THE EFFECTS OF CALISTHENIC EXERCISES ON SLEEP QUALITY, FATIGUE, AND DEPRESSION IN ELDER ADULTS

Abstract

Purpose: The physical, psychological, even economic and environmental changes emerged with age cause problems in sleep. The lack of exercise habits could increase the incidence of unfavorable sleep disorders with depression and fatigue. The aim of this non-randomized controlled study was to investigate the considerable effects of calisthenic exercises on sleep disorders, depression, and fatigue in elder adults. Methods: The study was conducted at Pamukkale University and Hatay Mustafa Kemal University. Sixty-two individuals participated in the study between May 2018-October 2019. While the Calisthenic Group (n=32) performed calisthenic exercises for 30-45minutes/session and 3days/6weeks, and Control Group (n=30) did not performed. Fatigue, depression, and sleep quality levels were assessed using the Fatigue Severity Scale (FSS), Beck Depression Scale (BDI), and Pittsburgh Sleep Quality Index (PSQI), respectively. Results: Statistically significant differences among FSS (p≤0.001), BDI (p=0.022), and PSQI (p=0.006) scores were found in the Calisthenic Group after the intervention, while there were differences only in fatigue (p=0.035) and total sleep quality (p=0.035) for the Control Group. We found that the Calisthenic Group’s PSQI latency, PSQI sleep duration and PSQI total scores decreased in post-treatment. Both fatigue severity (p≤0.001) and depression levels (p≤0.001) were highly correlated with PSQI-subscores, except for sleep duration subscore (FSS p=0.934, BDI p=0.276). Conclusion: Regular calisthenic exercise programs may enable elders to better manage changes in the aging process. Physiotherapists should consider including calisthenic exercises in the rehabilitation programs for its effects on all parameters of sleep, fatigue, mental and emotional status in this population.

Keywords

• Calisthenics
• Depression
• Exercise
• Fatigue
• Older Adults
• Sleep

YAŞLI ERİŞKİNLERDE KALİSTENİK EGZERSİZLERİN UYKU KALİTESİ, YORGUNLUK VE DEPRESYON ÜZERİNE ETKİLERİ

Öz

Amaç: Yaşla birlikte ortaya çıkan fiziksel, psikolojik, hatta ekonomik ve çevresel değişiklikler uykuda sorunlara neden olmaktadır. Egzersiz alışkanlığının olmaması, depresyon ve yorgunluk ile birlikte olumsuz uyku bozukluğu insidansını artırabilir. Bu randomize olmayan kontrollü çalışmanın amacı, yaşlı erişkinlerde kalistenik egzersizlerin uyku bozuklukları, depresyon ve yorgunluk üzerindeki önemli etkilerini araştırmaktı. Yöntem: Bu çalışma Pamukkale Üniversitesi ve Hatay Mustafa Kemal Üniversitesi’nde yapıldı. Çalışmaya Mayıs 2018-Ekim 2019 tarihleri arasında 62 kişi katıldı. Kalistenik Grup (n=32) 30–45 dakika/seans ve 3 gün/6 hafta kalistenik egzersizler yaparken, Kontrol Grubu (n=30) yapmadı. Yorgunluk, depresyon ve uyku kalitesi düzeyleri sırasıyla Yorgunluk Şiddet Ölçeği(YŞÖ), Beck Depresyon Ölçeği(BDÖ) ve Pittsburgh Uyku Kalitesi İndeksi(PUKİ) kullanılarak değerlendirildi. Sonuçlar: Müdahale sonrası Kalistenik Grup'ta YŞÖ(p≤0.001), BDÖ(p=0.022) ve PUKİ(p=0.006) puanlarında istatistiksel olarak anlamlı fark bulunurken, Kontrol Grubu için sadece yorgunluk(p=0.035) ve toplam uyku kalitesinde (p=0.035) bulundu. Kalistenik Grubunun PUKİ latansı, PUKİ uyku süresi ve PUKİ toplam puanlarının tedavi sonrasında azaldığını saptadık. Hem yorgunluk şiddeti (p≤0.001) hem de depresyon düzeyleri (p≤0.001), uyku süresi alt puanı (YŞÖ p=0.934, BDÖ p=0.276) hariç, PUKİ-alt puanları ile yüksek oranda ilişkiliydi. Tartışma: Düzenli kalistenik egzersiz programları, yaşlıların yaşlanma sürecindeki değişiklikleri daha iyi yönetmelerini sağlayabilir. Fizyoterapistler uykunun tüm parametreleri, yorgunluk seviyeleri, mental ve emosyonel durum üzerindeki etkileri nedeniyle bu popülasyonda kalistenik egzersizleri rehabilitasyon programlarına dahil etmeyi düşünmelidirler.

Anahtar Kelimeler

• Kalistenik egzersizler
• Depresyon
• Egzersiz
• Yorgunluk
• Yaşlı Erişkinler
• Uyku

References

1. Cho D, Kim S-H. Health Capability and Psychological Effects of Regular Exercise on Adults: Middle-Aged and Older. Int J Aging Hum Dev. 2020;91(4):520-37.
2. Kim K, Lee M. Depressive symptoms of older adults living alone: The role of community characteristics. Int J Aging Hum Dev. 2015;80(3):248-63.
3. Mecocci P, Boccardi V, Cecchetti R, Bastiani P, Scamosci M, Ruggiero C, et al. A long journey into aging, brain aging, and Alzheimer’s disease following the oxidative stress tracks. J Alzheimers Dis. 2018;62(3):1319-35.
4. Crowe M, Jordan J, Gillon D, McCall C, Frampton C, Jamieson H. The prevalence of pain and its relationship to falls, fatigue, and depression in a cohort of older people living in the community. J Adv Nurs. 2017;73(11):2642-51.
5. Angulo J, El Assar M, Álvarez-Bustos A, Rodríguez-Mañas L. Physical activity and exercise: Strategies to manage frailty. Redox Biol. 2020;35:1-21.
6. Lee Y-H, Chang Y-C, Chiang T, Liu C-T, Shelley M. Living arrangements and sleep-related outcomes among older adults in China: a panel analytic approach. Int J Aging Hum Dev. 2020;91(2):111-26.
7. Miner B, Kryger MH. Sleep in the aging population. Sleep Med Clin. 2020;15(2):311-8.
8. Mora JC, Valencia WM. Exercise and older adults. Clin Geriatr Med. 2018;34(1):145-62.

9. Cardalda IM, López A, Carral JMC. The effects of different types of physical exercise on physical and cognitive function in frail institutionalized older adults with mild to moderate cognitive impairment. A randomized controlled trial. Arch Gerontol Geriatr. 2019;83:223-30.
10. Duruturk N, Acar M. Effects of respiratory and callisthenic exercise training on exercise capacity and cuality of life in geriatrics. Eur Respir J. 2015;46(Suppl. 59):2221.
11. Kujawski S, Kujawska A, Kozakiewicz M, Jakovljevic DG, Stankiewicz B, Newton JL, et al. Effects of Sitting Callisthenic Balance and Resistance Exercise Programs on Cognitive Function in Older Participants. Int J Environ Res Public Health. 2022;19(22):2-18.
12. Saitoh M, Takahashi Y, Okamura D, Akiho M, Suzuki H, Noguchi N, et al. Prognostic impact of hospital‐acquired disability in elderly patients with heart failure. ESC Heart Fail. 2021;8(3):1767-74.
13. Zhao H, He Z, Yun H, Wang R, Liu C. A Meta-Analysis of the Effects of Different Exercise Modes on Inflammatory Response in the Elderly. Int J Environ Res Public Health. 2022;19(16):1-13.
14. Abd El-Kader SM, Al-Jiffri OH. Aerobic exercise modulates cytokine profile and sleep quality in elderly. Afr Health Sci. 2019;19(2):2198-207.
15. Seol J, Abe T, Fujii Y, Joho K, Okura T. Effects of sedentary behavior and physical activity on sleep quality in older people: A cross‐sectional study. Nurs Health Sci. 2020;22(1):64-71.
16. Manierre M, Jansen E, Boolani A. Sleep quality and sex modify the relationships between trait energy and fatigue on state energy and fatigue. PloS one. 2020;15(1):1-18.
17. Kanamori S, Takamiya T, Inoue S, Kai Y, Tsuji T, Kondo K. Frequency and pattern of exercise and depression after two years in older Japanese adults: the JAGES longitudinal study. Sci Rep. 2018;8(1):1-9.
18. Aibar-Almazán A, Hita-Contreras F, Cruz-Díaz D, de la Torre-Cruz M, Jiménez-García JD, Martínez-Amat A. Effects of Pilates training on sleep quality, anxiety, depression and fatigue in postmenopausal women: A randomized controlled trial. Maturitas. 2019;124:62-7.
19. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46(10):1121-3.
20. Armutlu K, Keser İ, Korkmaz N, Akbıyık Dİ, Sümbüloğlu V, Güney Z, et al. Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients. J Neurol Sci. 2007;255(1-2):64-8.
21. Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An Inventory for Measuring Depression. Arch Gen Psychiatry. 1961: 4(6), 561-71.
22. Hisli N. A validation study of Beck Depressior Inventory. Turk J Psychol. 1988;6:118-26.
23. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
24. Ağargün MY, Kara H, Anlar O. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. Turk Psikiyatri Derg. 1996;7(2):107-15.
25. Gebhart C, Erlacher D, Schredl M. Moderate exercise plus sleep education improves self-reported sleep quality, daytime mood, and vitality in adults with chronic sleep complaints: a waiting list-controlled trial. Sleep Disord. 2011;2011:1-10.
26. Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between sleep and exercise: a systematic review. Adv Prev Med. 2017;2017:1-14.
27. Hacimusalar Y, Eşel E. Suggested biomarkers for major depressive disorder. Neuropsych Arch. 2018;55(3):280-90.
28. Kelley GA, Kelley KS. Exercise and sleep: a systematic review of previous meta‐analyses. J Evid Based Med. 2017;10(1):26-36.
29. Chan JS, Ho RT, Chung K-f, Wang C-w, Yao T-j, Ng S-m, et al. Qigong exercise alleviates fatigue, anxiety, and depressive symptoms, improves sleep quality, and shortens sleep latency in persons with chronic fatigue syndrome-like illness. Evid Based Complement Alternat Med. 2014;2014:1-10.
30. Langhammer B, Bergland A, Rydwik E. The importance of physical activity exercise among older people. Hindawi; 2018;2018:1-3.
31. Ju H. The relationship between physical activity, meaning in life, and subjective vitality in community-dwelling older adults. Arch Gerontol Geriatr. 2017;73:120-4.
32. Zhai L, Zhang H, Zhang D. Sleep duration and depression among adults: A meta‐analysis of prospective studies. Depression and anxiety. 2015;32(9):664-70.
33. Cheng L, Qian L, Chang S, He B. Effect of Tai Chi on depression symptoms and sleep quality among older adult women after exercise cessation. Res in Sports Med. 2021;29(4):395-405.
34. Chang P-S, Knobf MT, Funk M, Oh B. Feasibility and acceptability of Qigong exercise in community-dwelling older adults in the United States. J Altern Complement Med. 2018;24(1):48-54.
35. Santos Rd, Viana VAR, Boscolo RA, Marques V, Santana MGd, Lira FSd, et al. Moderate exercise training modulates cytokine profile and sleep in elderly people. Cytokine. 2012;60(3):731-5.
36. Breneman CB, Kline CE, West DS, Sui X, Porter RR, Bowyer KP, et al. The effect of moderate-intensity exercise on nightly variability in objectively measured sleep parameters among older women. Behav Sleep Med. 2019;17(4):459-69.
37. Zaleski AL, Taylor BA, Panza GA, Wu Y, Pescatello LS, Thompson PD, et al. Coming of age: considerations in the prescription of exercise for older adults. Methodist deBakey cardiovascular journal. 2016;12(2):98-104.
38. Resnick B, Ory M, Coday M, Riebe D. Older adults' perspectives on screening prior to initiating an exercise program. Prev sci. 2005;6:203-11.