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A Practice Guide for Physical Therapists Prescribing Physical Exercise for Older Adults. 物理治疗师为老年人开具体育锻炼处方的实践指南》。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-06-11 DOI: 10.1123/japa.2023-0283
Frederico M Baptista, Rosa Andias, Nelson P Rocha, Anabela G Silva

Introduction: Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual.

Objectives: This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population.

Methods: Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults.

Results: Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities.

Conclusions: An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality.

Significance: Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population.

导言:体力活动和锻炼是老年人体力和认知能力下降的保护因素,但最近的研究表明,这一人群中有很大一部分人的锻炼水平并没有达到国际指南推荐的水平。频率、强度、类型、时间、运动量和渐进性(FITT-VP)原则是一种广泛使用的体育锻炼处方方法,可以根据每个人的需求制定个性化的锻炼计划:本大师班旨在为开具老年人体育锻炼处方的理疗师提供专业应用工具。我们为 FITT-VP 的每项原则提供了一个章节,以方便在为这一人群开具运动处方时单独处理这些原则:方法:回顾有关老年人体育锻炼处方的科学文献和国际指南:结果:有氧运动、活动能力、阻力运动、平衡运动、柔韧性运动以及功能性训练应纳入老年人的运动计划中,每种运动方式应采用不同的方法进行:结论:针对老年人的运动计划应整合不同的运动方式。结论:针对老年人的运动计划应整合不同的运动方式,运动进展应遵循 FITT-VP 原则和针对每种运动方式推荐的一些特定进展因素:考虑到临床医生在根据国际建议为老年人设计可行的锻炼计划时所面临的挑战,我们希望通过本大师班帮助物理治疗师规划可行的锻炼计划,同时满足这一人群的预期需求。
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引用次数: 0
Exploring the Lived Experiences of Physical Activity in Community-Dwelling Adults Living With Dementia and Their Carers. 探索居住在社区的老年痴呆症患者及其照顾者的体育锻炼生活体验。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-06-07 DOI: 10.1123/japa.2023-0195
Joanna Blackwell, Mo Ray

People living with dementia have the same right to well-being as anyone else, including physical activity. Yet, physical activity levels among people with dementia are lower than in the general population, and while the physical activity health benefits are well established, little is known about how people living with dementia experience physical activity. To explore these physical activity experiences, we visited six community settings in one English county and conducted informal interviews with 18 people who were either living with dementia and community dwelling (n = 4), caring for or who had cared for someone with dementia (n = 10), or providing a support service for people living with dementia and their carers (n = 4). Findings highlight both the challenges and facilitators presented by organized groups, service provider skills and qualities, and environmental factors. Additionally, these factors were influential in shaping the physical activity experience of people living with dementia. The findings may be relevant for people providing or planning support services, commissioners, policymakers, and researchers.

与其他人一样,痴呆症患者也有享受健康的权利,包括体育锻炼。然而,痴呆症患者的体育锻炼水平却低于普通人群,虽然体育锻炼对健康的益处已得到公认,但人们对痴呆症患者如何体验体育锻炼却知之甚少。为了探究这些体育锻炼经验,我们走访了英国一个郡的六个社区环境,并对 18 名痴呆症患者和社区居民(4 人)、护理或曾经护理过痴呆症患者(10 人)或为痴呆症患者及其护理者提供支持服务(4 人)的人进行了非正式访谈。研究结果强调了有组织的群体、服务提供者的技能和素质以及环境因素所带来的挑战和促进因素。此外,这些因素对痴呆症患者的体育活动体验也有影响。这些研究结果可能对提供或规划支持服务的人员、专员、政策制定者和研究人员有借鉴意义。
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引用次数: 0
Active Learning Through Video Conferencing to Maintain Physical Activity Among Older Adults: A Pilot Randomized Controlled Trial. 通过视频会议主动学习,让老年人保持体育锻炼:随机对照试验。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-06-03 DOI: 10.1123/japa.2023-0180
Kazuki Uemura, Tsukasa Kamitani, Atsuya Watanabe, Hiroshi Okamoto, Kenshi Saho, Minoru Yamada

This randomized pilot trial investigated the feasibility of an active learning physical activity intervention through video conferencing and its preliminary effects. Participants comprised community-dwelling older adults who could use e-mail. The intervention group underwent a 12-week active learning intervention via video conferencing to promote a healthy lifestyle, particularly physical activity. The control group received information via e-mail once per week. The amount of physical activity and sedentary behavior was measured using an accelerometer at baseline, postintervention, and 24-week postintervention (36 weeks). Of the 31 participants, 29 were eligible and randomized into two groups (15 for the intervention and 14 for the control). Adherence to the intervention was 83%-100% (mean, 97%). Compared with the control group, the intervention group showed moderate maintenance effects on total physical activity and sedentary behavior at 36 weeks. Active learning physical activity intervention through video conferencing was found to be feasible and contributed to the prevention of physical activity decline in older adults.

这项随机试点试验调查了通过视频会议进行主动学习体育活动干预的可行性及其初步效果。参与者包括居住在社区、会使用电子邮件的老年人。干预组通过视频会议接受为期 12 周的主动学习干预,以促进健康的生活方式,尤其是体育锻炼。对照组每周通过电子邮件接收一次信息。在基线、干预后和干预后 24 周(36 周)时,使用加速度计测量运动量和久坐行为。在 31 名参与者中,29 人符合条件并被随机分为两组(15 人干预组,14 人对照组)。干预的坚持率为 83%-100%(平均 97%)。与对照组相比,干预组在 36 周后对总体力活动量和久坐行为显示出中等程度的维持效果。通过视频会议主动学习体育锻炼干预是可行的,有助于预防老年人体育锻炼量下降。
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引用次数: 0
Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults. 评估理疗师的户外步行建议和老年人的邻里步行能力。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-05-31 DOI: 10.1123/japa.2023-0404
Hannah A Karczewski, Jennifer Blackwood

Background/objectives: Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults.

Methods: A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses.

Results: Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actually assess walkability (χ2 = 78.7, p < .001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents.

Conclusion: When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.

背景/目标:邻里步行能力是指建筑和社会环境支持步行的程度。步行能力会影响老年人对户外体育活动的参与。需要找出影响理疗师(PTs)开具户外步行处方的因素,尤其是对于居家养老的老年人。本研究的目的是描述为社区老年人服务的理疗师对社区步行能力的了解、看法和评估方法:方法:通过电子邮件向全国 5000 名护理人员发送了一份横向调查。该调查包含 40 个项目,对步行处方、步行认知和评估进行了评估,并收集了人口统计学数据。采用卡方分析对分类变量进行比较:结果:通过对122名在门诊老年理疗机构工作的理疗师进行调查,发现理疗师对是否应该评估步行能力的看法与他们是否实际评估步行能力之间存在显著差异(χ2 = 78.7,p < .001)。人行道的可用性(n = 79,64.8%)和维护性(n = 11,9.0%)、犯罪率(n = 9,7.4%)、地形(n = 7,5.7%)和美观性(n = 6,4.9%)都会影响到是否规定户外步行的决定。受访者没有使用客观的步行适宜性衡量标准:结论:在考虑评估步行适宜性时,公共交通参与者将建筑环境置于社会环境之上。尽管大多数人认为评估步行能力是公共交通参与者的责任,但大多数人并没有这样做。意义/影响:评估步行能力可以让康复治疗师识别障碍,并就老年人户外步行问题提出更明智的建议。为康复治疗师开具户外步行处方提供了客观的衡量标准。
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引用次数: 0
Synchronous Group-Based Online Exercise Programs for Older Adults Living in the Community: A Scoping Review. 针对社区老年人的同步集体在线锻炼计划:范围审查》。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-05-31 DOI: 10.1123/japa.2023-0214
Maria Fernanda Fuentes Diaz, Brianna Leadbetter, Vanessa Pitre, Sarah Nowell, Martin Sénéchal, Danielle R Bouchard

Older adults are the least physically active group with specific barriers to regular exercise, and online exercise programs could overcome some of those barriers. This scoping review aimed to describe the characteristics of supervised group-based synchronous online exercise programs for older adults living in the community, their feasibility, acceptability, and potential benefits. MEDLINE (Ovid), Embase, SPORTDiscus, and the Cumulative Index to Nursing and Allied Health Literature were searched until November 2022. The included studies met the following criteria: participants aged 50 years and above, a minimum of a 6-week group-based supervised and synchronous intervention, and original articles available in English. Eighteen articles were included, with 1,178 participants (67% female, average age of 71 [57-93] years), most (83%) published in the past 3 years. From the limited reported studies, delivering supervised, synchronous online exercise programs (one to three times/week, between 8 and 32 weeks) for older adults living in the community seems feasible, accepted, and can improve physical function.

老年人是体育锻炼最少的群体,他们在定期锻炼方面存在特殊障碍,而在线锻炼计划可以克服其中的一些障碍。本范围界定综述旨在描述针对居住在社区中的老年人的有监督小组同步在线锻炼计划的特点、可行性、可接受性和潜在益处。对 MEDLINE (Ovid)、Embase、SPORTDiscus 和《护理与联合健康文献累积索引》的检索截止到 2022 年 11 月。所纳入的研究符合以下标准:参与者年龄在 50 岁及以上,至少进行了为期 6 周的小组监督和同步干预,以及以英语撰写的原创文章。共纳入了 18 篇文章,涉及 1,178 名参与者(67% 为女性,平均年龄为 71 [57-93] 岁),大部分(83%)文章发表于过去 3 年。从报道的有限研究来看,为居住在社区的老年人提供有监督的同步在线锻炼计划(每周一至三次,为期 8 至 32 周)似乎是可行的、可接受的,并且可以改善身体功能。
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引用次数: 0
Interventions Based on Behavior Change Techniques to Encourage Physical Activity or Decrease Sedentary Behavior in Community-Dwelling Adults Aged 50-70: Systematic Review With Intervention Component Analysis. 基于行为改变技术的干预措施,以鼓励 50-70 岁社区居民中的成年人进行体育锻炼或减少久坐行为:通过干预成分分析进行系统回顾。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-04-24 DOI: 10.1123/japa.2023-0140
Saima Ahmed, Kimberly Lazo Green, L. McGarrigle, Annemarie Money, Neil Pendleton, Chris Todd
Increasing physical activity (PA) and/or decreasing sedentary behaviors is important in the delay and prevention of long-term conditions. PA can help maintain function and independence and decrease the need for hospitalization/institutionalization. Activity rates often decline in later life resulting in a need for interventions that encourage uptake and adherence through the use of Behavior Change Techniques (BCTs). We conducted a systematic review of the evidence for interventions that included BCTs in community-dwelling adults with a mean age of 50-70. The review followed PRISMA guidelines. The interventions were psychosocial, nonpharmacological, and noninvasive interventions utilizing components based on BCTs that evaluated change in PA and/or sedentary behavior. Intervention Component Analysis (ICA) was used to synthesize effectiveness of intervention components. Twelve randomized controlled trials were included in this review. The mean sample age was 50-64. Thirteen BCTs were used across all studies, and the most commonly used techniques were goals and planning, feedback and monitoring, and natural consequences. Seven intervention components linked with BCTs were found: personalized goal setting, tailored feedback from facilitators, on-site and postintervention support, education materials and resources, reinforcing change on behavior and attitudes, self-reported monitoring, and social connectedness. All components, except for social connectedness, were associated with improved health behavior and PA levels. The interventions that use BCTs have incorporated strategies that reinforce change in behavior and attitudes toward PA.
增加体力活动(PA)和/或减少久坐行为对于延缓和预防长期疾病非常重要。体力活动有助于保持身体功能和独立性,减少住院/入院治疗的需要。晚年人的体力活动率通常会下降,因此需要通过使用行为改变技术(BCTs)来采取干预措施,鼓励人们参加和坚持体力活动。我们对平均年龄为 50-70 岁、居住在社区的成年人进行了一次系统性的证据回顾,以了解包括 BCTs 在内的干预措施。综述遵循了 PRISMA 指南。干预措施包括社会心理干预、非药物干预和非侵入性干预,这些干预措施采用了基于 BCTs 的成分,可评估运动量和/或久坐行为的变化。干预成分分析法(ICA)用于综合干预成分的有效性。本综述纳入了 12 项随机对照试验。样本的平均年龄为 50-64 岁。所有研究中使用了 13 种 BCT,最常用的技术是目标和计划、反馈和监控以及自然后果。研究发现,有七项干预措施与 BCTs 有关:个性化目标设定、促进者提供的定制反馈、现场和干预后支持、教育材料和资源、强化行为和态度的改变、自我报告监测以及社会联系。除社会联系外,所有组成部分都与健康行为和活动量水平的改善有关。使用 BCTs 的干预措施已纳入了强化行为和态度改变的策略。
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引用次数: 0
Are Barriers to Physical Activity Associated With Changing Physical Activity Levels and Sedentary Time in Patients With Peripheral Arterial Disease? A Longitudinal Study. 体育锻炼的障碍与外周动脉疾病患者体育锻炼水平和久坐时间的变化有关吗?一项纵向研究。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-04-24 DOI: 10.1123/japa.2023-0120
Juliane Carolina da Silva Santos, R. Ritti-Dias, G. Cucato, Nelson Wolosker, M. Correia, Breno Quitella Farah
The aims of the current study were to analyze the association between the barriers to and changes in physical activity levels and sedentary behavior, as well as to examine whether these barriers change over time in patients with peripheral artery disease. In this longitudinal study, we assessed 72 patients (68% men; 65.7 ± 9.2 years). Physical activity was measured over a 7-day period using an accelerometer, and data were collected on time spent in sedentary activities, low-light physical activities, and moderate-to-vigorous physical activities. Personal and environmental barriers to physical activity were collected using yes or no questions. Assessments were repeated in the same patients after 27 months (95% confidence interval [26, 28] months). Most barriers remained stable in these patients; however, those who reported lack of money experienced an increase in sedentary behavior (β = 392.9 [159.7] min/week, p = .02) and a decrease in low-light physical activity (β = -372.4 [140.1] min/week, p = .02). These findings suggest that patients with symptomatic peripheral artery disease typically exhibit stable barriers over time, and individuals reporting lack of money demonstrated a decrease in low-light physical activity and an increase in sedentary behavior after 27 months.
本研究的目的是分析体力活动水平和久坐行为的障碍与变化之间的关联,以及研究这些障碍是否会随着时间的推移而在外周动脉疾病患者中发生变化。在这项纵向研究中,我们对 72 名患者(68% 为男性;65.7 ± 9.2 岁)进行了评估。我们使用加速度计测量了患者 7 天内的体力活动量,并收集了久坐不动、低光照体力活动和中等强度体力活动所花费的时间。使用 "是 "或 "否 "的问题收集了阻碍体育锻炼的个人和环境因素。27 个月后(95% 置信区间 [26, 28] 个月),对相同患者进行了重复评估。大多数障碍在这些患者中保持稳定;然而,那些报告缺钱的患者的久坐行为增加了(β = 392.9 [159.7] 分钟/周,p = .02),弱光下的体力活动减少了(β = -372.4 [140.1] 分钟/周,p = .02)。这些研究结果表明,有症状的外周动脉疾病患者通常会在一段时间内表现出稳定的障碍,而报告缺钱的患者在 27 个月后表现出低光体力活动的减少和久坐行为的增加。
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引用次数: 0
Erratum. Perceived Constraints to Pickleball Participation Among Black Older Adults. 勘误。黑人老年人参与皮克尔球运动的制约因素。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-04-11 DOI: 10.1123/japa.2024-0114
Journal of Aging and Physical Activ
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引用次数: 0
Prepandemic Feasibility of Tele-Exercise as an Alternative Delivery Mode for an Evidence-Based, Tai Ji Quan Fall-Prevention Intervention for Older Adults. 将远程锻炼作为以证据为基础的老年人太极拳防跌倒干预措施的替代交付模式的预流行可行性。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-04-10 DOI: 10.1123/japa.2023-0226
Dina L Jones, Maura B. Robinson, T. Selfe, Lucinda Barnes, McKinzey Dierkes, Samantha Shawley-Brzoska, Douglas J Myers, Sara Wilcox
There is a critical need for fall-prevention interventions to reach medically underserved, hard-to-reach, rural older adults. The evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program reduces falls in older adults. This pre-COVID-19 pandemic study assessed the feasibility and impact of a 16-week tele-TJQMBB intervention in older adults. Instructors led six tele-TJQMBB classes via Zoom for 52 older adults (mean age ± SD 68.5 ± 7.7 years) at one academic and four community sites. Nearly all (97%) planned sessions were delivered. Average attendance was 61%. There were no adverse events. Fidelity was fair to good (mean 67%). Forty-one percent of sessions experienced technical disruptions. Participants improved their gait speed, balance, lower-extremity strength, and body mass index. Tele-TJQMBB was feasible with a positive impact on outcomes. This study was the first step toward establishing an additional delivery mode that could potentially expand TJQMBB's reach and maintenance.
目前亟需采取预防跌倒的干预措施,以帮助医疗服务不足、难以接触到的农村老年人。以证据为基础的太极拳:移动改善平衡 (TJQMBB) 计划可减少老年人跌倒。这项在 COVID-19 大流行前进行的研究评估了对老年人进行为期 16 周的远程 TJQMBB 干预的可行性和影响。讲师们通过 Zoom 为 52 名老年人(平均年龄 ± SD 68.5 ± 7.7 岁)开设了六堂远程 TJQMBB 课程,授课地点分别在一所大学和四个社区。几乎所有计划课程(97%)都已完成。平均出席率为 61%。没有发生不良事件。忠实度从一般到良好(平均 67%)。41%的课程出现了技术中断。参与者的步速、平衡能力、下肢力量和体重指数均有所提高。远程 TJQMBB 是可行的,并对结果产生了积极影响。这项研究为建立一种新的提供模式迈出了第一步,这种模式有可能扩大 TJQMBB 的覆盖范围并使其得以维持。
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引用次数: 0
Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study. 养老院居民的体育锻炼、久坐行为及其预测因素--BaSAlt 研究的跨部门结果。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2024-04-08 DOI: 10.1123/japa.2023-0088
R. Pomiersky, Leon Matting, D. Haigis, Gerhard W Eschweiler, A. Frahsa, Andreas Niess, Ansgar Thiel, Gordon Sudeck
Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.
众所周知,体力活动能促进健康,但人们对养老院居民的体力活动(PA)和久坐行为(SB)知之甚少。本研究调查了养老院居民(n = 63)的体力活动、久坐行为及其预测因素。因变量是基于加速度计的 PA 和 SB。路径分析中的预测变量包括年龄、性别、体重指数、巴特尔指数、认知状况(迷你精神状态检查)、体能表现(手部握力和习惯步行速度)和幸福感(世界卫生组织-5 幸福感指数)。运动量很低(M 步数/天 = 2,433),SB 很高(M 久坐时间百分比 = 89.4%)。年龄(β = -0.27,p = .008)、体重指数(β = -0.29,p = .002)、巴特尔指数(β = 0.24,p = .040)和手部握力(β = 0.30,p = .048)对 PA 有明显的预测作用。体重指数(β = 0.27,p = .008)和巴特尔指数(β = -0.30,p = .012)对 SB 有明显的预测作用。研究结果可能有助于在日常实践中识别低PA和高SB的高危人群。
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引用次数: 0
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Journal of Aging and Physical Activity
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