Effects of Movement-Based Mind-Body Interventions on Physical Fitness in Healthy Older Adults: A Meta-Analytical Review.

INTRODUCTION: Declines in physical fitness can notably affect healthy aging of older adults. Multimodal exercise training regimen such as mind-body interventions (MBIs) has been reported to mitigate these aging-related declines of physical function. This meta-analytical review aimed at pooling the effects of MBIs on physical fitness indices compared to active control (AC) and inactive control (IC) conditions in healthy older adults. METHODS: The literature search was conducted in 3 databases using search terms with Boolean conjunctions. Randomized controlled trials applying MBIs focusing on improving physical fitness parameters in healthy seniors over 65 years of age were screened for eligibility. Eligibility and study quality were assessed by 2 researchers using the PEDro scale. Standardized mean differences (SMD) adjusted for small sample sizes (Hedges' g) served as main outcomes for the comparisons of MBIs versus IC and MBIs versus AC. RESULTS: Thirty trials with 2,792 healthy community dwellers (mean age: 71.2 ± 4.7 years) were included. Large overall effects were found for strength (p < 0.001, SMD: 0.87 [90% CI: 0.43, 1.30], I2 = 94%), medium effects were observed for functional mobility (p = 0.009, SMD: 0.55 [90% CI: 0.20, 0.89], I2 = 83%), and small overall effects were found for static balance (p = 0.02, SMD: 0.35 [90% CI: 0.10, 0.60], I2 = 77%), endurance (p = 0.0001, SMD: 0.44 [90% CI: 0.25, 0.62], I2 = 0%), and flexibility (p = 0.003, SMD: 0.46 [90% CI: 0.21, 0.72], I2 = 54%) in favor of MBIs compared to IC. Small effects of strength slightly favoring AC (p = 0.08, SMD: -0.22 [90% CI: -0.43, -0.01], I2 = 52%) were found, whereas static balance moderately improved in favor of MBIs (p < 0.001, SMD: 0.46 [90% CI: 0.16, 0.76], I2 = 73%). DISCUSSION/CONCLUSION: MBIs induce small to moderate effects in relevant domains of physical fitness in healthy older adults. Strength should be better targeted with traditional resistance training routines, whereas balance seems to sufficiently benefit from MBIs. However, large variability between the studies was observed due to differences in methodology, intervention content, and outcomes that affect conclusive evidence.

Negotiating stairs with an inconsistent riser: Implications for stepping safety.

Stairs are associated with falls, especially when step dimensions are inconsistent. However, the mechanisms by which inconsistencies cause this higher risk are mostly theoretical. In this experimental study we quantified the effect of inconsistent rise heights on biomechanical measurements of stepping safety from younger (n = 26) and older adults (n = 33). In ascent, both groups decreased foot clearance (~9 mm) over the inconsistently higher step (F(1,56) = 48.4, p < 0.001). In descent, they reduced foot contact length on the higher step by 3% (F(1,56) = 9.1, p < 0.01). Reduced clearance may result in a toe-catch potentially leading to a trip, while reduced foot contact lengths increase the risk of overstepping which may also lead to a fall. These effects occurred because participants did not alter their foot trajectories, indicating they either did not detect or were not able to adjust to the inconsistent rise, increasing the likelihood of a fall. Consistent stair construction is vital, and existing inconsistencies should be identified and safety interventions developed.