Monica Emma Liubicich

Effect of Ecological Walking Training in Sedentary Elderly People: Act on Aging Study

PURPOSE OF THE STUDY This study aims to investigate the effects of a walking program on aerobic endurance and function in a sample of sedentary elderly people. DESIGN AND METHODS For this study, 126 sedentary individuals were recruited: 63 individuals (mean age = 74.1±6.0 years) for the control group and 63 (mean age = 72.0±4.5 years) for the intervention group. The intervention consisted of walking training including balance exercises and lower limb strength activities twice a week for 4 months. We collected baseline and post-test measurements of aerobic endurance, lower limb strength, and mobility. We also measured aerobic endurance at increments of 4, 8, and 12 weeks between the baseline and the post-test. We used analyses of covariance with baseline value, gender, age, and body mass index scores as covariates (p < . 05) and calculated the effect size for the effects of the intervention. The changeover time of aerobic endurance was also analyzed with the repeated analysis of variance (p < .05). RESULTS The intervention group showed steady and significant improvements with respect to the 6-min walk (aerobic endurance) from 447.89 m (SD 73.87) to 561.51 m (SD 83.96), as well as the 30-s chair stand (lower limb strength) from 10 (SD 3) to 13 (SD 3) number of times and the Timed Up and Go Test (mobility) from 8.53 s (SD 2.86) to 7.13 s (SD 1.76) at the post-test, whereas the control group showed significant decrease in all measurements. IMPLICATION These results underline that an ecological walking training program can be used to improve physical functioning among sedentary elderly people.

The effects of a physical activity programme on the psychological wellbeing of older people in a residential care facility: an experimental study

ABSTRACT This experimental study aimed to analyse the effects of an aerobic activity intervention delivered by specially trained instructors to a sample of Italian older people living in a residential care facility. We assessed intervention effects on general health perception, perception that ones health represents a limitation for moderate and heavy physical activity, and positive and negative self-perception. The 36-item Short Form Health Survey Questionnaire (SF-36) was administered at pre-test and post-test to a sample of 22 older people (ten in the control group and 12 in the intervention group) of both genders with an average age of 80.6 years. The findings showed that: (a) the perception that ones health can limit moderate and heavy physical activity decreased significantly in the older people belonging to the intervention group between pre- and post-test, while it increased in the control group; (b) positive self-perception was found to be stable in the intervention group, while it decreased in the control group; and (c) there was no interaction between group and time with respect to both general health perception and negative self-perception. The exercise programme seemed to have a particularly positive effect on older peoples beliefs about their ability to master successfully the activities of daily living such as walking and moving objects.

A Longitudinal Study on the Relationship Between Aerobic Endurance and Lower Body Strength in Italian Sedentary Older Adults

Functional aging processes are characterized by a loss of performance capabilities for most physiological systems, such as aerobic endurance and lower body strength, which are important for independent living and active aging. The present study examines the direction of influence between aerobic endurance and lower body strength over time in Italian sedentary older adults. A three-wave longitudinal model was tested using cross-lagged analysis for 202 individuals aged over 65 years (mean = 73.92, SD = 5.84; 140 females). Analysis revealed that aerobic endurance and lower body strength decline over time. In addition, greater aerobic endurance positively affected lower body strength over time; however, the converse was true only during the first period (first 6 months). These findings emphasize the importance of these relationships for the design and implementation of effective physical intervention for older adults.

Age-related differences in dual task performance: A cross-sectional study on women

Simultaneous performances of motor and attention‐demanding tasks are common in activities of everyday life. The present cross‐sectional study examined the changes and age‐related differences on mobility performance with an additional cognitive or motor task, and evaluated the relative dual‐task cost (DTC) on the motor performance in young, middle‐aged and older women.

Changes in temporal parameters during performance of the Step Test in older adults

The purpose of this cross-sectional study was to examine the changes in the temporal parameters measured during the performance of the Step Test, to evaluate the relationship between age and these measurements and to determine their relationships to aerobic endurance, muscular strength and mobility in a sample of older adults. Eighty-eight older adults (mean age = 73.0 years, SD = 5.4) participated in the study. During the Step Test, we collected measurements of the following temporal parameters using the Optojump system: step number, support time and executive time. We also evaluated the performance of the Six-Minute Walk Test, the 30-Second Chair Rise Test and the Timed Up and Go Test. We observed a significant decrease in the step number and an increase in the support time and executive time (p = .001) during each minute of the test. The results revealed that the relationship between age and Step Test performance was attenuated when we controlled for potential confounding variables. Controlling for age, gender and BMI, variance in support time during the Step Test was accounted for by variance in 30-Second Chair Rise Test performance (partial r = -.224). Moreover, variance in executive time was accounted for by variance in 30-Second Chair Rise Test (partial r = .234) and Timed Up and Go Test performance (partial r = -.259). Understanding the factors that are associated with the performance of the Step Test may provide new insights into the development of specific intervention programmes for older adults.

Fear of falling and activities of daily living function: mediation effect of dual-task ability

ABSTRACT Objective: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults. Methods: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both single- and dual-task performances and ADL were collected. Results: Mediation analysis demonstrated the mediation effect of dual-task ability (β = 0.238, p = 0.011) between FOF and ADL level (β = 0.559, p < 0.001). Moreover, significantly lower performances were observed during dual-task condition [F (2, 73) = 7.386, p < 0.001], and lower ADL levels were also found in older adults with FOF [F (2, 73) = 13.734, p < 0.001]. Conclusion: The study underlines the relationship between FOF, dual-task ability and ADL level. These results could be used to develop specific intervention programmes for successful ageing.

Age-related decrements in dual-task performance: Comparison of different mobility and cognitive tasks. A cross sectional study

This cross-sectional study investigated the age-related differences in dual-task performance both in mobility and cognitive tasks and the additive dual-task costs in a sample of older, middle-aged and young adults. 74 older adults (M = 72.63±5.57 years), 58 middle-aged adults (M = 46.69±4.68 years) and 63 young adults (M = 25.34±3.00 years) participated in the study. Participants performed different mobility and subtraction tasks under both single- and dual-task conditions. Linear regressions, repeated-measures and one-way analyses of covariance were used, The results showed: significant effects of the age on the dual and mobility tasks (p<0.05) and differences among the age-groups in the combined dual-task costs (p<0.05); significant decreases in mobility performance under dual-task conditions in all groups (p<0.05) and a decrease in cognitive performance in the older group (p<0.05). Dual-task activity affected mobility and cognitive performance, especially in older adults who showed a higher dual-task cost, suggesting that dual-tasks activities are affected by the age and consequently also mobility and cognitive tasks are negatively influenced.

Neuromotor training in older women living in long-term care setting: A pilot study

This pilot study identified the effect and the feasibility of neuromotor training in a group of ageing women living in a long-term care setting. Thirty-five older women (mean age, 84.18 years; SD = 5.92 years) participated in the study. Twenty women were in the intervention group, and 15 women were in the control group. Data on mobility, activities of daily living (ADL) and fear of falling were collected before and after the 16-week training period. The neuromotor training program was based on concepts from motor control and motor learning. All participants completed the training program, and no adverse events occurred. The intervention group showed steady and significant improvements in mobility, ADL and fear of falling after the intervention, but the control group did not exhibit significant changes. Moreover, mediation analysis demonstrated the role of mobility as a mediator between participation in physical training and fear of falling.

Dual-task training in older adults: The effect of additional motor tasks on mobility performance

OBJECTIVES Dual-task (DT) performance is common to most activities of daily living and difficulties in DT activities may reduce quality of life in older adults. This study investigated the effect of DT training in a sample of older adults. METHODS Sixty older adults (mean=74.4±3.1years) participated in the study. Twenty-two older adults were included in the control (CG), 19 in the single-task (ST) training and 19 in DT training group. ST group received balance and walking training twice a week for16 weeks, while DT training group performed the same training with additional motor tasks. Data were gathered on 6m timed walk (6MTW), timed up and go test (TUG) and four square step test (FSST). DT conditions required participants to complete 6MTW, TUG and FSST, either (i) while carrying a glass of water or (ii) while carrying a ball on a round tray. RESULTS A significant Group x Time interaction was found in TUG (F [2,57]=29.5; p<0.01; partial η2=0.51) and in FSST (F [2,57]=23.2; p<0.01; partial η2=0.44). After intervention DT showed better scores in overall TUG (mean difference=1.21s [95% CI, 0.82-1.60]; p<0.05) and FSST (mean difference=2.51s [95% CI, 1.67-3.35]; p<0.01), whereas CG and ST did not exhibit significant changes. CONCLUSION Our results suggested that 16 weeks of motor DT training, using motor additional tasks as manipulation of common objects of everyday life, could improve mobility in older age.

A Multicomponent Exercise Program for Older Adults Living in Residential Care Facilities: Direct and Indirect Effects on Physical Functioning

The aim of this study was to assess the direct and indirect effects of a multicomponent exercise (MCE) program on mobility and balance in institutionalized older people. One hundred and twelve subjects (85 women; 83.0 years on average; SD = 7.5) were included in the study, and divided into a MCE-group (MCE-G) and a control group (CG) according to matching techniques. The MCE-G consisted of a 9-month program featuring range-of-motion, strength, and balance exercises performed in small groups. The CG received routine medical and nursing care. The timed up-and-go test and Tinetti Performance-Oriented Mobility Assessment balance subscale were administered at baseline and postintervention. After controlling for physical baseline value, age, sex, residential care facilities, and body mass index, the MCE-G showed positive effects both on mobility (p < .001) and balance (p = .001). The role of balance as mediator in the relationship between participation to the MCE program and mobility was demonstrated.