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Cross-country case study 4: Multidimensional physical fitness testing protocol for aging persons

Why: With aging people, functional independence is directly dependent on physical fitness. Ageing is inevitably associated with the declining functions of systems and organs (heart, lungs, blood vessels, skeletal muscles) that determine physical fitness. However, ageing is a complex process involving many variables that interact with one another e.g. lifestyle factors, chronic diseases and genetics. Relatively little is known about the physical fitness levels needed for maintaining physical independence. Many studies have shown that measurements of physical performance can predict future mobility disability, institutionalization and mortality. Studies have also shown a strong association between measurements of physical performance and self-reported mobility disability. However, most of these prospective studies used only a few measures of physical performance or were targeted at functionally limited persons, and therefore assessments have only limited value for counseling. Therefore, this case study is developing and testing a physical fitness testing protocol for aging persons in real-life settings in three countries: Finland, Spain and Hungary.

To whom – Sample size and recruitment: In Hungary, the sample group consists of persons over 55 years of old. Social media, posters in outdoor trail and fitness parks, former contact lists and snowball sampling are used for recruiting the participants. It is estimated that 30 to 50 persons will be recruited, but due dropouts during the training program, only 20 is expected to do the post-test.

What (materials): Each participant will have to fill informed consent form prior any measurements. Participant consent forms are tailored to meet the GDPR standards and local ethical requirements in Hungary. Two similar score sheets will be created for the physical fitness measurements – one for the participant and one for the researchers. General reference values and the interpretation of the results will be presented after the measurement session. This material will also be displayed on the www-pages for participants to view later. Participants will also fill a self-completion quality of life questionnaire (WHOQOL) before the test and User Experience Questionnaire (UEQ) at the end of test. Security of the participants in the event is carefully designed and considered. Security plan has been developed and will be gone through for all the participating event staff member. For the assessment/measurement simple material will be used including stop watches, tape measures, chairs, hand weights and cones.

In Hungary, participants will receive information regarding the 8 week training program and the related relax exercises. Training program utilizes 1.5 km outdoor fitness trail having 19 physical exercise stations equipped with information boards, which show different variations how to use the stations and how to get to the next station.

What (procedures): In Hungary, physical fitness is measured by following a protocol defined in senior fitness test manual [28]. After finishing the measurement track, participants will fill User Experience Questionnaire (UEQ), which in addition also includes an open text box to propose improvement suggestions or to give complaints about the testing procedure.

In Hungary and Spain the physical fitness testing battery is used to determine the baseline (T0, before start of the training program intervention) and to conduct the post-measure (T1) at the end of the 8 week training program. Participants’ daily activities are also measured with Armband device for 4 days during the training period. In Hungary, the training program includes outdoor trainings on the fitness trails having 19 stations in 1.5 km route. Feedback is collected from participants after the training interventions.

How: During the measurement day in Finland and Spain, there will be an open access time period when measurements are conducted by following walk-in principle. Participants will circulate individually from measurement point to another, where they receive instructions from students (physiotherapy or similar). After finishing the measurement track, participants will go to the meeting point where general reference values and the interpretation of the results can be self-read from presented materials. In the meeting point participants will also fill UEQ questionnaire. In Hungary, the process is similar but participants are invited and measurement track is based on a protocol as defined senior fitness test manual [28].

The physical fitness testing protocol will be first run in Finland. Afterwards modifications are made to testing protocol if change needs are identified based participant feedback. The same or revised protocol is then utilized in Spain to collect the cross country data. In Hungary, a different protocol [28] is utilized to get the baseline for user experience and to be able to compare how the extended measurement protocol is influencing to the user experience. At the end of the project, results comparison regarding measurement day experiences are made between the three countries and two different measurement protocols.

The participants receiving Armband device will be invited to specific location (e.g. university campus), where they receive detailed information about the test and how to keep the activity diary. In Spain some of the participants will also receive a Galaxy Watch 3 device, which is used for similar purposes as the Armband device. In Finland, participants will keep the device for one day (24 hours). In Hungary and Spain, participants will keep it for four days (96 hours). Due the limited number of devices and device rotation, the measurements time will vary between participants.

In Hungary, outdoor trainings on the fitness trails will be introduced by guided visits where participants can try and experience the fitness station activities with the help of a qualified trainer. In the fitness stations participants do exercises with their own body weight. At the stations, boards show the planned, recommended tasks that participants can do by three variants and how to get to the next station. Feedback collection and post measurement (T1) is done after the 8 weeks of training interventions.

Where: In Hungary, the pre measurement day will take place at Trebag premises and Rákospalota Elderly Centre. The 8 week training program is taking place at protected natural parks in Budapest, which is equipped with various fitness equipment.

When and how much: The first measurement events in each country will happen during one or two days in spring-summer 2023 at a spacious venue (e.g. sporthall, gym or similar space having enough space to establish the measurement track). Each participants will complete the measurement track once15-20 minutes. In Hungary, after the measurement event the outdoor fitness training program start and it will last 8 weeks.