Effect of group exercise on anthropometry, nutritional status and health related quality of life of older persons living in aged care homes within the eThekwini Municipality.

Abstract

Introduction: Globally, the prevalence of chronic disease is on the increase with cardiovascular disease being the leading cause of death. Worldwide the proportion of older persons aged 60 years and older is also increasing. The elderly within institutionalised setting are often neglected, with the probability of poor nutrition being highly prevalent. Increasing in age and visceral fat coupled with a lack of structured exercise results in inflammatory and pro-inflammatory processes, contributing to the deterioration of physical and physiological functioning. In the context of the elderly living in aged care homes, health related quality of life is defined as their functional status and independence in engaging in activities of daily living. Little is known about the effect of group based exercise and its relation to anthropometry, nutritional status and health related quality of life among the elderly living in aged care homes within the eThekwini central business district (CBD). Aim: The aim of the study was to establish the effect of group exercises in relation to anthropometry, nutritional status and health related quality of life of older persons living in age care homes in the eThekwini central business district. Methodology: A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. A total of 100 participants selected from five aged care homes. Twenty participants from each of the five facilities were randomly selected through convenient sampling. From the 20 participants, ten participants were randomly assigned to Group A –experimental group and 10 in Group Bobserved group. Group A exercise three times a week and group B exercise two times a week for 12 weeks. Group based 12 weeks exercise intervention was implemented for both groups. Anthropometrical indices investigated included sum of skinfold, waist circumference, waist to hip ratio and BMI. MNA-SF, SF-36 questionnaires were used before and after the exercise intervention to determine nutritional status and health related quality of life respectively. Data was analysed using the Statistical Package for Social Science Version 18.0 (SPSS) for Windows software. A p-value of <0.05 was considered statistically significant. A paired t-test and independent t-test was used to analyse parametric data. Wilcoxon signed rank test and Mann Whitney U test was used to analyse normally distributed and non-parametric data. Results/Discussion: An inverse relation between 12 weeks of group exercise and sum of skinfold was noted comparing before (M: 141.05 mm, SD: ±37.43mm) and following (M: 153.66 mm, SD: ±46.59mm) group exercise (p<0.01). However this cannot be attributed to group exercise independently, but as a result of the inherent inverse relationship that exists between fat free mass and age. Group exercise when compared to baseline (M: 12.96, SD: ±1.48) and follow up (M: 13.02, SD: ±1.11) was effective in improving nutritional status (p<0.01). Group exercise improved components of HRQoL. Participation in vigorous activities had improved following the group exercise intervention (p<0.01). Exercise was effective in reducing a feeling of worn out (p=0.01), improving social functioning (p<0.01), improved feeling of peace (p<0.01), happiness (p<0.01), change in reported health (p<0.01), mental health (p=0.03) and vitality (p=0.01). There was a significant difference in social functioning (p<0.01), vitality (p<0.01) and mental health (p=0.03) comparing before and following training thrice a week. Group exercise twice a week may improve social functioning (p=0.02). There was a significant difference in mental component summary following 12 weeks of group exercise (p<0.01). There was a significant difference in physical component summary scale (p=0.03) and mental component summary (p=0.04) comparing before and following training twice a week. A significant difference was evident in the mental component summary scale comparing before and following training thrice a week (p<0.01). Conclusion: Group exercise significantly improved nutritional status and health related quality of life of the elderly living in aged care homes. Group exercise performed three times a week may improve social functioning, vitality and mental health whilst exercising two times per week may improve social functioning. This may assist the elderly in accomplishing activities of daily living safely, improving their functional ability and quality of life.