Revista PODIUM, September-December 2019; 14(3): 355-371
Translated from the original in spanish
Methodology of physical activities for obese older adults with sedentary habits
Metodología de actividades físicas para adultos mayores obesos con hábitos sedentarios
Diego Samper Rivero,1 Jorge de Lázaro Coll Costa,2 Douglas Crispín Castellanos3
1Universidad de la Isla de la Juventud "Jesús Montané
Oropesa", Facultad de Cultura Física. Isla de la Juventud, Cuba. E-mail: email@example.com
2Universidad de las Ciencias de la Cultura Física y el Deporte "Manuel Fajardo" (UCCFD), La Habana, Cuba. E-mail: firstname.lastname@example.org
3Universidad de la Isla de la Juventud "Jesús Montané Oropesa", Facultad de Cultura Física. E-mail: email@example.com
Received: April 1st, 2019.
Approved: September 2nd, 2019.
Currently the number of obese people increases considerably, becoming a concern because of the health problems caused by this disease. Although physical activity is considered beneficial, in overweight people it can have some negative effects. This research was carried out in the 34th circumscription of the Consejo Popular Centro Histórico, of Nueva Gerona in the Isla de la Juventud, Cuba with the objective of proposing a methodology of physical activities for obese older adults with sedentary habits of 65 years of age and older from this community taking advantage of the marine aquatic environment. For this purpose, a mixed methodology was used, based on descriptive methods: analytical-synthetic and abstract logic, as well as through experimental analysis such as: scientific observation, surveys, interviews; statistic methods were also used to process the information obtained, mode and median. As a result of this methodology, the lifestyle was improved and contributed to the reduction of fat in obese older adults in this community taking advantage of the marine aquatic environment.
Keywords: older adults; obesity; lifestyle; sedentary habits methodology of physical activities in the marine aquatic environment.
Actualmente el número de personas obesas aumenta considerablemente, lo que se convierte en una preocupación, debido a los problemas de salud que genera esta enfermedad. Aunque la actividad física es considerada como beneficiosa, en personas con sobrepeso puede tener algunos efectos negativos. La presente investigación se llevó a cabo en la circunscripción 34 del Consejo Popular Centro Histórico, de Nueva Gerona, en la Isla de la Juventud, Cuba, con el objetivo de proponer una metodología de actividades físicas para adultos mayores obesos con hábitos sedentarios de 65 años y más, de dicha comunidad, aprovechando el medio acuático marino. Para ello, se utilizó una metodología mixta, basada en métodos descriptivos: analítico-sintético y lógico-abstracto, así como mediante el análisis experimental como: observación científica, encuestas, entrevistas; se emplearon además los estadísticos para el procesamiento de la información obtenida, moda y mediana. Como resultado de esta metodología, se elevó el estilo de vida lo que contribuyó a la disminución de grasas en los adultos mayores obesos de esta comunidad, con el aprovechamiento del medio acuático marino.
Palabras clave: adultos mayores; obesidad; estilo de vida; hábitos sedentarios; metodología de actividades físicas en el medio acuático marino.
According to data compiled by the World Health Organization, hereinafter "WHO Data and Statistics," (2017), it is estimated that there are about 605 million people in the world over the age of 60. The proportion of older persons will continue to increase over the coming decades. By 2025, there will be an estimated 1.2 billion older people worldwide, and two out of three will live in developing countries.
While the number of elderly men and women is almost equal in Africa, in Europe and America there are three elderly women for every two elderly men, perhaps because of the great political and financial power of European and American women. As women have greater self-care capacity, the task of caring for the elderly has been reduced by this difference in survival rate.
"It is worth noting that the projection of the elderly population in the different strata for the year 2025, with respect to the year 2005, will double. Rojas Barahona, (2006). P-3.
An important feature in the growth of the elderly population is that the increase in survival, after age 65, means that the percentage of the elderly, who are 80 years old, is growing at the same time. In 1960, 10 % of the population of developed countries was over 60; in 1990, 18 % and according to World Bank projections, by 2030, this figure will have reached 30 %. This is not only the case in developed countries, but also in Argentina and most other countries of the world, where the percentage of individuals over 60 will tend to double within 30 to 40 years; only the African continent will remain a young continent, a few more decades.
In Cuba, in the last 30 years, there has also been a significant growth in the elderly population.
According to the National Statistics Office in Cuba (2016), the total Cuban adult population already exceeds 1.5 million inhabitants (1,623,580) and presents a population dynamic characteristic of a country with an advanced demographic transition, which is clearly seen in the morphology of the pyramid that describes the structure by sex and age. ("Chapter 1-. Population, Demographic Yearbook of Cuba," 2016)
At the end of 2014, the Cuban population, in terms of aging, reached 19 percent of people aged 60 and over (4 141 090 million), which evidences the progress of this process in the country, a figure that is almost one million higher than that of 1980. Territorially, there is greater aging in the western provinces-excluding Pinar del Río-and central provinces, and less aging in the eastern provinces, which is closely related to fertility and mortality levels in the territories. The most aged provinces continue to be Villa Clara (17.4 per cent of people aged 60 and over) and Ciudad de La Habana (17.1 per cent) and the least aged Guantánamo (11.3 per cent). According to projections for 2020, we will reach 21.5 percent of older adults in our country "Anuario estadístico de Cuba 2014. Chapter: 3 Population. National Statistics and Information Office (ONEI)," (2015)
In La Isla de la Juventud, the total population is currently 84 893. There are 42044 women and 42849 men. It has the largest adult population of 19%. In the urban area, there are 34560 men and 35358 women and in the rural area, 8289 men and 6686 women. Of the total population, there are 9266 older adults, of whom 4520 are men and 4746 are women. "Statistical Yearbook of Cuba, 2014. Chapter: 3 Population. National Statistics and Information Office (ONEI)," (2015).
"Ageing is a gradual and multidimensional evolutionary process. On the other hand, it can be considered as a series of stages that are organized around certain characteristics of physical, psychological, social and material order. Gutiérrez Robledo, (1999). P-2.
This author states, "Systematic exercise, i.e. being physically active for thirty minutes a day, can significantly improve people's health and well-being" World Health Organization, (2001). P-3.
He also states, "Depression in old age, in addition to affecting the patient's quality of life, places the patient at greater risk of suffering cognitive impairment, immunological depression and various underlying illnesses and constitutes a frequent geriatric problem that affects 10 % of older adults living in the community". Yvonne Sánchez & Castañeda González, (2008). P-2.
Adults should aspire to be active every day. During a week, activity should add up to at least 150 minutes (2½ hours) of moderate-intensity activity in episodes of ten minutes or more. One way to address this is to do 30 minutes at least five days a week. Townsend, Wickramasinghe, Williams, Bhatnagar, & Rayner, (2015)
Older adults, who are physically active, may have greater balance and may be less likely to experience a fall. Being physically active for 150 minutes a week can help reduce the risk of developing chronic diseases, such as high blood pressure, diabetes, and heart disease. ("Canadian physical activity guidelines," 2011)
The fundamental objective of this research is: to elaborate a methodology of physical activities that elevates the lifestyle of the obese older adult with sedentary habits of 65 years and more, and to implement them in all the circles of grandparents and old people's homes of the special municipality of La Isla de la Juventud, Cuba.
MATERIALS AND METHODS
The research was carried out in the 34th constituency of the Consejo Popular Centro Histórico, Nueva Gerona, on La Isla de la Juventud, Cuba. There are currently 105 older adults in general; of these, ten systematically attend the average circle of grandparents that operates in the locality. Ninety-five do not attend the methodology of physical activities designed for this age; of these, 30 are included in the age of 65 years and over, 15 constitute the sample with which this research is carried out. Based on the selection criteria adopted by the researchers. Sedentary obese who are physically active are taken as a reference.
Criteria for the selection of the sample:
This group of older adults aged 65 and over, consists of nine women and six men, with an average age of 67.2 years, with a level of schooling between ninth and twelfth grade, including three university students. They show similarity in terms of tastes and preferences, are characterized by being very communicative and enterprising, although they are not very regular participants in grandparent circles systematically, also show sedentary traits.
For the implementation of this research, theoretical methods were used; among them, the logical historical, the analytical-synthetic, documentary and empirical analysis such as scientific observation, the survey, the interview and the SWOT matrix to determine the fundamental elements that are established in the process applied to the elderly, determining potentialities and vulnerable points that must be influenced, which by their characteristics are not more than an individual process of thought to arrive at the formation of the concept with a dialectical differentiated character, integrated, ordered and oriented towards a preconceived end, which operates in an interrelated way.
For the elaboration of the methodology of physical activities for obese older adults with sedentary habits, in 34th constituency of the Consejo Popular Centro Histórico, Nueva Gerona, on La Isla de la Juventud, Cuba, we proceeded to the task of organizing and orienting the work for the subsequent implementation of the actions. For the development of it, it was instrumented with the following order:
First stage: diagnosis (analysis of empirical methods)
At this stage, we proceeded to collect the main indicators with which we will work in this research; we began in the following order:
Observation, survey, interview, review of medical history.
Analysis of the observations carried out on older adults aged 65 and over obese, with sedentary habits, in the 34th district of the Consejo Popular Casco Histórico, Nueva Gerona, in The Isla de la Juventud.
This assessment was carried out through a scientific observation of obsessed older adults 65 years and older, with sedentary habits, in the 34th district of the Consejo Popular Casco Histórico, Nueva Gerona, on the Isla de la Juventud, Cuba. With a participation of 15 subjects, representing 100 % of the population of obese adults aged 65 and over, with sedentary habits, in order to know aspects related to physical activity at this age.
The results presented allow us to know their lifestyles and the percentages of the activities carried out by older adults who participate in the research, in their free time. (Figure 1)
Fig. 1. - Activities in their daily routine
An essential dimension that should be used in the studies of leisure activities and free time, is the one that refers to the frequency of its realization, since of the list of activities that have been presented, there are those that are realized daily, while others are realized two or three times per week and those that are realized only once per week. (Chart 1)
Chart 1. - Frequency of free time activities
It is pointed out that 10 % of those surveyed do not seem to carry out any type of specific activity, motivated, perhaps, by the lack of knowledge of some options to occupy their free time, so they admit not doing anything special in it.
Analysis and interpretation of the interview with the president of the 34th constituency of the Consejo Popular Casco Histórico, Nueva Gerona, in Isla de la Juventud, Cuba.
In an interview with the president of the 34th. constituency of the Consejo Popular Casco Histórico, Nueva Gerona, in Isla de la Juventud, it is stated that there are serious difficulties with physical-sports activities by the elderly or older adults, due largely to the few options available for this age group and the few conditions currently available.
A review of the health history of sedentary older adults, between 60 and 65, who have been clinically evaluated with overweight or obesity, in the 34th constituency of the Consejo Popular Casco Histórico, Nueva Gerona, in The Isla de la Juventud, showed that more than 50 % of them could not exercise on land, due to their body weight. They also suffer from diabetes, 35 %, blood pressure problems 40 %, osteoarticular disorders 45 %, physical ailments 70 % (lower back, bursitis, among other disorders).
Methodology of physical activities
Based on the methodology of physical activities, the National Institute of Sports and Recreation (Inder) and Ministry of Public Health (Minsap) supports the methodology of educational physical activities to reduce sedentary habits in older adults, overweight or obese 65 years and older. The starting point is to have defined its mission and vision, which will be declared below.
The mission of the methodology of physical activities is to guarantee, with a highly qualified technical work group, the elevation of the quality of life of the elderly, increasing life expectancy, starting from the formation of motor habits in correspondence with the Cuban socialist project, which guarantees a result in accordance with the development reached by the territory. Applying, generating and systematizing the scientific knowledge, technologies and experiences of the Physical Culture as a continuous process and the formation of an integral general culture.
The vision is to be recognized as a reference group in the provision of social services to adults, older adults and other categories of people in a reliable, efficient and effective manner, based on the constitutional principles of social justice, autonomy and participation; in addition, applying a scientific and technological policy to contribute to the development of the quality of life of the territory.
Problems detected towards which the actions in the methodology of physical activities must be intentional
Application of the SWOT matrix to detect the difficulties of the site to be investigated
In the first instance, the SWOT matrix was used to determine the fundamental elements established in the process applied to older adults, identifying potentialities and vulnerable points that should be affected. These were the results obtained. (Chart 2)
Chart. 2. - Matriz FODA
Source: Own elaboration.
Some measures that were used in the investigation
Initial state. Lack of material and financial resources. Action (Preparation of research projects for personalized work in the area, taking advantage of the work objectives of the UIJ). Stage. I Responsible. Department of Sports FCF (discipline CFT) taking into account the objectives of the work and the attention to the communities from its sphere of action.
Initial state. Sedentary habits among the elderly population
Increase in community actions for the dissemination, through the press and television, of the benefits of physical activity in the marine aquatic environment, as well as the dissemination of results obtained by older adults who systematically engage in physical activity in the marine aquatic environment. Responsible Students of the 4th year of the Physical Culture career, starting from the subjects CM, CFT. In charge of university extension of the FCF with the Main Professor of the discipline CFT.
Initial state. Little research applied to community work with the elderly. Action (intentional, research work addressing the treatment of the elderly in their current trends in the world). Stage. I. Responsible Inder Teaching, Head of the Department of Physical Culture of the Inder, Vice-Dean of Development of the Physical Culture Faculty.
The strategic planning of the activities is based on 11 planned actions among which they stand out: Diagnosis according to the SWOT matrix to determine the weaknesses, opportunities, strengths and threats of the research; management to give specialized courses or conferences by Geriatrics to the professionals of the Physical Culture; realization of the methodology of physical activities in the marine aquatic environment. It was planned, in a period of 6 months, other actions such as: the preparation of research projects for personalized work in the area, according to the problem to be investigated. The same will take place in October and November, as well as strategic alliances with the University of La Isla de la Juventud for the preparation of software or materials edited in relation to the educational technology part (11 weeks). Attempt to carry out research on the treatment of the elderly and its current trends in the world (22 weeks). Create an agreement with the Software department of the UIJ and the use of educational technology (five weeks). To increase the management for the concretion of work agreements with foreign entities Inder, Mes, Mined (three weeks). Elaboration of the system of exercises to be developed in the marine aquatic environment (two weeks). Dissemination, through the local media, of the results obtained, as well as recognizing the adults with the best progress in carrying out emulation checks in other communities, taking advantage of the university extension of the Faculty of Physical Culture (22 weeks). Training course on projects for working with the elderly, as well as themes given to schools (22 weeks).
RESULTS AND DISCUSSION
In La Isla de la Juventud today, the total population is 84 893. It has the largest adult population of 19 %. Of the total population, there are 9266 older adults; of these, 4520 are men and 4746 are women. ("Statistical Yearbook of Cuba 2014. Chapter: 3 Population. Oficina Nacional de estadísticas e información (Onei)," (2015). The level of population aging in our territory is worrisome, so the methodology of physical activities to be implemented plays a fundamental role in the reduction of obese older adults, with sedentary habits, who, for one reason or another, do not engage in physical activity.
The results achieved, in this research, are the scientific product of a part of the project "Physical activity to improve the lifestyle in obese older adults" which, directed by the Faculty of Physical Culture, at the University "Jesus Montané Oropesa", Isle of Youth, was designed since 2016. In addition, it is also endorsed by the National Institute of Sports and Recreation (Inder) in the pine territory, an element that highlights the importance of the social impact of this research, not only for the Isle of Youth, but for other parts of the country or the world that are able to generalize the results shown in this research.
Critical assessment of the background of the object of study
Consulting doctoral thesis, the author of this research assumes that,
"The continuous interaction of the human being with the aquatic environment, throughout the times, has generated the aquatic physical work. This, with the passing of time and continuous specialization in the field of sport, has given rise to the formation of aquatic programs which, in turn, are aimed at each of the population groups: babies, children, primary, secondary, university, adults and the elderly" Moreno Murcia, (n.d.) P-2.
The aquatic activities can be part of that creation of habits and, in addition, very well, because inside them, the swimming, they say, that it is the sport that has less sequels and it is the one advised by doctors. (Albarracín and Moreno, 2011) p. 8.
Assuming what this author said, when he states, “The aquatic environment can be used as a therapy in itself or as a complementary element to conventional medical treatments. The sectors that can benefit from an incidence in the practice of aquatic activities are very varied. Among the main aquatic programs, in the field of therapy, we highlight three clearly differentiated sectors, such as those represented by the physically, mentally and sensory disabled" Rodríguez García & Moreno Murcia, (1998). P-2.
As well as "Physical activity is essential for the health of elderly people (15), but it would be foolish to do it randomly and uncontrolled so the first step will be to perform a prior medical checkup" Jimeno Uclés, (2009). P-4.
Assuming that obesity "is the result of a permanent and prolonged imbalance between food intake and energy expenditure, where excess calories are stored in the form of adipose tissue" Bastos, González Boto, Molinero González, and Salguero del Valle, (2005).
Discussion of the results of the diagnosis
Analysis of observations applied to older adults, between 60 and 65 years old, with sedentary habits, in the 34th constituency of the Consejo Popular Casco Histórico, Nueva Gerona, in the Isla de la Juventud.
Objective: To obtain information about the lifestyle of adults in the community in their daily routine.
Aspects to observe:
On their return home, men watch television or listen to music until the time to pick up their grandchildren in the school, resting at noon for an average of one or two hours; in the case of women, they do the usual household chores.
They spend more than 70 % of their time doing leisure-related activities and do not engage in any kind of physical activity. This is shown in figure #1, above.
Discussion of the results obtained from the respondents
In the first question: Do you have any knowledge about the importance of physical exercise for health, in people who are overweight or obese? Eighty per cent responded that they knew something about the subject, while 20 per cent answered in the affirmative. This is because physical culture professionals do not implement these exercises in the marine aquatic environment, in their grandparents' circles, due to many internal and external factors.
In the second question, related to whether you are aware of the disorders that excess body weight brings with it to the body. One hundred percent answered in the affirmative. They are victims of chronic non-transmissible diseases.
In the third question, related to whether you know what it means not to be physically active on a regular basis. Seventy-five percent answered yes, while 15 percent answered no and 10 percent said they were unsure. In our country, the benefits of physical activity are made known through the mass media, as well as the chronic non-communicable diseases that appear more frequently in older adults who do not engage in physical activity, thus, the importance of this for the health and lifestyle of the geronte.
In the fourth question, related to whether you know what is advisable in relation to the type of physical activity and under what conditions are more appropriate to perform them? Ninety percent said yes, while 10% said they did not know. The physical activity, in this age period is moderate and low intensity, in addition, older obese adults are difficult, because of their body weight, the realization of physical activity.
In the fifth question, if you would like to increase your cognitive level about the subject. One hundred percent of the respondents answered in the affirmative. They are enthusiastic about the proposed activities.
In the sixth question, which deals with whether they would agree to participate in the development of the methodology of physical activities to reduce sedentary habits in older adults, with overweight or obesity. One hundred percent of respondents answered in the affirmative.
In the seventh question, which asks about the aspects that they would prefer to be included in the methodology of physical activities according to the exercises of their preference. There was diversity of criteria, 60% opted for aquatic exercises; 30 % opted for static exercises, while the other 10% opted for other types of exercises. After knowing their state of health, the older adults approved and agreed to carry out the activities in the aquatic environment.
In the eighth question, which deals with the schedule in which they would prefer to implement the technical part, 100% coincided with the afternoon schedule.
In the ninth question, what are the days of the week that you have the freest time available to you to receive the proposal to reduce sedentary habits in older adults with overweight or obesity? Eighty percent of respondents said they would like to receive the option any day of the week; 20% answered that on weekends. Therefore, the author of this research and coordinator of the project "Physical activity to improve lifestyle, in obese older adults” approved at the University of Isla de la Juventud and directed by the Faculty of Physical Culture, was scheduled to perform the activities every Wednesday.
In the tenth question, what activities do you carry out to occupy your free time? Ninety-five percent responded to the options posed and annexed other activities as reflected in table 1. Mainly, activities where they remain seated, watching television and sedentary activities, so a project arises to raise the lifestyle of older adults on the Isle of Youth.
In the eleventh question, how often do you do these activities in your free time? Fifty percent of older adults prefer to watch television every day, while 50 per cent listen to music every day, leaving reading for a third place, with 25 per cent and walking every day, with 25 per cent, as reflected in table 2, while doing sport, with 10 %, two or three times a week, and other activities, with 10 per cent, once a week, were the results of this question.
Through the survey, it was found that there is no knowledge about physical exercises in the aquatic environment to reduce sedentary lifestyle and obesity in the elderly and want to perform such exercises; in addition, people are interested in increasing their cognitive level about the subject, as it also contributes to improving their health, with the use of free time.
The results presented in Chart 1 allow us to know the percentages of the activities carried out by older adults who participate in the research, in their free time.
Following the classification of leisure (Sue, 1987), previously developed, it is observed that leisure activities, of a social nature, constitute the nucleus of activities carried out by a greater number of individuals: watching television, 50 %; listening to music, 50 %; reading books or magazines, 25 %. The methodology of physical activities reaches 25 %; walking is the most widespread activity among older adults, while practising sports is relegated to 10 %, as are other activities.
It should be pointed out that 10 % of the interviewees do not seem to carry out any type of specific activity, motivated, perhaps, by the lack of knowledge of some options to occupy their free time, so they admit not doing anything special in it.
Other different answers, to all the previous ones, have been pointed out by a small group of people, 5 %, who have answered the question on free time activities, giving answers that, due to their special and, in some cases, so original character, could not be included among the activities proposed in the questionnaire, which are those detailed in chart 1.
Depending on the result of the free time activities, it can be interpreted that the different responses given by the older adult population on the media, are especially rooted in television and radio, with their programs, which manage to connect an adult population, who every day become more in sedentary, given the response on activities of a sporting nature. It can be affirmed that the competition to which sport is subjected, taking into account the scientific-technical advances, has a direct impact on its level of preference, something that does not only occur in the elderly, but also in other age groups, which constitutes, without a doubt, a great challenge today for the entities in charge of governing physical sports activity.
Sport and walking are two other leisure activities, of a physical nature, whose practitioners also perform them with high frequency, about 80 % and 60 % respectively, two or three times a week, while other activities are performed, mostly once a week, for 80 %.
The productive characteristics of advanced societies, with jobs in all sectors requiring less physical effort and the hedonistic and consumerist offer of the rich leisure offer, of a social and cultural nature, encourage sedentary activities.
Analysis and interpretation of the interview conducted with the President of the 34th. constituency of the Consejo Popular Casco Histórico, Nueva Gerona, in La Isla de la Juventud.
In an interview with the President of the Consejo Popular Casco Histórico, Nueva Gerona, in La Isla de la Juventud, he stated that there are serious difficulties with the realization of physical-sports activities by the elderly or older adults. This is due, to a great extent, to the few options available for this age group and the few conditions currently available, in addition to sometimes not having adequate personnel (doctors, nurses). The popular council has only two technicians and the voluntary help of activists, in addition to the poor participation of older adults who do not see the importance of carrying out the methodology of physical activities to live more, in better conditions.
Sporting materials and recreational facilities are in great deficit; there are not many of them and the little that one has is in bad condition.
Activities are not sufficient to meet supply and demand needs; older people's preferences and expectations are not taken into account and there is very little motivation on their part. Therefore, it is exhorted to include, in community projects, proposals for specific activities related to physical work with older adults, and to plan activities, exploiting the sports areas of the community and the natural environment, not only on weekends or public holidays, but also during free time during the week. In this way, older adults will reach the goal of joining the 120-year-old club, living in better conditions, thus ensuring a better quality of life, thus allowing eliminating some pathologies characteristic of the aging process. The review of the health history of older sedentary adults between 60 and 65 who have been clinically evaluated with overweight or obesity, in the 34th. constituency of the Consejo Popular Casco Histórico, Nueva Gerona, in La Isla de la Juventud, showed that more than 50 % of them could not perform exercises on land, because of body weight.
In addition, 35 % suffer from diabetes, 40 % from pressure problems, 45 % from osteoarticular disorders, 70 % from physical ailments (lower back, bursitis, among other disorders).
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