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Biomedical subjects

Susie Dinan

Publications and source records attributed to Susie Dinan.

5 recordsLinked to original sources

Is the promotion of physical activity in vulnerable older people feasible and effective in general practice?

There is convincing evidence about the benefits of exercise training in community dwelling frailer older people, but little evidence that this intervention can be delivered in general practice. In this prospective cohort study in 14 general practices in north London we assessed the feasibility and effectiveness of a tailored exercise referral programme for frail elderly patients delivered within a variety of inner city primary care settings. One hundred and twenty-six women and 32 men aged 75 years and older, deemed borderline frail by their GPs, took part in a two-phase progressive exercise programme (Stage 1--primary care setting; Stage II--leisure/community centre setting) using the Timed Up And Go (TUG) test as the primary outcome measure. Baseline TUG measures confirmed that the participants were borderline frail and that GP selection was accurate. Of those referred by their GP or practice nurse 89% took up the exercise programme; 73% completed Stage I and 63% made the transition to the community Stage II programme. TUG improved in Stage I with a mean difference of 3.5 seconds (P<0.001). An individually tailored progressive exercise programme following GP referral, delivered in weekly group sessions by specialist exercise instructors within general practices, was effective in achieving participation in exercise sessions and in improving TUG values in a significant number of frailer older citizens.

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Aerobic training in the 'oldest old': the effect of 24 weeks of training.

OBJECTIVE: to determine the effects of aerobic training on the maximal aerobic power of healthy, very elderly people. DESIGN: a 12-week control period followed by 24 weeks of progressive, weight bearing, aerobic training. SUBJECTS: 26 men and women aged 79 to 91 years conforming to pre-determined health criteria. METHODS: we took measurements before and after a 12 week control period and following 24 weeks of training. These were maximal aerobic power (VO(2)max), heart rate at an oxygen consumption of 10 ml x kg(-1) x min(-1) (HR at VO(2)10), resting heart rate, isometric knee extensor strength, isometric elbow flexor strength and lower limb extensor power. MAIN RESULTS: pre-control values of VO(2)max for the women and men were 14.1 (SD 2.79) and 22.0 (5.12) ml.kg(-1).min(-1) respectively. There was no significant change in the VO(2)max of either group over the control period. After training, there was a 15% increase in the VO(2)max of the women (P<0.01) but no change was observed in the men. In the women, there was no significant change in HR at VO(2)10 over the control period but a 14% decrease (P<0.01) after training. In the men there was a 7% (P<0.05) increase in HR at VO(2)10 over the control period and a 5% (P<0.05) decrease after training. No effect of training was seen on isometric knee extensor strength, isometric elbow flexor strength or lower limb extensor power of either group. CONCLUSION: progressive aerobic training can increase the maximal aerobic power of very elderly women. A 15% increase in VO(2)max may prevent many elderly women from crossing functionally important thresholds, thereby helping to maintain independence.

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