Impact of aerobic exercise on neurobehavioral outcomes. A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis. What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Water- versus land-based exercise effects on physical fitness in older women. The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition High-intensity aquatic exercises (HydrOS) improve physical function and reduce falls among postmenopausal women Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines The Effectiveness of Exercise Interventions for the Management of Frailty: A Systematic Review Examining the theory‐effectiveness hypothesis: A systematic review of systematic reviews Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. The Effects of Exercise on Memory Function Among Young to Middle-Aged Adults: Systematic Review and Recommendations for Future Research Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Older women and physical activity: using the telephone to walk. The effect of land versus aquatic exercise program on bone mineral density and physical function in postmenopausal women with osteoporosis: a randomized controlled trial. Physical activity and mental well-being in older people participating in the Better Ageing Project Physical rehabilitation interventions for adult patients with critical illness across the continuum of recovery: an overview of systematic reviews protocol Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise
Numerous studies have examined the relationship between physical activity and cognitive function , demonstrating that greater physical activity is associated with lower incidence of cognitive impairment in later life . Due to an increasingly large number of older adults at risk for cognitive impairment , the relationship between physical activity and cognition has garnered increasing public health relevance and multiple r and omized trials have demonstrated that exercise interventions among sedentary adults improve cognitive performance in multiple domains of function . This article will examine the relationship between physical activity and cognitive function by review ing several different areas of literature , including the prevalence of cognitive impairment , assessment methods , observational studies examining physical activity and cognition , and intervention studies . The present review is intended to provide a historical tutorial of existing literature linking  physical activity , exercise , and cognitive function among both healthy and clinical population PURPOSE Despite the decreased gravitational loading that is experienced in an aquatic environment , little research has been conducted on this exercise medium for women with osteoporosis ( OP ) .  Aquatic exercise ( AE ) may improve function and balance , thus ultimately decreasing fall risk and the potential for hip fractures in this high-risk population . METHOD A total of 68 women with OP , aged 60 years or older , were recruited into a r and omized clinical trial evaluating the impact of AE , l and exercise ( LE ) , and no exercise ( NE ) on balance , functional mobility , and quality of life ( QOL ) . RESULTS Only one balance measure ( backward t and em walk ) significantly improved with AE compared to LE , but this did not translate into a greater improvement in self-report function . There were no significant differences between the exercise interventions and NE , except for in ratings of global change , where participants in the AE group were three times more likely to report improvement than those in the NE group . CONCLUSION There were no differences in balance , function , or QOL in women with OP who followed an AE or LE programme compared to those in an NE control group . However , the significant differences in backward t and em walk between the AE and LE groups and self-reported global change between the AE and NE groups warrant further investigation . Significant improvements in balance and global change suggest that AE is a viable alternative for older women with OP who have difficulty exercising on l and Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made AIM The effectiveness of a water-based exercise ( WE ) program and a walking on l and ( WL ) program was evaluated in older women ( aged 62 - 65 years ) . METHODS Fifty healthy sedentary women were r and omly assigned to sedentary ( S ) , WE and WL groups . The two groups were exercised for 12 weeks at 70 % of the age-predicted maximum heart rate ( HR ) . The subjects were evaluated before and after the training period , and measurements of bodyweight , HR at rest , maximum aerobic power ( VO(2max ) mL/kg per min ) and neuromuscular performance ( upper and lower body strength ; agility ; upper and lower body flexibility ) were included . RESULTS After training , bodyweight was unchanged in both programs . The WE decreased the HR at rest by 10 % . Both WE and WL enhanced VO(2max ) by 42 % and 32 % , respectively . However , for the WE group the VO(2max ) values were significantly higher compared with the WL group ( P < 0.05 ) . All neuromuscular parameters improved after exercise , but only the WE group showed a significant improvement on the upper body strength and lower body flexibility . Besides , the upper and lower body strength and upper and lower body flexibility were significantly higher in the WE group compared with the WL group ( P < 0.05 ) , respectively . CONCLUSIONS Current results indicate that the WE and WL programs improved the cardiorespiratory and neuromuscular fitness of older women . Furthermore , when the effectiveness of the training programs were compared , it was verified that the WE program was more powerful in inducing changes in physical fitness versus the WL program OBJECTIVE To evaluate the effect of aquatic exercise and education on fall risk factors in older adults with hip osteoarthritis ( OA ) . METHOD Seventy-nine adults , 65 years of age or older with hip OA and at least 1 fall risk factor , were r and omly assigned to 1 of 3 groups : aquatics and education ( AE ; aquatic exercise twice a wk with once-a-wk group education ) , aquatics only ( A ; 2 wk aquatic exercise ) and control ( C ; usual activity ) . Balance , falls efficacy , dual-task function , functional performance ( chair st and s ) , and walking performance were measured pre- and postintervention or control period . RESULTS There was a significant improvement in fall risk factors ( full-factorial MANCOVA , baseline values as covariates ; p = .038 ) ; AE improved in falls efficacy compared with C and in functional performance compared with A and C. CONCLUSION The combination of aquatic exercise and education was effective in improving fall risk factors in older adults with arthritis OBJECTIVES To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia ( FM ) and to determine exercise adherence levels . DESIGN A r and omized controlled trial . SETTING Testing and training were completed at the university . PARTICIPANTS Middle-aged women with FM ( n=60 ) and healthy women ( n=25 ) . INTERVENTION A 16-week aquatic training program , including strength training , aerobic training , and relaxation exercises . MAIN OUTCOME MEASURES Tender point count ( syringe calibrated ) , health status ( Fibromyalgia Impact Question naire ) ; sleep quality ( Pittsburgh Sleep Quality Index ) ; physical ( endurance strength to low loads tests ) , psychologic ( State Anxiety Inventory ) , and cognitive function ( Paced Auditory Serial Addition Task ) ; and adherence 12 months after the completion of the study . RESULTS For all the measurements , the patients showed significant deficiencies compared with the healthy subjects . Efficacy analysis ( n=29 ) and intent-to-treat analysis ( n=34 ) of the exercise therapy was effective in decreasing the tender point count and improving sleep quality , cognitive function , and physical function . Anxiety remained unchanged during the follow-up . The exercise group had a significant improvement of health status , not associated exclusively with the exercise intervention . There were no changes in the control group . Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program . CONCLUSIONS An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology . The therapeutic intervention 's effects can be assessed through applicable tests in the clinical practice The aim of this study was to assess the effectiveness of a 24-week exercise protocol carried out in geothermal spring water to improve overall physical function and muscle mass in a group of healthy elderly subjects . A further aim was to compare this water-based protocol with a l and -based protocol and a control group . For this purpose , 59 subjects were recruited and r and omly allocated to three groups : aquatic group ( AG ) , l and group ( LG ) , and control group ( CG ) . AG and LG followed a 6-month , twice-weekly , multimodality exercise intervention . AG underwent the protocol in hot-spring water ( 36 ° C ) while LG did it in a l and -based environment . After the intervention , knee-extension strength was maintained in AG and LG . The 8-foot up- and -go test showed a reduction in both exercise groups ( AG −19.3 % , P < 0.05 ; LG −12.6 % , P < 0.05 ) , with a significantly greater decrease in AG . The back-scratch test revealed an improvement only in AG ( 25.8 % ; P < 0.05 ) , while the sit- and -reach test improved in all groups . Finally , AG reduced fat mass by 4 % ( P < 0.05 ) , and dominant forearm fat decreased by 9.2 % ( P < 0.05 ) . In addition , calf muscle density increased by 1.8 % ( P < 0.05 ) . In summary , both water- and l and -based activities were beneficial in maintaining strength and in improving lower-body flexibility . Aquatic exercise appeared a better activity to improve dynamic balance . Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly Objective This study aims to investigate the effects of an aquatic exercise program ( HydrOS ) on neuromuscular function and falls among postmenopausal women . Methods One hundred eight postmenopausal women ( mean [ SD ] age , 58.8 [ 6.4 ] y ) were r and omly divided into the  control group ( CG ; n = 44 ) and the  aquatic exercise group  ( AEG ; n = 64 ) . Both groups received elementary calcium 500 mg/day and cholecalciferol 1,000 IU/day . For 24 weeks , the AEG participated in the aquatic exercise program , whereas the CG remained sedentary . The following variables were measured before and after the program : number of falls and fallers ( 7 mo before and after the intervention ) ; flexibility , using Wells ’ Sit- and -Reach Test ( FLEX ) ; static balance , using the Unipedal Stance Test ( UST ) ; mobility , using the Timed-Up- and -Go test ( TUG ) ; h and grip strength of the dominant h and ( HGS ) ; and maximal isometric strength of back extensor muscles ( SBE ) , strength of hip flexor muscles ( SHF ) , and strength of knee extensor muscles ( SKE ) . The muscle strength tests were considered the primary outcome , whereas the other neuromuscular tests , together with falls , were considered secondary outcomes . Results were significant when P ⩽ 0.05 . Results Serum 25-hydroxyvitamin D significantly increased by 21 % in the CG and by 23 % in the AEG ( P < 0.001 ) . The number of falls and fallers after the program remained unchanged in the CG ; in the AEG , the mean number of falls decreased from 2.00 to 0.29 ( P < 0.0001 ) , and the number of fallers decreased by 44 % ( P < 0.0001 ) . All neuromuscular variables significantly improved in the AEG : FLEX ( 26.6 % ; P < 0.0001 ) , UST ( 14.1 % ; P < 0.001 ) , TUG ( 23.7 % ; P < 0.001 ) , HGS ( 13.4 % ; P < 0.001 ) , SBE ( 26.2 % ; P < 0.001 ) , SHF ( 18.5 % ; P = 0.039 ) , and SKE ( 7.7 % ; P < 0.001 ) . In the CG , significant improvements in FLEX ( 12.2 % ; P = 0.009 ) , UST ( 4.5 % ; P < 0.001 ) , TUG ( 10 % ; P < 0.001 ) , and SHF ( 5.7 % ; P = 0.039 ) were observed and could be explained by increasing serum 25-hydroxyvitamin D level attributable to supplementation . Conclusions The aquatic exercise program HydrOS is a safe and efficient way to improve physical function and to reduce falls among postmenopausal women Background The purpose was to conduct systematic review s of the relationship between physical activity of healthy community-dwelling older ( > 65 years ) adults and outcomes of  functional limitations , disability , or loss of independence .  Methods Prospect i ve cohort studies with an outcome related to functional independence or to cognitive function  were search ed , as well as exercise training interventions that reported a functional outcome . Electronic data base search strategies were used to identify citations which were screened ( title and abstract ) for inclusion . Included articles were review ed to complete st and ardized data extraction tables , and assess study quality . An established system of assessing the level and grade of evidence for recommendations was employed . Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence , and 34 were included with a cognitive function outcome . Greater physical activity of an aerobic nature ( categorized by a variety of methods ) was associated with higher functional status ( expressed by a host of outcome measures ) in older age . For functional independence , moderate ( and high ) levels of physical activity appeared effective in conferring a reduced risk ( odds ratio ~0.5 ) of functional limitations or disability . Limitation in higher level performance outcomes was reduced ( odds ratio ~0.5 ) with vigorous ( or high ) activity with an apparent dose-response of moderate through to high activity . Exercise training interventions ( including aerobic and resistance ) of older adults showed improvement in physiological and functional measures , and suggestion of longer-term reduction in incidence of mobility disability . A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia ; however , there were mixed results of the effects of exercise interventions on cognitive function indices . Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence ; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age . Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult , it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes This systematic review examines the effectiveness of current exercise interventions for the management of frailty . Eight electronic data bases were search ed for r and omized controlled trials that identified their participants as “ frail ” either in the title , abstract , and /or text and included exercise as an independent component of the intervention . Three of the 47 included studies utilized a vali date d definition of frailty to categorize participants . Emerging evidence suggests that exercise  has a positive impact on some physical determinants and on all functional ability outcomes reported in this systematic review . Exercise programs that optimize the health of frail older adults seem to be different from those recommended for healthy older adults . There was a paucity of evidence to characterize the most beneficial exercise program for this population . However , multicomponent training interventions , of long duration ( ≥5 months ) , performed three times per week , for 30–45 minutes per session , generally had superior outcomes than other exercise programs . In conclusion , structured exercise training seems to have a positive impact on frail older adults and may be used for the management of frailty PURPOSE Health interventions based on theory may be more effective than those that are not . This review of review s synthesizes all published r and omized controlled trial ( RCT ) meta-analytic evidence from the last decade to examine whether theory-based interventions were found to be associated with more effective  adult health behaviour change interventions . METHODS Systematic review s including meta-analyses were identified by search ing Medline , CINAHL , PsycINFO , and CDSR . A narrative synthesis was used to summarize and analyse the evidence . Only review s including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included . RESULTS Of 8,659 articles , nine systematic review s met inclusion criteria . The majority of review s ( n = 8) suggested no increased effectiveness for theory-based compared to non-theory-based interventions for effectiveness of outcomes relating to health behaviour . Less than half of the RCTs included in the review s reported the use of theory ( 85/183 ) . Two review s suggested interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Method ological and reporting issues limit the conclusions . CONCLUSIONS Theory-based interventions as currently operationalized in systematic review s were not found to be more effective than non-theory-based interventions . Method ological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions . The promotion of theory use may benefit from using a multifaceted argument , rather than a narrow focus of increased effectiveness . Statement of contribution What is already known on this subject ? Theory use is regularly promoted by cl aim ing that it will lead to more effective behaviour change interventions . Theory use has been frequently linked to effectiveness within systematic review s of behaviour change interventions . The theory-effectiveness hypothesis has not been systematic ally examined at the systematic review level . What does this study add ? Theory use as operationalized by systematic review authors was not associated with increased effectiveness within systematic review s examining r and omized controlled trials of behaviour change interventions in adults . Interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Theory use should be promoted using a multifaceted argument , and assertions for increased effectiveness of theory-based interventions should only be used in domains where specific evidence exists to support this cl aim Background Meeting the needs of the growing number of older people is a challenge for health and social care services . Home-based interventions aim ing to modify health-related behaviours of frail older people have the potential to improve functioning and well-being . Previous review s have focused on whether such interventions are effective , rather than what might make them effective . Recent advances in behavioural science make possible the identification of potential ‘ active ingredients ’ of effective interventions , such as component behaviour change techniques ( BCTs ) , and intended intervention functions ( IFs ; e.g. to educate , to impart skills ) . This paper reports a protocol for a systematic review that seeks to ( a ) identify health behaviour change interventions for older frail people , ( b ) describe the content of these interventions , and ( c ) explore links between intervention content and effectiveness . The protocol is reported in accordance with Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol s ( PRISMA -P ) 2015 guidelines . Methods / design Studies will be identified through a systematic search of 15 electronic data bases , supplemented by citation tracking . Studies will be retained for review where they report r and omised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community setting s , written in English , and either published from 1980 onwards , or , for registered trials only , unpublished but completed with results obtainable from authors . Interventions will be coded for their content ( BCTs , IFs ) and for evidence of effectiveness ( outcome data relating to behavioural and health outcomes ) . Analyses will describe characteristics of all interventions . Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence . The potential for each intervention characteristic to contribute to change in behaviour or health outcomes will be estimated by calculating the percentage of all interventions featuring those characteristics that have shown effectiveness . Discussion Results will reveal the strategies that have been drawn on within home-based interventions to modify the health behaviours of frail older people , and highlight those more associated with positive changes in behaviour and health . Findings from this review will provide a useful basis for underst and ing , developing , and implementing behaviour change interventions in this field . Systematic review registration PROSPERO OBJECTIVE To ascertain the effectiveness of the National Arthritis Foundation ( NAF ) aquatic and on-l and exercise programs on functional fitness and perceived ability to perform activities of daily living ( ADL ) measures in older adults with arthritis . DESIGN The effects of aquatic and on-l and exercise intervention programs were analyzed by repeated- measures analysis of variance by using a planned comparison approach with an independent 3 x 2 ( group by test ) design . omega(2 ) analyses were used to ascertain the relative treatment magnitude of each dependent variable . SETTING Testing in an indoor track facility ; exercise programs conducted in community setting s. PARTICIPANTS A volunteer sample of 30 men and women with arthritis ( osteoarthritis , n=22 ; rheumatoid arthritis , n=8 ) , r and omly assigned into either an aquatic exercise ( n=10 ) , on-l and exercise ( n=10 ) , or control group ( n=10 ) . INTERVENTION Eight-week on-l and and aquatic exercise program . MAIN OUTCOME MEASURES Functional fitness , ADLs , and h and -held dynamometry measures assessed on a 1-day pretest and posttest session , before and after an 8-week exercise program . RESULTS Aquatic and on-l and exercise subjects showed significant improvements on 9 of 12 functional fitness , 3 of 4 ADLs , and 7 of 8 h and -held isometric strength tests after their respective exercise programs . No significant changes were found in any of these measures for the control group . CONCLUSION Both NAF exercise programs appear to be effective in improving functional physical fitness and perceived ability to perform ADL measures in older adults with arthritis Objective : To systematic ally summarize the experimental effects of exercise on cognitive-related memory function among young to middle-aged adults , which has yet to be done in the literature . Data Source : PubMed . Study Inclusion and Exclusion Criteria : Studies were included if they were published in the English language , indexed in PubMed , employed an experimental study design ( eg , traditional parallel group r and omized controlled trial : either acute intervention or chronic/training intervention study ) , and conducted among human adults . Studies were excluded if nonhumans ( ie , animal models ) were studied , if children/adolescents ( < 18 years ) or older adults ( > 50 years ) were evaluated , and if select chronic diseases ( eg , diabetes and dementia ) were present . Data Extraction : A systematic review approach was employed . Data Synthesis : An extraction table was created synthesizing the key results , and recommendations for future research are emphasized . Results : Among the 17 evaluated studies , 2 were published before the year 2000 ( ie , 1998 and 1999 ) , 2 were published in 2007 , and the remaining 13 were published in the years 2011 and beyond . This highlights the emergence of this research topic within this age-group ( young to middle-aged adults ) . Among the 17 evaluated studies , 14 were conducted among healthy sample s , with 3 conducted among those with a diagnosis of depression . Among the 17 studies , 4 employed a chronic training protocol , with 13 utilizing an acute exercise protocol . Among the 3 experimental studies in the depressed population , all demonstrated a favorable effect of exercise on memory function . Among the 14 trials in the nondepressed population , 10 ( 71 % ) demonstrated a favorable effect of exercise on some aspect of memory function . Conclusion : Acute and chronic exercise appears to play a pronounced effect on memory function  among young to middle-aged adults . Implication s and recommendations for future research are outlined in this systematic review AIM This paper reports a study of the effects of aquatic exercise on physical fitness ( flexibility , strength and aerobic fitness ) , self-reported physical functioning and pain in adults with osteoarthritis of the hip or knee . BACKGROUND Osteoarthritis is a common cause of disability and a primary reason for hip and knee joint replacement . Exercise is important for preventing and /or managing the functional limitations associated with joint disease . Aquatic exercise is thought to be beneficial and is often recommended for people with osteoarthritis ; however , few studies have examined the effects on people with osteoarthritis , and these have yielded inconsistent results . METHODS A two-group r and omized controlled trial with a convenience sample was used . Participants were recruited from community sources and r and omly assigned to a 12-week aquatic programme or a non-exercise control condition . Data for 38 participants were collected at baseline , week 6 , and week 12 during 2003 and 2004 . Instruments were a st and ard plastic goniometer , a h and held dynamometer , the 6-minute walk test , the multidimensional Health Assessment Question naire , and a visual analogue scale for pain . RESULTS Repeated measures analysis of variance showed that aquatic exercise statistically significantly improved knee and hip flexibility , strength and aerobic fitness , but had no effect on self-reported physical functioning and pain . The exercise adherence rate was 81.7 % , and no exercise-related adverse effect was observed or reported . CONCLUSIONS Beneficial short-term effects of aquatic exercise were found in adults with osteoarthritis of the hip or knee . Although the programme may not offer pain relief or self-reported improvements in physical functioning , results suggest that aquatic exercise does not worsen the joint condition or result in injury . Nurses engaging in disease management and health promotion for these patients should consider recommending or implementing aquatic classes for patients R egular physical activity has been shown to have beneficial effects on both physical and mental health.i4 The Centers for Disease Control and the American College of Sports Medicine have suggested that adults should accumulate at least 30 minutes of moderate physical activity during the course of most days . * In the elderly population , moderate physical activity , such as walking , is associated with improved health outcomes .*5 Nevertheless , the majority of older people are sedentary . Results from the 1985 National Health Interview Survey show that two-thirds of those ages 65 and over do not exercise regularly.‘j The benefits of physical activity for elderly women include decreased risk of osteoporosis , decreased incidence of depression , and increased functional status.‘~7W’0 Despite these findings , the Behavioral Risk Factor Surveillance System reported that in 1990 , 86.7 % of women surveyed ages 65 and over were sedentary.i ’ Yet , little is known about the determinants of exercise behavior in this population . Interventions to increase physical activity in the elderly include public education campaigns , formal education , and training programs.‘2-‘4 These efforts have been unsuccessful at maintaining the adoption of this behavior.‘2-‘4 Dishman et all3 report that 50 % of those who participate in organized exercise programs such as aerobics classes will drop out during the first 3 - 6 months . An individual ’s knowledge , attitude , and demographics are some factors that research ers have found to influence exercise habits.13 Among elderly women , physical and health problems , time constraints , personal issues such as inclement weather , lack of companionship , safety concerns , and lack of motivation interfere with regular exercise.15 Our objective was to use telecommunications technology to underpin an intervention that would be effective , easy to use , convenient , and inexpensive BACKGROUND Osteoporosis is a multifactorial progressive skeletal disorder characterized by reduced bone mass . Exercise is widely recommended to reduce osteoporosis , falls and related fragility fractures . The purpose of this study was to investigate the effects of l and exercise ( LE ) and aquatic exercise ( AE ) on physical function and bone mineral density ( BMD ) . MATERIAL AND METHODS Fifty-eight postmenopausal women , aged 50 - 70 years , diagnosed with osteoporosis according to BMD measures , enrolled in this study . The subjects were r and omly assigned to either the intervention group ( LE group ) or the control group ( AE group ) . Physical function and BMD were assessed in all subjects in both groups before and after 10 months of intervention . Muscle strength , flexibility , balance , gait time and pain were measured to assess physical function . Bone mineral density at the lumbar spine was measured by dual energy X-ray absorptiometry ( DEXA ) . RESULTS There were no significant differences between the two groups in the baseline anthropometric data . The two groups were similar with respect to age , weight , height , and body mass index ( p>0.05 ) . After the exercise program  , muscle strength , flexibility , gait time , pain , and bone density ( p<0.001 ) improved significantly with LE compared to AE . There was no significant difference between the two groups with regard to balance at the 10-month follow-up . CONCLUSION Significant improvements in physical function and BMD suggest that LE is a possible alternative for postmenopausal women with OP Increasing evidence suggests that physical activity can prevent some aspects of mental illness in older people such as depression , dementia and Alzheimer ’s disease . Additionally , limited research has shown that engagement in structured exercise can improve aspects of psychological well-being such as mood and self-perceptions in older adults . However , the relationship between incidental daily activity such as walking or time spent sedentary , with psychological well-being has not been investigated . The Better Ageing Project provided an opportunity to assess well-being and quality of life using st and ardised question naires with 176 adults aged 70 and over .  Accelerometry was used to objective ly assess daily energy expended in physical activity at different levels of intensity . In addition , an assessment of the impact of the 12-month Better Ageing structured group exercise programme was assessed through question naires and interviews . Total daily physical activity energy expenditure ( joules/day ) and amount of time spent in activity of at least moderate intensity were weakly related ( r = 0.20–0.28 ) to quality of life , subjective well-being and physical self-perceptions . Time spent sedentary ( min/day ) was weakly and negatively related to several mental health indicators . The quantitative data showed only minor psychological benefits of the exercise intervention . In contrast , interviews with 27 research participants and 4 exercise leaders suggested that important improvements in perceived function and social benefits had been experienced Background Patients admitted to the intensive care unit with critical illness often experience significant physical impairments , which typically persist for many years following resolution of the original illness . Physical rehabilitation interventions that enhance restoration of physical function have been evaluated across the continuum of recovery following critical illness including within the intensive care unit , following discharge to the ward and beyond hospital discharge . Multiple systematic review s have been published appraising the exp and ing evidence investigating these physical rehabilitation interventions , although there appears to be variability in review methodology and quality . We aim to conduct an overview of existing systematic review s of physical rehabilitation interventions for adult intensive care patients across the continuum of recovery . Methods / design This protocol has been developed according to the Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol ( PRISMA -P ) guidelines . We will search the Cochrane Systematic Review Data base , Data base of Abstract s of Review s of Effectiveness , Cochrane Central Register of Controlled Trials , MEDLINE , Excerpta Medica Data base and Cumulative Index to Nursing and Allied Health Literature data bases . We will include systematic review s of r and omised controlled trials of adult patients , admitted to the intensive care unit and who have received physical rehabilitation interventions at any time point during their recovery . Data extraction will include systematic review aims and rationale , study types , population s , interventions , comparators , outcomes and quality appraisal method . Primary outcomes of interest will focus on findings reflecting recovery of physical function . Quality of reporting and method ological quality will be appraised using the PRISMA checklist and the Assessment of Multiple Systematic Review s tool . Discussion We anticipate the findings from this novel overview of systematic review s will contribute to the synthesis and interpretation of existing evidence regarding physical rehabilitation interventions and physical recovery in post-critical illness patients across the continuum of recovery . Systematic review registration PROSPERO CRD42015001068 Background : Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults . Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight , sedentary , older adults . This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese , older adult women . Methods : Participants ( N = 34 ) were generally healthy , obese , older adult women ( age range 55–79 years ) with mild to moderate physical impairments ( ie , functional limitations ) . Participants were r and omly assigned to one of two groups for 24 weeks : ( i ) weight loss plus exercise ( WL+E ; n = 17 ; mean age = 63.7 years [ 4.5 ] ) or ( ii ) educational control ( n = 17 ; mean age = 63.7 [ 6.7 ] ) . In the WL+E group , participants attended a group-based weight management session plus three supervised exercise sessions within their community each week . During exercise sessions , participants engaged in brisk walking and lower-body resistance training of moderate intensity . Participants in the educational control group attended monthly health education lectures on topics relevant to older adults . Outcomes were : ( i ) body weight , ( ii ) walking speed ( assessed by 400-meter walk test ) , ( iii ) the Short Physical Performance Battery ( SPPB ) , and ( iv ) knee extension isokinetic strength . Results : Participants r and omized to the WL+E group lost significantly more weight than participants in the educational control group ( 5.95 [ 0.992 ] vs 0.23 [ 0.99 ] kg ; P < 0.01 ) . Additionally , the walking speed of participants in the WL+E group significantly increased compared with that of the control group ( reduction in time on the 400-meter walk test = 44 seconds ; P < 0.05 ) . Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test ( P < 0.05 ) , with significant differences between groups ( P = 0.02 ) . Knee extension strength was maintained in both groups . Conclusion : Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese , older adult women with mild to moderate physical impairments Background : The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonr and omized controlled trials ( n RCTs ) . Methods : Study design was a systematic review of nonr and omized controlled trials . Trials were eligible if they were nonr and omized clinical trials . Studies included one treatment group in which aquatic exercise was applied .  We search ed the following data bases from 2000 up to July 20 , 2009 : MEDLINE via PubMed , CINAHL , and Ichushi-Web . Results : Twenty-one trials met all inclusion criteria . Language s included were English ( N = 9 ) , Japanese ( N = 11 ) , and Korean ( N = 1 ) . Target diseases were knee and /or hip osteoarthritis , poliomyelitis , chronic kidney disease , discomforts of pregnancy , cardiovascular diseases , and rotator cuff tears . Many studies on nonspecific disease ( healthy participants ) were included . All studies reported significant effectiveness in at least one or more outcomes . However results of evaluations with the TREND and CLEAR-NPT checklists generally showed a remarkable lack of description in the studies . Furthermore , there was the problem of heterogeneity , and we were therefore not able to perform a meta- analysis . Conclusion : Because there was insufficient evidence on aquatic exercise due to poor method ological and reporting quality and heterogeneity of n RCTs , we were unable to offer any conclusions about the effects of this intervention . However , we were able to identify problems with current n RCTs of aquatic exercise , and propose a strategy of strengthening study quality , stressing the importance of study feasibility as a future research agenda objective
AE may improve physical functioning in healthy older people and is at least as effective as LE
BACKGROUND ageing and sedentary behaviour cause negative changes in the neuromuscular systems of healthy older adults result ing in a decrease in physical functioning .
Exercising in water ( aquatic exercise , AE ) has been shown to be effective at improving physical functioning in this population ; however , no systematic review with meta- analysis has been published .