evidence-based research to support community action canadian centre for activity and aging gareth r....
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Evidence-Based Research Evidence-Based Research toto
Support Community ActionSupport Community Action
Canadian Centre forCanadian Centre for
Activity and AgingActivity and Aging
Gareth R. Jones Ph.D. Gareth R. Jones Ph.D.
DirectorDirector Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Leaders in physical Leaders in physical activity and aging: from activity and aging: from research to actionresearch to action
ResearchResearch
DivisionDivision
Community Community
Outreach DivisionOutreach Division
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
TRANSLATIONTRANSLATION
Reduction in physical Reduction in physical activity as one ages may be activity as one ages may be due to: due to: Social attitudes – take it
easy, rest Lack of knowledge regarding
the ability to restore potential through exercise
Lack of facilities and convenience of participation
Lack of expertise and leadership to offer effective exercise programs
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Factors related to increasing Factors related to increasing physical activity in physical activity in community-dwelling seniors: community-dwelling seniors: Moderate intensity activities (to Moderate intensity activities (to
start)start) InexpensiveInexpensive Simple programs that support Simple programs that support
functional activitiesfunctional activities Programs are conveniently Programs are conveniently
locatedlocated Social support networkSocial support network Educational support for both Educational support for both
exercise leaders and participants.exercise leaders and participants.
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
2020 4040 6060 8080Age YearsAge Years
1010
2020
3030
4040A
ero
bic
Po
we
r (m
lA
ero
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r (m
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25%
50%
75%
100%
100%
75%
50%
25%
% Aerobic Capacity% Aerobic Capacity
% A
ero
bic
Cap
acit
y%
Aer
ob
ic C
apac
ity
Dressing
Domestic Work (vacuum, mow lawn, make beds)
Walk level 5km/hr (80m/min)Walk Staircase
Aerobic capacity required for selected activitiesAerobic capacity required for selected activitiesrelative to the age associated decline of fitnessrelative to the age associated decline of fitness
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Contribution of cardiorespiratory Contribution of cardiorespiratory fitness and muscular strength to fitness and muscular strength to functional limitations and functional limitations and DependenceDependence
M
Cardiorespiratory Fitness
Morphology
MuscularPerformance
PathologyFunctional Limitations
(Morey et al., 1998)(Morey et al., 1998)
Com
pon
en
ts o
f Fit
ness
Com
pon
en
ts o
f Fit
ness
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
In-house exercise In-house exercise programsprograms
• Community Exercise PhysiologistCommunity Exercise Physiologist• Program CoordinatorProgram Coordinator• 27 Instructors27 Instructors• Living LaboratoryLiving Laboratory
• ~ 400 participants~ 400 participants• 16 exercise programs16 exercise programs
CardiorespiratoryCardiorespiratory Power walkingPower walking Weight trainingWeight training Combined (weights & Combined (weights &
cardio)cardio) Get fit for Active Get fit for Active
LivingLiving
Osteoporosis COPD Functional fitness Hip Fracture Rehab Dynamic BalanceDynamic Balance
Tracking Older Participants of Twelve Physical Activity Classes Over a Three Year Period.Tracking Older Participants of Twelve Physical Activity Classes Over a Three Year Period.Ecclestone, Myers & Paterson. Ecclestone, Myers & Paterson. Journal of Aging and Physical ActivityJournal of Aging and Physical Activity (1998) 6: 70-82 (1998) 6: 70-82
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Community Outreach Community Outreach DivisionDivision
Community ProgramsCommunity Programs• Urban and ruralUrban and rural
Get Fit For Get Fit For Active LivingActive Living
Cherryhill Cherryhill Seniors Seniors CommunityCommunity
VON-HOMMEVON-HOMME VON-SMARTVON-SMART
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Leadership Training ProgramsLeadership Training ProgramsEducation, Training and ProgramsEducation, Training and Programs
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
RobustRobust RestorableRestorable FrailFrail Seniors Fitness Seniors Fitness Instructor Course (SFIC)Instructor Course (SFIC)
Peer leadershipPeer leadership Advanced versionAdvanced version
Get Fit For Active Living Get Fit For Active Living (GFAL) (GFAL)
Personal Trainers Personal Trainers for Older Adults (PTOA)for Older Adults (PTOA)
First Step Program First Step Program (FSP)(FSP)
Home Support Home Support Exercise Program Exercise Program (HSEP)(HSEP)
Functional Fitness for Older Adults (FFOA)
Restorative Care Education and Training (RCET)
NEWNEW
Get Fit For Active Living (GFAL)Get Fit For Active Living (GFAL)
Introduction to exercise, fitness and healthIntroduction to exercise, fitness and health
8 week program8 week program 2x per week 2x per week
cardiorespiratory classcardiorespiratory class 1x per week weight training1x per week weight training 1x per week lecture1x per week lecture
Lecture topics includeLecture topics include Benefits of Physical ActivityBenefits of Physical Activity Exercise AdherenceExercise Adherence Cardiorespiratory ExerciseCardiorespiratory Exercise Muscle strengtheningMuscle strengthening Flexibility & balanceFlexibility & balance Healthy eatingHealthy eating Exercise at home andExercise at home and community optionscommunity options
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Preliminary resultsPreliminary results80% adherence 80% adherence
at one yearat one year• 63% ex. program63% ex. program• 17% ex. at home17% ex. at home
(n=215)(n=215)
36 hours of in-class theory (advanced only 36 hours of in-class theory (advanced only 18hrs)18hrs)
Aging & physical activity -overviewAging & physical activity -overview Programming,includes screening and Programming,includes screening and
assessmentassessment Special health conditionsSpecial health conditions Planning and evaluationPlanning and evaluation
16 hours of practical experience required16 hours of practical experience required Take-home & Field test examTake-home & Field test exam Certification by the CCAACertification by the CCAA
1,300 certified1,300 certifiedRef: Govindasamy, D (1994). Physical Activity and the older adult: A knowledge base for managing exercise programs. Stipes
Publishing Company.
Seniors Fitness Instructor Course (SFIC)Seniors Fitness Instructor Course (SFIC)
Leaders trained to deliver safe and Leaders trained to deliver safe and effective exercise programs for effective exercise programs for older adultsolder adults
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
First Step Program (FSP)First Step Program (FSP)
Is the FSP effective at increasing physical Is the FSP effective at increasing physical activity when delivered through diabetes activity when delivered through diabetes education centres?education centres?
Sixty-one FSP facilitators across CanadaSixty-one FSP facilitators across Canada Include both professional diabetes educators Include both professional diabetes educators
and peer leadersand peer leaders Pilot study Pilot study (Diabetes Educator, 2002)(Diabetes Educator, 2002)
RCT RCT (Int J Obesity, 2003)(Int J Obesity, 2003)
Implementation and dissemination project Implementation and dissemination project (completed March 2004)(completed March 2004)
Prospective investigation of long-term Prospective investigation of long-term adherence adherence (2004-2005 recent 1-yr funding of $70,000)(2004-2005 recent 1-yr funding of $70,000)
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
A pedometer-based physical activity, behaviour modification program for those living with Type-2 diabetes
Training for those working with the frail, homebound elderly
10 simple, progressive exercise 4 hour workshop Resources include
training manual facilitator guide picture booklet video
Hong Kong & recent USA collaborations
Training for home care in SWO funded by MOH
Home Support Exercise Program Home Support Exercise Program (HSEP)(HSEP)
Tudor-Locke et al. (2000) Tudor-Locke et al. (2000) J Aging and Physical ActivityJ Aging and Physical ActivityJohnson et al. (2003) Johnson et al. (2003) J Aging and Physical ActivityJ Aging and Physical Activity..
Jones et al . (2003) Jones et al . (2003) Aging and GeriatricsAging and GeriatricsJones et al. (2003) Jones et al. (2003) Stride MagazineStride Magazine
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Functional Fitness for Older Adults Functional Fitness for Older Adults (FFOA)(FFOA)
16 hour workshop Long Term Care staff interested
in providing Safe Effective Challenging
Group-based program Evidence-based Lazowski, et al. (1999). Lazowski, et al. (1999).
A randomized outcome evaluation of group of exercises A randomized outcome evaluation of group of exercises programs in long-term care institutes. J Gerontol: Med programs in long-term care institutes. J Gerontol: Med Sci, 54(12), 621-628.Sci, 54(12), 621-628.
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Restorative Care Education and Restorative Care Education and Training (RCET)Training (RCET)
40 hour course (5 modules) Educate long term care staff
to deliver; individual exercise and
rehabilitation interventions positioning, mobility and
transfer techniques Communication and feeding
skills assessment and evaluation
Evidence-based JohnsonJohnson, et al. (In Press). Evaluation of , et al. (In Press). Evaluation of
restorative care education and training program restorative care education and training program for long term care residents. Can J Aging.for long term care residents. Can J Aging.
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
Train the TrainerTrain the Trainer Experienced and educated
exercise leaders 40 hour course Taught course facilitation
and adult education skills Web-based training Required to lead 2
education course within the first year and a minimum of 2 course per year in subsequent years.
Biannual review of facilitation skills
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
CCAA Certified Exercise Leaders and CCAA Certified Exercise Leaders and Program FacilitatorsProgram Facilitators
Training Program NUMBER TRAINED (as of May, 2004)
SFIC Leaders 1508
GFAL Facilitators 10
HSEP Leaders 800+
HSEP Facilitators 24
FSP Facilitators 61
FSP Trainers 15
FFOA Leaders 661
RCET Leaders 877
Total CCAA Course Trainers 80
CCAA trainers and programs throughout CanadaCCAA trainers and programs throughout Canada
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
www.uwo.ca/actagewww.uwo.ca/actage
National National Leadership Leadership Training InitiativeTraining InitiativeImproving the Quality of Physical Activity programs for Canada’s Older Adults
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging
International Guidelines to be International Guidelines to be tabled and endorsed tabled and endorsed by the WHO at the 6by the WHO at the 6thth World World Congress on Aging an Physical Congress on Aging an Physical ActivityActivity
ChairChairN EcclestoneN Ecclestone
Steering Steering CommitteeCommitteeW Chodzko-ZaijkoW Chodzko-ZaijkoP MarkonP MarkonD PatersonD PatersonA TaylorA TaylorG JonesG JonesN EcclestoneN Ecclestone
NationalNationalScientificScientificCommitteeCommitteeA TaylorA TaylorP ChilibeckP ChilibeckN EcclestoneN EcclestoneG GutmanG GutmanG JonesG JonesC JohnsonC JohnsonP MarkonP MarkonA MyersA MyersS O’Brien CousinsS O’Brien CousinsD PatersonD PatersonR PetrellaR PetrellaA PipeA PipeM PorterM PorterC PowellC PowellB TaylorB TaylorT VandervoortT Vandervoort
InternationalInternationalScientific Scientific CommitteeCommitteeW Chodzko-Zaijko USAW Chodzko-Zaijko USAG Gass G Gass AustraliaAustraliaH Baumann H Baumann GermanyGermanyE Heikkinen FinlandE Heikkinen FinlandJ Holloszy J Holloszy USAUSAJ Jones J Jones USAUSAJ Judge J Judge USAUSAA Kalache A Kalache WHOWHOS Lord S Lord AustraliaAustraliaV Matsudo V Matsudo BrazilBrazilK McCully K McCully USAUSAM McMurdo ScotlandM McMurdo ScotlandM Palaez M Palaez PAHOPAHOZ Radak Z Radak HungaryHungaryR Rikkli R Rikkli USAUSAF Schena F Schena ItalyItalyM Sagiv M Sagiv IsraelIsraelD Seals D Seals USAUSAA Stewart USAA Stewart USAK Tanaka K Tanaka JapanJapanC Tudor-Locke USAC Tudor-Locke USA
Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging