Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews The Active plus protocol: systematic development of two theory- and evidence-based tailored physical activity interventions for the over-fifties Impact of aerobic exercise on neurobehavioral outcomes. Strategies to Promote Physical Activity During Pregnancy Evaluating the effects of increasing physical activity to optimize rehabilitation outcomes in hospitalized older adults (MOVE Trial): study protocol for a randomized controlled trial Physical activity for the prevention and treatment of major chronic disease: an overview of systematic reviews Social-cognitive and perceived environment influences associated with physical activity in older Australians. Enhancing physical function in HIV-infected older adults: A randomized controlled clinical trial. Physical rehabilitation interventions for adult patients with critical illness across the continuum of recovery: an overview of systematic reviews protocol Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB‐HF) trial: Design and rationale What are the factors that influence physical activity participation in individuals with depression? A review of physical activity correlates from 59 studies. Intrapersonal, social and physical environmental determinants of moderate-to-vigorous physical activity in working-age women: a systematic review protocol Exercise: effects on physical functional performance in independent older adults. Cluster-randomised trial on participatory community-based outdoor physical activity promotion programs in adults aged 65–75 years in Germany: protocol of the OUTDOOR ACTIVE intervention trial Prospective Associations Between Leisure-Time Physical Activity and Cognitive Performance Among Older Adults Across an 11-Year Period Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study.
Background To counteract decline in physical performance and physical activity in older patients during hospitalization , multiple physical interventions were developed . However , it is unknown whether these are effective in this particular population . This systematic review aim ed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization . Methods The systematic search included PubMed , EMBASE , Cinahl , the Trials data base of The Cochrane Library and SPORTd iscus from inception to 22 November 2017 . Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on  physical performance or physical activity  was evaluated during hospitalization . Results Fifteen r and omized controlled trials met the inclusion criteria . Overall , the effect of physical interventions on physical performance was inconsistent . Patient tailored interventions , i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not . Physical activity as outcome measure was not addressed . Reporting of intensity of the interventions and adherence were frequently lacking . Conclusions Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain . Further research on the efficacy of the intervention is needed , comparing types of intervention with detailed reporting of frequency , intensity and duration Physical and cognitive training seem to counteract age-related decline in physical and mental function . Recently , the possibility of integrating cognitive dem and s into physical training has attracted attention . The purpose of this study was to evaluate the effects of twelve weeks of design ed physical-cognitive training on executive cognitive function and gait performance in older adults . Thirty-six healthy , active individuals aged 72.30 ± 5.84 years were assigned to two types of physical training with major focus on physical single task ( ST ) training ( n = 16 ) and physical-cognitive dual task ( DT ) training ( n = 20 ) , respectively . They were tested before and after the intervention for executive function ( inhibition , working memory ) through R and om Number Generation and for gait ( walking with/without negotiating hurdles ) under both single and dual task ( ST , DT ) conditions . Gait performance improved in both groups , while inhibitory performance decreased after exercise training with ST focus but tended to increase after training with physical-cognitive DT focus . Changes in inhibition performance were correlated with changes in DT walking performance with group differences as a function of motor task complexity ( with/without hurdling ) . The study supports the effectiveness of group exercise classes for older individuals to improve gait performance  , with physical-cognitive DT training selectively counteracting the age-related decline in a core executive function essential for daily living 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 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 Background Limited data are available on the development , implementation and evaluation processes of physical activity promotion programmes among older adults . More integrative insights into interventions describing the planned systematic development , implementation and evaluation are needed . Methods and design The purpose of this study is to give an integrative insight into the development of the Active plus programme applying the six-step Intervention Mapping protocol . The Active plus programme consisted of two theory- and evidence -based tailored physical activity promotion interventions , both comprising three tailored letters delivered over four months and aim ed at raising awareness of insufficient physical activity , and stimulating physical activity initiation and maintenance among the over-fifties . The first intervention , the basic tailored intervention , provided tailored letters that intervened on the psychosocial determinants of physical activity . The second intervention , the intervention plus , provided the same tailored information but additionally provided tailored information about physical activity opportunities in the specific environment in which the older adults lived . This environment-based component also provided access to a forum and e-buddy system on a website . A plan for implementation and evaluation is also described . Discussion The planned development of the Active plus programme result ed in two theory- and evidence -based tailored physical activity interventions targeted at the over-fifties . Trial Registration Dutch Trial Register NTR 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 Physical activity during pregnancy has been associated with significant health benefits ; however , most women in the United States do not meet the current guidelines . This systematic review evaluates evidence for interventions to improve physical activity during pregnancy in order to identify best practice s and inform future research . Electronic data bases ( PubMed , CINAHL , SportD ISCUS , Embase , ERIC , Psych Info , and ISI Web of Science ) were search ed in July 2011 for peer- review ed journal articles . Studies were included if they were English- language r and omized control trials that measured the efficacy of an intervention targeted at pregnant women and were design ed to change physical activity as a primary or secondary outcome . Out of 777 studies identified through the systematic search , 9 interventions were selected for inclusion by multiple review ers . Data were abstract ed using an abstract ion form modeled after the “ Guide to Community Preventive Services . ” Of the 9 interventions included in the review , 3 reported statistically significant positive results for physical activity . Although the interventions included a variety of strategies and techniques , none were uniquely associated with positive outcomes . Overall , this review suggests that little is known about the efficacy of interventions for physical activity during pregnancy . This study provides several recommendations for future research and intervention design Background Older adults who have received inpatient rehabilitation often have significant mobility disability at discharge . Physical activity levels in rehabilitation are also low . It is hypothesized that providing increased physical activity to older people receiving hospital-based rehabilitation  will lead to better mobility outcomes at discharge . Methods / Design A single blind , parallel-group , multisite r and omized controlled trial with blinded assessment of outcome and intention-to-treat analysis . The cost effectiveness of the intervention will also be examined . Older people ( age > 60 years ) undergoing inpatient rehabilitation to improve mobility will be recruited from geriatric rehabilitation units at two Australian hospitals . A computer-generated blocked stratified r and omization sequence will be used to assign 198 participants in a 1:1 ratio to either an ‘ enhanced physical activity ’ ( intervention ) group or a ‘ usual care plus ’ ( control ) group for the duration of their inpatient stay . Participants will receive usual care and either spend time each week performing additional physical activities such as st and ing or walking ( intervention group ) or performing an equal amount of social activities that have minimal impact on mobility such as card and board games ( control group ) . Self-selected gait speed will be measured using a 6-meter walk test at discharge ( primary outcome ) and 6 months follow-up ( secondary outcome ) . The study is powered to detect a 0.1 m/sec increase in self-selected gait speed in the intervention group at discharge . Additional measures of mobility ( Timed Up and Go , De Morton Mobility Index ) , function ( Functional Independence Measure ) and quality of life will be obtained as secondary outcomes at discharge and tertiary outcomes at 6 months follow-up . The trial commenced recruitment on 28 January 2014 . Discussion This study will evaluate the efficacy and cost effectiveness of increasing physical activity in older people during inpatient rehabilitation . These results will assist in the development of evidence d-based rehabilitation programs for this population .Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12613000884707 ( Date of registration 08 August 2013 ) ; Clinical Trials.gov Identifier NCT01910740 ( Date of registration 22 July 2013 ) Background The evidence that higher levels of physical activity and /or lower levels of physical inactivity are associated with beneficial health-related outcomes stems mainly from observational studies . Findings from these studies often differ from r and omised controlled trials and systematic review s currently demonstrate mixed results , due partly to heterogeneity in physical activity interventions , method ologies used and population s studied . As a result , translation into clinical practice has been difficult . It is therefore essential that an overview is carried out to compare and contrast systematic review s , and to identify those physical activity interventions that are the most effective in preventing and /or treating major chronic disease . This protocol has been registered on PROSPERO 2013 : CRD42013003523 . Methods We will carry out an overview of Cochrane systematic review s. We will search the Cochrane Data base of Systematic Review s for systematic review s of r and omised controlled trials that have a primary focus on disease-related outcomes . We will restrict review s to those in selected major chronic diseases . Two authors will independently screen search outputs , select studies , extract data and assess the quality of included review s using the assessment of multiple systematic review s tool ; all discrepancies will be resolved by discussing and reaching a consensus , or by arbitration with a third author . The data extraction form will summarise key information from each review , including details of the population ( s ) ( for example , disease condition ) , the context ( for example , prevention , treatment or management ) , the participants , the intervention(s ) , the comparison(s ) and the outcomes . The primary outcomes of interest are the prevention of chronic disease and /or improved outcomes , in the treatment or management of chronic disease . These outcomes will be summarised and presented for individual chronic diseases ( for example , any change in blood pressure in hypertension or glucose control in diabetes ) . Secondary outcomes of interest are to describe the structure and delivery of physical activity interventions  across chronic disease conditions and adverse events associated with physical activity . Discussion We anticipate that our results could inform research ers , guideline groups and policymakers of the most efficacious physical activity interventions in preventing and /or managing major chronic disease BACKGROUND Regular physical activity in older adults can facilitate healthy aging , improve functional capacity , and prevent disease . However , factors associated with physical inactivity in older population s are poorly understood . This study attempts to identify social-cognitive and perceived environmental influences associated with physical activity participation in older population s. METHODS In a r and omly selected sample of 449 Australian adults age 60 and older , we assessed self-reported physical activity and a range of social-cognitive and perceived environmental factors . Respondents were classified as sufficiently active and inactive based on energy expenditure estimates ( kcal/week ) derived from self-reported physical activity . Two logistic regression models , with and without self-efficacy included , were conducted to identify modifiable independent predictors of physical activity . RESULTS Significantly more males than females were physically active . Physical activity participation was related to age with a greater proportion of those age 65 - 69 being active than those age 60 - 64 or 70 or older .  High self-efficacy , regular participation of friends and family , finding footpaths safe for walking , and access to local facilities were significantly associated with being active . CONCLUSION Identifying predictors of physical activity in older population s , particularly social support , facility access , and neighbourhood safety , can inform the development of policy and intervention strategies to promote the health of older people OBJECTIVE HIV-infected older adults ( HOA ) are at risk of functional decline . Interventions promoting physical activity that can attenuate functional decline and are easily translated into the HOA community are of high priority . We conducted a r and omized , controlled clinical trial to evaluate whether a physical activity counseling intervention based on self-determination theory ( SDT ) improves physical function , autonomous motivation , depression and the quality of life ( QOL ) in HOA . METHOD In total , 67 community-dwelling HOA with mild-to-moderate functional limitations were r and omized to 1 of 2 groups : a physical activity counseling group or the usual care control group . We used SDT to guide the development of the experimental intervention . Outcome measures that were collected at baseline and final study visits included a battery of physical function tests , levels of physical activity , autonomous motivation , depression , and QOL . RESULTS The study participants were similar in their demographic and clinical characteristics in both the treatment and control groups . Overall physical performance , gait speed , measures of endurance and strength , and levels of physical activity improved in the treatment group compared to the control group ( p < .05 ) . Measures of autonomous regulation such as identified regulation , and measures of depression and QOL improved significantly in the treatment group compared with the control group ( p < .05 ) . Across the groups , improvement in intrinsic regulation and QOL correlated with an improvement in physical function ( p < .05 ) . CONCLUSION Our findings suggest that a physical activity counseling program grounded in SDT can improve physical function , autonomous motivation , depression , and QOL in HOA with functional limitations . ( PsycINFO Data base 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 Acute decompensated heart failure ( ADHF ) is a leading cause of hospitalization in older persons in the United States . Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF . However , these are not addressed by current heart failure ( HF ) management strategies and there has been little study of exercise training in older , frail HF patients with recent ADHF . Hypothesis Targeting physical frailty with a multi‐domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization . Study design REHAB‐HF is a multi‐center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be r and omized either to a novel 12‐week multi‐domain physical rehabilitation intervention or to attention control . The goal of the intervention is to improve balance , mobility , strength and endurance utilizing reproducible , targeted exercises administered by a multi‐disciplinary team with specific milestones for progression . The primary study aim is to assess the efficacy of the REHAB‐HF intervention on physical function measured by total Short Physical Performance Battery score . The secondary outcome is 6‐month all‐cause rehospitalization . Additional outcome measures include quality of life and costs . Conclusions REHAB‐HF is the first r and omized trial of a physical function intervention in older patients with hospitalized ADHF design ed to determine if addressing deficits in balance , mobility , strength and endurance improves physical function and reduces rehospitalizations . It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients , those with ADHF , frailty , and multiple comorbidities BACKGROUND The present review systematic ally evaluates correlates of physical activity across the socio-ecological model for people with depression . SUBJECTS AND METHODS Two independent review ers search ed Embase , PubMed , and CINAHL from their inception until May 2015 , combining the medical subject heading ' depression ' or ' depressive ' with ' physical activity ' or ' exercise ' . Data were extracted by the same independent research ers and summarized according to the socio-ecological model . RESULTS Fifty-nine papers involving 101,539 persons with depression were eligible and enabled us to evaluate 42 correlates . Correlates that were consistently ( n ≥ 4 ) associated with lower physical activity participation in depressed persons were a higher level of depressive symptoms , a higher body mass index , the presence of physical co-morbidity and a lower self-efficacy . The role of social , environmental and policy factors on  physical activity participation is unknown and should be addressed in future research . CONCLUSION In persons with depression  physical activity participation  is a complex behavior that is influenced by many different factors . Significant correlates should be confirmed in prospect i ve studies . Interventions to improve modifiable physical and mental health variables in people with depression should be developed and evaluated Background The majority of North American adult females do not meet current physical activity recommendations ( 150 min of moderate-to-vigorous intensity physical activity ( MVPA ) per week accrued in ≥10 min bouts ) ultimately placing themselves at increased risk of morbidity and mortality . Working-age females face particular challenges in meeting physical activity recommendations as they have multiple dem and s , including occupational , family and social dem and s. To develop effective interventions to increase MVPA among working-age females , it is necessary to identify and underst and the strongest modifiable determinants influencing these behaviours . Therefore , the objective of this systematic review is to examine the available evidence to identify intrapersonal , social and environmental determinants of MVPA among working-age females . Methods / Design Six electronic data bases will be search ed to identify all prospect i ve cohort studies that report on intrapersonal , social and /or environmental determinants of  MVPA  in working-age females . Grey literature sources including theses , published conference abstract s and websites from relevant organizations will also be included . Articles that report on intrapersonal ( e.g. health status , self-efficacy , socio-economic status ( SES ) , stress , depression ) , social environmental ( e.g. crime , safety , area SES , social support , climate and capital , policies ) , and environmental ( e.g. weather , workplace , home , neighbourhood , recreation environment , active transportation ) determinants of MVPA  in a working-age ( mean age 18–65 years ) female population will be included . Risk of bias will be assessed within and across all included studies using the Tool to Assess Risk of Bias in Cohort Studies and the Grade s of Recommendation , Assessment , Development and Evaluation approach . Harvest plots will be used to synthesize results across all determinants , and meta-analyses will be conducted where possible among studies with sufficient homogeneity . Discussion This review will provide a comprehensive examination of evidence in this field and will serve to highlight gaps for future research on the determinants of MVPA in working-age females and ultimately inform intervention design . Systematic review registration PROSPERO : CRD42014009750 BACKGROUND Age-related loss in physiologic capacities contributes to the decline in physical function in the elderly population . Despite the beneficial effects of exercise interventions on maximal physiologic capacity measures , the functional benefits have not been shown in independently living older adults . The objective of this study was to evaluate exercise in independent older adults for significant and meaningful improvements in physical function , not detected by commonly used measures of physical function . METHODS In a r and omized controlled study , 49 independently living men and women were assigned to either a nonexercise control group ( Control ; n = 26 ) or an exercise training group ( Exercise ; n = 23 ) . Participants ( age = 76+/-4 ) in good general health were recruited from retirement communities or apartments . The combined endurance and strength training was performed at 75 % to 80 % intensity ; the groups met 3 times/week for 6 months of supervised sessions . Outcome measures included physical capacity , health status , and physical function using a newly developed performance test -- the Continuous Scale-Physical Functional Performance test ( CS-PFP ) . RESULTS Compared to the Control group , the Exercise group showed significant increases in maximal oxygen consumption ( 11 % ) and muscle strength ( 33 % ) . No significant differences were found between groups for changes in the Sickness Impact Profile , SF-36 scales , or the 6-minute walk . However , the CS-PFP score improved significantly in the Exercise group ( 14 % , effect size 0.80 ) . CONCLUSIONS Independent older adults gain meaningful functional benefits from several months of exercise training . The public health importance of physical activity may relate not just to its role in preventing decline , but also to its role in enhancing physical function Background Despite its well-known benefits for health and well-being physical activity levels are insufficient and declining with age in Germany . Physical activity promotion programs for older adults are often not successful , one reason is insufficient relevance of intervention measures for the study population . Community-based participatory research ( CBPR ) is a possible key strategy for tailoring more meaningful intervention programs to a specific community . However , evidence for the effectiveness of CBPR in the general population is scarce . This study aims to formally evaluate the efficacy of a CBPR approach for developing and implementing an outdoor physical activity program for older adults . Methods / design The OUTDOOR ACTIVE intervention trial is a cluster-r and omised intervention study carried out in a r and om sample of eight subdistricts in the city of Bremen , Germany . The eight subdistricts are grouped into four homogenous pairs with regard to socioeconomic level and l and use mix of the subdistrict . Within the pairs , the subdistricts are assigned r and omly to the two study arms : participatory development and implementation of a community-based program to promote outdoor physical activity ( intervention ) versus no intervention ( controls ) . For evaluation , a survey is carried out before ( baseline ) and after ( follow-up ) the intervention period . The measurements include 7-day accelerometer measurement , physical fitness test , blood pressure , basic anthropometry , and self-administered question naire . Discussion The OUTDOOR ACTIVE intervention trial will provide detailed information on PA intervention for older adults in an urban setting . Through the participatory nature of the study it will provide valuable insights into drivers and barriers to PA in this group , and it will inform policy makers and other stakeholders how to benefit from the results .Trial registration German Clinical Trials Register DRKS00015117 ( Date of registration 17 - 07 - 2018 ) Background Few studies have explored the relations between naturally occurring changes in physical activity and cognitive performance in later life . This study examined prospect i ve associations between changes in physical activity and cognitive performance in a population -based sample of Taiwanese older adults during an 11-year period . Methods Analyses were based on nationally representative data from the Taiwan Health and Living Status of the Elderly Survey collected in 1996 , 1999 , 2003 , and 2007 . Data from a fixed cohort of 1160 participants who were aged 67 years or older in 1996 and followed for 11 years were included .  Cognitive performance ( outcome ) was assessed using 5 questions from the Short Portable Mental Status Question naire . Physical activity ( exposure ) was self-reported as number of sessions per week . The latent growth model was used to examine associations between changes in physical activity and cognitive performance after controlling for sociodemographic variables , lifestyle behaviors , and health status . Results With multivariate adjustment , higher initial levels of physical activity were significantly associated with better initial cognitive performance ( st and ardized coefficient β = 0.17 ) . A higher level of physical activity  at baseline ( 1996 ) was significantly related to slower decline in cognitive performance , as compared with a lower level of activity ( β = 0.22 ) . The association between changes in physical activity and changes in cognitive performance was stronger ( β = 0.36 ) than the previous 2 associations . The effect remained after excluding participants with cognitive decline before baseline . Conclusions Physical activity in later life is associated with slower age-related cognitive decline OBJECTIVES To examine whether activity restriction specifically induced by fear of falling ( FF ) contributes to greater risk of disability and decline in physical function .  DESIGN Prospect i ve cohort study . SETTING Population -based older cohort . PARTICIPANTS Six hundred seventy-three community-living elderly ( > or = 65 ) participants in the Invecchiare in Chianti Study who reported FF . MEASUREMENTS FF , fear-induced activity restriction , cognition , depressive symptoms , comorbidities , smoking history , and demographic factors were assessed at baseline . Disability in activities of daily living ( ADLs ) and instrumental activities of daily living ( IADLs ) and performance on the Short Performance Physical Battery ( SPPB ) were evaluated at baseline and at the 3-year follow-up . RESULTS One-quarter ( 25.5 % ) of participants did not report any activity restriction , 59.6 % reported moderate activity restriction  ( restriction or avoidance of < 3 activities ) , and 14.9 % reported  severe activity restriction  ( restriction or avoidance of > or = 3 activities ) . The severe restriction group reported significantly higher IADL disability and worse SPPB scores than the no restriction and moderate restriction groups . Severe activity restriction was a significant independent predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3-year follow-up . Severe and moderate activity restriction were independent predictors of worsening IADL disability . Results were consistent even after adjusting for multiple potential confounders . CONCLUSION In an elderly population , activity restriction associated with FF is an independent predictor of decline in physical function . Future intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long-term effects on physical abilities and autonomy of older persons
Overall , the effect of physical interventions on physical performance was inconsistent .
Patient tailored interventions , i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not .
Conclusions Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain .
Background To counteract decline in physical performance and physical activity in older patients during hospitalization , multiple physical interventions were developed .
However , it is unknown whether these are effective in this particular population .
This systematic review aim ed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization .