Search Results (57)

Background: The Callista Roy Adaptation Model posits that adaptation in later life emerges from the interaction among physical, psychological, and social dimensions. However, empirical evidence integrating these domains through predictive approaches remains limited. The aim of this study was to identify the main predictors of adaptive classification in older adult women using functional and subjective well-being measures. Methods: A predictive study was conducted in older adult women enrolled in community-based exercise programs. Assessments included the Senior Fitness Test and the SF-12 and WHO-5 questionnaires. Multiclass classification models were trained, with Random Forest selected due to superior performance. Model evaluation incorporated oversampling strategies and robustness analyses without oversampling, using metrics resilient to class imbalance (macro-F1 and balanced accuracy). Model interpretability was examined through variable importance analysis, partial dependence, and ICE plots. Results: Under the oversampling framework, the Random Forest model achieved an overall accuracy of 74% and a macro-F1 score of 0.73, with reduced performance observed in robustness analyses, particularly for the minority “High” class. The most influential predictors were the physical component of the SF-12, the 2 min step test, the mental component of the SF-12, and the chair sit-and-reach test. Conclusions: The findings highlight the joint contribution of physical and psychosocial factors to adaptive processes, in alignment with the Roy Adaptation Model. This study provides exploratory evidence supporting the integrated use of the SFT, SF-12, and WHO-5; however, external validation and longitudinal evaluation are required prior to clinical implementation. Full article

Background/Objectives: Pilates exercises performed on different apparatuses may elicit distinct acute responses in cardiovascular function and musculoskeletal flexibility, yet comparative data on the immediate effects of reformer (RF), cadillac (CD), and chair (CH) pilates exercises remain unclear. This study aimed to investigate and compare the acute effects of RF, CD, and CH pilates sessions on cardiac autonomic modulation and flexibility in sedentary middle-aged women. Methods: Fifteen participants (mean age: 42.2 ± 1.5 years) completed all three exercise conditions in a randomized crossover design, with sessions separated by at least 72 h. Heart rate variability (HRV) was assessed at pre-exercise, during exercise, and at 10 min intervals up to 40 min post-exercise. Flexibility was measured using standardized sit-and-reach tests at pre-exercise, immediately post-exercise, and 40 min post-exercise. Results: Results revealed a significant condition × time interaction for flexibility (p < 0.010, η²p = 0.207), with the RF session producing greater immediate improvements in flexibility compared to CD (p = 0.030; g = 0.24) and CH sessions (p = 0.030; g = 0.24). Notably, flexibility gains from the RF session were maintained at 40 min post-exercise relative to the CH session (p = 0.035; g = 0.28). In contrast, no significant interactions between condition × time were observed for HRV parameters (p > 0.05). However, the main effect of time was evident across all HRV measures (p < 0.05), indicating post-exercise autonomic modulation independent of apparatus type. Conclusions: These findings suggest that while acute cardiovascular responses may not differ substantially between pilates apparatuses, the RF apparatus may be more effective for immediate flexibility enhancement in sedentary middle-aged women. Practitioners and clinicians may consider selecting apparatus based on specific functional goals, such as improving flexibility, when designing pilates-based interventions for this population. Full article

Background/Objectives: Sarcopenia is an age-related decline in muscle mass and strength, reducing mobility and functional independence and increasing the risk of falls. Non-pharmacological interventions remain the most effective strategies to prevent or delay its progression, with exercise recognized as the primary approach. Virtual reality (VR)-based training has recently emerged as a promising tool to promote physical activity; however, its application among the oldest-old individuals remains underexplored. This is a randomized controlled pilot study to evaluate the effects of VR-based intervention using the game “Beat Saber” on muscle strength and selected physical performance indicators related to sarcopenia risk in older adults. Methods: Thirty-eight residents (mean age: 87.2) of a long-term care facility were randomly assigned to either a VR group or a control group. The VR group participated in 12 supervised VR-based training sessions of 20 min per session, three times per week for four weeks. Handgrip strength, the arm curl test, 30-s chair stand, a 2-min step-in-place test, and an 8-foot up-and-go test were assessed before and after the intervention. Results: Linear mixed-model analyses revealed significant group-by-time interactions for upper- and lower-limb strength (handgrip, arm curl, chair stand; p < 0.05), favoring the VR group. Agility and endurance (8-foot up-and-go, 2-min step-in-place) showed no significant interactions. In the VR group, the 30-s chair stand performance correlated positively with the arm curl and the 2-min step-in-place tests results, while handgrip strength correlated with the arm curl performance. In the control group, the 30-s chair stand test results correlated strongly with the 8-foot up-and-go and 2-min step-in-place tests, but no significant correlations were found for handgrip strength. Conclusions: The findings indicate short-term functional benefits of VR exercise among the oldest-old adults. VR-based training appears to be an effective and well-tolerated method to enhance physical performance in individuals aged 80 and older and may represent a valuable strategy for improving functional performance indicators associated with sarcopenia risk in adults aged 80 years and older. Full article

Background and Objectives: Hamstring strain injuries (HSIs) are frequent and recurrent in athletes who perform high-speed running. The long head of the biceps femoris (BFlh) is often affected by HSIs. While the Nordic hamstring exercise (NHE) is used for prevention, evidence shows it mainly activates the semitendinosus (ST) instead of the biceps femoris (BF). It was argued that hamstrings may contract isometrically during sprinting’s late swing phase; exercises like the single-leg Roman Chair-Hold (RCH) might better mimic sprinting. Limited electromyographic (EMG) data compare NHE and RCH. This study examined EMG activation of BF and ST during both exercises in athletes. Materials and Methods: Thirty-six professional handball players (17 females, 19 males) were randomly assigned to NHE (n = 18; mean age 22.1 ± 3.9 years) or RCH (n = 18; mean age 22.6 ± 4.9 years). A wireless EMG system recorded dominant leg BFlh and ST activity, normalised to maximal voluntary isometric contraction (MVIC%). NHE participants completed one set of ten repetitions; RCH participants performed three sets of ten repetitions with progressive loads (bodyweight, +10 kg, +20 kg). Results: RCH led to a significantly higher mean BFlh activation in the third set with +20 kg weight compared to NHE (72.9% versus 46.5%; p < 0.001, g = 1.52). BFlh activation steadily increased across RCH sets, coinciding with additional load increments (p < 0.001). Conversely, NHE produced greater ST activation than the RCH at the first set, where RCH was performed with only bodyweight (p < 0.001). Conclusions: NHE primarily activates the ST, while RCH gradually increases BFlh activation, particularly under load. Future research should investigate which exercises are more effective at reducing HSIs to draw more robust conclusions based on the study’s findings. Full article

Background/Objectives: The development of safe and effective online exercise interventions is essential for enhancing physical activity among older adults and supporting healthy aging. However, the effects of online slow-movement bodyweight resistance training (SBRT) programs and exercise continuation after such interventions remain unclear. This pilot study examined the effects of a seven-week online exercise class (OEC) using SBRT on physical function in community-dwelling older adults and further explored exercise continuation and its effects on physical function during a subsequent seven-week self-directed exercise (SDE) period. Methods: Eight community-dwelling older adults (age: 70.0 ± 7.7 years) participated in a seven-week OEC (twice per week), followed by a seven-week SDE. Their physical function was assessed remotely using the 30-second chair stand test (CS-30) at baseline, after the OEC, and following the SDE. Training frequencies and volumes were recorded throughout the periods to evaluate exercise adherence and continuation. Results: The participants’ CS-30 performance significantly improved after the OEC (21.3 ± 2.7 vs. 24.0 ± 3.2 times; p = 0.004) and even more following the SDE (24.0 ± 3.2 vs. 27.8 ± 3.8 times; p = 0.002). The training frequency during the SDE period was comparable to that during the OEC period (2.5 ± 1.2 vs. 2.1 ± 1.0 days/week; p = 0.916), with there being no significant difference in lower limbs training volume between the two periods (1313.1 ± 376.4 vs. 1421.3 ± 673.2 repetitions; p = 0.698). Conclusions: A seven-week SBRT-based OEC may be a feasible remote exercise intervention that effectively improves physical function in older adults and encourages post-intervention exercise continuation. Full article

Introduction and Aim: Sarcopenia has emerged as a key prognostic factor in patients with chronic limb-threatening ischemia (CLTI), with potential implications for clinical decision-making. This study aimed to assess the association between sarcopenia and clinical outcomes, mortality, and amputation, using simple, accessible screening tools in a CLTI population. Methods: In this prospective, single-center study conducted between December 2023 and December 2024, 170 patients with CTLI were enrolled. Sarcopenia screening was performed using the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaires, handgrip strength measurement, and calf circumference, adjusted for body mass index and sex. The primary outcome was 6-month all-cause mortality and/or major amputation. Results: Sarcopenia was identified in 77 patients (45.3%). Compared to non-sarcopenic individuals, sarcopenic patients were significantly older. They exhibited greater functional impairment, as well as poorer nutritional and muscle status. They also had significantly higher in-hospital mortality (16.9% vs. 3.2%, p = 0.002), 30-day mortality (24.7% vs. 4.3%, p = 0.001), and 6-month mortality (50.6% vs. 15.1%, p = 0.001). Sarcopenia was significantly associated with the primary outcome in univariate analysis (HR: 2.05; 95% CI: 1.31–3.20; p = 0.002) and remained an independent predictor after multivariate adjustment (HR: 1.95; 95% CI: 1.01–3.79; p = 0.048). Conclusions: Sarcopenia is a strong, independent predictor of poor outcome in patients with CLTI. Its detection through simple tools offers an easy and cost-effective strategy to improve risk stratification and guide early intervention through exercise-based therapy. Full article

Ensuring that older adults perform chair-based exercises (CBEs) correctly is essential for improving physical outcomes and reducing the risk of injury, particularly in home and community rehabilitation settings. However, evaluating the correctness of movements accurately and objectively outside clinical environments remains challenging. In this study, camera-based methods have been used to evaluate practical exercise quality. A single-camera system utilizing MediaPipe pose estimation was used to capture joint angle data as twenty older adults performed eight CBEs. Simultaneously, surface electromyography (sEMG) recorded muscle activity. Participants were guided to perform both proper and commonly observed incorrect forms of each movement. Statistical analyses compared joint angles and sEMG signals, and a support vector machine (SVM) was trained to classify movement correctness. The analysis showed that correct executions consistently produced distinct joint angle patterns and significantly higher sEMG activity than incorrect ones (p < 0.001). After modifying the selection of joint angle features for Movement 5 (M5), the classification accuracy improved to 96.26%. Including M5, the average classification accuracy across all eight exercises reached 97.77%, demonstrating the overall robustness and consistency of the proposed approach. In contrast, high variability across individuals made sEMG less reliable as a standalone indicator of correctness. The strong classification performance based on joint angles highlights the potential of this approach for real-world applications. While sEMG signals confirmed the physiological differences between correct and incorrect executions, their individual variability limits their generalizability as a sole criterion. Joint angle data derived from a simple single-camera setup can effectively distinguish movement quality in older adults, offering a low-cost, user-friendly solution for real-time feedback in home and community settings. This approach may help support independent exercise and reduce reliance on professional supervision. Full article

This study evaluated the differential effects of an advanced Vivifrail D-level exercise intervention on arterial stiffness, functional fitness, and body composition in robust older women with varying baseline fitness levels. A total of 41 participants were assigned to a higher-fitness group (HFG, n = 22) or a lower-fitness group (LFG, n = 19) based on their 30 s chair stand performance. Over 12 weeks, both groups completed five weekly sessions incorporating strength, balance, aerobic, and dual-task elements. Significant within-group improvements were observed in the arm curl test (HFG: p = 0.031; LFG: p = 0.002), chair stand (LFG: p < 0.001), and 2 min step test (LFG: p = 0.002). Between-group analysis showed greater percentage gains in the LFG for the chair stand (33.8% ± 28.2% vs. 7.1% ± 21.6%, p = 0.001) and step test (13.7% ± 14.5% vs. 5.3% ± 14.7%, p = 0.040). No significant changes were found in handgrip strength, gait speed, pulse wave velocity, or muscle mass. These results suggest that the modified Vivifrail protocol enhances lower-limb endurance in lower-fitness individuals, but additional adaptations may be necessary to impact vascular and compositional outcomes. Full article

Objectives: This study aimed to analyze the effect of a multimodal prehabilitation program for colorectal cancer patients in body composition, physical and cardiorespiratory fitness as well as its ability to reduce postoperative complications. Methods: A longitudinal observational study evaluated the efficacy of a prehabilitation intervention based on four components: (a) health education and self-care, (b) nutritional counseling, (c) psychological support, and (d) supervised physical exercise. Body composition was determined through bioelectrical impedance analysis; physical fitness variables such as strength was measured by a handgrip dynamometer for upper limbs, and a squat–jump test, countermovement jump test using a contact platform, and a chair–stand test for lower limbs. Flexibility was assessed with the sit-and-reach test. Cardiorespiratory fitness was assessed with the 6 min walking test (6MWT). Moreover, we measured lifestyles related to the amount of physical exercise by accelerometry. Results: The final cohort included 30 patients. Patients completed an average of 9.90 ± 5.26 exercise sessions. Statistically significant changes with varying effect sizes were observed in the following outcomes: SJ values in cm and W for both sexes (p = 0.021/d = 0.14 and p = 0.043/d = 0.10, respectively), SJ in W for women (p = 0.023/d = 0.21), all chair-stand test values (p = 0.021/d = 0.65 for men, p = 0.004/d = 2.08 for women, and p = 0.000/d = 0.84 for both sexes), and sit-and-reach for both sexes (p = 0.005/d = 0.12) and for men (p = 0.044/d = 0.08). All 6MWT values had statistically significant changes (p = 0.001/0.46). Women reduced the weekly minutes spent in sedentary behavior (p = 0.037/d = 0.65) and increased the minutes spent performing light physical activity (p = 0.037/d = 0.63). With regard to surgical outcomes, there was a tendency towards a decrease in postoperative complications and hospitalization days, as well as minutes in postoperative REA (p = 0.009/d = 0.69) in relation to the control group. Conclusions: Participation in a multimodal prehabilitation program improves several aspects of physical condition and lifestyles related to the amount of physical exercise and reduces both days of hospitalization and several complications post-surgery. Full article

Background/Objectives: Hip and knee arthroplasty relieves pain, restores mobility, and improves function in severe joint damage, though pain and strength loss may persist post-surgery. Better pre-surgery function and activity predict improved arthroplasty outcomes. Prehabilitation programs enhance functional abilities, reducing hospitalization duration, and lowering peri-surgery complication risks. This study aims to evaluate the efficacy of four weeks of different modalities of tele-home-prehabilitation programs on perceived pain and functional capacity in patients who are eligible for hip or knee arthroplasty. Methods: Forty-four patients (aged 65–80 years) eligible for elective lower limb arthroplasty were enrolled in the present randomized controlled trial study. Participants were randomly assigned to the Electrostimulation Group (EG) or the Home-Based Exercise Group (HG). The EG performed underwent teleprehabilitation program using indirect neuromuscular electrostimulation therapy, while the HG performed home-based exercise supervised by a sports specialist. Functional capacity was assessed with the Timed Up and Go test (TUG), the 30 s Chair Stand test (30CST) and the Six-Minute Walking Test (6MWT). Quality of life was assessed with the Oxford Hip Score (OHS) or Oxford Knee Score (OKS), depending on the participants’ surgery. The Technology Acceptance Model (TAM) questionnaire was completed by the EG after the intervention. Results: No significant differences were found among groups in the 30CST and TUG tests. The analyses revealed significant differences for the Oxford Questionnaires and 6MWT. Conclusions: Our study highlights the potential of teleprehabilitation using indirect neuromuscular electrostimulation to improve walking autonomy and quality of life of individuals who are candidates for lower limb arthroplasty. Full article

Background: This study aimed to investigate the effects of a 12-week body-weight-based resistance training program on balance ability and fear of falling in community-dwelling older women. Methods: Twenty-three older women were assigned to either an intervention group that performed the low-load resistance training with slow movement using the body weight (LRT group; n = 12) or a control group (CON group; n = 11). The LRT group participated in the exercise session twice weekly for 12 weeks, while the CON group maintained their daily routine. The 30 s chair stand test (CS-30) was applied to measure lower-extremity muscle strength, balance ability was evaluated using one-leg standing tests with eyes open (OLST-O) and closed (OLST-C), and fear of falling among all participants was assessed using the Falls Efficacy Scale International (FES-I) before (pre) and after (post) the intervention. A two-way analysis of variance with repeated measures [group (LRT and CON) × time (pre and post)] was carried out to evaluate the intervention effects. Results: Significant interactions were observed in the CS-30 (F = 9.503, p < 0.01, ${\eta }_p^2$ = 0.312), OLST-O (F = 5.211, p < 0.05, ${\eta }_p^2$ = 0.199), and OLST-C (F = 5.257, p < 0.05, ${\eta }_p^2$ = 0.200), though significant simple main effects from pre to post were observed only in the LRT group. The CS-30 scores (pre: 19.8 ± 3.8 times, post: 25.5 ± 5.6 times; p < 0.001), OLST-O time (pre: 78.8 ± 35.8 s, post: 96.2 ± 29.9 s; p < 0.01), and OLST-C time (pre: 10.2 ± 5.9 s, post: 17.4 ± 12.2 s; p < 0.01) were improved before and after the intervention. However, a significant interaction was not observed in FES-I (F = 1.335, p = 0.261, ${\eta }_p^2$ = 0.06). Conclusions: The 12-week body-weight-based resistance training program enhanced lower-extremity muscle strength and balance ability but did not lessen the fear of falling in community-dwelling older women. The study findings offer relevant information for fall prevention in older adults. Full article

(1) Background: Aging is associated with a progressive decline in physical capacity, which is further exacerbated by conditions such as arthritis and chronic joint pain. This study aimed to compare the effects of aquatic and land-based exercise on the functional fitness of older adult women. (2) Methods: Sixty older women (mean age 66.9 ± 3.8 years) participated in this study, divided into two groups: aquatic exercise and land-based exercise. Both groups completed functional fitness tests, including flexibility (Back Scratch and Chair Sit-and-Reach Tests), lower body strength (Chair Stand Test), and dynamic balance (8-Foot Up-and-Go Test). Statistical analyses compared group performance. (3) Results: Improvements in flexibility were observed in the aquatic group, with trends toward significance for the Back Scratch Test (−0.2 ± 1.0 cm vs. −2.0 ± 0.0 cm, p = 0.08) and the Chair Sit-and-Reach Test (2.87 ± 2.0 cm vs. 0.27 ± 1.0 cm, p = 0.07). No statistically significant differences were observed between the groups in measures of lower body strength (Chair Stand Test: 19.1 ± 4.47 reps vs. 18.97 ± 3.77 reps, p = 0.9) or dynamic balance (8-Foot Up-and-Go Test: 6.28 ± 6.2 s vs. 6.03 ± 5.83 s, p = 0.07). (4) Conclusions: Aquatic exercise showed greater improvements in flexibility, particularly in the upper and lower body, although these differences did not reach statistical significance. Both training modalities were equally effective in maintaining lower body strength and dynamic balance in older adult women. These findings support the inclusion of tailored exercise programs in aging populations to address specific functional needs. Full article

(1) Background: Numerous exercise programs that improve physical capacity and the risk of falls in older adults have been proposed with varying degrees of success. A novel approach may be to use a video game system that uses real-time force feedback to train older adults. The aim of this study was to evaluate the effects of a Nintendo™ Wii-based exercise program on physical function and risk of falls in older people. (2) Methods: This 12-week randomized controlled clinical trial involved 73 participants: 36 individuals participating in a control group (CG) and 37 in an experimental group (EG) participating in a combined program. Balance was measured using the Tinetti scale, flexibility was assessed with the back scratch test and the sit-and-reach test, and lower body strength was assessed with the 30 s chair stand-up test. (3) Results: The results of this study show significant improvements in balance, gait, flexibility, and strength of the lower limbs compared to a control group. (4) Conclusions: A Nintendo™ Wii-based exercise program for seniors produces improvements in the physical health of older adults. These improvements highlight the importance of integrating physical exercise through video games as an effective strategy to improve the general health and quality of life of older adults. Full article

Introduction: This study aims to provide a safe, effective, and sustainable resistance training environment for the elderly by modifying chairs and movement systems used during training, particularly under unsupervised conditions. Materials and Methods: The research focused on investigating the effect of modified chair designs on enhancing physical stability during resistance training by involving 19 elderly participants (mean 72.1, SD 4.7). The study measured changes in the body’s acceleration during movements to compare the effectiveness of the modified chairs with those commonly used in chair-based exercise (CBE) training in maintaining physical stability. A system was developed based on experimental video data, which leverages MediaPipe to analyze the videos and compute joint angles, identifying whether the actions are executed correctly. Results and Conclusions: Comparisons revealed that modified chairs offered better stability during sitting (p < 0.001) and stand-up (p < 0.001) resistance training. According to the questionnaire survey results, compared to the regular chair without an armrest, the modified chair provided a greater sense of security and a better user experience for the elderly. Video observations indicated that the correct completion rate for most exercises, except stand-up resistance training, was only 59.75%, highlighting the insufficiency of modified chairs alone in ensuring accurate movement execution. Consequently, the introduction of an automatic system to verify proper exercise performance is essential. The model developed in this study for recognizing the correctness of movements achieved an accuracy rate of 97.68%. This study proposes a new chair design that enhances physical stability during resistance training and opens new avenues for utilizing advanced technology to assist the elderly in their training. Full article

Virtual reality (VR) exercise has been used as a strategy to promote physical health in older adults. Studies have revealed that the effects of exercise interventions vary across age groups. This study aimed to investigate the effects of a 12-week semi-immersion VR-based multicomponent exercise program on the functional fitness of young-old (65–73 years) and middle-old (74–85 years) adults. This study recruited two age groups (young-old adults, n = 49; middle-old adults, n = 37) and randomly assigned them to the experimental (EG) and control (CG) groups. EG participants performed a 75–90-min semi-immersion VR exercise routine twice weekly for 12 weeks, whereas CG participants maintained their original lifestyles without any alterations. The Senior Fitness Test was used to measure functional fitness by assessing upper- and lower-limb flexibility and muscle strength, cardiorespiratory fitness, and balance. EG participants exhibited greater improvements than their CG counterparts in certain functional fitness tests, specifically the Back Scratch, Arm Curl, 2-Minute Step, and 8-Foot Up-and-Go Tests. On comparing the age groups, a difference was exclusively noted in the effects of the Chair Sit-and-Reach Test. In the EG, the intervention significantly improved lower-body flexibility in young-old adults but elicited no such improvement in middle-old adults. Semi-immersion VR exercise improved the functional fitness of young-old and middle-old adults in the EG, with superior results in the former. Elucidating the impact of age-specific exercise interventions on functional capacity will help practitioners design age-specific exercise training content that enhances functional fitness in older adults of different ages. Full article