Benefits of physical activity for those with arthritis are clear, yet physical activity is difficult to initiate and maintain. Self-efficacy is a key modifiable psychosocial determinant of physical activity. This study examined two scales for self-efficacy for exercise behavior (SEEB) to identify their strengths and weaknesses using item response theory (IRT) from community-based randomized controlled trials of physical activity programs in adults with arthritis. The 2 SEEB scales included the 9-item scale by Resnick developed with older adults and the 5-item scale by Marcus developed with employed adults. All IRT analyses were conducted using the graded-response model. IRT assumptions were assessed using both exploratory and confirmatory factor analysis. The IRT analyses indicated that these scales are precise and reliable measures for identifying people with arthritis and low SEEB. The Resnick SEEB scale is slightly more precise at lower levels of self-efficacy in older adults with arthritis.
Thelma J. Mielenz, Michael C. Edwards and Leigh F. Callahan
Seung-Youn Hong, Susan Hughes and Thomas Prohaska
Many different constructs are used currently in the literature to assess exercise adherence. This study examined whether the same or different variables predict exercise attendance and exercise completion among sedentary older adults.
Thirty-seven randomized control trials were selected from articles published between 1980 and 2000 that tested exercise interventions for sedentary older adults. Block-entry, weighted, hierarchical meta-regression analyses were conducted.
Different factors predicted attendance and completion. Group-based (P < .05) and resistance exercise (P < .1) predicted higher attendance rates than individual-based and aerobic exercise. In contrast, facility-based exercise was associated with higher completion rates than home-based exercise (P < .1).
Results show that completing a program is not synonymous with good attendance. Program designers need to consider different strategies to boost both of these rates that need to be maximized to best benefit program participants.
Carolyn Rabin, Bernardine M. Pinto and Georita M. Frierson
Physical activity (PA) interventions diminish some of the physical and psychosocial sequelae of breast cancer diagnosis and treatment. To increase intervention efficacy and portability, it is necessary to determine the factors mediating intervention effects on physical and psychosocial outcomes. This study presents mediator analyses from a randomized controlled trial of a home-based PA intervention (focused primarily on brisk walking) for breast cancer survivors. Eighty-six survivors were randomized to PA or contact control groups (mean age = 53.42 years, SD = 9.08 and 52.86 years, SD = 10.38 respectively; mean time since diagnosis < 2 years). The PA intervention was based on the transtheoretical model (TTM). Kraemerʼs approach was used to test hypothesized mediators. TTM variables did not mediate intervention effects on PA. Data indicate that increases in moderate-intensity PA and improved fitness may mediate intervention effects on vigor (β = .21; p = .01) and fatigue (β = .24; p = .05) and suggest the value of future research on these potential mediators.
Margie E. Lachman, Shevaun D. Neupert, Rosanna Bertrand and Alan M. Jette
The authors examined whether resistance training has an effect on working memory span. Participants included 210 community-residing older adults with at least one disability from the Strong for Life program, a randomized controlled trial that examined the effects of home-based resistance exercise. Memory was assessed with the WAIS backward digit span at baseline and 3 and 6 months into the intervention. Although there were no differences between the experimental treatment and control groups in average levels of memory change, within the treatment group change in resistance level during the intervention was a significant predictor of memory change, controlling for age, education, sex, and disability level. The results suggest that strength training can benefit memory among older adults, especially when using higher resistance levels.
Susan Williams, Claudia Meyer, Frances Batchelor and Keith Hill
The objective of this study was to determine whether improved balance outcomes achieved in a randomized controlled trial (RCT) using balance screening to identify mild balance dysfunction and home exercises could be translated into community settings. Community-dwelling people aged over 65 who expressed concerns about their balance, had less than two falls in the preceding 12 months, and who had mild balance impairment on screening were given an individualized home-based balance and strengthening exercise program with intermittent home-visit support by a physiotherapist. Of 71 participants assessed (mean age 77.3 years, 76% female), 58 (82%) completed the six-month intervention. Twenty six percent of participants regained balance performance within normal limits—similar to those achieved in the previous RCT. Successful results from a previous RCT were able to be translated into community settings, with a similar magnitude of effect on balance and mobility.
Kathleen Benjamin, Nancy Edwards, Jenny Ploeg and Frances Legault
Despite the benefits of physical activity, residents living in long-term care (LTC) are relatively sedentary. Designing successful physical activity and restorative care programs requires a good understanding of implementation barriers. A database search (2002–2013) yielded seven studies (nine articles) that met our inclusion criteria. We also reviewed 31 randomized controlled trials (RCTs) to determine if the authors explicitly discussed the barriers encountered while implementing their interventions. Eleven RCTs (13 articles) included a discussion of the barriers. Hence, a total of 18 studies (22 articles) were included in this review. Barriers occurred at resident (e.g., health status), environmental (e.g., lack of space for physical activity), and organizational (e.g., staffing and funding constraints) levels. These barriers intersect to adversely affect the physical activity of older people living in LTC. Future studies targeting physical activity interventions for residents living in LTC are needed to address these multiple levels of influence.
Edel Langan, John Toner, Catherine Blake and Chris Lonsdale
We conducted a cluster randomized controlled trial (RCT) to test the effects of a self-determination theory-based intervention on athlete motivation and burnout. In addition, we examined the feasibility and acceptability of the intervention. We randomly assigned youth Gaelic football coaches (N = 6) and their teams to an experimental or a delayed treatment control group (n = 3 each group). We employed linear mixed modeling to analyze changes in player motivation and burnout as a result of their coach participating in a 12-week SDT-based intervention. In addition, we conducted a fidelity assessment to examine whether the intervention was implemented as planned. The findings demonstrated the feasibility and acceptability of implementing a self-determination theory-based intervention in the coaching domain. In addition, this study demonstrated favorable trends in the quality of player motivation and burnout symptoms as a result of an SDT-based intervention.
Dennis Hamacher, Daniel Hamacher, Kathrin Rehfeld, Anita Hökelmann and Lutz Schega
Dancing is a complex sensorimotor activity involving physical and mental elements which have positive effects on cognitive functions and motor control. The present randomized controlled trial aims to analyze the effects of a dancing program on the performance on a motorcognitive dual task. Data of 35 older adults, who were assigned to a dancing group or a health-related exercise group, are presented in the study. In pretest and posttest, we assessed cognitive performance and variability of minimum foot clearance, stride time, and stride length while walking. Regarding the cognitive performance and the stride-to-stride variability of minimum foot clearance, interaction effects have been found, indicating that dancing lowers gait variability to a higher extent than conventional health-related exercise. The data show that dancing improves minimum foot clearance variability and cognitive performance in a dual-task situation. Multi-task exercises (like dancing) might be a powerful tool to improve motor-cognitive dual-task performance.
Marijke Hopman-Rock and Marja H. Westhoff
Edited by Wojtek J. Chodzko-Zajko
The Aging Well and Healthily (AWH) program consists of health education by peers and low-intensity exercise. It was evaluated via a small randomized controlled trial and a community intervention trial involving older adults in the Netherlands. Reasons stated for participation were to exercise (35%), to acquire information about health (28%), and for social reasons (12%). The program was rated 8.2 on a 10-point scale. Twenty-five percent of participants joined exercise groups after the program ended, and 28% intended to do so. The mean physical activity score improved from 2.6 to 4.6 at follow-up (F = 16.9, p = .00) and was for the least active participants significantly different from that of the control group (F = 22.9, p = .02). Four to 6 months later, 60% of respondents reported still doing the exercises regularly at home. It is concluded that AWH is a potentially effective program for older adults.
Erwin C.P.M. Tak, Jannique G.Z. van Uffelen, Mai J.M. Chin A Paw, Willem van Mechelen and Marijke Hopman-Rock
After a randomized controlled trial showing that improvement on some aspects of cognitive function was related to adherence to an exercise program, determinants of adherence and maintenance were further studied. Older adults with mild cognitive impairment were contacted 6 mo after the end of exercise programs for a telephone interview addressing patterns of adherence and determinants of maintenance. Mean adherence during the trial was 53%. About one third of participants had lapses during the trial but completed, one third had no lapses, and one third dropped out or never started. Practical barriers (time, location) were related to not starting and functional limitations to dropout. After the trial 25% of participants continued the programs, 14% reported intention to continue, and 61% quit. Maintenance was determined by fewer health complaints, higher satisfaction with the programs, and better adherence during the programs. Although maintenance was low, this study identified several reasons and barriers to adherence and maintenance that could be addressed.