title: Spinal-flexibility-plus-aerobic versus aerobic-only training: effect of a randomized clinical trial on function in at-risk older adults.
abstract: BACKGROUND
  As exercise is associated with favorable health outcomes, impaired older adults may benefit from specialized exercise interventions to achieve gains in function. The purpose of this study was to determine the added benefit of a spinal flexibility-plus-aerobic exercise intervention versus aerobic-only exercise on function among community-dwelling elders.
  
  
  METHODS
  We employed a randomized clinical trial consisting of 3 months of supervised exercise followed by 6 months of home-based exercise with telephone follow-up. A total of 210 impaired males and females over age 64 enrolled in this study. Of these, 134 were randomly assigned to either spinal flexibility-plus-aerobic exercise or aerobic-only exercise, with 116 individuals completing the study. Primary outcomes obtained at baseline, after 3 months of supervised exercise, and after 6 months of home-based exercise included: axial rotation, maximal oxygen uptake (VO2max); functional reach, timed-bed-mobility; and the Physical Function Scale (PhysFunction) of the Medical Outcomes Study SF-36.
  
  
  RESULTS
  Differences between the two interventions were minimal. Overall change scores for both groups combined indicated significant improvement for: axial rotation (p=.001), VO2max (p=.0001), and PhysFunction (p=.0016). Secondary improvements were noted for overall health (p=.0025) and reduced symptoms (p=.0008). Differences between groups were significant only for VO2max (p=.0014) at 3 months with the aerobic-only group improving twice as much in aerobic capacity as the spinal flexibility-plus-aerobic group. Repeated measures indicated both groups improved during the supervised portion of the intervention but tended to return toward baseline following the home-based portion of the trial.
  
  
  CONCLUSIONS
  Gains in physical functioning and perceived overall health are obtained with moderate aerobic exercise. No differential improvements were noted for the spinal flexibility-plus-aerobic intervention.
authors.affiliation: Geriatric Research, Education and Clinical Center, Durham, North Carolina, USA. morey@geri.duke.edu
authors.forename: M C
authors.initials: MC
authors.lastname: Morey
authors.forename: M
authors.initials: M
authors.lastname: Schenkman
authors.forename: S A
authors.initials: SA
authors.lastname: Studenski
authors.forename: J M
authors.initials: JM
authors.lastname: Chandler
authors.forename: G M
authors.initials: GM
authors.lastname: Crowley
authors.forename: R J
authors.initials: RJ
authors.lastname: Sullivan
authors.forename: C F
authors.initials: CF
authors.lastname: Pieper
authors.forename: M E
authors.initials: ME
authors.lastname: Doyle
authors.forename: M B
authors.initials: MB
authors.lastname: Higginbotham
authors.forename: R D
authors.initials: RD
authors.lastname: Horner
authors.forename: H
authors.initials: H
authors.lastname: MacAller
authors.forename: C M
authors.initials: CM
authors.lastname: Puglisi
authors.forename: K G
authors.initials: KG
authors.lastname: Morris
authors.forename: M
authors.initials: M
authors.lastname: Weinberger
mesh_terms: D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013131:Spine / Q000502:physiology*