Abby C. King

BACKGROUND: Although inactivity is an important contributor to impairedfunctioning and disability with age, little is known concerning howimprovements in physical functioning and well-being in older adults varywith the type of physical activity undertaken. METHODS: One hundred threeadults age 65 years and older, recruited via population- based methods,were randomized to 12 months of community-based, moderate-intensityendurance and strengthening exercises (Fit & Firm) or stretching andflexibility exercises (Stretch & Flex). A combination of class- andhome-based exercise formats was used. Measured and self- rated physicalperformance along with perceived functioning and well- being were assessedpre- and postintervention. RESULTS: Fit & Firm subjects showed greater12-month improvements in both measured and self- rated endurance andstrength compared to Stretch & Flex subjects. Stretch & Flexsubjects reported greater improvements in bodily pain, and Stretch &Flex men evidenced greater improvements in flexibility relative to Fit& Firm subjects. Although overall exercise adherence was high in bothexercise conditions (approximately 80%), subjects in both conditions showedbetter adherence to the home- versus class-based portions of their exerciseprescriptions. CONCLUSIONS: Community-based programs focusing onmoderate-intensity endurance and strengthening exercises or flexibilityexercises can be delivered through a combination of formats that result inimprovement in important functional and well-being outcomes. Thisrepresents one of the first studies to report significant improvements inan important quality of life outcome-bodily pain-with a regular regimen ofstretching and flexibility exercises in a community-based sample of olderadults.

To determine the effects of moderate-intensity exercise training on self-rated (subjective) sleep quality among healthy, sedentary older adults reporting moderate sleep complaints. Randomized controlled trial of 16 weeks' duration. General community. Volunteer sample of 29 women and 14 men (of 67 eligible subjects) aged 50 to 76 years who were sedentary, free of cardiovascular disease, and reported moderate sleep complaints. No participant was withdrawn for adverse effects. Randomized to 16 weeks of community-based, moderate-intensity exercise training or to a wait-listed control condition. Exercise consisted primarily of four 30- to 40-minute endurance training sessions (low-impact aerobics; brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. Pittsburgh Sleep Quality Index (PSQI). Compared with controls (C), subjects in the exercise training condition (E) showed significant improvement in the PSQI global sleep score at 16 weeks (baseline and posttest values in mean [SD] for C=8.93 [3.1] and 8.8 [2.6]; baseline and posttest values for E=8.7 [3.0] and 5.4 [2.8]; mean posttest difference between conditions=3.4; P<.001; 95% confidence interval, 1.9-5.4), as well as in the sleep parameters of rated sleep quality, sleep-onset latency (baseline and posttest values for C=26.1 [20.0] and 23.8 [15.3]; for E=28.4 [20.2] and 14.6 [13.0]; net improvement=11.5 minutes), and sleep duration baseline and posttest scores for C=5.8 [1.1] and 6.0 [1.0]; for E=6.0 [1.1] and 6.8 [1.2]; net improvement=42 minutes) assessed via PSQI and sleep diaries (P=.05). Older adults with moderate sleep complaints can improve self-rated sleep quality by initiating a regular moderate-intensity exercise program.

--To determine the effectiveness of group- vs home-based exercise training of higher and lower intensities among healthy, sedentary older adults. --Year-long randomized, controlled trial comparing (1) higher-intensity group-based exercise training; (2) higher-intensity home-based exercise training; (3) lower-intensity home-based exercise training; or (4) assessment-only control. --General community located in northern California. --One hundred sixty women and 197 men 50 to 65 years of age who were sedentary and free of cardiovascular disease. One out of nine persons contacted through a community random-digit-dial telephone survey and citywide promotion were randomized. --For higher-intensity exercise training, three 40-minute endurance training sessions per week were prescribed at 73% to 88% of peak treadmill heart rate. For lower-intensity exercise training, five 30-minute endurance training sessions per week were prescribed at 60% to 73% of peak treadmill heart rate. --Treadmill exercise test performance, exercise participation rates, and heart disease risk factors. --Compared with controls, subjects in all three exercise training conditions showed significant improvements in treadmill exercise test performance at 6 and 12 months (P less than .03). Lower-intensity exercise training achieved changes comparable with those of higher-intensity exercise training. Twelve-month exercise adherence rates were better for the two home-based exercise training conditions relative to the group-based exercise training condition (P less than .0005). There were no significant training-induced changes in lipid levels, weight, or blood pressure. --We conclude that (1) this community-based exercise training program improved fitness but not heart disease risk factors among sedentary, healthy older adults; (2) home-based exercise was as effective as group exercise in producing these changes; (3) lower-intensity exercise training was as effective as higher-intensity exercise training in the home setting; and (4) the exercise programs were relatively safe.