 39) who needed assistance to perform ADL. The CSMP expressed in watts (velocity × load) for each repetition was assessed by a device that measures mean velocity. Results:The intraclass correlation coefficient for CSMP suggested a high level of reproducibility (intra-class correlation coefficient = 0.88-0.92, P < .05). Relationships existed between CSMP and age (r = −0.37; P < .001), CSMP and height (r = 0.31; P < .001), CSMP and body mass (r = 0.43; P < .001), and CSMP and body mass index (r = 0.30; P < .001). A receiver operator characteristic curve analysis revealed the optimal threshold criteria; a CSMP of 214 watts resulted in the highest combination of sensitivity (82.1%) and specificity (81.2%). Conclusion:The threshold of CSMP below which assistance is required to perform ADL in community-dwelling older women was identified.

Progressive, Site-Specific Loss of Muscle Mass in Older, Frail Nursing Home Residents

To clarify the progression of muscle loss in nursing home residents, frail women (n = 16; age: 85 ± 9 years; residence time: 764 days) were assessed for physical activity, caloric intake, and site-specific muscle thickness (MTH) and subcutaneous fat thickness (SFT) using B-mode ultrasound at nine anatomical sites at four intervals over one year. Height, body weight, and BMI did not change. Physical activity (246 steps/ day) and nutritional intake (1,441 kcal, 60.3 g protein/day) were unaltered throughout the study. Subjects experienced a significant, progressive loss of muscle indicated by decrements in anterior upper arm (20%), posterior upper arm (25%), abdomen (20%), subscapular (33%), anterior thigh (15%), posterior thigh (22%), anterior lower leg (11%), posterior lower leg (13%), and forearm (15%) MTH. At study inception, prevalence of sarcopenia was related to muscle loss in the upper leg, while upper body muscle wasting contributed to sarcopenia later and was unrelated to physical activity, nutritional input, or duration of residence.

Passive and active exercises are similarly effective in elderly nursing home residents.

[Purpose] The aim of this study was to compare the efficacy of passive motion exercise and active motion exercise on functional fitness in elderly nursing home residents. [Subjects and Methods] Twenty-three (female 22 and male 1) nursing home residents (84.8±4.3 yr) volunteered for this study. They were divided into a passive motion exercise group (n=12) and an active motion exercise group (n=11) and performed 30-min sessions of training twice a week for 12 weeks. Functional fitness (Arm Curl, Chair Stand, Up & Go, Sit & Reach, Back Scratch, functional Reach, and 12-min Walk tests) was evaluated before and after the intervention. [Results] No significant baseline difference was noted between the groups in measured variables. Following the 12 week intervention, no significant interaction (group × time) was noted in functional fitness variables between the groups, except for the functional reach scores (active motion exercise 40%, passive motion exercise 9%). Significant improvement over time was noted in passive motion exercise group in Arm Curl (19%), Chair Stand (15%), Up & Go (6%), and 12-min Walk (12%) scores; and in the active motion exercise group in Arm Curl (14%), Chair Stand (19%), Up & Go (11%), functional Reach (40%) and 12-min Walk (13%) scores. The adherence rates in the passive and active motion exercise groups were 95.8% and 93.1% respectively. [Conclusion] Passive motion exercise and active motion exercise were found to be similarly effective for improving the functional fitness of elderly nursing home residents.