Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program

Effects of Detraining on Physical Capacity and Its Relationship With Depressive Symptoms, Quality of Life and Sedentary Behavior in Community-Dwelling Older Adults: A Longitudinal Study

BACKGROUND

Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL).

OBJECTIVE

To evaluate the effects of detraining, in the pandemic, on physical capacity and its relationship with DS, QoL, and SB of community-dwelling older adults.

METHODS

The physical capacity (static balance, dynamic balance, and lower limb and handgrip strength) of 35 participants was assessed prepandemic and after 18 and 24 months of the pandemic. DS, QoL, and SB were evaluated only at 18-month period. The analysis of variance for repeated measures or the Friedman and Pearson or Spearman tests were used for statistical analysis.

RESULTS

There was a decline in dynamic balance (p < .001) and strength in the lower limbs (p < .001) in the first 18 months, as well as maintenance in the following 6 months. The reduction in dynamic balance during the 18 months of the pandemic was associated with greater DS (p = .015; r = .414) and worse QoL (p = .024; r = -.381) in this period. More time spent on SB (p = .024; r = .386) in the 18th month was associated with worse dynamic balance in the following 6 months.

CONCLUSION

Detraining in the pandemic setting led to long-lasting harmful effects, which can last for 2 years, on the physical capacity of community-dwelling older adults.

IMPLICATION

Our findings highlight how periods of detraining can interfere in physical and mental health of older adults.

Self-perception of health and physical activity levels among the youth and adults before and amidst the COVID-19 pandemic

Background

Emerging research indicates that the COVID-19 pandemic and associated restrictions led to decreased physical activity levels and poorer health globally. However, most studies on this topic have focused on advanced countries, leaving a gap in understanding the impact in countries like Ghana. This study aimed to fill this gap by assessing self-perceived health status and physical activity levels among youth and adults in Ghana before, during, and after the COVID-19 restrictions. Understanding these dynamics is crucial for informing public health interventions and policies to promote well-being during and beyond the pandemic.

Methods

A cross-sectional survey using online data collection methods was conducted, involving 937 participants. Data included demographic information, and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Analysis was done using SPSS version 25, with descriptive statistics and multinomial regression.

Results

Most participants (89.6%) reported good health. Male participants were significantly more likely to engage in moderate (1.78 times) and high (3.17 times) physical activity during the COVID-19 period compared to females.

Conclusion

This study highlights gender disparities in physical activity levels during the pandemic in Ghana. Addressing these disparities and promoting healthier lifestyles, especially during crises, is crucial for general and mental health. Further research should explore socio-demographic factors' role in health behaviors during pandemics.

The impact of a mixed reality technology-driven health enhancing physical activity program among community-dwelling older adults: a study protocol

Background

Physical inactivity and a sedentary lifestyle among community-dwelling older adults poses a greater risk for progressive physical and cognitive decline. Mixed reality technology-driven health enhancing physical activities such as the use of virtual coaches provide an emerging and promising solution to support healthy lifestyle, but the impact has not been clearly understood.

Methods and analysis

An observational explanatory sequential mixed-method research design was conceptualized to examine the potential impact of a user-preferred mixed reality technology-driven health enhancing physical activity program directed toward purposively selected community-dwelling older adults in two senior centers in the Philippines. Quantitative components of the study will be done through a discreet choice experiment and a quasi-experimental study. A total of 128, or 64 older adults in each center, will be recruited via posters at community senior centers who will undergo additional screening or health records review by a certified gerontologist to ensure safety and proper fit. Treatments (live coaching with video-based exercise and mixed reality technology-driven exercise) will be assigned to each of the two senior center sites for the quasi-experiment. The participants from the experimental group shall be involved in the discreet choice experiment, modeling, and usability evaluations. Finally, a qualitative sample of participants (n = 6) as key informants shall be obtained from the experimental group using purposive selection.

Discussion

This study protocol will examine the health impact of a promising mixed reality program in health promotion among older adults. The study utilizes a human-centered mixed method research design in technology development and evaluation in the context of developing nations.Clinical trial registration: ClinicalTrials.gov, identifier NCT06136468.

An Australian exploratory study of individual physical functioning and wellbeing of rural clients with chronic diseases whose structured exercise groups were cancelled due to social distancing requirements of the COVID-19 pandemic

BACKGROUND

The primary aim of this study was to describe if there was a change in physical functioning of rural clients with chronic diseases who were unable to attend their structured exercise groups during the COVID-19 pandemic. The secondary aim was to describe their physical activity during lockdown and their wellbeing upon return to their structured exercise groups.

METHOD

Physical functioning measures collected in January to March 2020 (prior to suspension of structured exercise groups due to the lockdown) were repeated in July 2020 (when face-to-face activity resumed) and compared. A survey collected information about the client's level of physical activity during lockdown and wellbeing measures at the end of the lockdown.

RESULTS

Forty-seven clients consented to provide physical functioning tests and 52 completed the survey. Only the modified 2-min step-up test displayed a statistically (but not clinically) significant change (n =29, 51.7vs 54.1 rep, P =0.01). Physical activity undertaken during lockdown was less in 48% (n =24), the same in 44% (n =22) and increased in 8% (n =4) of clients. Despite the lockdown, clients had high global satisfaction, high subjective wellbeing and normal resilience.

CONCLUSIONS

Clinically significant changes in physical functioning when clients were unable to attend structured exercise groups for three months during the COVID-19 pandemic were not observed in this exploratory study. Further research is required to confirm the impact of isolation on physical functioning in those participating in group exercise to improve their chronic disease management.

COVID-19 Infection Was Associated with the Functional Outcomes of Hip Fracture among Older Adults during the COVID-19 Pandemic Apex

Background and Objectives: Hip fractures are associated with mortality and poor functional outcomes. The COVID-19 pandemic has affected patterns of care and health outcomes among fracture patients. This study aimed to determine the influence of COVID-19 infection on hip fracture recovery. Materials and Methods: We prospectively collected data on patients with hip fractures who presented at Hualien Tzu Chi Hospital between 9 March 2022 and 9 September 2022. The data included demographic information and functional scores taken before, during, and after surgery. The patients were divided into two groups: COVID-19 (+) and COVID-19 (-). Results: This study recruited 85 patients, 12 of whom (14.12%) were COVID-19 (+). No significant differences in preoperative or perioperative parameters between the two groups were observed. The postoperative Barthel index score was significantly impacted by COVID-19 infection (p = 0.001). The incidence of postoperative complications was significantly correlated with general anesthesia (p = 0.026) and the length of stay (p = 0.004) in hospital. Poor postoperative functional scores were associated with lower preoperative Barthel index scores (p < 0.001). Male sex (p = 0.049), old age (p = 0.012), a high American Society of Anesthesiologists grade (p = 0.029), and a high Charlson comorbidity index score (p = 0.028) were associated with mortality. Conclusions: Hip fracture surgeries were not unduly delayed in our hospital during the COVID-19 pandemic, but the patients' postoperative Barthel index scores were significantly influenced by COVID-19 (+). The preoperative Barthel index score may be a good predictive tool for the postoperative functional recovery of these patients.

Mechanisms of Physical Exercise Effects on Anxiety in Older Adults during the COVID-19 Lockdown: An Analysis of the Mediating Role of Psychological Resilience and the Moderating Role of Media Exposure

The purpose of this study was to explore the effects of physical exercise on anxiety in older adults during the COVID-19 pandemic lockdown, as well as the mediating role of psychological resilience and the moderating role of media exposure. An online questionnaire was used to survey older adults in Chengdu, Southwest China. A total of 451 older adults aged 60 years and older participated in the study (209 males and 242 females). The results suggest that physical exercise negatively influenced anxiety symptoms in older adults; psychological resilience mediated the effect of physical exercise on anxiety in older adults and negatively predicted it; furthermore, media exposure moderated the effects of physical exercise and psychological resilience on anxiety, and low levels of media exposure strengthened these effects. This study suggests that participation in physical exercise and reduced media exposure during the COVID-19 pandemic lockdown may have reduced anxiety in older adults.

Balance and Fall Risk Assessment in Community-Dwelling Older Adults after Recovery from COVID-19: A Cross-Sectional Study

BACKGROUND

SARS-CoV-2 atypical symptoms in older persons include falls, confusion, dizziness, and unusual weariness. Falls and their consequences are among the most prevalent causes of disability among older adults, significantly lowering quality of life and resulting in the loss of independence as well as impaired psychosocial functioning. The study purpose was to examine the impact of the SARS-CoV-2 infectious disease on balance in community-dwelling older adults.

METHODS

Sixty-four older adults aged ≥ 60 years from both sexes, 31 treated for SARS-CoV-2 infection and 33 matched normal controls participated in the study. The Biodex Stability System (BSS) and Berg Balance Scale (BBS) were used for evaluation of balance and fall risk. The correlation between the Biodex overall stability index and the Berg Balance Scale score was investigated.

RESULTS

When compared to controls, the SARS-CoV-2 group had significantly higher values of the Biodex overall stability index (OSI) (p = 0.011), anterior-posterior stability index (APSI) (p = 0.013), mediolateral stability index (MLSI) (p = 0.018), and fall risk index (FRI) (p = 0.008), as well as statistically lower scores on the Berg balance scale (p = 0.003). A moderate negative correlation was found between the two assessment tools in the SARS-CoV-2 group.

CONCLUSION

Balance impairment and an increased risk of falling are among the outcomes of SARS-CoV-2 in community-dwelling older adults.

Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study

This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (-0.7 ± 1.3), and FTS-5 (-5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (-1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.

Tendency of older adults to leave big cities in the COVID‐19 pandemic: A qualitative regional analysis in Turkey

This study investigates how territorial and age group disparities in implementing COVID‐19 measures in Turkey triggered some of the older adults living in those regions to move to rural settlements and small towns. The direction of this mobility was from urbanized regions to rural regions. Data is collected from 201 older adult participants nationwide through longitudinal qualitative research. A combination of purposive and snowball sampling techniques was used to form the sampling of the research. Chi‐squared test was applied to the collected data and significant correlation values are found between the age groups and the main motives for them leaving the big cities. Findings show that this mobility caused unexpected problems for older adults and contributed to the spread of the virus, but represents a counter‐urbanization tendency in Turkey.

Implementation of Rehabilitation and Patient Outcomes During the Initial COVID-19 Pandemic

Objectives:

This study investigated the impact of the initial outbreak of coronavirus disease (COVID-19) on rehabilitation and functional outcomes of patients in Japanese hospitals.

Methods:

The study subjects were hospitals belonging to Japan’s National Hospital Organization that provided inpatient care for patients with coronavirus COVID-19 during March–May 2020. We specifically focused on patients who were hospitalized for acute diseases, such as stroke, hip fracture, acute myocardial infarction, congestive heart failure, or chronic obstructive pulmonary disease, and received rehabilitation during hospitalization. Data were sourced from Japanese administrative data. The primary outcome was rehabilitation provision time in the target hospitals. The secondary outcomes were patient outcomes: rehabilitation participation time, length of hospital stay, 30-day readmission rate, and improvement of activities of daily living. Interrupted time series analysis was performed to evaluate the trend of rehabilitation provision time. Patient outcomes were compared with those for 2019.

Results:

The rehabilitation provision time for outpatients declined by 62% during the pandemic, while that for inpatients declined temporarily, and then increased. Compared with 2019 outcomes, rehabilitation participation time was longer and hospital stay length was shorter for stroke and hip-fracture patients, the 30-day readmission rate was increased for hip-fracture patients, and improvement of activities in daily living was less for patients with congestive heart failure who were totally dependent at admission. Other outcomes did not change.

Conclusions:

The findings suggest that during the initial COVID-19 pandemic, resources for rehabilitation were quickly reallocated to inpatient care, and the impact on inpatient outcomes was minimized.