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Keywords = safe exercise in older adults

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25 pages, 705 KB  
Article
The Effect of a Personalized Exercise Program on Muscle Functional Capacity and Quality of Daily Life: A Randomized Pilot Study
by Semra Ercan, Türkü Yalçınol and Özge Öngel
Int. J. Environ. Res. Public Health 2025, 22(9), 1344; https://doi.org/10.3390/ijerph22091344 - 28 Aug 2025
Viewed by 255
Abstract
Objectives: This study aimed to examine the effects of a personalized exercise program on muscle functional capacity and daily life activities among individuals of various age groups and health conditions. Methods: A total of 169 participants aged between 16 and 94 years with [...] Read more.
Objectives: This study aimed to examine the effects of a personalized exercise program on muscle functional capacity and daily life activities among individuals of various age groups and health conditions. Methods: A total of 169 participants aged between 16 and 94 years with varying health statuses were enrolled. The EN-Dynamic system—comprising progressive resistive exercise equipment and Enraf Nonius’ Entrack software—was utilized alongside a newly developed exercise programming software. Maximum functional capacity was measured across 13 distinct muscle groups for each participant. Four different questionnaires were administered pre-intervention to evaluate daily activity levels and disease severity. Based on the collected data, a personalized exercise program was generated using a mathematical formula tailored to each muscle group. The program was applied three times per week for 12 weeks (36 total sessions). Following the intervention, the same measurements and questionnaires were repeated and analyzed statistically. Results: Data were analyzed using t-test, one-way ANOVA, Pearson correlation analysis, and Bonferroni post hoc tests. A statistically significant improvement in muscle functional capacity was found (t(168) = −30.65, p < 0.01; 95% CI: [16.95, 19.31]; Cohen’s d = 2.35, very large effect size). The questionnaire results also demonstrated substantial reductions (e.g., t(168) = 18.51, p < 0.01; Cohen’s d = 1.42). Conclusions: These findings suggest that personalized exercise programs can significantly enhance muscle functional capacity while reducing psychological and physical stress and disease severity. Nonetheless, further controlled and longer-term clinical trials comparing traditional and personalized methods are required to confirm these benefits at the population level. Full article
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27 pages, 1483 KB  
Systematic Review
Effectiveness of Virtual Reality-Based Training Versus Conventional Exercise Programs on Fall-Related Functional Outcomes in Older Adults with Various Health Conditions: A Systematic Review
by Krzysztof Kasicki, Ewa Klimek Piskorz, Łukasz Rydzik, Tadeusz Ambroży, Piotr Ceranowicz, Maria Belcarz Ciuraj, Paweł Król and Wiesław Błach
J. Clin. Med. 2025, 14(15), 5550; https://doi.org/10.3390/jcm14155550 - 6 Aug 2025
Viewed by 633
Abstract
Background/Objectives: The aim of this systematic review was to compare the effectiveness of virtual reality (VR)-based training with conventional exercise programs in improving functional outcomes related to fall risk among older adults with various health conditions. Methods: The review was conducted in accordance [...] Read more.
Background/Objectives: The aim of this systematic review was to compare the effectiveness of virtual reality (VR)-based training with conventional exercise programs in improving functional outcomes related to fall risk among older adults with various health conditions. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines and registered in PROSPERO (registration number CRD42022345678). The databases Scopus, PubMed, Web of Science, and EBSCO were searched up to 31 March 2025. Randomized controlled trials (RCTs) were included if they involved participants aged ≥60 years, a VR intervention lasting ≥6 weeks, and a control group performing traditional exercises or receiving usual care. Methodological quality was assessed using the PEDro scale, and a narrative synthesis was performed across four outcome domains: balance, mobility, cognitive function, and fall risk. Results: Seven RCTs were included in the analysis (totaling 664 participants). VR training was found to be at least as effective as conventional exercise in improving balance (e.g., Berg Balance Scale) and mobility (e.g., Timed Up and Go), with some studies showing superior effects of VR. One RCT demonstrated that combining VR with balance exercises (MIX) yielded the greatest improvements in muscle strength and physical performance. Additionally, two studies reported cognitive benefits (e.g., MoCA) and a 42% reduction in fall incidence within six months following VR intervention. The methodological quality of the included studies was moderate to high (PEDro score 5–9/10). Conclusions: VR-based training represents a safe and engaging supplement to geriatric rehabilitation, effectively improving balance, mobility, and, in selected cases, cognitive function, while also reducing fall risk. Full article
(This article belongs to the Section Geriatric Medicine)
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17 pages, 2353 KB  
Article
Integration of Mobility-Assisting Technologies in the Rehabilitation of Drivers with Neurological Disorders: A Preliminary Study
by Jacek S. Tutak and Krzysztof Lew
Electronics 2025, 14(11), 2298; https://doi.org/10.3390/electronics14112298 - 5 Jun 2025
Viewed by 456
Abstract
This publication aims to present the preliminary results of research on an innovative device designed to support the rehabilitation of drivers with neurological disorders, developed as part of a multidisciplinary project. The device was designed for individuals recovering from neurological diseases, injuries, and [...] Read more.
This publication aims to present the preliminary results of research on an innovative device designed to support the rehabilitation of drivers with neurological disorders, developed as part of a multidisciplinary project. The device was designed for individuals recovering from neurological diseases, injuries, and COVID-19-related complications, who experience difficulties with coordination and the speed of performing motor exercises. Its goal is to improve the quality of life for patients and increase their chances of safely driving vehicles, which also contributes to the safety of all road users. The device allows for controlled upper limb exercises using a diagnostic module, exercise program, and biofeedback system. The main component is a mechatronic driving simulator, enhanced with dedicated software to support the rehabilitation of individuals with neurological disorders and older adults. Through driving simulations and rehabilitation tasks, patients perform exercises that improve their health, facilitating a faster recovery. The innovation of the solution is confirmed by a submitted patent application, and preliminary research results indicate its effectiveness in rehabilitation and improving mobility for individuals with neurological disorders. Full article
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20 pages, 664 KB  
Article
Walking Football Programme for Elderly People: Study Protocol
by Jofre Pisà-Canyelles, María Mendoza-Muñoz, Jesús Siquier-Coll and Jorge Pérez-Gómez
Sports 2025, 13(5), 149; https://doi.org/10.3390/sports13050149 - 17 May 2025
Viewed by 890
Abstract
This study aims to evaluate the effects of a Walking Football (WF) programme on physical fitness, body composition, health-related quality of life (QoL), and happiness in men and women over 60 years. WF is proposed as a safe and accessible activity to counteract [...] Read more.
This study aims to evaluate the effects of a Walking Football (WF) programme on physical fitness, body composition, health-related quality of life (QoL), and happiness in men and women over 60 years. WF is proposed as a safe and accessible activity to counteract physical inactivity and chronic conditions in ageing populations. A randomized controlled trial will be conducted with 120 participants (both sexes), assigned to either an experimental group (WF intervention) or a wait-list control group. The six-month intervention includes bi-weekly sessions with skills training, match simulations, and fitness exercises. Assessments will be performed at baseline, 3 months, and 6 months. Primary outcome measures will be: body composition (weight, BMI, fat and lean mass), muscular strength, aerobic endurance, agility, range of motion, and subjective well-being (QoL and happiness scales). Linear mixed-effects models and ANCOVA will be used to analyse the data. It is expected that WF will lead to improvements in physical and mental health, contributing to active ageing. This study may also support WF as a tool for social inclusion and well-being in older adults. Full article
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11 pages, 624 KB  
Case Report
Effects of a Concurrent Mixed-Modality (Telerehabilitation and Face-to-Face) Exercise Rehabilitation Program in a Patient with Multiple Myeloma Prior to Spinal Cord Transplantation: A Case Study
by Juan Carlos Hernández-Sigüenza, Paula Blanco-Gimenez, Luis Baraja-Vegas, Josep López-Soler, Francisco Javier Falaguera-Vera, Eloy Jaenada-Carrilero and Juan Vicente-Mampel
Curr. Oncol. 2025, 32(5), 282; https://doi.org/10.3390/curroncol32050282 - 16 May 2025
Viewed by 567
Abstract
Introduction: Multiple myeloma constitutes approximately 12% of hematologic malignancies and predominantly affects older adults, significantly compromising their quality of life. Although exercise interventions have shown benefits in oncology, evidence specific to MM remains limited and of low certainty. The presence of complex comorbidities [...] Read more.
Introduction: Multiple myeloma constitutes approximately 12% of hematologic malignancies and predominantly affects older adults, significantly compromising their quality of life. Although exercise interventions have shown benefits in oncology, evidence specific to MM remains limited and of low certainty. The presence of complex comorbidities in MM patients necessitates highly individualized approaches. Prehabilitation has emerged as a promising strategy to enhance functional capacity prior to autologous stem cell transplantation. This case study evaluates the feasibility of a personalized, scheduled exercise intervention delivered via telerehabilitation. Intervention: This case study seeks to examine the feasibility of implementing a personalized and scheduled exercise intervention within a telerehabilitation framework for a medically complex patient with multiple myeloma (MM). The 12-week prehabilitation protocol is designed to enhance physical function prior to autologous bone marrow transplantation by integrating therapeutic exercise targeting key parameters related to quality of life and clinical resilience, such as muscular strength, aerobic capacity, coordination, and overall well-being. The intervention includes concurrent training (strength and aerobic exercises) delivered 2–3 times per week, with aerobic activities conducted independently at home through a virtual format. Assessments were performed at baseline and post-intervention. Results and conclusion: A personalized exercise program, implemented through a hybrid model of in-person and telerehabilitation, is both feasible and safe. It has the potential to enhance physical function and quality of life in patients with multiple myeloma. Further research is necessary to validate these findings across broader patient populations. Full article
(This article belongs to the Section Hematology)
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12 pages, 933 KB  
Review
Elderly Hip Osteoarthritis: A Review of Short-Term Pain Relief Through Non-Weight-Bearing Therapies
by Olivia Norato, Sarah Velez, Arbonor Lleshi, Gordon Lam, Marlon Morales, Glory Udechi, Edwin Cung and Jean-Philippe Berteau
J. Funct. Morphol. Kinesiol. 2025, 10(2), 124; https://doi.org/10.3390/jfmk10020124 - 8 Apr 2025
Viewed by 1422
Abstract
Older individuals with hip osteoarthritis (OA) who have difficulty walking, climbing stairs, or performing daily tasks often find non-weight-bearing (NWB) exercises essential for rebuilding strength and preserving function without further stressing the joints. In addition, those with a higher body mass index (BMI) [...] Read more.
Older individuals with hip osteoarthritis (OA) who have difficulty walking, climbing stairs, or performing daily tasks often find non-weight-bearing (NWB) exercises essential for rebuilding strength and preserving function without further stressing the joints. In addition, those with a higher body mass index (BMI) particularly benefit from NWB therapy, as it alleviates joint pressure while facilitating safe and effective rehabilitation. Thus, NWB interventions, such as manual therapy (MT) and aquatic therapy (AT), are especially critical for older adults aged 60 and above, offering pain relief and functional improvement by minimizing gravitational impact on the hip joint. This review examines the effectiveness of these approaches in managing hip OA symptoms and decreasing pain. The inclusion criteria for the study consisted of randomized controlled trials or controlled trials focused on adult patients with primary osteoarthritis of the hip joint, utilizing interventions such as MT (including thrust joint mobilizations, non-thrust/oscillatory mobilizations, and soft tissue mobilization) or AT (including hydrotherapy and water therapy), and assessing outcomes related to pain. We selected nine studies that included a total of n = 1037 individuals. It evaluated outcomes such as self-reported pain levels using measures like the Western Ontario and McMaster Universities Osteoarthritis (WOMAC), Numeric Rating Scale (NRS), and Visual Analog Scale (VAS). Beyond statistical differences, both therapies were evaluated for Minimal Clinically Important Difference (MCID). While MT studies indicated a decrease in pain according to pain index scores, they showed short-term effectiveness till five weeks but lacked sustained clinical efficacy beyond this period. AT showed positive results within a ten-week period, although its effectiveness seemed to level off beyond this duration, falling below the threshold of clinical efficiency. After 10 weeks of treatment, there is no discernible clinical benefit in terms of pain reduction. Both interventions without gravitational impact seem suitable for providing short-term pain relief for primary hip osteoarthritis patients, but long-term pain relief—meaning after ten weeks—should be maintained through therapeutic exercise and patient education. Full article
(This article belongs to the Section Physical Exercise for Health Promotion)
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11 pages, 965 KB  
Article
Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
by Kap-Soo Han and Myoung-Hwan Ko
Geriatrics 2025, 10(1), 23; https://doi.org/10.3390/geriatrics10010023 - 7 Feb 2025
Cited by 1 | Viewed by 1537
Abstract
Background/Objectives: This clinical trial aimed to determine whether perturbation-based gait training (PBGT) on a split-belt treadmill enhances balance and muscle strength in older adults, comparing its effectiveness with walking-only training on a treadmill. Methods: This single-center, prospective, single-blind (assessor), randomized controlled [...] Read more.
Background/Objectives: This clinical trial aimed to determine whether perturbation-based gait training (PBGT) on a split-belt treadmill enhances balance and muscle strength in older adults, comparing its effectiveness with walking-only training on a treadmill. Methods: This single-center, prospective, single-blind (assessor), randomized controlled trial included 24 older adults from the Rehabilitation Center of Jeonbuk National University Hospital. Participants were equally divided into the PBGT and control groups. Both groups underwent 12 training sessions, three times a week for 4 weeks, for a total of 43 min per session. The outcomes, including the Five Times Sit-to-Stand Test (FTSST), Falls Efficacy Scale International, timed up-and-go (TUG) test, functional reach test, and lower-extremity manual muscle test scores, were measured at three time points: pre-training, post-training, and four weeks after training. Results: While there were no significant differences between the two groups, the PBGT group demonstrated significant improvements in its FTSST and TUG values. Conclusions: Unpredictable perturbation training on a split-belt treadmill can be safely performed by older adults and may serve as an alternative exercise method to enhance physical performance and balance ability for fall prevention. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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15 pages, 311 KB  
Article
Analysis of Hydration Habits Before and During a Specific Training Session in Male Padel Athletes Aged over 65: Physiological and Psychological Implications
by Ana Júlia Lopes, Maria João Campos, Fátima Rosado, Luís Rama, Alex Silva Ribeiro, Diogo Martinho, Ana Teixeira and Alain Massart
Nutrients 2024, 16(20), 3513; https://doi.org/10.3390/nu16203513 - 16 Oct 2024
Cited by 1 | Viewed by 2081
Abstract
(1) Background: Since older adults are more susceptible to dehydration and there is a lack of information on older athletes, this study observed a group of 12 male padel players in this age group (70.42 ± 3.50 years) to characterize their hydration habits, [...] Read more.
(1) Background: Since older adults are more susceptible to dehydration and there is a lack of information on older athletes, this study observed a group of 12 male padel players in this age group (70.42 ± 3.50 years) to characterize their hydration habits, physiological demands, and psychological responses before and during a 90 min padel training (PT). (2) Methods: After approval from the Ethics Committee (CE/FCDEF-UC/00022023) and the provision of signed informed consent, participants’ body mass, height, waist and hip circumferences, body mass index, waist-to-hip ratio, and waist-to-height ratio were measured. Habitual fluid intake was monitored by diary from the evening until before the PT; the subjects completed a Profile of Mood States questionnaire (POMS) and a satiety scale (SLIM). To assess hydration levels at different moments, we used a portable osmometer and an eight-point urine color chart and weighed the participants immediately before and after the PT. During the PT, heart rate (HR) and hydration were monitored. After the PT, subjects completed another POMS and SLIM. (3) Results: Subjects trained at 73.2 ± 12.3% of their maximum HR, with brief peaks at the anaerobic threshold or higher (130.00 ± 18.78 bpm). The mean urine osmolality indicated normal hydration or minimal dehydration. However, the urine color values indicated dehydration after the training. Subjects drank 438 mL of liquids at night, 333 mL before PT, and 900 mL during the PT, with a good repartition of the liquids. POMS and SLIM were not affected by the training. (4) Conclusions: Older male padel athletes achieved challenging yet safe training, staying within healthy intensity zones; their hydration patterns nearly met the recommendations for exercise and should be slightly increased. Full article
9 pages, 1835 KB  
Article
Acute Effect of Three Aerobic Exercise Intensities on Glomerular Filtration Rate in Healthy Older Adults
by Marina Trejo-Trejo, Luis M. Gómez-Miranda and Arnulfo Ramos-Jiménez
Diseases 2024, 12(10), 249; https://doi.org/10.3390/diseases12100249 - 11 Oct 2024
Cited by 1 | Viewed by 2030
Abstract
No consensus exists on whether acute aerobic exercise alters the glomerular filtration rate in older adults. Objective: To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Methods: Eighteen healthy, sedentary [...] Read more.
No consensus exists on whether acute aerobic exercise alters the glomerular filtration rate in older adults. Objective: To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Methods: Eighteen healthy, sedentary older adults (ten men and eight women) voluntarily participated in this study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerols, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. Results: eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R = −0.512, R = −0.582, R = −0.531; p < 0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. In addition, a negative correlation existed for age vs. eGFR at 60% of the maximal heart rate (R = −0.516; p < 0.05). Conclusions: Short-duration aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults. However, regular monitoring of kidney function in older people engaged in moderate- and high-intensity exercise is advised. Full article
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13 pages, 1262 KB  
Article
Randomized Controlled Trial of Cardiac Rehabilitation Using the Balance Exercise Assist Robot in Older Adults with Cardiovascular Disease
by Akihiro Hirashiki, Atsuya Shimizu, Takahiro Kamihara, Manabu Kokubo, Kakeru Hashimoto, Ikue Ueda, Kenji Sato, Koki Kawamura, Naoki Itoh, Toyoaki Murohara, Hitoshi Kagaya and Izumi Kondo
J. Cardiovasc. Dev. Dis. 2024, 11(5), 133; https://doi.org/10.3390/jcdd11050133 - 25 Apr 2024
Viewed by 2722
Abstract
Background: Recent studies have investigated the effects of exercise on the functional capacity of older adults; training with a balance exercise assist robot (BEAR) effectively improves posture. This study compared the clinical safety and efficacy of training using BEAR video games to conventional [...] Read more.
Background: Recent studies have investigated the effects of exercise on the functional capacity of older adults; training with a balance exercise assist robot (BEAR) effectively improves posture. This study compared the clinical safety and efficacy of training using BEAR video games to conventional resistance training in older adults with cardiovascular disease (CVD). Methods: Ninety patients (mean age: 78 years) hospitalized due to worsening CVD were randomized to cardiac rehabilitation (CR) Group R (conventional resistance training) or Group B (training using BEAR). After appropriate therapy, patients underwent laboratory testing and functional evaluation using the timed up-and-go test (TUG), short physical performance battery (SPPB), and functional independence measure (FIM) just before discharge and 4 months after CR. The rates of CVD readmission, cardiac death, and fall-related fractures were monitored. Results: BEAR had no adverse effects during exercise. At 4 months, TUG and SPPB improved significantly in both groups, with no significant difference between them. FIM motor and the Geriatric Nutritional Risk Index were significantly improved in Group B versus Group R. There was no significant difference in cardiac events and fall-related fractures between the two groups. Conclusion: CR with BEAR is safe and comparable to conventional resistance training for improving balance in older adults with CVD. Full article
(This article belongs to the Special Issue Exercise and Cardiovascular Disease in Older Adults)
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16 pages, 456 KB  
Article
The Experiences of Older Adults with Dementia of “Balance Wise”—An Individual or Group-Delivered Exercise Programme: A Qualitative Study
by Normala Mesbah, Meredith Perry, Keith D. Hill, Donald Manlapaz and Leigh Hale
Disabilities 2024, 4(1), 11-26; https://doi.org/10.3390/disabilities4010002 - 27 Dec 2023
Cited by 1 | Viewed by 2260
Abstract
This study aimed to understand the experience of older adults with dementia towards, and the practicality of, the Balance Wise exercise programme. A qualitative study guided by the General Inductive Approach was employed. Ten people with dementia aged 71–87 years who completed the [...] Read more.
This study aimed to understand the experience of older adults with dementia towards, and the practicality of, the Balance Wise exercise programme. A qualitative study guided by the General Inductive Approach was employed. Ten people with dementia aged 71–87 years who completed the exercise programme and four care partners aged 69–76 years old (three of whom also participated in Balance Wise) were interviewed in dyads. The programme (individually or group delivered) was held once a week for 30 min for 10 weeks and included balance and strength exercises, cognitive training, and other enjoyable physical activities. Interviews were thematically analysed. Three overarching themes were identified (i) decision making, (ii) comprehension, and (iii) perceived benefits. Participants acknowledged their decision to participate was influenced by ‘awareness’ about their declining memory and their ‘health belief’ about the potential benefits of exercise. ‘Perceived benefits’ were influenced by the ‘support system’ and improvement in postural stability. ‘Comprehension’ was, however, an important cognitive ability to understand the purpose of the activities in the programme and facilitated motivation. This study highlighted an important message that such programmes should be developed from the end-user perspective, and this included that the programme be flexible and safely delivered, as well as be fun and pleasurable, thus promoting socialisation. Full article
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13 pages, 1209 KB  
Article
Smartphone- and Paper-Based Delivery of Balance Intervention for Older Adults Are Equally Effective, Enjoyable, and of High Fidelity: A Randomized Controlled Trial
by Vipul Lugade, Molly Torbitt, Suzanne R. O’Brien and Patima Silsupadol
Sensors 2023, 23(17), 7451; https://doi.org/10.3390/s23177451 - 27 Aug 2023
Cited by 3 | Viewed by 2371
Abstract
Home-based rehabilitation programs for older adults have demonstrated effectiveness, desirability, and reduced burden. However, the feasibility and effectiveness of balance-intervention training delivered through traditional paper-versus novel smartphone-based methods is unknown. Therefore, the purpose of this study was to evaluate if a home-based balance-intervention [...] Read more.
Home-based rehabilitation programs for older adults have demonstrated effectiveness, desirability, and reduced burden. However, the feasibility and effectiveness of balance-intervention training delivered through traditional paper-versus novel smartphone-based methods is unknown. Therefore, the purpose of this study was to evaluate if a home-based balance-intervention program could equally improve balance performance when delivered via smartphone or paper among adults over the age of 65. A total of 31 older adults were randomized into either a paper or phone group and completed a 4-week asynchronous self-guided balance intervention across 12 sessions for approximately 30 min per session. Baseline, 4-week, and 8-week walking and standing balance evaluations were performed, with exercise duration and adherence recorded. Additional self-reported measures were collected regarding the enjoyment, usability, difficulty, and length of the exercise program. Twenty-nine participants completed the balance program and three assessments, with no group differences found for any outcome measure. Older adults demonstrated an approximately 0.06 m/s faster gait velocity and modified balance strategies during walking and standing conditions following the intervention protocol. Participants further self-reported similar enjoyment, difficulty, and exercise effectiveness. Results of this study demonstrated the potential to safely deliver home-based interventions as well as the feasibility and effectiveness of delivering balance intervention through a smartphone-based application. Full article
(This article belongs to the Special Issue Wearable and Unobtrusive Technologies for Healthcare Monitoring)
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18 pages, 913 KB  
Article
Impact of Exercise Guidance Timing on Physical and Cognitive Function in Older Adults: A Pilot Study
by Sofia Lampropoulou, Anthi Kellari and Vasiliki Sakellari
Appl. Sci. 2023, 13(17), 9526; https://doi.org/10.3390/app13179526 - 23 Aug 2023
Viewed by 2341
Abstract
Guidance through an exercise program improves balance and gait in older adults, but the efficacy of the timing these are given is unclear. The objective of this study is to evaluate the effects of guidance delivery time on balance, gait, falls, and cognitive [...] Read more.
Guidance through an exercise program improves balance and gait in older adults, but the efficacy of the timing these are given is unclear. The objective of this study is to evaluate the effects of guidance delivery time on balance, gait, falls, and cognitive functions. In a single (participants)-blinded clinical trial, a convenient sample of 24 older adults (aged 74 ± 6 years) were separated in two age-matched groups, both of which received a progressive 12-week Otago Exercise Program (OEP) for strength and balance. Group 1 received visual and verbal guidance before the performance of each of the exercises, while group 2 received the visual and verbal guidance only synchronously with the exercises. Balance, gait, fear of falling, and cognitive function were evaluated at baseline, week 6, and week 12 of the program. Fall incidence and exercise adherence were also documented. Significant improvements (p < 0.05) were revealed in all assessed variables post intervention, regardless of the guidance delivery time. Only the mental function and the adherence to the exercise tended to be better when the guidance was given in advance of the exercise execution, but further studies of a bigger sample size and with a control group should be conducted before safe conclusions are extracted. Full article
(This article belongs to the Special Issue Recent Advances in Exercise-Based Rehabilitation)
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39 pages, 5273 KB  
Article
Operational Modal Analysis of Near-Infrared Spectroscopy Measure of 2-Month Exercise Intervention Effects in Sedentary Older Adults with Diabetes and Cognitive Impairment
by Fei Zhao, Machiko Tomita and Anirban Dutta
Brain Sci. 2023, 13(7), 1099; https://doi.org/10.3390/brainsci13071099 - 20 Jul 2023
Cited by 6 | Viewed by 3806
Abstract
The Global Burden of Disease Study (GBD 2019 Diseases and Injuries Collaborators) found that diabetes significantly increases the overall burden of disease, leading to a 24.4% increase in disability-adjusted life years. Persistently high glucose levels in diabetes can cause structural and functional changes [...] Read more.
The Global Burden of Disease Study (GBD 2019 Diseases and Injuries Collaborators) found that diabetes significantly increases the overall burden of disease, leading to a 24.4% increase in disability-adjusted life years. Persistently high glucose levels in diabetes can cause structural and functional changes in proteins throughout the body, and the accumulation of protein aggregates in the brain that can be associated with the progression of Alzheimer’s Disease (AD). To address this burden in type 2 diabetes mellitus (T2DM), a combined aerobic and resistance exercise program was developed based on the recommendations of the American College of Sports Medicine. The prospectively registered clinical trials (NCT04626453, NCT04812288) involved two groups: an Intervention group of older sedentary adults with T2DM and a Control group of healthy older adults who could be either active or sedentary. The completion rate for the 2-month exercise program was high, with participants completing on an average of 89.14% of the exercise sessions. This indicated that the program was practical, feasible, and well tolerated, even during the COVID-19 pandemic. It was also safe, requiring minimal equipment and no supervision. Our paper presents portable near-infrared spectroscopy (NIRS) based measures that showed muscle oxygen saturation (SmO2), i.e., the balance between oxygen delivery and oxygen consumption in muscle, drop during bilateral heel rise task (BHR) and the 6 min walk task (6MWT) significantly (p < 0.05) changed at the post-intervention follow-up from the pre-intervention baseline in the T2DM Intervention group participants. Moreover, post-intervention changes from pre-intervention baseline for the prefrontal activation (both oxyhemoglobin and deoxyhemoglobin) showed statistically significant (p < 0.05, q < 0.05) effect at the right superior frontal gyrus, dorsolateral, during the Mini-Cog task. Here, operational modal analysis provided further insights into the 2-month exercise intervention effects on the very-low-frequency oscillations (<0.05 Hz) during the Mini-Cog task that improved post-intervention in the sedentary T2DM Intervention group from their pre-intervention baseline when compared to active healthy Control group. Then, the 6MWT distance significantly (p < 0.01) improved in the T2DM Intervention group at post-intervention follow-up from pre-intervention baseline that showed improved aerobic capacity and endurance. Our portable NIRS based measures have practical implications at the point of care for the therapists as they can monitor muscle and brain oxygenation changes during physical and cognitive tests to prescribe personalized physical exercise doses without triggering individual stress response, thereby, enhancing vascular health in T2DM. Full article
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14 pages, 1693 KB  
Article
Baseline Serum Biomarkers Predict Response to a Weight Loss Intervention in Older Adults with Obesity: A Pilot Study
by David H. Lynch, Blake R. Rushing, Wimal Pathmasiri, Susan McRitchie, Dakota J. Batchek, Curtis L. Petersen, Danae C. Gross, Susan C. J. Sumner and John A. Batsis
Metabolites 2023, 13(7), 853; https://doi.org/10.3390/metabo13070853 - 17 Jul 2023
Cited by 11 | Viewed by 2849
Abstract
Caloric restriction and aerobic and resistance exercise are safe and effective lifestyle interventions for achieving weight loss in the obese older population (>65 years) and may improve physical function and quality of life. However, individual responses are heterogeneous. Our goal was to explore [...] Read more.
Caloric restriction and aerobic and resistance exercise are safe and effective lifestyle interventions for achieving weight loss in the obese older population (>65 years) and may improve physical function and quality of life. However, individual responses are heterogeneous. Our goal was to explore the use of untargeted metabolomics to identify metabolic phenotypes associated with achieving weight loss after a multi-component weight loss intervention. Forty-two older adults with obesity (body mass index, BMI, ≥30 kg/m2) participated in a six-month telehealth-based weight loss intervention. Each received weekly dietitian visits and twice-weekly physical therapist-led group strength training classes with a prescription for aerobic exercise. We categorized responders’ weight loss using a 5% loss of initial body weight as a cutoff. Baseline serum samples were analyzed to determine the variable importance to the projection (VIP) of signals that differentiated the responder status of metabolic profiles. Pathway enrichment analysis was conducted in Metaboanalyst. Baseline data did not differ significantly. Weight loss was 7.2 ± 2.5 kg for the 22 responders, and 2.0 ± 2.0 kg for the 20 non-responders. Mummichog pathway enrichment analysis revealed that perturbations were most significant for caffeine and caffeine-related metabolism (p = 0.00028). Caffeine and related metabolites, which were all increased in responders, included 1,3,7-trimethylxanthine (VIP = 2.0, p = 0.033, fold change (FC) = 1.9), theophylline (VIP = 2.0, p = 0.024, FC = 1.8), paraxanthine (VIP = 2.0, p = 0.028, FC = 1.8), 1-methylxanthine (VIP = 1.9, p = 0.023, FC = 2.2), 5-acetylamino-6-amino-3-methyluracil (VIP = 2.2, p = 0.025, FC = 2.2), 1,3-dimethyl uric acid (VIP = 2.1, p = 0.023, FC = 2.3), and 1,7-dimethyl uric acid (VIP = 2.0, p = 0.035, FC = 2.2). Increased levels of phytochemicals and microbiome-related metabolites were also found in responders compared to non-responders. In this pilot weight loss intervention, older adults with obesity and evidence of significant enrichment for caffeine metabolism were more likely to achieve ≥5% weight loss. Further studies are needed to examine these associations in prospective cohorts and larger randomized trials. Full article
(This article belongs to the Special Issue Treatment of Obesity and Its Metabolic Complications)
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