Participation in physical activity is an evidence-based strategy for improving health in older adults. However, less than 30% of older adults engage in any form of regular physical activity. Despite the development of best practice recommendations, the impact of physical activity programs on older adult participation and the performance of activities of daily living (ADL) is not well understood. This dissertation examined best practice programs in relation to ADL performance through a literature review and an intervention study. Our systematic review identified 15 studies on multi-component, group, exercise interventions for community-dwelling older adults. Studies varied greatly in terms of setting, sample size, mode of exercise, length of intervention, and outcomes, and only four studies included all the recommendations of best practice. ADL performance was the least frequently included outcome, supporting the need for additional research. Our pretest, posttest, and post-posttest cohort study evaluated the effects of a 10 week, multi-component, best practice, exercise program on physical activity, ADL performance, physical performance, and depression in community-dwelling, older adults from low-income households (N = 15). Comparison of pretest and posttest scores using a one-tailed paired samples t-test resulted in improvement (p < .05) for 2 of 3 ADL domains on the Activity Measure-Post Acute Care (AM-PAC) and on all 6 physical performance measures of the Senior Fitness Test (SFT), with medium to large effect sizes for all measures. The Geriatric Depression Scale (GDS) yielded no significant change. Physical activity was evaluated at pretest, at 4 weeks posttest, and at 8 weeks post-posttest using the Yale Physical Activity Scale (YPAS). Repeated measures ANOVA revealed significant main effects for 3 of 8 measures - Total Activity Hours, Total Energy Expenditure, and the Leisurely Walking Index. Post-hoc analysis using the Bonferroni adjustment was significant only for the Leisurely Walking Index from pretest to posttest. Retention rate was 78.9%, and the adherence rate for group sessions was 89.7%. These results suggest that implementation of a multi-component, best practice exercise and physical activity program with sedentary, community-dwelling older adults may be well tolerated and may positively impact physical activity, ADL performance, and physical performance.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12062010-113705 |
| Date | 23 December 2010 |
| Creators | Toto, Pamela E |
| Contributors | Elizabeth A. Schlenk, PhD, RN, Ketki D. Raina, PhD, OTR/L, Margo B. Holm, PhD, OTR/L, Joan C. Rogers, PhD, OTR/L |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12062010-113705/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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