Thesis (M.S.)--East Carolina University, 2009. / Presented to the faculty of the Department of Exercise and Sport Science. Advisor: Timothy P. Gavin. Title from PDF t.p. (viewed May 5, 2010). Includes bibliographical references.

Objective: To evaluate the effectiveness of exercises on fall prevention among community-dwelling elderly. Design: Systematic review of randomized controlled trials. Method: The literature search of articles was conducted through the electronic databases of PubMed, Medline and EMBASE and manual search, and was confined to articles in English language with full text and publications from 2002 to 2012. Randomized controlled trials with exercise as the only intervention which aimed at reducing falls in older people aged 60 or above in community i.e. community-dwelling elderly were included. The primary outcomes were number of fallers, fall rate, time to the first and subsequent falls. Data Extraction: A total of 145 articles were retrieved through the electronic data bases (137 articles) and manual search (8 articles) of which 10 were selected after applying the inclusion criteria. According to the checklist developed by National Institute for Health and Clinical Excellence (NICE) for randomized controlled trials, the overall methodological quality of the 10 studies was rated as good as they had fulfilled 79%-93% of the assessment criteria in the NICE checklist. Results: The studies involved a sample size of 3,138 at the median age of 69 to 83. All the subjects were ambulatory and able to mobilize independently. The duration of exercise interventions ranged from 1.5 months to 12 months at a total of 11-156 hours. Eight studies showed that exercises were effective in fall prevention whereas two studies found no evidence of such effectiveness. The effect of exercises on fall prevention was multifactorial including the duration, frequency and continuity of the exercise programs, the health status of the target population and the individuals’ adherence to the exercise programs. Shorter exercise programs and make-up class arrangement resulted in higher adherence rate. Tailor-made (based on the functional capabilities of the subjects) and progressive (gradual increase of the intensity and challenge of the exercises during the intervention period) nature of the exercise programs also enhanced their effectiveness on the elderly. For the studies in which exercise did not have any positive effect on fall prevention, the subjects were generally older (median age at 81) and frailer (with 3-7 frail attributes). Conclusions: This review suggests exercise may be an effective intervention for fall prevention among community-dwelling elderly. Different types of exercise including strengthening, balance, endurance and weight-bearing exercises as well as Tai Chi may prevent falls. The elderly’s age and health status must be taken into consideration when designing exercise intervention programs for the elderly. Further researches are recommended to determine the optimal type, intensity, frequency and duration of exercises in fall prevention. Observations from the studies provide insights for future researches, such as the fall prevention effect of group and home exercises, tailor-made and progressive exercise programs. In Hong Kong, no randomized controlled trial studies have been conducted to examine different intervention programs on fall prevention. To achieve generalizabilty of the studies in the review, further local researches, particularly well designed and powered randomized controlled trials have to be conducted to assess the effect of different kinds of exercise interventions on fall prevention among the community-dwelling elderly. / published_or_final_version / Public Health / Master / Master of Public Health

Not available / text

Not available / text

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The purpose of this study was to examine the participants of the Ball State University Retirees Fitness (BSURF) program in order to determine the role that habitual participation in an exercise program plays on the aging process. The participants of the BSURF program were divided into two groups: those that have been exercising for seven or more years (LT; n=14), and those that have been exercising for six years or less (ST; n=10). Subjects underwent testing on the following variables: BMI, body composition, resting heart rate and blood pressure, blood lipid profile, biceps muscular strength, trunk flexibility, and the Rockport Walk Test. Group differences were determined using an independent t-test. Despite a significant difference in age and duration of participation time between the LT and ST groups, no statistically significant differences in cardiovascular measurements, anthropometric measurements, and body size were seen between the two study groups. The only exception to the positive effects of this exercise program on the aging process is demonstrated by the trunk flexibility data. The ST group was significantly more flexible (27.6 ± 1.51 cm) than the LT group (17.7 ± 2.67 cm). The results of this study suggest that continued participation in the BSURF program enabled the LT group to maintain their physiological functioning. Further, the length of participation by the members of the BSURF program clearly demonstrates significant adherence, and suggests that a program of moderate intensity in combination with a large social aspect may play a role in the exercise adherence of older adults. / School of Physical Education

Findings were that caregivers considered all items on the Information Needs and Patient Care Needs subscales to be important but most of the unmet needs were from the Patient Care subscale. The needs less satisfied in relation to importance were (a) ways to improve patient appearance, (b) activities that will make patient feel purposeful, (c) information on how to give medications, (d) ways to reassure patient, (e) ways of coping with patient's diagnosis, (f) ways to dress patient comfortably, (g) ways to deal with patient's decreased energy, and (h) importance of not leaving patient alone.The implications for nursing are to assess and anticipate the needs of the caregiver of the stroke survivor so that his or her needs can be met. Preparing caregivers for their new role by meeting their needs will help the nurse met the primary goal of helping the patient. / School of Physical Education

The purpose of this study was to investigate whole muscle and single muscle fiber adaptations in old men (OM) and old women (OW) over 80 years of age in response to progressive resistance training (PRT). Six OM (82±1 y, 74±4 kg, BMI 25±1 kg•m-2) and six OW (85±1 y, 67±3 kg, BMI 27±1 kg•m-2) resistance trained the knee extensors (3 sets, 10 repetitions) at 70% one repetition maximum 3 d•wk-1 for 12 wks. Vastus lateralis muscle biopsies were obtained before and after the PRT program. Isolated muscle fibers were studied in vitro at 15°C for diameter (Dia), peak tension (Po), unloaded shortening velocity (Vo), and absolute peak power (Abs Pwr). With PRT, OM increased whole muscle strength (40±6%, p<0.05), with no change in whole muscle size. OW also increased whole muscle strength (26±6%, p<0.05) without a change in whole muscle size. No differences were observed in any of the single muscle fiber parameters among MHC I or MHC IIa muscle fibers from OM or OW. The novel finding of this study was that despite an increase in whole muscle strength there was no change in whole muscle size, single fiber diameter, or single fiber contractile function. Given that there was no change in muscle size or cellular function with PRT, the improvement in whole muscle strength point to neurological changes. These data suggest that the hypertrophic mechanisms that are typically apparent in humans with PRT are attenuated in individuals over 80 y. / School of Physical Education, Sport, and Exercise Science

The Center for Disease Control (2008) and William (2006) reported that the American older population has dramatically increased recently. Numerous studies found that when people get old, they are more likely to have functional disabilities with physical components. Frontera et al. (2000) and Doherty (2003) reported that older adults have significantly decreased muscle force and power. They also have a higher risk of chronic disease, arthritis, type 2-disabetes, obesity, and certain types of cancer compared to young adults (Grembowski et al, 1993; & Wojtek et al, 2009). Self-efficacy is a person’s belief in his or her ability to succeed in a particular situation (Bandura, 1997 and 1999), and several studies have shown that a strong sense of self-efficacy could maintain regular physical activity and change health behavior to reduce the risk of illness or mortality of older adults (CDC, 1999; & MaAuley et al. 1997). The current study examined the relationship between self-efficacy for exercise and level of physical activity for older adults. This study also examined the relationship between self-efficacy for exercise and the level of physical activity through various demographic dimensions including age, gender, marital status, years of completed education, and household income. Participants of the study were 50 years of age and older, who currently live in the Midwest. Two local senior centers and one volunteer group provided the participants. A total of 202 questionnaires were distributed to volunteer participants during the spring and summer of 2010, and 124 were returned. Data analysis included the use of one-way ANOVA to determine the relationship between the self-efficacy for exercise and the level of physical activity. Multiple Regression determined the relationships between self-efficacy for exercise and the level of physical activity through the demographic variables. Results indicated that the exercise self-efficacy scale positively related with leisure activity group. However, no differences were observed for the exercise self-efficacy scale by habitual and occupational physical activity. The results also indicate that significant correlations were found between age and exercise self-efficacy. Younger adults indicated that moderate and regular physical activity positively affected their exercise self-efficacy. The findings suggest that young adults who engage in more physical activity attain more favorable exercise self-efficacy than older adults. The conclusions indicate that some differences were observed between the level of physical activity and exercise self-efficacy, and these findings add to our understanding of the physiological and cognitive benefits of physical activity, and its impact on older adults’ cognitive perspectives. / Department of Educational Studies

Research has shown the benefits of exercise are transient and gains achieved in geriatric rehabilitation progams are not maintained post discharge. Sedentary behaviour increases with advancing age, making levels of exercise frequency and long-term program adherence difficult to achieve in older populations. The primary aim of the study was to investigate whether once a week exercise is as effective as twice a week for maintaining outcomes post physical rehabilitation in a consecutive sample of older adults. / Thesis (PhD)--University of South Australia, 2008.