title: Physical activity and performance in older persons with musculoskeletal impairment: results of a pilot study with 9-month follow-up.
abstract: OBJECTIVE
  Physical activity in older adults improves fitness, but few studies have examined the short- and long-term effects on physical performance. This analysis is preliminary to a RCT investigating physical activity effects on performance over time in older persons with musculoskeletal impairment.
  
  
  METHODS
  Fifty sedentary participants, aged 65+, with musculoskeletal impairment and difficulties in complex mobility, but independent in basic activities of daily living (ADLs) were randomly assigned to 3- monthly, twice-a-week, supervised physical exercise (E) or unsupervised regular walking (W), and advised to keep active.
  
  
  METHODS
  baseline (T0), discharge (T1), 6 (T2) and 9 (T3) months from baseline.
  
  
  RESULTS
  Summary of Performance Score (SPS), strength, flexibility; general mental health (GMH), vitality, and self reported disability.
  
  
  RESULTS
  All participants completed follow-ups. At T3, only 12 E and 2 W participants reported exercising regularly. Each outcome, except for GMH, trunk flexibility and basic ADLs, changed over time significantly more in E than in W. After training, E increased SPS (1 point), along with muscle strength, flexibility, vitality, and reduced difficulties in complex mobility. At 9 months, all parameters, except passive hip flexion and shoulder abduction, had reverted to baseline levels. In the same time-frame, W progressively decreased SPS, knee flexion/ extension strength and passive flexion, and increased difficulties in basic and complex mobility.
  
  
  CONCLUSIONS
  In this physically impaired sample, a 3- month exercise program, compared with unsupervised regular walking, was associated with improved performance, fitness and vitality after discharge, and to delayed physical decline in the next 6-month follow-up.
authors.affiliation: Fondazione Don Carlo Gnocchi, Istituto di Ricovero e Cura a Carattere Scientifico, V. Caccini 18, 50141 Florence, Italy. francescacecchi2002@libero.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Cecchi
authors.forename: Guido
authors.initials: G
authors.lastname: Pasquini
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Chiti
authors.forename: Raffaello
authors.initials: R
authors.lastname: Molino Lova
authors.forename: Enrico
authors.initials: E
authors.lastname: Enock
authors.forename: Giacomo
authors.initials: G
authors.lastname: Nofri
authors.forename: Anita
authors.initials: A
authors.lastname: Paperini
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Conti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mannoni
authors.forename: Claudio
authors.initials: C
authors.lastname: Macchi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009043:Motor Activity; D009140:Musculoskeletal Diseases / Q000503:physiopathology* / Q000628:therapy*; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D016138:Walking