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RESEARCH AND EVIDENCE

Science Class

I work from an evidence-based perspective and look to keep up to-date with research, current thinking and best practice to help my clients get results whilst still exercising safely. 

 

Below are some references to research papers relating to the benefits of exercise and movement in improving health, mobility, wellbeing, independence and quality of life.

Chronic Health Conditions

Cheryl Roumen, Ellen E Blaak, Eva Corpeleijn, Lifestyle intervention for prevention of diabetes: determinants of success for future implementation, Nutrition Reviews, Volume 67, Issue 3, 1 March 2009, Pages 132–146

Improvements in lifestyle can have a large and beneficial impact on diabetes risk. …. weight loss seems to be the most important factor for reducing diabetes risk.  At the same time, physical activity has proven to be an important contributor, independent of obesity.  Relatively small changes in physical activity that are prolonged over several years seem to contribute to a reduction in diabetes risk, although moderate-to-vigorous physical activity seems to have a larger effect. 

Raphaël Bize a b, Jeffrey A. Johnson c d, Ronald C. Plotnikoff a, Physical activity level and health-related quality of life in the general adult population: A systematic review, Preventive Medicine, Volume 45, Issue 6, December 2007, Pages 401-415

Sedentary lifestyle increases the risk of developing many health conditions particularly cardiovascular diseases, hypertension, type 2 diabetes mellitus, colon and breast cancers, osteoporosis, depression, and backaches (U.S. Department of Health and Human Services, 1996, Morrow et al., 1999, Oja and Borms, 2004).  Although many observational and experimental studies have demonstrated the benefit of increased physical activity (PA) in reducing chronic diseases in the general adult population (Hambrecht et al., 2004, Helmrich et al., 1994, Hoidrup et al., 2001, Hu et al., 2005, Laaksonen et al., 2005, McTiernan et al., 2003, Schnohr et al., 2003, Whelton et al., 2002), little is known however, regarding the association between health-related quality of life (HRQL), and physical activity (PA) level in this population.

Most conceptualizations of HRQL include physical, mental (including emotional dimensions), and social components (Revicki, 1989). HRQL encompasses the perceived, valued health attributes such as the sense of comfort or well-being, the ability to maintain good physical, emotional, and intellectual functions, and the ability to satisfactorily take part in social activities.

Falls and Bone Health

Catherine Sherrington PhDJulie C. Whitney MScStephen R. Lord DScRobert D. Herbert PhDRobert G. Cumming PhDJacqueline C. T. Close MD, Effective Exercise for the Prevention of Falls: A Systematic Review and Meta-Analysis, Journal of the American Geriatrics Society, Volume56, Issue12 December 2008 Pages 2234-2243
Exercise can prevent falls in older people (estimate of the effect of exercise was that it reduced the rate of falling by 17%).  Greater relative effects are seen in programs that include exercises that challenge balance, use a higher dose of exercise, and do not include a walking program.

Sherrington C, Michaleff ZA, Fairhall N, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis, Br J Sports Med 2017;51:1749–1757.
Falls are a leading cause of morbidity and mortality in older adults.  Approximately one in three community-dwelling people aged 65 years or older will fall at least once per year, and the risk of falling increases with age.  Falls impose a significant social and economic burden for individuals, their families, community health services and the economy.  As the proportion of older people is rising globally, the costs associated with falls will increase.  The prevention of falls is therefore an urgent public health challenge.

There is strong evidence that appropriately designed intervention programmes can prevent falls in older people.  A Cochrane systematic review established that exercise interventions reduce the rate of falls (number of falls per person) and risk of falling (proportion of people having one or more falls) in community-dwelling older people. Furthermore, exercise as a single intervention has a fall prevention effect similar to multifaceted interventions, suggesting implementation of exercise as a stand-alone intervention may be the optimal and potentially most cost-effective approach to fall prevention at a population level (exercise reduced the rate of falls in community-dwelling older people by 21%).

World Health Organization. (2022). Physical activity and sedentary behaviour: a brief to support older people. World Health Organization.

In older people, physical activity – in particular multicomponent physical activity programmes that include combinations of balance, strength, endurance, gait, and physical function training – is associated with a reduced rate of falls by as much as 23% and risk of injury from falls.

Engaging in a variety of different physical activity, such as balance and functional exercises plus resistance exercises can reduce rate of falls even further and multiple exercise types have greater positive effects on bone health.

Mobility and Physical Function

Mian, O.S., Baltzopoulos, V., Minetti, A.E. et al. The Impact of Physical Training on Locomotor Function in Older People. Sports Med 37, 683–701 (2007).

Locomotor function declines in old age. … physical training can have a beneficial impact on locomotor function in older people…Improvements in locomotor function can be seen within 4–6 weeks of physical training.

 

Manini TM, Pahor M, Physical activity and maintaining physical function in older adults, British Journal of Sports Medicine 2009;43:28-31.

Physical activity has a myriad of effects that stem from physiological adaptations that may transfer to improvements in clinical outcomes such as reducing the risk of falls.  … Individuals who begin a regular physical activity programme early in life and maintain this over the years will likely have high physical performance throughout the lifespan, although a decline in physical function is inevitable.

Muscular Strength and Sarcopenia 

Geirsdottir, Gundy O, Arnarson A, Ramel, A, Briem, K,  Jonsson, PV, Thorsdottir I, Muscular Strength and Physical Function in Elderly Adults 6-18 Months after a 12-Week Resistance Exercise Program, Scandinavian Journal of Public Health 43, no. 1 (2015): 76–82. 

Aging is associated with a decrease in lean body mass, muscular strength, and physical function which can lead to a decrease in mobility and independence, an increase in the requirement for health care provision and nursing home admissions, and earlier death.

 

Vicki S. Conn, Adam R. Hafdahl, David R. Mehr, Interventions to Increase Physical Activity Among Healthy Adults: Meta-Analysis of Outcomes, American Journal of Public Health 101, no. 4 (April 1, 2011): pp. 751-758.
Adequate physical activity is linked with important health outcomes, including reductions in cardiovascular disease, type 2 diabetes, some cancers, falls, osteoporotic fractures, and depression, and improvements in physical function, weight management, cognitive function, and quality of life.  Despite this compelling evidence for the benefits of physical activity, healthy adults commonly get an inadequate amount of physical activity.

Mark D. Peterson a, Matthew R. Rhea b, Ananda Sen c, Paul M. Gordon a, Resistance exercise for muscular strength in older adults: A meta-analysis, Ageing Research Reviews, Volume 9, Issue 3, July 2010, Pages 226-237

Resistance exercise  is effective for improving strength among older adults, particularly with higher intensity training.  Findings therefore suggest that resistance exercise  may be considered a viable strategy to prevent generalized muscular weakness associated with aging.

Campbell and Buchner 1997; Waltson and Fried 1999; Rockwood and Mitniski 2007; Rodríguez Mañas et al. 2012

Frailty syndrome is an age-associated syndrome, characterized by decreases in the functional reserve, strongly associated with sarcopenia that places older individuals at special risk for disability, hospitalization and death induced by falls.

World Health Organization. (2022). Physical activity and sedentary behaviour: a brief to support older people. World Health Organization.

Muscle and bone mass tend to decline with increasing age (i.e. sarcopenia and osteopenia/osteoporosis), and this can be associated with declining strength and physical function. Regular physical activity improves physical function and reduces the risk of age-related loss of physical capacity in older people. Evidence also shows that higher levels of physical activity may improve bone health and thus prevent osteoporosis.

Quality of Life and Wellbeing

Raphaël Bize a b, Jeffrey A. Johnson c d, Ronald C. Plotnikoff a, Physical activity level and health-related quality of life in the general adult population: A systematic review, Preventive Medicine, Volume 45, Issue 6, December 2007, Pages 401-415

There is a consistently positive association between physical activity level and health-related quality of life.

World Health Organization. (2023). Physical activity. World Health Organization. Retrieved March 7, 2023, from https://www.who.int/health-topics/physical-activity#tab=tab_2

Physical inactivity is one of the leading risk factors for noncommunicable diseases (NCDs) and death worldwide.  It increases the risk of cancer, heart disease, stroke and diabetes by 20–30%. It is estimated that four to five million deaths per year could be averted if the global population was more active…. Older adults and people living with disabilities are less likely to be active and miss out on the physical, mental and social health benefits.  

World Health Organization. (2022). Physical activity and sedentary behaviour: a brief to support older people. World Health Organization.

Regular physical activity is important to promote well-being in older people. It is beneficial for physical and mental health, and facilitates social inclusion by reducing isolation. Being active supports healthy ageing and can also help manage conditions such as hypertension and type 2 diabetes, reduce symptoms of depression and anxiety, and enhance cognitive function. Conversely, too much sedentary behaviour can be unhealthy.

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