Artykuł zawiera 20832 znaki ze spacjami + grafika

WELLNESS AND AGE
CHAPTER XI
1
Department of Anatomy, Wroclaw Medical University
Katedra i Zakład Anatomii Człowieka,
Uniwersytet Medyczny we Wrocławiu
2
Department of Biostructure, University of Physical Education in Wroclaw
Katedra Biostruktury, Akademia Wychowania Fizycznego we Wrocławiu
3
Academy of Physioterapy in Wroclaw
Wyższa Szkoła Fizjoterapii z siedzibą we Wrocławiu
4
Physioterapy and Prevention Center SALUBER in Wroclaw
Ośrodek Profilaktyki i Rehabilitacji SALUBER we Wrocławiu
ROHAN ANNA1, FUGIEL JAROSŁAW2, BURACZYŃSKA SANDRA3,
KOWALSKI HENRYK4, PINKOWSKA AGNIESZKA1,
GWORYS BOHDAN1
Fitness effects of resistance tube exercise
in women over 60 years of age
Efekty ćwiczeń z wykorzystaniem elastomerów
u kobiet po 60 roku życia
Słowa kluczowe: ćwiczenia auksotoniczne, kobiety starsze, efekty treningu
Key words: auxotonic exercises, older women, effects of training
INTRODUCTION
Many European countries have rapidly aging populations. For example, current
estimates in Poland project that 35% of the population in 2050 will be in older age
(GUS). This shift in demographics has instigated wide-scale research on how to
improve the quality of life of this increasing age group. One area of focus has been
the role of physical activity and its recognition as an essential component of a healthy lifestyle [6, 21]. The literature unequivocally states that systematic exercise,
performed at an appropriate intensity and volume, improves physical fitness and
health [7, 9, 19]. These effects have been observed across all life stages. As a result,
WELLNESS AND AGE
in recent years there has been an upsurge of interest in the application of various
exercise modalities and protocols in older adults [, 8, 13, 14, 16, 27]. Most focus
primarily on enhancing physical fitness, as the aging process involves an inevitable
decrease in function and the onset of numerous physiological limitations [20, 24, 25,
33]. However, research has indicated that the rate of aging differs between individuals [21]. Regardless of chronological age and its non-correlation with biological age,
interventions involving regular physical activity are conducive to the anti-aging
process [4, 14]. Exercise induces a number of beneficial structural and functional
adaptations that can be observed in tissue composition and measures of performance
and physical fitness. In addition, individuals who frequently exercise show improved
well-being and greater living independence and autonomy, factors of considerable
importance among older adults [2, 5, 29, 30, 32].
While the literature has confirmed the applicability of various forms of physical
activity in improving physical fitness in older populations [7, 9, 19, 27], interventions to promote physical activity among older adults are marked with complications. Old age is a period marked with significant differences in motor function
between individuals. Another issue is that some older individuals are reluctant to
engage in new forms of exercise or increase physiological effort [22, 27]. Therefore,
the types of exercises introduced to seniors need to be properly selected and modulated. However, while physical activity interventions in older adults frequently involve
a wide share of exercises, there is a paucity of information if the applied exercise
induces similar adaptations.
Senior fitness classes enhance motor performance by executing a range of exercises and routines, although their selection is frequently dependent on local spatial constraints, the adopted program, and therapist experience. The aim of this study was to
assess the effects of general fitness program involving resistance tube (band) exercises
in older women and compare them with an age-matched control group executing a
traditional general fitness program.
MATERIAL
The study was conducted in 2015 and involved two groups of women over 60
years of age. The first group involved 41 participants (mean age 72.3) attending the
Saluber Health Clinic and the second group involved 41 participants (mean age 74.3
years) from the Community Social Center, both in the city of Wrocław, Poland. The
groups did not significantly differ in age. The inclusion criterion was good overall
health. Participants were excluded if they presented any contraindications for exercise testing as determined by their doctor. Informed consent to voluntarily participate
in the study was obtained. The study procedures were explained in full during an
interview in which health status was confirmed.
METHODS
The study was conducted over a period of 12 weeks in which both groups attended fitness classes twice a week in the morning. The duration of each class was 60
min and led by a physical therapist. The first group (TUBE) from the Saluber Health
138
Rohan Anna, Fugiel Jarosław, Buraczyńska Sandra, Kowalski Henryk,
Pinkowska Agnieszka, Gworys Bohdan
Fitness effects of resistance tube exercise in women over 60 years of age
Clinic performed exercises with the use of the Pragma resistance tube device [35] as
part of a comprehensive fitness program designed by the authors. The second group
(GEN) from the Community Social Center performed general conditioning exercises
that involved gymnastics elements.
Pre- and post-intervention fitness was assessed with the Senior Fitness Test (Fullerton Functional Fitness Test) [25]. Only four items measuring strength and endurance were selected from this test battery as the remaining two items only examined
flexibility, a component not included in either group’s exercise programs. These
four items were the:
– Arm Curl Test (n) of upper body strength (dominant arm),
– Chair Stand Test (n) of lower body strength,
– 8-Foot Up and Go Test (s) of agility and dynamic balance,
– and the 2-Min Step in Place Test of aerobic fitness.
The test battery was administered before the 12-week program was scheduled to
begin and 1 day after its conclusion.
The normality of the distribution was confirmed using the Kolmogorov–Smirnov
test after which basic descriptive statistics were calculated including min and max,
mean ( x ), and standard deviation (s) values. Repeated measures analysis of variance (ANOVA) was used to compare group means. Statistically significant results
were analyzed post-hoc with Tukey's honest significant difference (HSD) test. The
significance level for all statistical procedures was set at α = 0.05. Data processing
was performed with the Statistica 9.1 software package.
RESULTS
Between-group comparisons revealed that upper body strength was significantly
higher in the resistance tube exercise group (TUBE) in pre- and post-intervention
testing. However, significant improvements were observed in both groups although
in group GEN this difference was of a greater magnitude (Tab. I–IV, Fig. 1).
A similar relationship was found in lower body strength, in which the TUBE
group showed greater improvement. The increase in the number of post-intervention
chair stands was significant in both groups although the improvement (Tab. I–IV,
Fig. 2).
The same was observed in the 8-Foot Up and Go Test, in which the TUBE group
achieved significantly better results than the GEN group. Significantly shorter times
to finish were observed in both pre- and post-intervention testing although the magnitude was similar in both groups (Tab. I–IV, Fig. 3).
The fourth test on aerobic fitness also indicated that the TUBE group achieved
significantly better results than the GEN group in both pre- and post-intervention
testing. One change from the previous testing was that while the improvement between time points was significant in group TUBE, no significant differences in group GEN were observed (Tab. I–IV, Fig. 4).
139
WELLNESS AND AGE
Mean ± 0,95 conf idence interv al
28
SALUBER Group
MCUS Group
26
24
Arm Curl [n]
22
20
18
16
14
12
pre-
post-
Fig. 1. Descriptive characteristics of pre- and post-intervention
Arm Curl Test results
Mean ± 0,95 conf idence interv al
19
SALUBER Group
MCUS Group
18
17
16
Chair Stand [n]
15
14
13
12
11
10
9
8
pre-
post-
Fig. 2. Descriptive characteristics of pre- and post-intervention
Chair Stand Test results
140
Rohan Anna, Fugiel Jarosław, Buraczyńska Sandra, Kowalski Henryk,
Pinkowska Agnieszka, Gworys Bohdan
Fitness effects of resistance tube exercise in women over 60 years of age
Mean ± 0,95 conf idence interv al
22
SALUBER Group
MCUS Group
20
8-Foot Up and Go [s]
18
16
14
12
10
8
6
4
pre-
post-
Fig. 3. Descriptive characteristics of pre- and post-intervention 8-Foot Up
and Go Test results
Mean ± 0,95 conf idence interv al
75
SALUBER Group
MCUS Group
70
65
2-Min Step in Place [n]
60
55
50
45
40
35
30
25
20
pre-
post-
Fig. 4. Descriptive characteristics of pre- and post-intervention 2-Min Step
in Place Test results
141
WELLNESS AND AGE
Tab. I. Descriptive characteristics of pre- and post-intervention physical fitness
in the resistance tube exercise group (TUBE)
Test
Time point
PreArm Curl Test [n]
PostPreChair Stand Test [n]
PostPre8-Foot Up and Go Test [s]
PostPre2-Min Step in Place [n]
Post-
x
21.9
23.7
14.2
16.4
9.6
8.3
58.3
62.2
s
4.3
4.0
3.9
4.1
3.5
2.9
15.0
15.1
Min
13.0
17.0
4.0
5.0
5.3
5.0
19.0
22.0
Max
30.0
32.0
25.6
22.2
22.3
18.3
83.0
90.0
Tab. II. Descriptive characteristics of pre- and post-intervention physical fitness in the general conditioning exercise group (GEN)
Test
Arm Curl Test [n]
Chair Stand Test [n]
8-Foot Up and Go Test [s]
2-Min Step in Place [n]
Time point
PrePostPrePostPrePostPrePost-
x
15.4
16.0
10.4
11.1
19.3
18.3
28.8
28.3
s
4.6
4.7
4.1
3.9
5.2
4.5
11.7
10.9
Min
6.0
5.0
5.0
5.0
10.6
10.0
7.0
8.0
Max
26.0
26.0
21.0
20.0
30.2
25.9
50.0
53.0
Tab. III. Main effects and interactions of two-way ANOVA
Test
Group
Arm Curl Test
Chair Stand Test
8-Foot Up and Go Test
2-Min Step in Place
F
54.703
68.311
156.14
117.99
p
0.0000
0.0000
0.0000
0.0000
Main effects
Time point
Group x Time point
F
P
F
p
43.625 0.0000 10.466 0.0018
68.322 0.0000 24.879 0.0000
26.714 0.0000 4.006 0.0487
23.508 0.0000 39.860 0.0000
Statistically significant differences at p < 0.05 are marked in bold
Tab. IV. Post-hoc analysis of significant differences in group fitness test means
TUBE – GEN
Pre
Post
Arm Curl Test
0.0002 0.0002
Chair Stand Test
0.0002 0.0002
8-Foot Up and Go Test 0.0001 0.0001
2-Min Step in Place
0.0002 0.0002
Test
Pre – Post
TUBE
GEN
0.0002 0.0887
0.0002 0.0887
0.0006 0.0112
0.0002 0.7290
Statistically significant differences at p < 0.05 are marked in bold
142
Rohan Anna, Fugiel Jarosław, Buraczyńska Sandra, Kowalski Henryk,
Pinkowska Agnieszka, Gworys Bohdan
Fitness effects of resistance tube exercise in women over 60 years of age
DISCUSSION
While the effects of senescence are inevitable, the decreases in physical fitness and
motor function with age are largely dependent on lifestyle [6, 22]. The literature has
confirmed the benefits of physical activity in aging adults. Increased physical activity
shows a number of protective effects on age-related functional limitations, and an active
lifestyle is considered to be one of the main factors significantly affecting the health,
independence, and quality of life of older individuals [10, 16]. Research finds that the
long-term effects of exercise are the most beneficial in terms of improving independent
living and quality of life in older adults [31]. However, exercise frequency and intensity
decrease with age, commonly explained by this population's reluctance to perform exercise or overexert themselves [11]. Therefore, it is important to motivate older individuals
to adopt exercise strategies that are interesting and willingly executed. However, it is
important that the executed exercises also provide the greatest improvement in fitness.
One such exercise strategy attempting to combine these requirements was developed
by the Saluber Health Clinic based on the application of resistance tube exercises. Resistance tube, while still a relatively new exercise methodology, allows for a natural
movement pattern. The aim of the present study was to assess the effects of such resistance tube training on physical fitness. Our results indicated that the proposed training
methodology improved fitness in all four assessed fitness components. In the group
performing general conditioning exercises (GEN), significant improvements were observed only the test assessing agility and dynamic balance (8-Foot Up and Go Test). No
significant improvements were found in any of the remaining fitness tests. Besides a
general lack of improvement, the TUBE group obtained significantly higher results than
the GEN group. This was found in testing performed before and after the 12-week period
of observation. Due to the non-significant changes in fitness levels in most of the tests,
the post-intervention between-group differences increased even further. Such differences
in the physical fitness between older adults of different physical activity levels have been
reported by Skrzek et al. [30] primarily in tests of muscle strength. This finding is important in light of the fact that muscle strength is significantly correlated with fall risk as
well as activities of daily living including standing from a chair, climbing stairs, or carrying various objects [18, 26, 28].
Demographic data on the health status of Poles in 2009 found that poor physical fitness was endemic among the older population (GUS). Other studies on older populations
have indicated that many older adults (25% of 60-year-olds and 60% of 70-year-olds or
older individuals) have considerable problems with walking over even short distances or
climbing even one flight of stairs without assistance [34]. Hence, there is an acute need
for exercise programs that can improve the physical status of older age adults. Besides a
purely functional component, regular physical activity has been shown to have a positive
effect on mental performance in late age [12] and associated with both psychological and
social well-being [3, 17]. Besides the type of exercise (aerobic vs. anaerobic) and use of
specialized equipment, the type of exercises and their execution are of undeniable importance particularly in older adults. There is no consensus on what exercises are best suited
for this population in terms of training effects that, at the same time, are simple to execute, willingly performed, but also easily modulated to meet different ability levels. While
additional investigation is needed to confirm training applicability and efficacy, the use
of resistance tube shows promising results.
143
WELLNESS AND AGE
CONCLUSIONS
Physical activity improved the fitness of both groups of older women although significant differences were observed between the two types of exercise interventions, indicating that exercising with resistance tube exercise is more effective than a general fitness
exercise protocol.
REFERENCES
1. Bień B., Synak B. Stan zdrowia i sprawność populacji ludzi starszych w Polsce 23.
w roku 2000. [W:] Charzewski J. (red.) Problemy Starzenia. Warszawa, AWF
2001, 21–36.
2. Biernat E., Tomaszewski P. Socio-Demographic and Leisure Activity Determinants of Physical Activity of Working Warsaw Residents Aged 60 to 69 Years.
Journal of Human Kinetics 2011, 30, 173-181.
3. de Souza Santos A. i wsp. Correlation of physical aptitude; functional capacity,
corporal balance and quality of life (QoL) among elderly women submitted to a
post-menopausal physical activities program Ce´sar. Archives of Gerontology
and Geriatrics 2011, 53, 344–349.
4. Faulkner J.A. i wsp. Agerelated changes in the structure and function of skeletal
muscles. Clinical and Experimental Pharmacology and Physiology 2007,
34(11), 1091–1096.
5. Ignasiak Z. i wsp. Wstępna ocena kondycji biologicznej wrocławskich seniorek. Gerontologia Polska 2011,19 (2), 91–98.
6. Ignasiak Z. i wsp. Ocena zmian inwolucyjnych wybranych aspektów kondycji
biologicznej osób starszych. Studia i Monografie AWF we Wrocławiu 2012,
109.
7. Ignasiak Z. i wsp. Wpływ 8-tygodniowego treningu nordic walking na wybrane
parametry somatyczne i zmiany zakresów ruchów w stawach starszych kobiet.
Antropomotoryka 2013, 63, 39-46.
8. Ignasiak Z. i wsp. The structure of physical activity in seniors from lower Silesia. Roczniki Państwowego Zakładu Higieny 2013, 64(1), 67–73.
9. Katan A. i wsp. Sprawność fizyczna kobiet oceniana testem seniora w aspekcie
pobytu sanatoryjnego. Antropomotoryka 2013, 63, 55-60.
10. Keysor J.J. Does late-life physical activity or exercise prezent or minimize
disablement? A critical review of scientific evidence. Prev Med 2003,
25(3),129-136.
11. Krems C. i wsp. Physical activity in young and elderly subjects. The Journal of
Sports Medicine and Physical Fitness 2004, 44(1), 71-76.
12. Lampinen P. i wsp. Activity as a predictor of mental well-being among older
adults. Aging & Mental Health 2006, 10, 454–466.
13. Leś A., Gaworska M. Wybrane aspekty jakości życia i sprawności funkcjonalnej osób starszych. Wychowanie Fizyczne i Sport 2011, 55(2), 95–98.
14. Li Y. i wsp. Effects of extended Tai Chi intervention on balance and selected
motor functions of the elderly. The American Journal Chinese Medicine 2007,
144
Rohan Anna, Fugiel Jarosław, Buraczyńska Sandra, Kowalski Henryk,
Pinkowska Agnieszka, Gworys Bohdan
Fitness effects of resistance tube exercise in women over 60 years of age
35, 383–391.
15. McAuley D. Potencjalne korzyści płynące z aktywności fizycznej podejmowanej przez ludzi starszych. Medicina Sportiva 2001, 5(4), 229–394.
16. McAuley E. i wsp. Effects of change in physical activity on physical function
limitations in older women: mediating roles of physical function performance
and self-efficacy. J Am Geriatr Soc 2007, 55(12), 1967-1973.
17. Milanović, Z. i wsp. Age-related decrease in physical activity and functional
fitness among elderly men and women. Clinical interventions in aging
2013, 8, 549.
18. Newman A.B., i wsp. Strength, but not muscle mass, is associated with mortality in the Health, Aging and Body Composition Cohort. Journal of Gerontology, Medical Sciences 2006, 61A, 72-77.
19. Nowak M., Woitas-Ślubowska D. Sprawność motoryczna kobiet uprawiających
rekreacyjną gimnastykę (w świetle wyników Eurofit). Kultura Fizyczna 1998,
3–4, 16–18.
20. Onder G. i wsp. Change in physical performance over time in older women: the
Women’s Health and Aging Study. J Gerontol A Biol Sci Med Sci 2002, 57, 289–
293.
21. Osiński W. Aktywność fizyczna podejmowana przez osoby w starszym wieku.
Antropomotoryka 2002, 24, 3–24.
22. Osiński W. Gerokinezjologia. Nauka i praktyka aktywności fizycznej w wieku
starszym. PZWL, Warszawa 2013.
24. Rikli R.E., Jones C.J. Development and validation of a functional fitness test for
community-residing older adults. Journal of Aging and Physical Activity 1999, 7,
129-161.
25. Rikli R., Jones CJ. Senior Fitness Test Manual-2nd Edition. Human Kinetics,
Champaign, 2013.
26. Sherrington C. i wsp. Effective exercise for the prevention of falls — a systematic review and meta-analysis. J. Am. Geriatr. Soc 2008, 56, 2234–2243.
27. Skrzek A. Trening zdrowotny a procesy inwolucyjne narządu ruchu u kobiet.
Studia i Monografie, AWF, Wrocław 2005.
28. Skrzek A. i wsp. Dynamika zmian inwolucyjnych narządu ruchu w aspekcie
czynników ryzyka złamań. Ortopedia, Traumatologia, Rehabilitacja 2008, 5, 10,
449-462.
29. Skrzek A. i wsp. Structural and functional markers of health depending on lifestyle in elderly women from Poland. Clinical Interventions in Aging 2015, 10,
781-793.
30. Skrzek A. i wsp. Fine motor skills of the hands in Polish and Czech female senior citizens from different backgrounds. Aging Clinical and Experimental Research 2015, 27, 4, 491-498.
145
WELLNESS AND AGE
31. Spirduso W.W., Cronin D.L. Exercise dose-response effects on quality of life and
independent living in older adults. Med Sci Sports Exerc 2001, 33, 598-608.
32. Warburton D.E.R. i wsp. Health benefits of physical activity: the evidence. Can.
Med. Assoc. J. 2006, 174, 801–809.
33. Weiss E.P. i wsp. Gender differences in the decline in aerobic capacity and its
physiological determinants during the lates decades of life. J Appl Physiol 2006,
101, 938–944.
34. Wizner B. i wsp. Ocena stanu funkcjonalnego u osób w starszym wieku. [W:]
Mossakowska M., Więcek A., Błędowski P. (red.) Aspekty medyczne, psychologiczne, socjologiczne i ekonomiczne starzenia się ludzi w Polsce. Termedia
Wydawnictwa Medyczne, Poznań 2012.
35. www.saluber.pl [data dostępu: 12.04.2015].
ABSTRACT
The aim was to assess the effects of general fitness program involving resistance tube
exercises in older women group and compare them with an age-matched control group
executing a traditional general fitness program. The study was conducted in 2 groups of
women over 60 years of age. The 1st group performed exercises with the use of resistance tube devices. The 2nd group performed general conditioning exercises that involved
gymnastics elements. The study was conducted over a period of 12 weeks, twice a week.
Pre- and post-intervention fitness was assessed with the Senior Fitness Test: Arm Curl
Test, Chair Stand Test, 8-Foot Up and Go Test, 2-Min Step in Place Test. Physical activity improved the fitness of both groups of older women although significant differences were observed between the two types of exercise interventions, indicating that exercising with resistance tube is more effective than a general fitness exercise protocol.
STRESZCZENIE
W pracy oceniano efekty ćwiczeń z elastomerami. Porównano je do grupy, w której
prowadzono ćwiczenia ogólnoustrojowe. Badania wykonano u kobiet po 60 r.ż., z 2
grup. W 1. stosowano ćwiczenia przy użyciu gum tubingowych. W 2. prowadzono gimnastykę ogólnoustrojową. Program trwał 12 tyg., 2 razy w tyg., przez 60 min. Do oceny
sprawności fizycznej wykorzystano próby z Senior Fitness Test. Przeprowadzono testy:
uginanie przedramienia, wstawanie z krzesła, wstań i idź, 2-minutowe wchodzenie na
stopień. Badania wykonano 2 razy: przed rozpoczęciem programu ćwiczeń i po ich zakończeniu. Zaobserwowano, że aktywność fizyczna wpływa na poprawę sprawności
motorycznej kobiet w okresie starości. Istotny był również dobór ćwiczeń prowadzonych
w ramach programów profilaktycznych dla seniorów. Ćwiczenia z wykorzystaniem
elastomerów, w postaci gum tubingowych, przynoszą większe efekty niż ćwiczeń ogólnorozwojowe.
Artykuł zawiera 20832 znaki ze spacjami + grafika
146