Participants
syncope, shock, stroke, pain, vascular injury, organ damage, disease or injury, major injury
RECRUITMENT, SHOCK, STROKE, DISEASES, INCREASED OXYGEN DEMAND, ELEVATED BLOOD PRESSURE, HEART, HIGH BLOOD PRESSURE
Inclusion criteria were women aged 60 to 80 years living in Khon Kaen who discussed their participation with their community doctor. Although not used as a screening procedure the blood pressure of each participant was measured before the study commenced. In particular, blood pressure was measured by using a Omron HEM-7124 blood pressure monitor (Omron Healthcare Company Limited, Kyoto, Japan). The whole measurement process is almost automatic. The cuff is placed around the bare arm 1 to 2 cm above the elbow joint. The device is then turned on and the cuff inflates automatically to start the measurement, deflates when the measurement has been taken and the blood pressure reading appears automatically on the screen. Mean Arterial Pressure (MAP) is the average pressure in a person’s blood vessels during the cardiac cycle and was estimated by using a formula in which the lower (diastolic) pressure is doubled and added to the higher (systolic) pressure and the composite sum is then divided by three. This calculation accounts for the fact that the period of diastole lasts approximately twice as long as the period of systole. Low MAP can cause inadequate blood flow to organs, syncope and shock and high MAP contributes to increased oxygen demand by the heart, ventricular remodeling, vascular injury, organ damage and stroke. A small number of subjects had elevated blood pressure or high blood pressure of stage 1 or 2 as defined by the American Heart Association but were still encouraged to participate by their doctor on the basis that the low intensity physical exercise could be beneficial for their health and were appropriately monitored, including regular measurement of blood pressure, throughout the study.Participants were also required to have good mental faculties and ability to communicate with the investigators in Thai or another language, normal recognition of people, time and place as tested using the Thai version of the Mini-Mental State Examination. Exclusion criteria were serious joint pain, disease or injury that contra-indicated performance of SSG exercise, history of diseases affecting movement, history of major injury due to a fall in the previous year, smoking or alcohol consumption. Additionally, participants should not have regularly performed physical exercise during the past 6 months.Recruitment of participants proceeded smoothly. This was due to their being great enthusiasm to participate, not only by members of the Exercise group but also by members of the Control group who knew that they would be offered the SSG training, albeit without recording of outcome measures, later in the study. Entry to the study was on a first come first served basis in each group and, provided that the subject who had signed up met the relevant inclusion and exclusion criteria, they were enrolled. The target of 28 participants in each group was achieved within 2 weeks of the invitation being given to the Community and there were no dropouts.