Effectiveness of Blended Active Aging Education Program on Active Aging Factors and Wellbeing in Community-dwelling Older Adults in Pakistan. A Randomized Control Trail

Road Map of the Study Development of BAAEP Development of content for face-to-face training consisted of lectures, group activities, and hand on practice with the intention to improve physical, mental, cognitive, and behavioral approaches for active aging.

Booklet contents: Tips on mindfulness eating habit practice to mentally prepare for any food items before eating, positive thought generation practice by different scenarios, benefits of exercises in pictorial form, pictures of healthy couples and beneficial effects of relationships, tips for spiritual health, and the booklet contents homework after each session.

Video development Detail about Muslim prayers like exercises

• Prepared guidelines from two published papers along with comprehensive descriptions regarding each picture to develop a video on the mimic Muslim prayer's body movements' video for home practice.
• Appointment of a physiotherapist holding a Masters's degree and practicing as a physiotherapist in a private rehabilitation center, the checklist was shared to practice.
• The physiotherapist will develop an outline to develop a video and will arrange a meeting with other two physiotherapists, one doctor, and one community health nurse. The major focus was to assess any restrictions for elders with any disease. The physiotherapist will develop a video by adding instructions in the local language.
• A series of movements consisting of body parts movement starting from deep two deep breaths.
• Movement of neck, shoulders, hands and arms, head, feet, and every joint of the body. It will take only 10 to 15 minutes. The structured exercise steps follow all the steps mentioned in the traditional Islamic prayers and yoga breathing. The detail of the Muslim Salat-like exercise is mentioned below
• 1: Standing and Takbir: Takbir, is the movement of raising hands to the level of one's face so that the thumbs touch the ear lobule, by doing that taking one deep breath, precedes another prayer posture.
• 2: The Standing (Qiyam): Fundamental standing position for up to 60-90 seconds, with some exceptions such as wrapping the arms in front of the belly in such a way that the scapula is slightly retracted, taking two deep breaths. The chin is tucked in and the person looks at his feet while standing, resulting in flexion at the upper cervical spine, thus activation of the deep neck flexors, which are prone to getting weak as in upper cross syndrome[50].
• 3: Rukuk: The bowing, or Rukuk, is a very important position biomechanically in which forward bending occurs at the thoracic and lumbar spines, which leads to the stretching of the Para spinal muscles and structures. The trunk and the lower extremity are at an approximately 90-degree angle to each other. The person attempts to look between his toes while adopting this position, which results in the activation of deep neck flexors, which are usually prone to getting weak. The hip joint is in flexion, the knees are extended, and the ankle is at 90° with the lower leg as in standing. The shoulders are slightly flexed and the elbows are fully extended, whereas the hands rest on the knees. The average duration of a Rukuk may last up to 10-15 seconds along
• 4: Prostration ( Sajdah): The prostration posture of Salat is similar to a fetus's pose, and flexion occurs at the thoracic and lumbar spines, accompanied by hip flexion. The knees are in mid-flexion, the ankle is in the neutral position, and the toes are extended. The shoulders are slightly abducted, the elbows in mid-flexion, and the wrists extended with the palms parallel to the ears. The lower cervical spine is also slightly extended during prostration. It strengthen the triceps brachii and showed the greatest activation. Triceps brachial activation in Salah was also significantly higher than in the child's pose.
• The Sitting (Tahiyyat/Jalsa) Posture of Salat: The sitting (taqiyya) two-time head position involves sitting on the floor with the lumbar and thoracic spines in neutral, the hip joint in flexion, and the knee joint in full flexion for up to 30-60 seconds. This results in a stretching of the quadriceps Femoris muscle. The hands are placed on the distal aspect of the anterior thigh, with shoulders flexed and elbows extended, though the full extension is not present, along with slight extension at the wrists.
• Turning of head side by side: Cervical exercises. Turns the head to both shoulders fit right and then left.

Study Area: Study setting: Two residential areas of Peshawar, Khyber Pakhtunkhwa