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Katherine S. Hall and Edward McAuley

Background:

Few studies have examined physical activity behavior and its associated outcomes in older adults living in retirement communities. Guided by the disablement model and social cognitive theory, we tested a cross-sectional model in which physical activity was hypothesized to influence disability indirectly through self-efficacy, functional performance, and functional limitations.

Methods:

One hundred six older men and women residing in independent-living (ILF) assisted-living (ALF) facilities completed self-report measures of self-efficacy, function, and disability. Objective assessments of physical activity and functional performance were conducted using waist-mounted accelerometers and the short physical performance battery (SPPB), respectively. Path analysis was used to examine the proposed associations among constructs.

Results:

Older adults who were more active were also more efficacious and had better physical function and fewer functional limitations. Only higher levels of self-efficacy were associated with less disability. The effects of individual-level covariates were also examined.

Conclusions:

This cross-sectional study is among the first to examine the associations between physical activity, function, and disability among older adults residing in ILFs and ALFs. Future research addressing the physical and psychological needs of this growing population is warranted.

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Katherine S. Hall, Gail M. Crowley, Hayden B. Bosworth, Teresa A. Howard and Miriam C. Morey

The purpose of this study was to examine what happens to goals over the course of a physical activity counseling trial in older veterans. At baseline, participants (N = 313) identified 1 health-related goal and 1 walking goal for their participation in the study and rated where they perceived themselves to be relative to that goal at the current time. They rated their current status on these same goals again at 6 and 12 mo. Growth-curve analyses were used to examine longitudinal change in perceived goal status. Although both the intervention and control groups demonstrated improvement in their perceived proximity to their health-related and walking goals (L = 1.19, p < .001), the rates of change were significantly greater in the intervention group (β = –.30, p < .05). Our results demonstrate that this physical activity counseling intervention had a positive impact on self-selected goals over the course of the intervention.

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Katherine S. Hall, Thomas R. Wójcicki, Siobhan M. Phillips and Edward McAuley

Objective:

The current study examined the psychometric properties and validity of the Multidimensional Outcome Expectations for Exercise Scale (MOEES) in a sample of older adults with physical and functional comorbidities.

Methods:

Confirmatory factor analysis was used to examine the hypothesized 3-factor model in 108 older adults (M age 85 yr) residing in continuing-care retirement communities.

Results:

Analyses supported the 3-factor structure of the MOEES reflecting physical, social, and self-evaluative outcome expectations, with a 12-item model providing the best fit. Theorized bivariate associations between outcome expectations and physical activity, self-efficacy, and functional performance were all supported.

Conclusions:

The 12-item version of the MOEES appears to be a reliable and valid measure of outcome expectations for exercise in this sample of older adults with physical and functional comorbidities. Further examination of the factor structure and the longitudinal properties of this measure in older adults is warranted.

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Frances A. Kanach, Amy M. Pastva, Katherine S. Hall, Juliessa M. Pavon and Miriam C. Morey

This review examined effects of structured exercise (aerobic walking, with or without complementary modes of exercise) on cardiorespiratory measures, mobility, functional status, healthcare utilization, and quality of life in older adults (≥60 years) hospitalized for acute medical illness. Inclusion required exercise protocol, at least one patient-level or utilization outcome, and at least one physical assessment point during hospitalization or within 1 month of intervention. MEDLINE, Embase, and CINAHL databases were searched for studies published from 2000 to March 2015. Qualitative synthesis of 12 articles, reporting on 11 randomized controlled trials (RCTs) and quasi-experimental trials described a heterogeneous set of exercise programs and reported mixed results across outcome categories. Methodological quality was independently assessed by two reviewers using the Cochrane Collaboration Risk of Bias tool. Larger, well-designed RCTs are needed, incorporating measurement of premorbid function, randomization with intention-to-treat analysis, examination of a targeted intervention with predefined intensity, and reported adherence and attrition.

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Nina Sperber, Katherine S. Hall, Kelli Allen, Brenda M. DeVellis, Megan Lewis and Leigh F. Callahan

Background:

Physical and psychological symptoms limit physical activity for people with arthritis. This study examined if self-efficacy mediated a relationship between symptom and physical activity (PA) frequency change.

Methods:

This was a secondary analysis of older adults with arthritis and joint pain in a trial of a lifestyle PA program (n = 339). Measures were depressive symptoms, pain, fatigue, arthritis self-efficacy, PA self-efficacy, and PA frequency. A panel model was used to analyze relationships at baseline and changes at 20 weeks.

Results:

The mean age was 68.8 years. At baseline, depression and fatigue were associated with arthritis self-efficacy (β = –.34 and –.24) and, in turn, PA self-efficacy (β = .63); PA self-efficacy was associated with PA (β = .15). Pain and depression changes were associated with arthritis self-efficacy change (β = –.20 and –.21) and, in turn, PA self-efficacy (β = .32) change; PA self-efficacy change was associated with PA change (β = .36).

Conclusion:

Change in symptom severity affected change in PA frequency. These relationships appeared to operate through self-efficacy. Over time, pain appeared to have a stronger relationship than fatigue with self-efficacy and PA. These findings support strategies to help people with arthritis strengthen their confidence for symptom coping and PA participation.

Open access

Juliessa M. Pavon, Richard J. Sloane, Carl F. Pieper, Cathleen S. Colón-Emeric, David Gallagher, Harvey J. Cohen, Katherine S. Hall, Miriam C. Morey, Midori McCarty, Thomas L. Ortel and Susan N. Hastings

This study describes the availability of physical activity information in the electronic health record, explores how electronic health record documentation correlates with accelerometer-derived physical activity data, and examines whether measured physical activity relates to venous thromboembolism (VTE) prophylaxis use. Prospective observational data comes from community-dwelling older adults admitted to general medicine (n = 65). Spearman correlations were used to examine association of accelerometer-based daily step count with documented walking distance and with duration of VTE prophylaxis. Only 52% of patients had documented walking in nursing and/or physical therapy/occupational therapy notes during the first three hospital days. Median daily steps recorded via accelerometer was 1,370 (interquartile range = 854, 2,387) and correlated poorly with walking distance recorded in physical therapy/occupational therapy notes (median 33 feet/day [interquartile range = 12, 100]; r = .24; p = .27). Activity measures were not associated with use or duration of VTE prophylaxis. VTE prophylaxis use does not appear to be directed by patient activity, for which there is limited documentation.