Stand Up Now: A Sedentary Behavior Intervention in Older Adults of Moderate to Low Physical Function

in Journal of Aging and Physical Activity
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Objectives: To examine the efficacy of an the intervention Stand Up Now (SUN) to reduce sedentary behavior (SB) and improve physical function and mobility. Methods: SUN included two groups: (a) focused on reducing total SB (SUNSL) and (b) focused on increasing sit-to-stand (STS) transitions (SUNSTS). The participants (N = 71; Mage = 87 ± 7 years) had 12 weekly health coaching sessions. SB, physical function, and mobility were measured at the baseline, 6, and 12 weeks via the activPAL, Short Physical Performance Battery, and the 8-foot up and go, respectively. Linear mixed models examined the outcome variables over time. Results: Both groups decreased sedentary time (1.3 ± 0.3 hr, p < .001), increased standing time (0.5 ± 0.2 hr, p < .02), and improved physical function (1.5 ± 0.4 points, p < .001) from the baseline to 6 weeks, and they maintained it at 12 weeks. SUNSTS increased STS transitions (5.4 ± 4.1, p < .001), while SUNSL had no changes (0.5 ± 3.1, p > .9). There were no changes in mobility for either group (0.5 ± 1.5 s, p > .05). Discussion: SUN demonstrates the efficacy to improve SB and physical function in older adults.

Thralls Butte is with the Seattle Pacific University, Seattle, WA, USA. Levy is with the San Diego State University, San Diego, CA, USA.

Thralls Butte (kthralls@spu.edu) is corresponding author.
  • Agency for Healthcare Research and Quality. (2015). Use the Teach-Back Method: Tool #5. Content. Rockville, MD: Author. Retrieved from https://www.ahrq.gov/health-literacy/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html

    • Search Google Scholar
    • Export Citation
  • Andresen, E., Malmgren, M., Carter, A., & William, B. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10(2), 7784. PubMed ID: 8037935 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143164. PubMed ID: 15090118 doi:

  • Cadore, E., Cadore, L., Sinclair, A., & Izquierdo, M. (2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: A systematic review. Rejuvenation Research, 16(2), 105114. PubMed ID: 23327448 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Davis, M.G., Fox, K.R., Stathi, A., Trayers, T., Thompson, J.L., & Cooper, A.R. (2014). Objectively measured sedentary time and its association with physical function in older adults. Journal of the American Academy of Physicians Assistants, 22, 474481.

    • Search Google Scholar
    • Export Citation
  • De Labra, C., Guimaraes-Pinheiro, C., Maseda, A., Lorenzo, T., & Millan-Calenti, J.C. (2015). Effects of physical exercise interventions in frail older adults: A systematic review of randomized controlled trials. Biomedical Center for Geriatrics, 15(1), 154. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dogra, S., Ashe, M.C., Biddle, S.J., Brown, W.J., Buman, M.P., Chastin, S., … Copeland, J.L. (2017). Sedentary time in older men and women: An international consensus statement and research priorities. British Journal of Sports Medicine, 51(21), 15261532. PubMed ID: 28724710 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dunlop, D., Song, J., Arnston, E., Semanik, P., Lee, J., Chang, R., & Hootman, J.M. (2014). Sedentary time in U.S. older adults associated with disability in activities of daily living independent of physical activity. Journal of Physical Activity & Health, 12(1), 93101. PubMed ID: 24510000 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Edwardson, C.L., Winkler, E.A.H., Bodicoat, D.H., Yates, T., Davies, M.J., Dunstan, D.W., & Healy, G.N. (2017). Considerations when using the activPAL monitor in field-based research with adult populations. Journal of Sports and Health Science, 6(2), 162178. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Evenson, K.R., Buchner, D.M., & Morland, K.B. (2012). Objective measurement of physical activity and sedentary behavior among US adults aged 60 years or older. Preventing Chronic Disease, 9, E26. PubMed ID: 22172193

    • Search Google Scholar
    • Export Citation
  • Fairhall, N., Sherrington, C., Lord, S.R., Kurrle, S.E., Langron, C., Lockwood, K., … Cameron, I.D. (2014). Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: A randomised controlled trial. Age and Ageing, 43(5), 616622. PubMed ID: 24381025 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fitzsimons, C.F., Kirk, A., Baker, G., Michie, F., Kane, C., & Mutrie, N. (2013). Using an individualized consultation and activPAL feedback to reduce sedentary time in older Scottish adults: Results of a feasibility and pilot study. Preventive Medicine, 57(5), 718720. PubMed ID: 23891853 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fried, L.P. (1996). Functional decline in older adults: Expanding methods of ascertainment. Journal of Gerontology, 5, 206214.

  • Fried, L.P., Bandeen-Roche, K., Chaves, P.H., & Johnson, B.A. (2000). Preclinical mobility disability predicts incident mobility disability in older women. Journal of Gerontology and Biology of Science and Medicine, 55(1), M43M52. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gardiner, P.A., Eakin, E.G., Healy, G.N., & Owen, N. (2011). Feasibility of reducing older adults’ sedentary time. American Journal of Preventive Medicine, 41(2), 174177. PubMed ID: 21767725 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gennuso, K.P., Gangnon, R.E., Matthews, C.E., Thraen-Borowski, K.M., & Colbert, L.H. (2013). Sedentary behavior, physical activity, and markers of health in older adults. Medicine & Science in Sports & Exercise, 45(8), 14931500. PubMed ID: 23475142 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gibbs, B., Brach, J., Byard, T., Creasy, S., Davis, K., McCoy, S., … Jakicic, J.M. (2016). Reducing sedentary behavior versus increasing moderate-to-vigorous intensity physical activity in older adults: A 12 week randomized clinical trial. Journal of Aging and Health, 29(2), 247267. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gibson, K., Day, L., Flicker, L., & Hill, K.D. (2010). Screening for pre-clinical disability in different residential settings. British Medical Center Geriatrics, 10, 5263.

    • Search Google Scholar
    • Export Citation
  • Giné-Garriga, M., Guerra, M., Pagès, E., Manini, T.M., Jiménez, R., & Unnithan, V.B. (2010). The effect of functional circuit training on physical frailty in frail older adults: A randomized controlled trial. Journal of Aging and Physical Activity, 18(4), 401424. PubMed ID: 20956842 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Giné-Garriga, M., Roqué-Fíguls, M., Coll-Planas, L., Sitjà-Rabert, M., & Salvà, A. (2014). Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 95(4), 753769.e3. PubMed ID: 24291597 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gomez, J.F., Curcio, C., Alvarado, B., Zunzunegui, M.V., & Gurlanik, J. (2013). Validity and reliability of the short physical performance battery a pilot study on mobility in the Colombian Andes. Colombian Medicine, 44, 165171.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Guralnik, J.M., Ferrucci, L., Pieper, C.F., Leveille, S.G., Markides, K.S., Ostir, G.V., … Wallace, R.B. (2000). Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. Journal of Gerontology, 55, M221M231.

    • Search Google Scholar
    • Export Citation
  • Guralnik, J.M., Simonsick, E.M., Ferrucci, L., Glynn, R.J., Berkman, L.F., Blazer, D.G., … Wallace, R.B. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, M85M94.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hankonen, N., Heino, M.T.J., Araujo-Soares, V., Sniehotta, F.F., Vasankari, T., Sund, R., & Haukkala, A. (2016). Let’s move it- a school-based multi-level intervention to increase physical activity and reduce sedentary behavior among older adolescents in vocational secondary schools: A study protocol for a cluster-randomized trial. British Medical Center, 16, 451466.

    • Search Google Scholar
    • Export Citation
  • Harris-Kojetin, L., Sengupta, M., Park-Lee, E., Valverde, R., Caffrey, C., Rome, V., & Lendon, J. (2016). Long-term care providers and services users in the United States: Data from the National Study of Long-Term Care Providers. National Center for Health Statistics, 3, 1105.

    • Search Google Scholar
    • Export Citation
  • Karim, J., Weisz, R., Zainab, B., & Rehman, S. (2015). Validation of the eight-item CESD among older adults. Current Psychology, 34(4), 681692. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kerr, J. (2017). Research portfolio online reporting tools (RePORTer) (Project-2, 1P01AG052352-01A1). UC San Diego

  • Kerr, J., Rosenberg, D., Nathan, A., Millstein, R.A., Carlson, J.A., Crist, K., … Marshall, S. (2012). Applying the ecological model of behavior change to a physical activity trial in retirement communities: Description of the study protocol. Contemporary Clinical Trials, 33(6), 11801188. PubMed ID: 22921641 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kerr, J., Takemto, M., Bolling, K., Atkin, A., Carlson, J., Rosenberg, D., … Merchant, G. (2016). Two-arm randomized pilot intervention trial to decrease sitting time and increase sit-to-stand transitions in working and non-working older adults. PLoS One, 11(1), e0145427. PubMed ID: 26735919 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leung, P.M., Ejupi, A., Van Schooten, K.S., Aziz, O., Feldman, F., Mackey, D.C., … Robinovitch, S.N. (2017). Association between sedentary behavior and physical, cognitive, and psychosocial status among older adults in assisted living. Biomedical Research International, 17, 7.

    • Search Google Scholar
    • Export Citation
  • Levy, S.S., Thralls, K.J., Goble, D.J., & Krippes, T.K. (2020). Effects of a community-based exercise program on older adults’ physical function, activities of daily living, and exercise self-efficacy: Feeling fit club. Journal of Applied Gerontology 39(1), 4049. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lewis, L.K., Rowlands, A.V., Gardiner, P.A., Standage, M., English, C., & Olds, T. (2016). Small steps: Preliminary effectiveness and feasibility of an incremental goal-setting intervention to reduce sitting time in older adults. Maturitas, 85, 6470. PubMed ID: 26857881 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Li, F., Fisher, K.J., Harmer, P., & McAuley, E. (2005). Falls self-efficacy as a mediator of fear of falling in an exercise intervention for older adults. Journal of Gerontology, 60(1), P34P40. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lyden, K.. (2016). activpalProcessing: Process activPAL Events Files. R package version 1.0.2. Retrived from https://CRAN.R-project.org/package=activpalProcessing

    • Search Google Scholar
    • Export Citation
  • Mather, M., Jacobson, L.A., & Pollard, K.M. (2015). Aging in the United States. Population Bulletin, 70, 118.

  • Matthews, C.E., Hagstromer, M., Pober, D.M., & Bowles, H.R. (2012). Best practices for using physical activity monitors in population-based research. Medicine & Science in Sports & Exercise, 44, S68S76. PubMed ID: 22157777 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Matthews, C.E., Laditka, S.B., Laditka, J.N., Wilcox, S., Corwin, S.J., Liu, R., … Logsdon, R.G. (2010). Older adults’ perceived physical activity enablers and barriers: A multicultural perspective. Journal of the American Academy of Physician Assistants, 18, 199140.

    • Search Google Scholar
    • Export Citation
  • Michie, S. (2008). From theory to intervention: Mapping theoretically derived behavioural determinants to behavior change techniques. Applied Psychology: An International Review, 57(4), 660680. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Miller, D.K., Andresen, E.M., Malmstrom, T.K., Miller, J.P., & Wolinsky, F.D. (2006). Test–retest reliability of subclinical status for functional limitations and disability. Journal of Gerontology, 61(1), S52S56. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pahor, M., Guralnik, J.M., Ambrosius, W.T., Blair, S., Bonds, D.E., Church, T.S., … Williamson, J.D. (2014). Effect of structured physical activity on prevention of major mobility disability in older adults: The LIFE study randomized clinical trial. Journal of American Medical Association, 311(23), 23872396. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Penninx, B.W., Ferrucci, L., Leveille, S.G., Rantanen, T., Pahor, M., & Gurlanik, J.M. (2000). Extremity performance in nondisabled older persons as a predictor of subsequent hospitalizations. Journal of Gerontology, 55, 691697.

    • Search Google Scholar
    • Export Citation
  • Perera, S., Mody, S.H., Woodman, R.C., & Studenski, S.A. (2006). Meaningful change and responsiveness in common physical performance measures in older adults. Journal of American Gerontology and Sociology, 54, 743749.

    • Search Google Scholar
    • Export Citation
  • Raudenbush, S.W., & Bryk, A.S. (2002). Hierarchical linear models. Thousand Oaks, CA: SAGE.

  • R Core Team. (2018). R: A language and environment for statistical computing. R version 3.5.1. R Foundation for Statistical Computing.

  • Reid, N., Eakin, E., Henwood, T., Keogh, J.W., Senior, H.E., Gardiner, P.A., … Healy, G.N. (2013). Objectively measured activity patterns among adults in residential aged care. International Journal of Environmental Research and Public Health, 10(12), 67836798. PubMed ID: 24304508 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rikli, R.E., & Jones, C.J. (1999). Development and validation of a functional fitness test for community residing older adults. Journal of Aging and Physical Activity, 6, 127159.

    • Search Google Scholar
    • Export Citation
  • Rose, D.J., Jones, C.J., & Lucchese, N. (2000). Predicting the probability of falls in community-residing older adults using the 8-foot up-and-go: A new measure of functional mobility. Journal of Aging and Physical Activity, 10(4), 466475. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosenberg, D.E., Anderson, M.L., Renz, A., Matson, T.E., Lee, A.K., Greenwood-Hickman, M.A., … McClure, J.B. (2020). Reducing sitting time in obese older adults: The I-STAND Randomized Controlled Trial. Journal of Aging and Physical Activity. Advance online publication. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Rosenberg, D.E., Gell, N.M., Jones, S.M.W., Renz, A., Kerr, J., Gardiner, P.A., & Arternurn, D. (2015). The feasibility of reducing sitting time in overweight and obese older adults. Health Education & Behavior, 42(5), 669676. PubMed ID: 25794518 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosenberg, D.E., Kerr, J., Sallis, J., Patrick, K., Moore, D., & King, A. (2009). Feasibility and outcomes of a multilevel place-based walking intervention for seniors: A pilot study. Health Place, 15(1), 173179. PubMed ID: 18502164 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sardinha, L.B., Santos, D.A., Silva, A.M., Baptista, F., & Owen, N. (2015). Breaking-up sedentary time is associated with physical function in older adults. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences 70(1), 119124. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans (2nd ed.). Washington, DC: Author.

  • Vasunilashorn, S., Coppin, A.K., Patel, K.V., Lauretani, F., Ferrucci, L., & Bandinelli, S. (2009). Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: Analysis from the InCHIANTI study. Journal of Gerontology, Aging, and Biology Science Medicine, 64(2), 223229. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wolinsky, F.D., Miller, D.K., Andresen, E.M., Malmstrom, T.K., & Miller, J.P. (2005). Further evidence for the importance of subclinical functional limitation and subclinical disability assessment in gerontology and geriatrics. Journal of Gerontology, Psychology, Science, and Sociology, 60(3), S146S151. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wullems, J.A., Verschueren, S.M.P., Degens, J., Morse, C.I., & Onambele, G.L. (2016). A review of the assessment and prevalence of sedentarism in older adults, its physiology/health impact and non-exercise mobility counter-measures. Biogerontology, 17(3), 547565. PubMed ID: 26972899 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
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