VAAP eNews

Edition 9 – October 2018



VAAP UPDATE
VAAP to continue for another year? | VAAP 2018 Research and Practice Forum well attended | Forum attendees organisational profiles | Is your organisation using the VAAP self-assessment tool and resources (SaTR)? | VAAP series of short films on ‘harder to reach’ groups of older people

STAKEHOLDER SPOTLIGHT
Active ageing in the outdoors for seniors | Mitchell Leisure Services’ outreach model achieving great success | Eltham Leisure Centre’s Active Movers Gym Transition Group builds confidence

RESEARCH UPDATE
Contribution of physical activity to the management of chronic pain | Relative impacts from strength training, aqua fitness, and aerobic exercise in older people | Understanding the impact of fear of falling upon physical activity

STAY IN THE KNOW
Sport Australia grant opportunity | Deakin University study about post-menopausal women with osteoporosis and exercise | Age shouldn’t be a barrier to playing competitive sports | Victorian Carer Strategy 2018-22 released | WHO global action plan on physical activity | Do you know about the Victorian Continence Resource Centre? | Information and advice on musculoskeletal conditions

UPCOMING EVENTS
Australian Association of Gerontology 2018 Conference | Free webinar for health and fitness professionals

VAAP Update

VAAP to continue for another year?

Question mark image

The Victorian Active Ageing Partnership (VAAP) commenced in October 2015 and has run for three years. The initiative has been led by Musculoskeletal Australia in collaboration with Monash University and Fitness Australia. Staff from these organisations have made up the ‘VAAP Coordination Team’.

The current funding for the VAAP is due to finish on in mid-October and it is anticipated that the initiative will be funded for at least another year.

The places and settings where older people spend their time and are physically and socially active are recognised as important platforms for change. Accordingly, the VAAP has not been about direct service delivery to older people, but more about influencing the systems that deliver physical activity to them. Accordingly, the VAAP Coordination Team has worked closely with stakeholders, particularly staff and volunteers from community health services, fitness/leisure centres, local councils, neighbourhood houses, University of the Third Age and the sports industry.

In line with this approach, strategies have focused on establishing, enabling and supporting networking and collaboration; improving capacity of organisations and their workforce to promote and deliver accessible and appropriate physical activity in collaboration with older people; and improving the pathways to make physical activity more accessible for a diverse group of older people.

It is hoped that the work that has been undertaken in the last three years can be progressed further with another year’s funding.

Stakeholder Spotlight

Active ageing in the outdoors for seniors

Whittlesea exercise park

The WHO Global Network for Age-friendly Cities and Communities was established with the aim of promoting healthy and active ageing and a good quality of life for older people around the world. Creating inclusive and accessible outdoor environments that encourage and provide opportunities for older adults to engage in physical activity and social interaction is critical for healthy ageing.

Only 25% of older people in Australia meet the recommended physical activity guidelines. With higher sedentary behaviour and physical inactivity reported among older people, creating opportunities for older people to engage in outdoor physical activity is important and requires commitment from the community and local governments.

A research study conducted in Melbourne was the first outdoor exercise park intervention trial (randomised controlled trial) in the community. The innovative seniors-only outdoor exercise park is specifically designed for older people to improve strength, balance, joint movement, mobility and function. Senior outdoor exercise parks may provide an opportunity for seniors to socialise and improve their physical and mental health through enjoyable physical activity. Consequently, a growing interest among the community in the seniors’ exercise parks (in particular by local councils), led to the development of a further larger research trial: the ENJOY trial (Exercise interveNtion outdoor proJect in the cOmmunitY ). This research project is led by the National Ageing Research Institute (NARI) in partnership with Whittlesea City Council, Wyndham City Council, Old Colonists Association of Victoria and Gandel Philanthropy.

The overall ENJOY project aims to implement and evaluate the effects of sustained engagement in physical activity on mental health and physical outcomes through the use of a community-based, novel, outdoor physical activity program (the seniors exercise park) for older people.

The new WHO global action plan on physical activity 2018–2030, ‘More active people for a healthier world’ advocates for a systems-based approach to increase physical activity. A collaborative approach is required to provide older person-friendly outdoor active spaces and reduce the global prevalence of physical inactivity. Interested community organisations, groups and local councils are encouraged to get in touch with NARI to explore how we can achieve this important health goal.

This article was submitted to the VAAP newsletter by Associate Professor Pazit Levinger, Senior Research Fellow, National Ageing Research Institute; Contact details: p.levinger@nari.edu.au

Mitchell Leisure Services’ outreach model achieving great success

Mitchell Shire Leisure logo

For many Mitchell Shire seniors, a lack of public transport or not having access to their own transport is a major barrier to accessing services and participating in community activities.

This information was the catalyst for Mitchell Leisure Services team to begin taking services to residents in order to keep them active, healthy and independent.

Mitchell Leisure Services now run senior-specific group exercise classes at two retirement villages and two council facilities each week, with plans to expand to other towns soon.

The first retirement village-based program was the brainchild of one of the Council’s Positive Ageing Ambassadors – a group of seven ‘savvy’ seniors who work closely with Mitchell Shire’s older population to develop programs that help overcome age barriers.

By consulting with fellow seniors, Positive Ageing Ambassador, Tom Thomson, identified that many residents of Kingsgate Village in Kilmore would love to exercise. They were, however, unable to attend the leisure centre to participate in the programs on offer.

An information session at Kingsgate Village saw over 30 residents register to participate in weekly seniors’ exercise classes. The success of this program inspired further outreach programs.

In establishing each of these programs, Mitchell Leisure Services staff deliver an information session addressing the benefits of exercise, what to expect and most importantly, any perceived barriers to exercise such as illness, injury or being ‘too old’.

Following this, individual health and fitness appraisals are conducted including general screening, a ‘Par-Q’ and some simple mobility and function assessments.

The appraisals provide extremely valuable information about the capabilities of the group, allowing classes to be tailored for the individuals and progressions and regressions can be prescribed accordingly.

The Positive Ageing Ambassadors, social groups, and the delivery of these programs in community hubs have been central in the promotion of these programs.

With a large portion of the senior population are not using social media or email, face-to-face and word of mouth communication have been paramount to success.

These programs have been extremely successful, with regular attendees experiencing profound improvements in strength, flexibility and function. The programs are also providing an important source of social interaction and networking.

This article was submitted to the VAAP newsletter by Billie Asprey, Health and Wellness Team Leader, Mitchell Shire Leisure Services

Eltham Leisure Centre’s Active Movers Gym Transition Group builds confidence

Eltham Leisure Centre photoEltham Leisure Centre’s primary aim is to increase active living and increase social connections through community participation.

They have been fortunate to work alongside healthAbility on the Active Movers Gym Transition Group, which is delivered at the leisure centre twice per week. The aim of the program is to support and encourage participants with chronic health conditions through assessment, education and exercise. Participants are required to complete an assessment with a healthAbility Exercise Physiologist (EP) prior to commencing.
After their assessment, participants are then placed in either the gym transition group or group fitness class, which is run by their Age Friendly Coordinator – Betty Anderson. The class is structured so that participants work on cardiovascular fitness, strength and balance.

The gym program is run by a healthAbility EP supported by an Eltham Leisure Centre Personal Trainer. With a small group, the Personal Trainer assists and oversees the program for ongoing participants, whilst the EP supports new members through their program. With both groups ongoing, participants can attend for as long as they wish. With support and encouragement, participants gain confidence, knowledge and independence to transition into an Eltham Leisure Centre membership to maintain long-term lifestyle changes.

Barriers to this program have included times of sessions, availability and gym space. Through two-way communication, however, they have been able to balance multiple factors to deliver a well-executed, comprehensive program that provides full access for all members and patrons.

This program has provided fantastic development opportunities for the staff at Eltham Leisure Centre. There is great support from the healthAbility EPs allowing staff to gain more confidence and upskill themselves in ways to best assist the older population.

Since commencing this program with healthAbility, both groups of staff have forged a great working relationship extending out of the gym setting. As an example, they have held seminars for the Active Movers about healthy footwear and footcare delivered by a healthAbility Podiatrist. They hope in future to continue with these seminars on other relevant health topics.

This article was submitted to the VAAP newsletter by Emma Pacconi, Healthy Nillumbik Coordinator, Aligned Leisure; email: Emma.pacconi@alignedleisure.com.au

Research Update

Contribution of physical activity to the management of chronic pain

Chronic pain is a prevalent problem in older adults, with international estimates placing the proportion of people aged 50 years and over who are affected at 50%, and possibly up to 67%. Pain is a common symptom of underlying disability, and a major contributor to functional impairment, loss of mobility, poor mental health and reduced quality of life. A substantial body of research has investigated strategies that are beneficial for pain management, but there has been much less attention to the primary prevention of this problem. This study set out to identify the multimodal activities, including physical activity and different forms of social and cultural participation that may contribute to a lower incidence of pain among older people.

A cohort study was undertaken using data collected over 10 years (beginning in 2004-05) in the English Longitudinal Study of Ageing, which includes a representative sample of adults aged 50 years and over. There were 2163 people who were free of pain at the first wave of measurement and who completed all of the subsequent two-yearly surveys. The exposures measured at baseline were frequency of taking part in moderate or vigorous forms of sports and other activity, and frequency of engagement in community groups or cultural activities. The outcome measure of interest was the frequency of moderate to severe pain, reported at any of the follow-up points, with additional questions asking whether the pain was generalised or contained to particular sites (e.g., back, hip, etc).

After controlling for socioeconomic characteristics, health status and social isolation, participation in vigorous physical activity once or more per week was associated with a 26% lower risk of the development of chronic pain. It was postulated that this may be due to the anti-inflammatory, anti-oxidative benefits of vigorous intensity physical activity. Interestingly, a similar level for risk reduction (25%) was observed in those who took part in cultural activities (attending museums, galleries, concerts etc). The explanation for this association was less clear, but it was hypothesised that it may be due to the fact that such activities often entail a mix of social engagement, gentle physical activity, and positive affect responses. The findings of this study inform messages that can be conveyed to older people about the prevention of chronic pain.

The complete article can be viewed at: Fancourt D, Steptoe A. Physical and psychosocial factors in the prevention of chronic pain in older age. The Journal of Pain. 2018; Jun 24. pii: S1526-5900(18)30304-3. Available at: https://www.jpain.org/article/S1526-5900(18)30304-3/fulltext

Relative impacts from strength training, aqua fitness, and aerobic exercise in older people

The audit of physical activity programs for older people in Victoria, undertaken by VAAP in 2016, revealed a large and diverse array of opportunities that are available, including gentle exercise, aqua fitness, strength training, Tai Chi and dance, among others. Given that each of these comprises a different mix of strength, endurance and flexibility exercise, it can be expected that the physical and functional benefits they offer participants may vary substantially. In light of this, it is valuable to examine the findings of studies such as the one reported in this article, which compared the physical and health benefits of strength training, aqua fitness, and aerobic exercise in older people.

The study was undertaken in Spain and used a randomised controlled trial design. There were 108 participants, with an average age of 66 years and an even quota of men and women, who were divided equally between each of the physical activity types. The strength, aqua fitness and aerobic classes were supervised and conducted in groups on a weekly basis. The classes included a warm-up period, were progressive in intensity, and had a duration ranging from 45-55 minutes per session. The measures collected at baseline and 24 weeks follow-up included strength and flexibility in upper and lower limbs, physical functioning and limitations, general physical and mental well-being, and body mass index.

All of the groups achieved significant improvements in measures of strength and flexibility, with the exception of those undertaking aqua fitness who did not show gains in lower leg strength. The aqua fitness and aerobics classes showed the most gains in physical functioning and general physical and mental health. When men were analysed independently, the largest improvements in upper limb strength and general physical health were shown by those in the strength training group. Men in the aerobic class showed more improvements in general mental health, leg strength, and flexibility of legs and arms. Separate analysis of women found that those in the strength training group obtained greater gains in general physical and mental health and in upper and lower limb strength. The authors concluded that older people will benefit most from aerobic activity, and that older women can obtain general physical and mental health gains from strength training.

The full report of this study is provided at: Leirós-Rodríguez R, Soto-Rodríguez A, Pérez-Ribao I, García-Soidán JL. Comparisons of the health benefits of strength training, aqua-fitness, and aerobic exercise for the elderly. Rehabilitation Research and Practice. 2018; Jun 19;2018:5230971. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029484/

Understanding the impact of fear of falling upon physical activity

Fear of falling among the elderly contributes to a reduction in activity and social participation, functional decline and a greater risk of falls independent of physical impairment. In order to address such consequences, it is valuable to understand how a fear of falling affects physical activity behaviours, which may inform guidance and support that older people who display this concern should receive. The study reported in this article set out to test a hypothesis that fear of falling is associated with a lower level of participation in more challenging, complex and dynamic forms of physical activity among older people, which are important for daily functioning.

In the study, conducted in Switzerland, 40 community-dwelling people aged 65 years who were mobile and free of frailty, were recruited. Fear of falling was measured using the standardised Fall Efficacy Scale-International (FES-I). Physical activity was measured by requiring participants to wear a tri-axial accelerometer over two consecutive days while they undertook their usual daily routines. This objective device enabled calculation of physical activity endurance, performance, and complexity metrics for each participant. Complexity was quantified according to variations in type, intensity, and duration of activities.

Using the FES-I, participants were classified as not concerned at all/fully confident or concerned/less confident in regard to the risk of falls, and it was found that the demographic and health-related characteristics of individuals in each of these groups did not differ. In regard to the physical activity measures, there were no significant differences for endurance activity between those with higher and lower levels of concern about falls, however, the performance and complexity metrics were significantly lower in the less confident group. The findings add to knowledge about the impacts of fear of falling among the elderly, and may be beneficial for personalising physical activity prescriptions for older people displaying this concern.

The full article can be found at: Paraschiv-Ionescu A, Büla CJ, Major K, Lenoble-Hoskovec C, Krief H, El-Moufawad C, Aminian K. Concern about falling and complexity of free-living physical activity patterns in well-functioning older adults. Gerontology. 2018;64:603-11.
Available at: https://www.karger.com/Article/FullText/490310

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