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Stronger Bodies, Sharper Minds: Promoting Wellness In Community-Dwelling Older Adults Through Exercise And Health Education, Michael Webb

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Due to the increasing population of older adults, the need for health promotion and wellness-based interventions that support effective participation in their respective occupations is essential. Literature supports that engaging in physical activity, health education, and social participation are critical factors in increasing the quality and longevity of life among community-dwelling older adults. A doctoral capstone project was conducted at a community-based day program for low-income older adults to promote wellness, engagement, and continued participation in meaningful occupations.

The purpose of this project was to design and implement group sessions consisting of therapeutic exercise and health education to integrate education, …

Relative Impact Of Multidomain Lifestyle Interventions On Deficit Accumulation Frailty Over 24 Months In The U.S. Pointer Trial, Mark A Espeland, Kayloni Olson, Christy C Tangney, Darren R Gitelman, Maryjo Cleveland, Amber A Thro, Yitbarek N Demesie, Heather M Snyder, Rachel A Whitmer, Pankaja Desai, Rifat Alam, Lucia Crivelli, Thomas M Holland, Olivia Preissle, Rema Raman, Michele K York, Laura D Baker

Faculty, Staff and Students Publications

Background: Multidomain lifestyle interventions hold promise as approaches to slow aging. Deficit accumulation frailty indices (FIs) are increasingly used to capture aging processes. Frailty is highly associated with increased mortality and chronic disease risk, but the degree to which multidomain lifestyle changes impact frailty is not clear.

Methods: The U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk (U.S. POINTER) was a 2-year randomized clinical trial to compare two multidomain lifestyle interventions designed to increase exercise, improve diet, and promote social and cognitive stimulating activities and health monitoring. The Structured intervention incorporated greater structure, intensity, and accountability …

Associations Of Moderate-To-Vigorous Physical Activity Timing With Type 2 Diabetes Incidence In Uk Biobank And Prevalent Glycemic Measures In Nhanes, Qiuyu Feng, Gali Albalak, Linjun Ao, Qian Xiao, Heming Wang, Jeroen H P M Van Der Velde, Jessica C Kiefte-De Jong, Martin K Rutter, Charles E Matthews, Joshua R Freeman, Ko Willems Van Dijk, Diana Van Heemst, Raymond Noordam

Faculty, Staff and Student Publications

Objective: We assessed the association between timing of moderate-to-vigorous physical activity (MVPA) with incident type 2 diabetes (T2D) and glycemic measures.

Research design and methods: Regression models were used to assess associations between accelerometer-derived MVPA timing and incident T2D in UK Biobank (UKB) (n = 84,528, prospective), prevalent diabetes, and glycemic measures in the National Health and Nutrition Examination Survey (NHANES) (n = 6,998, cross-sectional).

Results: In UKB, with early morning (0500-0959) MVPA as reference and before adjustment for total MVPA, "variable-timing" MVPA was associated with the lowest incident T2D risk; while after adjustment, afternoon-evening MVPA (1500-2400) showed the lowest …

The Impact Of Education And Awareness In Influencing Lifestyle Behaviors That Prevent And Treat Sarcopenia In Older Adults: A Mixed-Methods Cross-Sectional Research Study, Alan Lynn Jones

Doctoral Dissertations and Projects

This mixed-methods, cross-sectional study assessed the current level of knowledge and awareness among people aged 50 and older about sarcopenia, as well as their willingness to adopt lifestyle changes that could prevent or reverse the condition as they age. The study aimed to determine whether a lack of awareness and knowledge is linked to current lifestyle behaviors that contribute to or protect against the development of the disease. The population included men and women 50 and older, living independently in the community with no prior diagnosis of sarcopenia. The study used a custom-designed questionnaire and semi-structured interviews. A total of …

Exercise As A Treatment For Depression And Anxiety Symptoms In College Students, Ashley J. Fountain

ATU Honors Projects

Anxiety and depression have become increasingly prevalent among college students, with rates rising to levels that demand urgent and accessible treatment alternatives. Traditional interventions such as psychotherapy and pharmacological treatments, while effective for many, present limitations including high cost, side effects, and barriers to access. This paper examines exercise as a holistic, evidence-based treatment modality for reducing symptoms of depression and anxiety in college students. Recent research demonstrates that aerobic exercise, resistance training, and yoga each produce meaningful physiological and psychological benefits through mechanisms involving neurotransmitter regulation, reduced cortisol levels, and enhanced self-esteem. Studies comparing exercise with antidepressant medications show …

An Interdisciplinary Functional Exercise Program For Individuals With Parkinson’S Disease: A Case Series, Lauren Turbeville, Caroline Adams, Amy Wedge, Kailey Smitherman, Kathrin Rothermich

The Open Journal of Occupational Therapy

Background: Traditional exercise programs are beneficial in managing Parkinson’s disease (PD). Little research exists on interdisciplinary, functional exercise programs designed and implemented by licensed therapists.

Method: Our case series presents the development, implementation, and results of an interdisciplinary functional exercise program for individuals with PD and the effects this program had on daily functioning and quality of life. Participants were recruited via flyers, email, and phone communication, and consented to data collection for our objectives. Participants attended two sessions per week for 8 weeks. Sessions addressed fine and gross motor skills, dexterity, cognition, functional strength, gait, balance, and …

Bone Quality Response To Lifestyle Intervention In Older Adults With Obesity (Limb-Q Trial): A Randomised Controlled Trial, Giulia Gregori, Sanjay Mediwala, Michael Liebschner, Daeseung Kim, Mon S Bryant, Nina Klonis, Reina Armamento-Villareal, Clifford Qualls, Dennis T Villareal

Faculty, Staff and Students Publications

Background: Lifestyle interventions for weight loss might exacerbate age-related bone loss and osteoporosis. However, there is limited knowledge about their effects on bone quality. We examined whether lifestyle intervention can preserve or enhance bone quality, despite reductions in bone mineral density.

Methods: The Lifestyle Intervention to Improve Bone Quality (LIMB-Q) study was a randomised controlled trial conducted at Baylor College of Medicine and the Michael E DeBakey VA Medical Center (Houston, TX, USA) including older adults (aged 65-85 years) with obesity (BMI ≥30 kg/m2). Participants were randomly assigned to receive either an intensive lifestyle intervention (intensive lifestyle group, consisting of …

Optimising Exercise For Managing Chemotherapy-Induced Peripheral Neuropathy In People Diagnosed With Cancer, Dhiaan Sidhu, Jodie Cochrane Wilkie, Jena Buchan, Kellie Toohey

Research outputs 2022 to 2026

Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise current evidence on exercise interventions for managing chemotherapy-induced peripheral neuropathy and provide practical insights to support clinicians in integrating these approaches into patient care. Methods: A search was conducted across MEDLINE, CINAHL, and SPORTDiscus using keywords related to exercise and CIPN. Studies were included if they involved adults receiving neurotoxic chemotherapy and exercise-based interventions. Two authors independently …

Physical Activity Mediates Age Differences In Cognition Among Tsimane Forager-Horticulturalists, Phoebe E. Imms, Nikhil N. Chaudhari, Daniel Cummings, Daniel Eid Rodriguez, Giuseppe Barisano, Paul L. Hooper, M. Katherine Sayre, Edmond Seabright, Randall C. Thompson, M. Linda Sutherland, James D. Sutherland, Benjamin C. Trumble, Michael Gurven, Jonathan Stieglitz, Caleb E. Finch, Hillard S. Kaplan, Wendy J. Mack, Margaret Gatz, Andrei Irimia

ESI Publications

Background: The Tsimane and Moseten of the Bolivian Amazon are highly physically active and exhibit low rates of cognitive impairment and brain atrophy.

Methods: We use structural equation modelling to examine how their physical activity levels mediate the relationship between (1) age and cognition, and (2) age and cognition via brain volume (BV).

Results: Tsimane males (n = 305, mean ± SD age = 59.94 ± 9.68) and Tsimane females (n = 265, mean ± SD age = 59.28 ± 9.79) exhibit significantly higher levels of physical activity than Moseten males (n = 106, mean ± SD …

Patient-Centered, Theory-Based, Online Intervention To Promote A Physically Active Lifestyle For People With Multiple Sclerosis: Protocol For A Randomized Controlled Trial, Chungyi Chiu, Vaishnavi Sridharan, Mojtaba Khaliji, Md Refat Uz Zaman Sajib, Xiaotian Gao, Kathleen Zackowski

Children’s Nutrition Research Center Staff Publications

Background: People with multiple sclerosis (MS) experience life challenges due to the nature of disease progression. Although an active lifestyle has been shown effective for symptom and relapse management, most people with MS lead a sedentary lifestyle and do not reach the recommended physical activity (PA) guidelines.

Objective: This study aims to test the preliminary efficacy of a codeveloped, online self-management intervention based on the health action process approach (HAPA) adapted for people with MS to cultivate a physically active lifestyle.

Methods: The 8-week intervention program was developed using community-based participatory research based on the HAPA. The program includes increasing …

Improving Brain Health: Exercise As A Tool For Enhancing Executive Function And Reducing Stress In Older African Americans, Destiny Ellise Ramos

Theses, Dissertations and Culminating Projects

Older African American (AA) adults face disproportionately higher risk of stress and Alzheimer's Disease and Related Dementias (ADRD) compared to other racial and ethnic groups, yet they remain underrepresented in intervention-based research. Previous research has suggested aerobic exercise may reduce stress and benefit executive functioning, which is among the first cognitive domains to be affected in ADRD; however, no studies to date have directly tested the impact of aerobic vs. non-aerobic exercise in older AAs at high risk for developing ADRD. The current study evaluated the effects of a group-based cardio dance fitness (CDF) exercise intervention versus a strength, flexibility, …

Multi-Omic Analysis Of Biological Aging Biomarkers In Long-Term Calorie Restriction And Endurance Exercise Practitioners: A Cross-Sectional Study, Giovanni Fiorito, Valeria Tosti, Silvia Polidoro, Beatrice Bertozzi, Nicola Veronese, Edda Cava, Francesco Spelta, Laura Piccio, Dayna S Early, Daniel Raftery, Paolo Vineis, Luigi Fontana

2020-Current year OA Pubs

Calorie restriction (CR) and physical exercise (EX) are well-established interventions known to extend health span and lifespan in animal models. However, their impact on human biological aging remains unclear. With recent advances in omics technologies and biological age (BioAge) metrics, it is now possible to assess the impact of these lifestyle interventions without the need for long-term follow-up. This study compared BioAge biomarkers in 41 middle-aged and older adult long-term CR practitioners, 41 age- and sex-matched endurance athletes (EX), and 35 sedentary controls consuming Western diets (WD), through PhenoAge: a composite score derived from nine blood-biomarkers. Additionally, a subset of …

Barriers To Exercise For Individuals With Developmental Disabilities, Mark Fleming

Doctorate in Kinesiology

Individuals with developmental disability have been known to be less physically active and more prone to obesity than the rest of the population. One way to understand this is to examine the barriers that these individuals perceive to prevent them from getting the proper amount of exercise. An online survey was conducted to determine whether previously known barriers significantly affected these individuals' perceptions. The survey consisted of 513 individuals who identified as having Attention Deficit Hyperactivity Disorder, Autism, Cerebral Palsy, Down Syndrome, or being a parent/caregiver. The barriers they were asked about were time, cost, transportation, energy, and interest. It …

Associations Of Parental Perceived Health With Child Movement Behaviors Within Two-Parent Households, You Fu, Hayley Almes, Nora Constantino, Doria Schmidt, Ryan D. Burns

International Journal of Physical Activity and Health

This study aimed to examine how perceived parental mental and physical health status was associated with child physical activity, screen time, and sleep. Participants were 6- to 17-year-old minors (N = 20,156; 47.9% female) from the 2022 US National Survey of Children’s Health. Dependent variables were children’s physical activity frequency, screen time, and sleep. Independent variables were parents’ physical and mental health status. Using the Actor-Partner Interdependence Model, two adjusted path models were constructed. One for parent mental health associating with parental physical health, another for parent physical health associating with parental mental health–both further associating with child movement behaviors. …

Associations Between Deficit Accumulation Frailty And Baseline Markers Of Lifestyle In The Us Pointer Trial, Mark A Espeland, Yitbarek N Demesie, Kayloni Olson, Samuel N Lockhart, Sarah E Tomaszewski Farias, Maryjo L Cleveland, Christy C Tangney, Lucia Crivelli, Heather M Snyder, Michele K York, Laura D Baker, Rachel A Whitmer, Rena R Wing, Katelyn R Garcia, Kathryn E Callahan

Faculty, Staff and Students Publications

BACKGROUND: Multidomain lifestyle interventions may have the potential to slow biological aging as captured by deficit accumulation frailty indices. We describe the distribution and composition of the 49-component frailty index developed by the U.S. POINTER clinical trial team of investigators and assess its cross-sectional associations with sociodemographic factors and markers chosen to be representative of behaviors targeted by the trial's multidomain interventions.

METHODS: We draw baseline data from the 2 111 volunteers enrolled in U.S. POINTER who were ages 60-79 years and at increased risk for cognitive decline. Frailty components were grouped into 9 domains. Associations that frailty index scores …

Assessing Older Adults’ Readiness For Adopting Fall Prevention Recommendations Using The Transtheoretical Stages Of Change, Janice Mark, Ankita Henry, Briana Moreland, Dawson Dobash, Gwendolyn Bergen

Nursing and Health Professions Faculty Research and Publications

Objectives: Reducing fall risk requires older adults (age 65+) to adopt effective prevention strategies. This study has three aims: 1) understand Stage of Change (SOC) for three fall prevention strategies; 2) determine strategies older adults’ use; and 3) understand which characteristics relate to readiness to take action.

Methods: A survey of 1063 older adults assessed fall risk, SOC, and use of fall prevention strategies. Data analysis included descriptive statistics and regression analysis.

Results: The most common SOC for older adults by strategy was action for overall fall prevention (61%), contemplation for medication management (45%) and preparation and …

Impact Of Aerobic Exercise On Cardiometabolic Health In Patients With Diabesity: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Sameer Badri Al-Mhanna, Barry A. Franklin, John M. Jakicic, Emmanuel Stamatakis, Linda S. Pescatello, Deborah Riebe, Walter R. Thompson, James S. Skinner, Sheri R. Colberg, Jonathan K. Ehrman, George S. Metsios, Norsuhana Omar, Nouf H. Alkhamees, Bodor Bin Sheeha, Abdullah F. Alghannam, Alexios Batrakoulis

Human Movement Studies & Special Education Faculty Publications

Purpose

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity).

Methods

PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity.

Results

A total of 1391 middle-aged/older adult patients (55 % females) were included …

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

Impact Of Low-Load Resistance Exercise With And Without Blood Flow Restriction On Muscle Strength, Endurance, And Oxidative Capacity: A Pilot Study, Brett H. Davis, James E. Stampley, Joshua Granger, Matthew C. Scott, Timothy D. Allerton, Neil M. Johannsen, Guillaume Spielmann, Brian A. Irving

Clinical Research Faculty Publications

Low-load resistance exercise (LLRE) to failure can increase muscle mass, strength, endurance, and mitochondrial oxidative capacity (OXPHOS). However, the impact of adding blood flow restriction to low-load resistance exercise (LLBFR) when matched for volume on these outcomes is incompletely understood. This pilot study examined the impact of 6 weeks of single-legged LLBFR and volume-matched LLRE on thigh bone-free lean mass, strength, endurance, and mitochondrial OXPHOS. Twenty (12 males and 8 females) untrained young adults (mean ± SD; 21 ± 2 years, 168 ± 11 cm, 68 ± 12 kg) completed 6 weeks of either single-legged LLBFR or volume-matched LLRE. Participants …

Does Breaking Up Moderate Intensity Continuous Exercise Into Accumulated Bouts Improve Postprandial Metabolic Outcomes In Middle Aged And Older Adults?, Miranda Janis

Masters Theses, 2020-current

Due to the high incidence of CVD in older adults, low levels of habitual physical activity, and poor dietary habits, it is imperative to determine an effective minimal dose of exercise that is attainable to mitigate adverse postprandial (post-meal) responses. This study is the first to our knowledge to assess whether accumulated exercise to expend 25% of the calories consumed in a high-fat meal (HFM) of moderate intensity walking will lower postprandial triglycerides (TRG), glucose (GLU) and metabolic load index (MLI: summation of GLU and TRG), compared to continuous exercise, in middle-aged and older adults (OA). Methods: Ten OA (n=10, …

Physical Activity Patterns Within Dementia Care Dyads, N Farina, R Mcardle, Rg Lowry, S Banerjee

Peninsula Medical School

Previous research has explored the physical activity habits of people with dementia and their family carers separately, with little consideration of how physical habits are associated within dyads. In this observational study, we sought to explore the relationship between people with dementia and their carers' physical activity, at a group level and at a dyadic level. Twenty-six participant dyads (persons with dementia and their carer spouses) were asked to wear an accelerometer for 30 days continuously. Comparisons were made at a group level and a dyadic level. People with dementia did not participate in significantly more moderate to vigorous physical …

Improvement Of Hypertension Self-Care Management In African American Older Adults With Uncontrolled Hypertension Through Shared Decision-Making, Sigga Jobe

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension affects nearly half of the population in the U.S., with the prevalence disproportionately higher in African Americans (Centers for Disease Control and Prevention [CDC], 2023). Complications of uncontrolled hypertension, such as cardiovascular disorders and stroke, increase with age, prompting the importance of controlling high blood pressure in older adults. African American older adults are at higher risk of developing uncontrolled hypertension and related complications due to the lack of healthcare access, financial constraints leading to the inability to access healthier food choices, exercise capabilities, weight control, adherence to recommended medications, and knowledge deficit.

Methods: This project focused on …

The Effect Of Intermittent Fasting, Caloric Restriction And Exercise On Aging And Longevity: Systematic Review, Romi Hardin

Honors Undergraduate Theses

The purpose of this study was to gain a better understanding of the effects of caloric restriction, intermittent fasting, and exercise on human longevity and aging, and explore their practical applications and inclusions into a healthy lifestyle. By reviewing the existing research and studies, this literature review focuses on identifying and explaining the biological mechanism behind these practices and exploring whether combining practices can be advantageous in extending not only lifespan but health span. The results generally indicate that following either caloric restriction or intermittent fasting and participating in regular exercise have immense results on promoting healthy aging in an …

Analyzing Sex Differences In Human Performance Through 3d Isotonic Resistance, Jacob M. Cunha

University of the Pacific Theses and Dissertations

Appraisal of scientific literature and understanding continues to grow in the domain of human performance. The effects of sex on concentric resistance training and power output are not well understood. Recent advancements in technology permit more precise measurements of force output and the kinematic changes elicited by training stress. A unique device in capturing kinematic performance output is Proteus Motion. The machine produces an external magnetic load through a protruding apparatus connected to a gyrosphere, which in turn captures concentric movement through all three planes of movement (sagittal, coronal, transversal). The aim of this study is to investigate power output …

Psychosocial Factors Associated With Physical Activity In People With Dementia: A Pilot Cross-Sectional Study, Nicolas Farina, Uzma Niazi, Riona Mc Ardle, Johanna Eronen, Ruth Lowry, Sube Banerjee

Peninsula Medical School

Objectives: To understand how psychosocial factors associated with physical activity differ based on disease severity in people with dementia, and how these factors are associated with physical activity participation. Methods: Eighty-seven people with dementia, alongside their family carer were asked to complete a series of questions related to physical activity participation, including barriers, motivators, and facilitators. Regression models were developed to understand how psychosocial factors were associated with physical activity participation in the cohort. Results: In the final models, only the absence of intrapersonal barriers was associated with overall physical activity and regular moderate-to-vigorous physical activity. Feelings of relatedness were …

Effects Of Aging On Post-Exercise Oxygen Consumption: A Preliminary Study, Steven Klepacz

Health, Exercise, and Sports Sciences ETDs

Aging and excess post-exercise oxygen consumption (EPOC) is something that has not been adequately studied. Studies looking at EPOC mostly are compiled of young college age individuals. Aging in humans is a topic of much research with still more to be learned. The study in this paper attempts to answer the question of whether age affects EPOC when performing a certain exercise. Preliminary findings based on general age-related research suggest the possibility. This thesis will explore the current research related to age and EPOC, analyze the findings, and discuss additional avenues for future research.

Effects Of Progressive Functional Ankle Exercises In Spastic Cerebral Palsy, Plantarflexors Versus Dorsiflexors: A Randomized Trial, Melek Volkan Yazici, Gamze Çobanoğlu, Gökhan Yazici, Bülent Elbasan

Turkish Journal of Medical Sciences

Background/aim: Children with cerebral palsy (CP), even those who have very mild impairment, have lower muscle strength than their typically developing peers. The ankle dorsiflexors (DFs) and plantarflexors (PFs) of children with CP are especially weak. Weakness in the ankle muscles causes problems in functional skills, mobility, and balance in spastic CP (SCP). The aim of this study was to investigate the effects of progressive functional exercises (PFEs) on the DF, PF, or dorsi-plantar flexor (DPF) muscles in children with SCP, specifically, the functional mobility, balance, and maximum voluntary contraction (MVC), and compare the effects of strengthening these muscles individually …

Relationship Between Reward-Related Brain Activity And Opportunities To Sit, Juliana O. Parma, Mariane F. B. Bacelar, Daniel A. R. Cabral, Robyn S. Recker, Dan Orsholits, Olivier Renaud, David Sander, Olav E. Krigolson, Matthew W. Miller, Boris Cheval, Matthieu P. Boisgontier

Kinesiology Faculty Publications and Presentations

The present study tested whether energy-minimizing behaviors evoke reward-related brain activity that promotes the repetition of these behaviors via reinforcement learning processes. Fifty-eight healthy young adults in a standing position performed a task where they could earn a reward either by sitting down or squatting while undergoing electroencephalographic (EEG) recording. Reward-prediction errors were quantified as the amplitude of the EEG-derived reward positivity. Results showed that reward positivity was larger on reward versus no reward trials, confirming the validity of our paradigm to measure evoked reward-related brain activity. However, results showed no evidence that sitting (versus standing and squatting) trials led …

Strength Training Is More Effective Than Aerobic Exercise For Improving Glycaemic Control And Body Composition In People With Normal-Weight Type 2 Diabetes: A Randomised Controlled Trial, Yukari Kobayashi, Jin Long, Shozen Dan, Neil M. Johannsen, Ruth Talamoa, Sonia Raghuram, Sukyung Chung, Kyla Kent, Marina Basina, Cynthia Lamendola, Francois Haddad, Mary B. Leonard, Timothy S. Church, Latha Palaniappan

Clinical Research Faculty Publications

Aims/hypothesis: Type 2 diabetes in people in the healthy weight BMI category (< 25 kg/m2), herein defined as ‘normal-weight type 2 diabetes’, is associated with sarcopenia (low muscle mass). Given this unique body composition, the optimal exercise regimen for this population is unknown. Methods: We conducted a parallel-group RCT in individuals with type 2 diabetes (age 18–80 years, HbA1c 47.5–118.56 mmol/mol [6.5–13.0%]) and BMI < 25 kg/m2). Participants were recruited in outpatient clinics or through advertisements and randomly assigned to a 9 month exercise programme of strength training alone (ST), aerobic training alone (AER) or both interventions combined (COMB). We used stratified block randomisation with a randomly selected block size. Researchers and caregivers were blinded to participants’ treatment group; however, participants themselves were not. Exercise interventions were conducted at community-based fitness centres. The primary outcome was absolute change in HbA1c level within and across the three groups at 3, 6 and 9 months. Secondary outcomes included changes in body composition at 9 months. Per adherence to recommended exercise protocol (PP) analysis included participants who completed at least 50% of the sessions. Results: Among 186 individuals (ST, n=63; AER, n=58; COMB, n=65) analysed, the median (IQR) age was 59 (53–66) years, 60% were men and 83% were Asian. The mean (SD) HbA1c level at baseline was 59.6 (13.1) mmol/mol (7.6% [1.2%]). In intention-to-treat analysis, the ST group showed a significant decrease in HbA1c levels (mean [95% CI] −0.44 percentage points [−0.78, −0.12], p=0.002), while no significant change was observed in either the COMB group (−0.35 percentage points, p=0.13) or the AER group (−0.24 percentage points, p=0.10). The ST group had a greater improvement in HbA1c levels than the AER group (p=0.01). Appendicular lean mass relative to fat mass increased only in the ST group (p=0.0008), which was an independent predictor of HbA1c change (beta coefficient −7.16, p=0.01). Similar results were observed in PP analysis. Only one adverse event, in the COMB group, was considered to be possibly associated with the exercise intervention. Conclusions/interpretation: In normal-weight type 2 diabetes, strength training was superior to aerobic training alone, while no significant difference was observed between strength training and combination training for HbA1c reduction. Increased lean mass relative to decreased fat mass was an independent predictor of reduction in HbA1c level. Trial registration: ClinicalTrials.gov NCT02448498. Funding: This study was funded by the National Institutes of Health (NIH; R01DK081371). Graphical Abstract: [Figure not available: see fulltext.].

Impact Of 10-Week Evidence–Based Falls Prevention Program On Outcomes Related To Falls Risk In Community-Dwelling Older Adults, Mark A. Schafer, Paula Upright, Jana Michalik, K. Jason Crandall

International Journal of Exercise Science

International Journal of Exercise Science 16(7): 1131-1141, 2023. This quasi-experimental study evaluated the impact of a 10-week evidence-based falls prevention program (Bingocize®) on self-reported fear of falling, general health, physical activity, social isolation, and avoidance behavior, in community-dwelling older adults in Virginia. Participants > 60 years of age (n= 481) attended Bingocize® group sessions twice per week for 10 weeks. The program combined conventional bingo with periodic strength, balance, flexibility exercises, and fall prevention education. Pre and post assessments gauged participants' self-perception of fear of falling, general health, physical activity, social isolation, and avoidance behavior. 481 participants attended at least 80% …