knowledge
Putting research to action!


Knowledge Translation: CCAA research to action

Evidence-based Research

Education Course Derived from Research

International Dissemination of Knowledge

(as of October, 2008)

  • Ecclestone NA, Myers AM, Paterson DH. Tracking Older Participants of Twelve Physical Activity Classes Over a Three-Year Period.Journal of Aging and Physical Activity, 1998. 6: p. 70-82.
  • Paterson DH, Govindasamy D, Vidmar M., Cunningham DA, Koval JJ. Longitudinal Study of Determinants of Dependence in an Elderly Population. Journal of the American Geriatrics Society, 2004(52): p. 1632–1638.
  • Thomas SG, Cunningham DA, Rechnitzer PA, Donner AP, Howard JH. (1985). Determinants of the Training Response in Elderly Men. Medicine Science Sports & Exercise, 17(6):667-72.
  • Cunningham DA, Rechnitzer PA, Howard JH, Donner AP. (1987). Exercise Training of Men at Retirement: A clinical trial. Journal of Gerontology, 42(1):17-23.
  • Rice CL, Cunningham DA, Paterson DH, Rechnitzer PA. (May 1989). Strength in an Elderly Population. Archives of Physical Medicine & Rehabilitation, 70(5):391-7.
  • Paterson DH, Cunningham DA, Koval JJ, St Croix CM. (1999). Aerobic Fitness in a Population of Independently Living Men and Women Aged 55-86 Years. Medicine Science Sports & Exercise, 31(12):1813-20.
  • Stathokostas L, Jacob-Johnson S, Petrella RJ, Paterson DH. (1997). Longitudinal Changes in Aerobic Power in Older Men and Women. Journal of Applied Physiology, 2;781-9.

Seniors Fitness Instructors Course (SFIC)

Courses: 250

Participants: 2700

Certified: 900

Provinces/Countries:
AB, BC, MB, NS, ON, SK, USA

  • Jones GR, Wark G, Cyarto E, Boris J, Storry E. Evaluation Report: Canadian Centre for Activity and Aging's Get Fit for Active Living Program. 2004, Canadian Centre for Activity and Aging: London , ON . p. 19.

Get Fit for Active Living

(GFAL)

Courses: 75

Participants: 650

Facilitators: 25

Province: ON, PEI, NS, ND, NFLD

  • Tudor-Locke C, Myers AM, Jacob SC, Jones GR, Lazowski D-A, Ecclestone NA. Development and Formative Evaluation of the Centre for Activity and Ageing's Home Support Exercise Program for Frail Older Adults.Journal of Aging and Physical Activity, 2000. 8: p. 59-75.
  • Myers AM , Cyarto E, Fitzgerald C, Johnson CS & Jones GR. Sustainability and dissemination of The Home Support Exercise Program. Gerontologist, 43:311, 2003. (abstract)
  • Cyarto EV , Fitzgerald C, Myers AM & Jones GR. Coordinated Home Support Exercise for Frail Older Adults. 32nd Annual Meeting of the Canadian Association on Gerontology, Toronto , October 2003. (presentation)
  • Jones G, Frederick J. The Canadian Centre for Activity and Aging's Home Support Exercise Program.Geriatrics & Aging, 2003. 6(7): p. 48-49.
  • Jones, G.R. The Home Support Exercise Program for Frail Older Adults. Stride, 2004. p. 4-9.

Home Support Exercise Program (HSEP)

Courses: 175

Participants: 1780

Facilitators: 85

Provinces/Countries:
AB, BC, NB, NFLD, NS, ON, China

  • Luxton S. Development of a Training Program for Restorative Care.Stride, 2002: p. 14-16.
  • Luxton S & Jones GR. Restorative Care - Promoting Independence and Improved Quality of Life for Residents in Long-term Care. Canadian Association of Gerontology, Toronto , October 2003. (presentation)
  • Jacob Johnson SC , Myers AM, Jones GR, Fitzgerald C, Lazowski D-A, Stolee P, Segall N, & Ecclestone NA. Evaluation of the Restorative Care Education and Training Program for Nursing Homes.Canadian Journal on Aging, 2005. In Press.

Restorative Care Education and Training

(RCET)

Courses: 95

Participants: 1450

Provinces: BC, ON

  • Lazowski D-A, Ecclestone NA, Myers AM, Paterson DH, Tudor-Locke C, Fitzgerald C, Jones G, Shima N, & Cunningham DA. A Randomized Outcome Evaluation of Group Exercise Programs in Long-Term Care Institutes.The Journals of Gerontology, 1999. 54A(12): p. M621-M628.

Functional Fitness for Older Adults (FFOA)

Courses: 40

Participants: 950 Provinces/Countries:
ON, PEI , NB, NS, MB, AB, BC, NT, Italy

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Other publications on Aging and Physical Activity from the CCAA

  • Rice CL, Cunningham DA, Paterson DH, Lefcoe MS. (Jun 1989). Arm and Leg Composition Determined by Computed Tomography in Young and Elderly Men. Clinical Physiology, 9(3):207-20.
  • Overend TJ, Cunningham DA, Kramer JF, Lafcoe MS, Paterson DH. (1992). Knee Extensor and Knee Flexor Strength: cross-sectional area ratios in young and elderly men. Journal of Gerontology: MEDICAL SCIENCES, 47(6):M204-210.
  • Koval JJ, Ecclestone NA, Paterson DH, Brown B, Cunningham DA, Rechnitzer PA. Response Rates in a Survey of Physical Capacity Among Older Persons. (1992). Journal of Gerontology: SOCIAL SCIENCES, 47(3):S140-147.
  • Wong DG, Rechnitzer PA, Cunningham DA, Howard HJ. (1990). Effect of an Exercise Program on the Perception of Exertion in Males at Retirement. Canadian Journal of Sport Science, 15(4):249-253.
  • International Society for Aging and Physical Activity. (2004). International Curriculum Guidelines for Preparing Physical Activity Instructors of Older Adults. Human Kinetics, 16.
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Knowledge Translation Activity

Basic Research

To date, knowledge exchange and translation has focused on helping researchers introduce their work into the decision-making process. Equally important is the need for organizations to be capable of using evidence-based research in their decision-making. This capability involves an organization having the ability to conduct evidence-based research, judge its reliability, quality, relevance, and applicability, adapt it into a useable format, and apply it within the real world to determine its effectiveness 1.

The Canadian Centre for Activity and Aging (CCAA) has shown innovation and effectiveness in translating research-based knowledge through education programs delivered to and through health care organizations. The CCAA’s physical activity and restorative programs reach tens of thousands older Canadians annually through these front-line health care organizations.

The CCAA (formerly the Centre for Activity and Ageing) was founded in 1989 and is affiliated with The University of Western Ontario (UWO), St. Joseph’s Health Care London (SJHC) and the Lawson Health Research Institute (LHRI). The mandate is to investigate the interrelationship of physical activity and aging to develop strategies, based on research, to promote the independence of older adults. Research at the CCAA is divided into both Basic and Applied research with knowledge translation being delivered through the Community Outreach division.

In the late 1970’s Dr. Peter Rechnitzer and Dr. David Cunningham (Faculties of Kinesiology and Medicine, UWO) began to focus their research on activity and aging after some initial work in the area of exercise rehabilitation for cardiac patients. The first project for the pair was a two-year study of 220 men approaching retirement. After participating in an exercise program three times per week for one year, the men reclaimed the functional fitness usually lost within a decade 2, 3.

In the mid 1980’s studies included the investigation of changes in muscle strength and composition with aging. The results from these projects showed great gains (25-30%) in measures of strength and suggested that resistance training produced significant improvements in muscle strength, which had functional benefits for older adults 4, 5, 6 .

Another study describing the association between perception of exertion and exercise was performed over one-year using 138 male subjects at retirement. Results indicated that perception of a physical task normally changes at retirement such that a given amount of exertion may seem subjectively greater 7. Furthermore, a structured exercise program is successful at maintaining perception of task at pre-retirement levels. This maintenance of a low rating of perception may retard a reluctance to be physically active which often accompanies aging 8.

Findings from a 10-year longitudinal study found that after controlling for age, disease and gender, lower cardiorespiratory fitness (VO2max) was significantly associated with increased dependency in the elderly 9. Routine exercise, including walking, seems to be the key to improved cardiorespiratory fitness 10. An achievable 10% increase in fitness would decrease the risk of becoming dependent by approximately 30% 11.
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Community Outreach

From the beginning, an important goal of the CCAA was the development of an extensive community outreach division to apply activity and aging research findings to community programs to ultimately promote the independence of older adults.
Community Outreach Objectives include:

  1. expanding community programs for the aged both locally and nationally;
  2. developing model activity programs that are applications of research findings that will benefit elderly people and will enable older adults to maintain an independent lifestyle;
  3. developing and evaluating exercise programs for the frail elderly (Long-Term Care settings);
  4. providing exercise testing and prescriptions for the community, both for internal and outreach programs, and educating and training exercise specialists for careers in this area;
  5. providing, through seminars and workshops, the opportunity for fitness activity leaders, including older adults, to develop exercise expertise;
  6. establishing working relationships with agencies that provide physical activity programs for seniors; and
  7. studying factors that affect adherence to programs and developing strategies that will attract a larger segment of elderly people who do not normally participate in fitness activities.

The need for leadership training programs nationwide and the potential for collaboration among researchers nationally to address application of research into the community led to the incorporation of the CCAA in 2000. Furthermore, the research identified a need for appropriate exercise programs for older adults, thus the development of leadership programs began.
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Leadership Training Courses (updated October 2008)

  • Seniors Fitness Instructors Course (SFIC) – developed to address a need for training and information about appropriate physical activity programs for community dwelling older adults. To date the CCAA has trained over 2,700 leaders in Ontario, Nova Scotia, Manitoba, Alberta and British Columbia, and internationally in Illinois (US), Hong Kong and Italy.
  • Get Fit for Active Living Program (GFAL) – an eight-week exercise and education program that introduces older adults to the benefits of exercise and the importance of leading a healthy and active lifestyle 12. Over 650 participants have completed the program and 25 facilitators have been trained in Ontario and the Atlantic provinces.
  • Home Support Exercise Program (HSEP) – 10 simple, yet progressive, exercises designed to enhance and maintain functional fitness, mobility, balance and independence of homebound older adults. The training is geared to Personal Support Workers, volunteers, or caregivers who instruct, encourage, and monitor home-based exercise programs 13. The HSEP has been proven to be cost-effective 14. The CCAA has trained over 1780 leaders and 85 Home Support Exercise Program Facilitators.
  • Restorative Care Education Training (RCET) – educates those working in long-term care facilities about the development of an effective and beneficial restorative aide program. Many facilities do not have access to regular, ongoing physiotherapy, occupational therapy or speech pathology services. Restorative care aides can provide assistance to residents before they receive therapy and follow up with programs initiated by other health professionals 15. Findings from a randomized evaluation study involving 12 long-term care facilities showed significant differences for several indicators. Residents who received restorative intervention improved, while those in the control condition declined in several areas of functioning 16. To date the CCAA has trained over 1,450 RCET leaders across Ontario, from Windsor to Ottawa to Iroquois Falls and many points in between.
  • Functional Fitness for Older Adults (FFOA) - The goal of the exercises presented in this workshop is to improve the functional abilities of older adults and to promote their independence for activities of daily living. The FFOA is for staff working in long-term care facilities, retirement residences and adult day programs. The feasibility and efficacy of the program were evaluated and it was concluded that institutionalized seniors, even those who are physically frail, incontinent and or/ have mild dementia; can respond positively to a challenging exercise program. With minimal training, the program can be safely delivered at low cost by institutional staff and volunteers 17. To date the CCAA has trained over 950 leaders nationally in Northwest Territories, British Columbia and Ontario. The FFOA has been incorporated into the Motor Sciences curriculum at the University of Verona, Italy and so far 25 students have been trained.
  • Train the Trainer - Designed to make the CCAA’s leadership training courses available to communities around world. To date the CCAA has trained 115 trainers.
  • Post Rehabilitation Exercise for Stroke Survivors (PRES) – Developed in 2008 to teach interested individuals to deliver an exercise program that will improve stroke survivors’ independence for activities of daily living and reduce the loss of functional mobility associated with discharge from a stroke rehabilitation program. The first course was delivered in September 2008 and 16 people were trained.
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National Leadership Training Initiatives

The CCAA leadership programs led to the development of the National Leadership Training Initiatives Project. The objective of this three-year project was to develop guidelines for training leaders of physical activity programs for older adults based on the goals outlined in the national Blueprint for Action for Active Living and Older Adults document.

Sixty-six individuals, from all provinces as well as some international members, representing a cross-section of health-related fields were instrumental in contributing to the guidelines. In 2004 the CCAA was awarded the 6th World Congress on Aging and Physical Activity by the International Society for Aging and Physical Activity (ISAPA) in recognition of their work in the field of Aging and Physical Activity. At the Congress the national guidelines were endorsed by the World Health Organization (WHO) and were tabled as the International Curriculum Guidelines for Preparing Physical Activity Instructors of Older Adults 18. The guidelines have subsequently been translated into other languages.

The CCAA Community Outreach team is constantly improving information delivery

  • Website – All CCAA trainers post upcoming course information on the community outreach website. Now, anyone with internet access can view course calendars, find local trainers/instructors and access archives of research articles and newsletters.
  • Newsletters – Distributed twice a year, newsletters provide valuable information about recent and upcoming courses and events. Informative research articles from the CCAA basic research team and other information updates.
  • E-newsletters – In an effort to reduce the size of our carbon footprint the CCAA has moved toward increased electronic distribution of newsletters and course and information updates.
  • Community Presentations and Refresher Workshops – CCAA Community Outreach staff provide a variety of presentations and continuing education workshops locally as well as nationally and internationally each year.
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CCAA Partners

Partners in delivering leadership courses have included YMCA-YWCAs, hospitals, The University of Western Ontario, the Regional Geriatric Program in London, the Victorian Order of Nurses (VON), local public health units, long-term care facilities, and many national organizations such as the Osteoporosis, Alzheimer, Diabetes, and Arthritis societies/associations.

Building knowledge through leadership development, especially for older adults, is a viable solution to the epidemic loss of functional mobility. The CCAA team is conscious of the effectiveness of collaborative, community-based efforts which are necessary for sending a unified message leading to long-term, positive change. The CCAA will continue to have a positive impact on the functional status of older adults through the implementation of physical activity programs and the training of leaders to deliver these programs.
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REFERENCES

  1. Canadian Health Services Research Foundation. Knowledge Transfer and Exchange. Accessed April 25,2005. Retrieved from: http://www.chsrf.ca/knowledge_transfer/index_e.php.
  2. Thomas SG, Cunningham DA, Rechnitzer PA, Donner AP, Howard JH. (1985). Determinants of the Training Response in Elderly Men. Medicine Science Sports & Exercise, 17(6):667-72.
  3. Cunningham DA, Rechnitzer PA, Howard JH, Donner AP. (1987). Exercise Training of Men at Retirement: A clinical trial. Journal of Gerontology, 42(1):17-23.
  4. Rice CL, Cunningham DA, Paterson DH, Rechnitzer PA. (May 1989). Strength in an Elderly Population. Archives of Physical Medicine & Rehabilitation, 70(5):391-7.
  5. Rice CL, Cunningham DA, Paterson DH, Lefcoe MS. (Jun 1989). Arm and Leg Composition Determined by Computed Tomography in Young and Elderly Men. Clinical Physiology, 9(3):207-20.
  6. Overend TJ, Cunningham DA, Kramer JF, Lafcoe MS, Paterson DH. (1992). Knee Extensor and Knee Flexor Strength: cross-sectional area ratios in young and elderly men. Journal of Gerontology: MEDICAL SCIENCES, 47(6):M204-210.
  7. Koval JJ, Ecclestone NA, Paterson DH, Brown B, Cunningham DA, Rechnitzer PA. Response Rates in a Survey of Physical Capacity Among Older Persons. (1992). Journal of Gerontology: SOCIAL SCIENCES, 47(3):S140-147.
  8. Wong DG, Rechnitzer PA, Cunningham DA, Howard HJ. (1990). Effect of an Exercise Program on the Perception of Exertion in Males at Retirement. Canadian Journal of Sport Science, 15(4):249-253.
  9. Paterson DH, Cunningham DA, Koval JJ, St Croix CM. (1999). Aerobic Fitness in a Population of Independently Living Men and Women Aged 55-86 Years. Medicine Science Sports & Exercise, 31(12):1813-20.
  10. Stathokostas L, Jacob-Johnson S, Petrella RJ, Paterson DH. (1997). Longitudinal Changes in Aerobic Power in Older Men and Women. Journal of Applied Physiology, 2;781-9.
  11. Paterson DH, Govindasamy D, Vidmar M, Cunningham DA, Koval JJ. (2004). Longitudinal Study of Determinants of Dependence in an Elderly Population. Jornal of the American Geriatrics Society, 52;1632–1638.
  12. Jones GR, Wark G, Cyarto E, Boris J, Storry E. (2004). Evaluation Report: Canadian Centre for Activity and Aging's Get Fit for Active Living Program. London: Canadian Centre for Activity and Aging, 19.
  13. Jones GR. (2004). The Home Support Exercise Program for Frail Older Adults. Stride, 4-9.
  14. Jones G, Frederick JAB. (2003). The Canadian Centre for Activity and Aging's Home Support Exercise Program. Geriatrics & Aging, November 2003/January 2004, 48-49.
  15. Luxton S. (2002). Development of a Training Program for Restorative Care. Stride, February/April 2002;14-16.
  16. Jacob Johnson SC, Myers AM, Jones GR, Fitzgerald C, Lazowski D-A, Stolee P, Segall N, Ecclestone NA. (2005). Evaluation of the Restorative Care Education and Training Program for Nursing Homes. Canadian Journal on Aging, In Press.
  17. Lazowski D-A, Ecclestone NA, Myers AM, Paterson DH, Tudor-Locke C, Fitzgerald C, Jones GR, Shima N, and Cunningham DA. (1999). A Randomized Outcome Evaluation of Group Exercise Programs in Long-Term Care Institutes. The Journals of Gerontology, 54A (12):M621-M628.
  18. International Society for Aging and Physical Activity. (2004). International Curriculum Guidelines for Preparing Physical Activity Instructors of Older Adults. Human Kinetics, 16.
  19. Speechley M, Belfry S, Borrie MJ, Bray Jenkyn K, Crilly R, Gill DP, McLean S, Stolee P, Vandervoort AA, Jones GR. (2005). Risk Factors for Falling Among Community-Dwelling Veterans and their Caregivers. Canadian Journal on Aging, In Press.

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Contact

Clara Fitzgerald
Canadian Centre for Activity and Aging
Toll Free 1.866.661.1603
Fax 519.661.1612
Email: cfitzge4@uwo.ca

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