Effectiveness of resistance exercise using elastic bands on flexibility and balance among the elderly people living in the community: a systematic review and meta-analysis

Effectiveness of Home-Based Stretching and Strengthening Training for Improving Flexibility, Strength, and Physical Function in Older Adults with Leg Tightness and/or Suspected Sarcopenia

BACKGROUND/OBJECTIVES

The aim of the present study was to assess the effectiveness of flexibility or strengthening exercises to improve flexibility, strength, muscle architecture, and functional performance in older adults with leg tightness and/or suspected sarcopenia.

METHODS

Ninety adults with leg tightness and/or suspected sarcopenia (age: 66.8 ± 4.9 years) were randomly allocated to two subtypes of intervention at home: resistance-band exercise (RE) or eccentric exercise (ECC) for those with weakness; static or dynamic stretching for those with tightness; and static stretching plus ECC or no exercise for those with both muscle tightness and weakness. The program consisted of 3-6 weekly sessions over eight weeks. Blinded outcome assessments before and after the eight-week program and at the three-month follow-up included mobility performance via Timed Up-and-Go (TUG), and flexibility and strength tests, as well as measurement of stiffness.

RESULTS

All groups had increased peak torque after eight weeks and improved TUG at the three-month follow-up (p < 0.05). Improved plantar flexor strength persisted at the three-month follow-up (p = 0.009). In addition, the RE and ECC groups had increased muscle thickness by 4.0 and 8.7% after eight weeks (p < 0.05). Hamstring flexibility increased in all exercise groups, except the RE group. Moreover, all six groups showed improved calf flexibility, whereas no changes in stiffness were noted.

CONCLUSIONS

Increases in mobility performance, strength, and flexibility appeared due to learning effects and increased physical activity, rather than the specific training impact. However, strength-based programs may be recommended for older adults with suspected sarcopenia, as they provide additional benefits, such as short-lasting muscle hypertrophy.

Effects of elastic band training on body composition and physical performance in older people: A systematic review with meta-analysis

OBJECTIVES

This systematic review with meta-analysis aimed to evaluate the effects of elastic band training (EBT) on body composition and physical performance in apparently healthy older people.

METHODS

A systematic literature search was conducted between October 2023 and May 2024 using the core collection of six generic databases: PubMed, ProQuest, EBSCOhost, CINAHL Complete, Scopus, and Web of Science. The PRISMA, TESTEX, RoB 2, and GRADE tools assessed the evidence's methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024547050).

RESULTS

Of 5916 records, 9 randomized and non-randomized controlled trials involving 477 healthy older people were included. Six meta-analyses were performed showing significant improvements in 30-second chair stand (SMD = 3.03; 95 % CI = 0.14 to 5.93; I2 = 100 %; p = 0.04), sit-and-reach (SMD = 2.09; 95 % CI = 0.15 to 4.03; I2 = 100 %; p = 0.04) and timed up-and-go (SMD = 3.10; 95 % CI = 1.67 to 4.53; I2 = 98 %; p < 0.0001) tests. However, in maximal isometric handgrip strength, back-scratch test, and fat-free mass, no significant improvements (p > 0.05) in favor of EBT were reported.

CONCLUSION

EBT improves 30-second chair stand, sit-and-reach, and timed up-and-go in older people. Nevertheless, the certainty of evidence is very low; thus, not definitive recommendations can be made.

Effects of elastic band resistance training on the physical and mental health of elderly individuals: A mixed methods systematic review

OBJECTIVES

Elastic band resistance training in elderly individuals can improve physical fitness and promote mental health in addition to other benefits. This systematic review aimed to review, summarize, and evaluate quantitative, qualitative, and mixed methodological studies on the use of elastic band resistance training in elderly individuals, and to investigate the influence of elastic band resistance training on the physical and mental health of elderly individuals, as well as their preferences and obstacles in training.

METHODS

A convergent separation approach was used to synthesize and integrate the results, specifically the mixed systematic review approach recommended by the Joanna Briggs Institute. The extensive search strategy included electronic database searches in the Cochrane Library, PubMed, Embase, Web of Science, Google Scholar, MEDLINE, and CINAHL. The researchers rigorously screened the literature, extracted and analyzed the data, and evaluated the quality of the included studies using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Twenty-eight studies were included, of which 25 were quantitative studies, 2 were qualitative studies, and 1 was a mixed-methods study. A total of 1,697 subjects were investigated across all studies. Quantitative evidence supports the notion that elastic band resistance training can improve upper and lower limb flexibility, endurance, upper strength, physical balance, and cardiopulmonary function and enhance the mental health of elderly individuals. Participants in the qualitative study reported some preferences and obstacles with band resistance training, but most participants reported physical benefits.

CONCLUSIONS

Despite the heterogeneity between studies, this review is the first systematic review to comprehensively evaluate the effectiveness of elastic band resistance training in older adults. It not only shows the influence of elastic band resistance training on the physical and mental health of the elderly, but also emphasizes the preference and obstacles of elderly individuals face.

Effects of active exergames on physical performance in older people: an overview of systematic reviews and meta-analysis

This overview assessed the available body of published peer-reviewed systematic reviews and meta-analyses related to the effects of active exergames compared with active/passive control on physical performance outcomes in older people. The methodological quality and certainty of evidence were assessed using PRISMA, AMSTAR 2, and GRADE. The protocol was registered in PROSPERO (code: CRD42023391694). The main outcomes indicate that 4,477 records, five systematic reviews, and 10 meta-analyses were included. The AMSTAR-2 reported six meta-analyses with high methodological quality, four moderate quality, two systematic reviews with low quality, and three very-low quality. Meta-analysis was performed on balance using the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG) tests, on cardiorespiratory fitness using the 6-min walk test, and on upper and lower limbs muscle strength using the handgrip strength, knee extension, and 30-s chair stand tests. Significant differences in favor of the active exergames groups concerning active/passive groups were reported in BBS (SMD = 0.85; 95% CI = 0.12-1.58; I2 = 96%; p = 0.02), TUG (SMD = 1.44; 95% CI = 0.71-2.16; I2 = 97%; p < 0.0001), and 30-s chair stand test (SMD = 0.79; 95% CI = 0.33-1.25; I2 = 88%; p = 0.0008). However, no significant differences were reported in favor of the active exergames groups in 6-min walk (SMD = 0.93; 95% CI = -0.64 to 2.50; I2 = 95%; p = 0.24), handgrip strength (SMD = 0.67; 95% CI = -0.04 to 1.38; I2 = 84%; p = 0.06), and knee extension tests (SMD = 0.20; 95% CI = -0.05 to 0.44; I2 = 95%; p = 0.12) compared to active/passive control. However, it was impossible to perform a meta-analysis for the variables of walking speed as a fall risk due to the diversity of instruments and the small number of systematic reviews with meta-analysis. In conclusion, interventions utilizing active exergames have shown significant improvements in the static and dynamic balance and lower limb muscle strength of apparently healthy older people, compared to control groups of active/inactive participants, as measured by BBS, TUG, and 30-s chair stand tests. However, no significant differences were found in the 6-min walk, HGS, and knee extension tests.

Systematic review registration

PROSPERO, CRD42023391694.

Feasibility, Psychosocial Effects, Influence, and Perception of Elastic Band Resistance Balance Training in Older Adults

This study utilised feedback from older adults during balance-challenging, elastic band resistance exercises to design a physical activity (PA) intervention.

METHODS

Twenty-three active participants, aged 51-81 years, volunteered to perform a mini balance evaluation test and falls efficacy scale, and completed a daily living questionnaire. Following a 10 min warm-up, participants performed eight pre-selected exercises (1 × set, 8-12 repetitions) using elastic bands placed over the hip or chest regions in a randomised, counterbalanced order with 15 min seated rests between interventions. Heart rate (HR) and rate of perceived exertion (RPE) were measured throughout. Participant interview responses were used to qualify the experiences and opinions of the interventions including likes, dislikes, comfort, and exercise difficulty.

RESULTS

Similar significant (p < 0.01) increases in HR (pre- = 83-85 bpm, mid- = 85-88 bpm, post-intervention = 88-89 bpm; 5-6%) and RPE (pre- = 8-9, mid- = 10, post-intervention = 10-11) were detected during the PA interventions (hip and chest regions). Interview data revealed that participants thought the PA interventions challenged balance, that the exercises would be beneficial for balance, and that the exercises were suitable for themselves and others. Participants reported a positive experience when using the PA interventions with an elastic band placed at the hip or chest and would perform the exercises again, preferably in a group, and that individual preference and comfort would determine the placement of the elastic band at either the hip or chest.

CONCLUSION

These positive outcomes confirm the feasibility of a resistance band balance program and will inform intervention design and delivery in future studies.

Randomized Controlled Trial of Group Exercise Intervention for Fall Risk Factors Reduction in Nursing Home Residents

OBJECTIVE

The aim of this study was to assess the effectiveness of a multidimensional exercise intervention on improving fall risk deterrent factors, such as overall strength and flexibility in nursing home residents.

METHODS

A multi-centre, randomized controlled trial was finally utilized in 40 older adults (>65 years) who were randomly allocated to the intervention or the control group (20 subjects in each). The intervention group attended an exercise program twice a week for eight weeks, to improve functional mobility. The control group did not receive any intervention. Measurements before and after intervention included the Hand Grip Strength (HGS) testing, the Sit-to-Stand test (SST), the Back Scratch Test (BST), and the Sit-and-Reach test (SRT).

RESULTS

MANOVA revealed significant time effects, V = 0.336, F(6, 33) = 2.78, p = 0.027, partial η² = 0.336; group effects, V = 0.599, F(6, 33) = 8.22, p < 0.001, partial η² = 0.599; and group*time interaction, V = 0.908, F(6, 33) = 54.52, p < 0.001, partial η² = 0.908. A subsequent univariate analysis did not reveal a significant time effect for any variable (p > 0.05). Significant group effects were observed only for SRT (p < 0.05). Significant group*time interactions were observed for all the examined variables (p < 0.05). Dependent t-tests showed that the older adults in the exercise group were significantly improved in all the examined parameters (p < 0.05). Except for SRT (p > 0.05), all the other parameters significantly deteriorated in the control group (p < 0.05).

CONCLUSIONS

Significant improvements were demonstrated in strength and flexibility among nursing home residents following an eight-week group exercise training program.

Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review

Aims

The aim of this review study was to examine the effectiveness of home-based and community-based exercise programmes in the rate of falls and improving physical functioning in community-dwelling older adults.

Methods

All types of home-based and community-based exercise interventions were searched. From 1186 studies identified, 14 studies were selected for the umbrella review. Most studies had high methodological quality. The types of interventions were multi-functional programmes (n = 11 studies) and Otago Exercise Programme (OEP) (n = 3 studies).

Results

The results showed that home-based and community-based exercise interventions can reduce falls by 22-32%. Studies that included meta-analysis showed that the clinical significance of home-based interventions in fall prevention and improving physical function was moderate to high.

Conclusions

In conclusion, home-based and community-based exercise interventions are a safe, effective, and feasible method of fall prevention that could be implemented with minimum supervision by allied health professionals to maximise autonomy, self-efficacy, and adherence in community-dwelling older adults.

Upper versus lower body resistance exercise with elastic bands: effects on cognitive and physical function of institutionalized older adults

PURPOSE

To compare the effects of upper versus the lower-body resistance exercise on cognitive and physical functions of institutionalized older people.

METHODS

This was a non-randomized multi-center comparative and crossover study (clincialtrials.gov code NCT03831373). Two experimental groups performed a 12-week intervention of resistance exercises with low-intensity elastic bands, one program focused on exercises of the upper body (n = 20, mean age 87.6 ± 6.4 years, 75% women) and the other on the lower body (n = 29, mean age 81.4 ± 7.7 years, 55% women). Following 12 weeks of detraining, the groups performed the other intervention. After another 12 weeks, a follow-up assessment was carried. The control group (n = 19, mean age 81.3 ± 9.5, 68% women) performed a full body stretching exercise program in both phases. Before and after each period, cognitive and physical function was assessed by standardized test (Mini-Mental State Examination, Trail Making test and Phototest; Timed Up and Go, Back Scratch, Chair Sit and Reach and had grip strength, respectively). Intention-to-treat and per-protocol analyses were carried.

RESULTS

After the first intervention, significant improvements (p < 0.05) were observed in the cognitive function in both experimental groups, and in the hand grip strength in the group that performed lower-body exercise. After the second phase, all groups showed improvements in lower-body and shoulder flexibility and a significant worsening in hand grip strength. The lower-body exercise group showed a worsening in cognitive function, and the upper-body group in functional mobility and dynamic balance.

CONCLUSIONS

Resistance exercise with elastic bands showed beneficial effects on cognitive function and functional independence in institutionalized older adults. While upper body exercises seemed to be more effective on cognitive function, lower limb exercises showed better results on physical function parameters.

Effects of resistance bands exercise for frail older adults: A systematic review and meta-analysis of randomised controlled studies

AIMS AND OBJECTIVES

Research examining the effectiveness of resistance band exercises for improving physical and psychological dimensions among frail older adults has been inconsistent. We aimed to examine the effects of resistance band exercises for improving outcomes in frail older adults.

BACKGROUND

To provide robust evidence regarding the effectiveness of resistance band exercises and explore other potential outcomes in frail older adults, a systematic review of RCTs remains necessary.

DESIGN

Systematic literature review and meta-analysis were conducted in accordance with the PRISMA guidelines.

METHODS

Four databases were searched. English language papers were retrieved from 2006 to 2020. Three reviewers reviewed the methodology of the selected studies using the Joanna Briggs Institute tool for randomised controlled trials. The pooled standardised mean difference was calculated using a random-effects model. Heterogeneity among pooled studies was assessed using the τ² , Q and I² statistics, and publication bias was evaluated using Egger's test and the visual inspection of funnel plots.

RESULTS

A total of 15 studies met the eligibility criteria for this study. Overall, resistance band exercise reduced frailty after 24 weeks (SMD: -0.29; 95% CI: -0.55 to -0.03) and reduced depression after both 12 weeks (SMD: -0.19; 95% CI: -0.38 to -0.01) and 24 weeks (SMD: -0.30; 95% CI: -0.52 to -0.09). However, no significant effects were observed for frailty after 12 weeks, and no significant effects were observed for grip strength, leg strength, activities of daily living or quality of life at any time.

CONCLUSION

Resistance band exercise might be considered a viable strategy for frail older adults in the community or in long-term care facilities. More research implementing a standardised protocol remains necessary to identify the effects of different training volumes and the dose-response relationship for the very old and frail population.

RELEVANCE TO CLINICAL PRACTICE

As a safe complementary intervention for frail older adults, health providers should consider resistance band exercises when caring for frail older adults because this intervention has clinical benefits.

Effects of Resistance Training With Machines and Elastic Tubes on Functional Capacity and Muscle Strength in Community-Living Older Women: A Randomized Clinical Trial

The aim of the present study is to compare the effects of 12 weeks of resistance training with machines and elastic tubes on functional capacity and muscular strength in older women aged 60 years or over. The participants were randomized into two groups: a machine group (n = 23) and an elastic group (n = 20). They performed 12 weeks of progressive resistance training, twice a week, with similar exercises. Outcomes were assessed at three time points: baseline, postintervention, and 8 weeks after the end of the training. A significant intragroup effect was demonstrated for both groups at postintervention on functional tests and muscle strength. For the functional reach test and elbow flexion strength (180°/s), only the machine group demonstrated significant intragroup differences. No differences were observed between groups for any outcome. At the 8-week follow-up, functional capacity outcome values were maintained. The muscle strength outcome values decreased to baseline scores, without differences between groups.

Effects of School-Based Exercise Program on Obesity and Physical Fitness of Urban Youth: A Quasi-Experiment

(1) Purpose: The purpose of this study was to evaluate if an after-school intervention program could prevent obesity and promote the physical fitness of urban sedentary school children. (2) Methods: A 16-week after-school physical fitness program was provided to 36 middle school students (7th, 8th, and 9th graders) recruited from a middle school for three days a week. They were high-risk youth showing poor health status (level 4 or 5) in the regular physical fitness evaluation conducted. Their body mass index (BMI), cardiovascular endurance, muscular strength and endurance, quickness, and flexibility were evaluated. (3) Results: A paired sample t-test was used (α = 0.05). There were statistical differences ((x ± s), p < 0.05) between the pre-Progressive Aerobic Cardiovascular Endurance Run (PACER) (13.36 ± 4.98 (# of laps)) and post-PACER (18.64 ± 6.31 (# of laps)) (p < 0.001), between the pre-sit-up (18.06 ± 7.22 (# of sit-ups)) and post-sit-up (24.89 ± 7.52 (# of sit-ups)) (p < 0.001), and between the pre-Trunk Flexion (2.64 ± 3.49 ((cm))) and post-Trunk Flexion (5.97 ± 2.78 ((cm)) (p < 0.001). There was no statistical difference between the pre-50m-Run (10.74 ± 1.30 ((sec))) and post-50m-Run results (10.69 ± 1.25 (sec)) (p = 0.063) or between the pre-BMI (24.84 ± 3.97 (kg/m2)) and post-BMI (24.76 ± 3.61 (kg/m2)) (p = 0.458). Overall, the physical fitness measures improved, whereas BMI did not change after 16 weeks. (4) Conclusion: Sixteen weeks of the school-based Health-related Physical Fitness (HrPF) program can be effective in improving overall physical fitness levels of adolescents, although additional treatments would be required to change BMI, which showed no improvement in the present study. It is concluded that in order for adolescents to maintain and promote physical fitness and health, participation in a school-based HrPF program is recommended for at least 30 min a day, three days a week. In addition, schools should provide high-risk youth with easy access to physical activities that are similar to the objectives of the physical education curriculum. In order to promote the health of school-age children, each school should establish and operate school-based systematic intervention programs.

Exercise interventions for older adults: A systematic review of meta-analyses

BACKGROUND

The evidence concerning which physical exercise characteristics are most effective for older adults is fragmented. We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of meta-analyses of exercise interventions in older adults.

METHODS

We searched the Cochrane Database of Systematic Reviews, PsycInfo, MEDLINE, Embase, CINAHL, AMED, SPORTDiscus, and Web of Science for articles that met the following criteria: (1) meta-analyses that synthesized measures of improvement (e.g., effect sizes) on any outcome identified in studies of exercise interventions; (2) participants in the studies meta-analyzed were adults aged 65+ or had a mean age of 70+; (3) meta-analyses that included studies of any type of exercise, including its duration, frequency, intensity, and mode of delivery; (4) interventions that included multiple components (e.g., exercise and cognitive stimulation), with effect sizes that were computed separately for the exercise component; and (5) meta-analyses that were published in any year or language. The characteristics of the reviews, of the interventions, and of the parameters improved through exercise were reported through narrative synthesis. Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews. The study included 56 meta-analyses that were heterogeneous in relation to population, sample size, settings, outcomes, and intervention characteristics.

RESULTS

The largest effect sizes for improvement were found for resistance training, meditative movement interventions, and exercise-based active videogames.

CONCLUSION

The review identified important gaps in research, including a lack of studies investigating the benefits of group interventions, the characteristics of professionals delivering the interventions associated with better outcomes, and the impact of motivational strategies and of significant others (e.g., carers) on intervention delivery and outcomes.

Effect of modified Khon dance performance on functional fitness in older Thai persons

Purpose

Aging population is on the rise around the world. Strategies to improve quality of life in this population are being implemented. Exercise is one of those strategies that has been proven to be effective as it produces many health benefits. The purpose of this paper is to determine the effects of Khon exercise on functional fitness in older persons.

Design/methodology/approach

In total, 44 older people aged 60–65 years were recruited through a senior club in an urban area. They were divided into two groups: the Khon exercise group (performed exercise for 12 weeks, 60 min/day, 3 times/week) and the control group (engaged in routine physical activity). The Senior Fitness Test, which consisted of chair stand, arm curl, 2-min step, chair sit and reach, back scratch, 8-ft up and go, and body mass index, was performed before and at 12 weeks after the exercise.

Findings

After 12 weeks of training, significant differences in chair stand, 2-min step, chair sit and reach, and 8-ft up and go tests were noted between the exercise and control groups.

Originality/value

These findings showed that Khon exercise has positive effects on lower body strength and flexibility, aerobic endurance and balance. Hence, it is recommended for health promotion among older persons.

Elastic Band Exercises for Patients with Intensive Care Unit-Acquired Weakness: A Case Report

Intensive care unit-acquired weakness is characterised by severe impairment of muscle function that often arises after prolonged mechanical ventilation, difficult weaning, and severe sepsis. Elastic band exercises constitute an inexpensive and simple technique that is quite appealing for implementation in a "protected environment" such as the intensive care unit; however, elastic band application in the intensive care unit and in critical patients has not yet been described. A 72-year-old male was referred to the respiratory intensive care unit for hypoxemic respiratory failure due to acute respiratory distress syndrome. Upper limb active exercises were performed using an elastic band exploring three main movement rays: abduction, forward flexion, and external rotation. At discharge, major improvements were observed for upper limb activities. The patient was also able to maintain a sitting position at the edge of the bed starting from day 27. We found that an elastic band exercise program in a critical ill patient recovering from intensive care unit-acquired weakness was a suitable, safe, viable, and inexpensive therapeutic option to preserve residual upper limb motor activities and improve trunk control.