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Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program.

ABSTRACT: INTRODUCTION:Mobility significantly depends on the ankle muscles' strength which is particularly relevant for the performance of daily activities. Few tools are available, to assess ankle strength with all of the measurement properties tested. The purpose of this study is to test the responsiveness of Calf-Raise Senior Test (CRS) in a sample of elderly participants undergoing a 24-week community exercise program. METHODS:82 older adults participated in an exercise program and were assessed with CRS Test and 30-second chair stand test (CS) at baseline and at follow-up. Effect size (ES), standardized response mean (SRM) and minimal detectable change (MDC) measures were calculated for the CRS and CS tests scores. ROC curves analysis was used to define a cut-off representing the minimally important difference of Calf-Raise Senior test. RESULTS:Results revealed a small (ES = 0.42) to moderate (SRM = 0.51) responsiveness in plantar-flexion strength and power across time, which was lower than that of CS test (ES = 0.64, SRM = 0.67). The responsiveness of CRS test was more evident in groups of subjects with lower initial scores. A minimal important difference (MID) of 3.5 repetitions and a minimal detectable change (MDC) of 4.6 was found for the CRS. CONCLUSION:Calf-Raise Senior Test is a useful field test to assess elderly ankle function, with moderate responsiveness properties. The cutoff scores of MDC and MID presented in this study can be useful in determining the success of interventions aiming at improving mobility in senior participants.

SUBMITTER: Andre HI

PROVIDER: S-EPMC7190110 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program.

André Helô-Isa HI Moniz-Pereira Vera V Ramalho Fátima F Santos-Rocha Rita R Veloso António A Carnide Filomena F

PloS one 20200429 4

<h4>Introduction</h4>Mobility significantly depends on the ankle muscles' strength which is particularly relevant for the performance of daily activities. Few tools are available, to assess ankle strength with all of the measurement properties tested. The purpose of this study is to test the responsiveness of Calf-Raise Senior Test (CRS) in a sample of elderly participants undergoing a 24-week community exercise program.<h4>Methods</h4>82 older adults participated in an exercise program and were ...[more]

PMID: 32348321

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Project description:BackgroundGastrointestinal (GI) health is an important aspect of general health. Gastrointestinal symptoms are of specific importance for the elderly, an increasing group globally. Hence, promoting the elderly's health and especially gastrointestinal health is important. Gut microbiota can influence gastrointestinal health by modulation of the immune system and the gut-brain axis. Diverse gut microbiota have been shown to be beneficial; however, for the elderly, the gut microbiota is often less diverse. Nutrition and physical activity, in particular, are two components that have been suggested to influence composition or diversity.Materials and methodsIn this study, we compared gut microbiota between two groups of elderly individuals: community-dwelling older adults and physically active senior orienteering athletes, where the latter group has less gastrointestinal symptoms and a reported better well-being. With this approach, we explored if certain gut microbiota were related to healthy ageing. The participant data and faecal samples were collected from these two groups and the microbiota was whole-genome sequenced and taxonomically classified with MetaPhlAn.ResultsThe physically active senior orienteers had a more homogeneous microbiota within the group and a higher abundance of Faecalibacterium prausnitzii compared to the community-dwelling older adults. Faecalibacterium prausnitzii has previously shown to have beneficial properties. Senior orienteers also had a lower abundance of Parasutterella excrementihominis and Bilophila unclassified, which have been associated with impaired GI health. We could not observe any difference between the groups in terms of Shannon diversity index. Interestingly, a subgroup of community-dwelling older adults showed an atypical microbiota profile as well as the parameters for gastrointestinal symptoms and well-being closer to senior orienteers.ConclusionsOur results suggest specific composition characteristics of healthy microbiota in the elderly, and show that certain components of nutrition as well as psychological distress are not as tightly connected with composition or diversity variation in faecal microbiota samples.

Project description:BACKGROUND:Creating inclusive and accessible outdoor environments that provide and encourage opportunities for older adults to engage in physical activity and social interaction is important for healthy ageing. The Senior Exercise Park is outdoor exercise equipment designed specifically for use by older people that provides physical and social benefits for older people in the community, and has the potential to be used widely as a sustainable mode of physical activity. The aim of this study is to implement and evaluate the effects of sustained engagement through the use of a community-based novel outdoor physical activity program (purpose-built exercise park) for older people on physical, mental and social health and physical activity outcomes (the ENJOY project). METHODS:This is a prospective pre-post design study with 12 months follow up. Adults aged ≥60 years will be recruited from the general community from the suburbs close to the Senior Exercise Parks locations in Melbourne. Participants will undergo a 12 week structured supervised physical activity program using the outdoor Senior Exercise Park equipment followed by 6 months unstructured physical activity program. Participants will be assessed at baseline, 3, 9, and 12 months. The following outcomes will be assessed: physical activity, physical function, psychosocial and mental health outcomes, falls risk and falls occurrence, participants' feedback and satisfaction, and health care resource use. DISCUSSION:The ENJOY trial is designed to operate in a community setting with local government engagement to maximise the usage of the exercise park and provide an outdoor space for older people to be physically active. This project will evaluate the effectiveness and sustainability of the outdoor exercise park on a range of health outcomes and its long-term usability in the community. TRIAL REGISTRATION:This trial is prospectively registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12618001727235 registered 18th of October 2018.

Project description:ImportanceTiming and coordination exercises may be an important addition to community-based health promotion exercise programs to improve walking in older adults.ObjectiveTo compare the effectiveness of the On the Move group exercise program, which focuses on the timing and coordination of movement, with a seated strength, endurance, and flexibility program (usual care) at improving function, disability, and walking ability of older adults.Design, setting, and participantsCluster-randomized, single-blind intervention trial. Thirty-two independent living facilities, senior apartment buildings, and senior community centers were randomized to On the Move (16 sites; 152 participants) or usual care (16 sites; 146 participants). Participants were 65 years or older, able to ambulate independently with a gait speed of at least 0.60 m/s, able to follow 2-step commands, and were medically stable.InterventionsExercise classes were 50 minutes, twice a week for 12 weeks and had 10 or fewer participants per class. On the Move consisted of warm-up, timing and coordination (stepping and walking patterns), strengthening, and stretching exercises. The usual-care program consisted of warm-up, strength, endurance, and stretching exercises.Main outcomes and measuresThe primary outcomes were self-report of function and disability (Late Life Function and Disability Instrument) and mobility (6-minute walk distance and gait speed) assessed by blinded individuals.ResultsParticipants (mean [SD] age, 80.0 [8.1] years) were mostly female (251 [84.2%]) and white (249 [83.6%]) and had a mean (SD) of 2.8 (1.4) chronic conditions. Intervention groups were similar on baseline characteristics. Postintervention, 142 (93.4%) participants in On the Move and 139 (95.2%) participants in usual care completed testing. On the Move had greater mean (SD) improvements than the usual-care group in gait speed (0.05 [0.13] vs -0.01 [0.11] m/s; adjusted difference = 0.05 [0.02] m/s; P = .002) and 6-minute walk distance (20.6 [57.1] vs 4.1 [55.6] m; adjusted difference = 16.7 [7.4] m; P = .03). Attendance was greater in the usual-care program compared with On the Move (95 [65.1%] vs 76 [50.0%] attended ≥20 classes; P = .03). There were no significant differences in any of the other primary or secondary outcomes.Conclusions and relevanceThe On the Move group exercise program was more effective at improving mobility than a usual-care exercise program, despite lower attendance. Additional research examining the impact of the intervention on long-term disability outcomes is needed before recommending routine implementation into clinical practice.Trial registrationclinicaltrials.gov Identifier: NCT01986647.

Project description:BackgroundImpaired balance has a significant negative impact on mobility, functional independence, and fall risk in older adults. Although several, well-respected balance measures are currently in use, there is limited evidence regarding the most appropriate measure to assess change in community-dwelling older adults.ObjectiveThe aim of this study was to compare floor and ceiling effects, sensitivity to change, and responsiveness across the following balance measures in community-dwelling elderly people with functional limitations: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment total scale (POMA-T), POMA balance subscale (POMA-B), and Dynamic Gait Index (DGI).DesignRetrospective data from a 16-week exercise trial were used. Secondary analyses were conducted on the total sample and by subgroups of baseline functional limitation or baseline balance scores.MethodsParticipants were 111 community-dwelling older adults 65 years of age or older, with functional limitations. Sensitivity to change was assessed using effect size, standardized response mean, and paired t tests. Responsiveness was assessed using minimally important difference (MID) estimates.ResultsNo floor effects were noted. Ceiling effects were observed on all measures, including in people with moderate to severe functional limitations. The POMA-T, POMA-B, and DGI showed significantly larger ceiling effects compared with the BBS. All measures had low sensitivity to change in total sample analyses. Subgroup analyses revealed significantly better sensitivity to change in people with lower compared with higher baseline balance scores. Although both the total sample and lower baseline balance subgroups showed statistically significant improvement from baseline to 16 weeks on all measures, only the lower balance subgroup showed change scores that consistently exceeded corresponding MID estimates.LimitationsThis study was limited to comparing 4 measures of balance, and anchor-based methods for assessing MID could not be reported.ConclusionsImportant limitations, including ceiling effects and relatively low sensitivity to change and responsiveness, were noted across all balance measures, highlighting their limited utility across the full spectrum of the community-dwelling elderly population. New, more challenging measures are needed for better discrimination of balance ability in community-dwelling elderly people at higher functional levels.

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Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program.

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Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program.

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