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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.

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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.

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Katherine M. White, Deborah J. Terry, Carolyn Troup, Lynn A. Rempel, Paul Norman, Kerry Mummery, Malcolm Riley, Natasha Posner and Justin Kenardy

A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.

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Fuzhong Li, Edward McAuley, Peter Harmer, Terry E. Duncan and Nigel R. Chaumeton

The article describes a randomized, controlled trial conducted to examine the effects of a Tai Chi intervention program on perceptions of personal efficacy and exercise behavior in older adults. The sample comprised 94 low-active, healthy participants (mean age = 72.8 years. SD = 5.1) randomly assigned to either an experimental (Tai Chi) group or a wait-list control group. The study length was 6 months, with self-efficacy responses (barrier, performance efficacies) assessed at baseline, at Week 12, and at termination (Week 24) of the study. Exercise attendance was recorded as an outcome measure of exercise behavior. Random-effects models revealed that participants in the experimental group experienced significant improvements in self-efficacy over the course of the intervention. Subsequent repeated-measures ANOVA revealed that participants’ changes in efficacy were associated with higher levels of program attendance. The findings suggest that self-efficacy can be enhanced through Tai Chi and that the changes in self-efficacy are likely to improve exercise adherence.

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Kathleen T. Rhyner and Amber Watts

Depressive symptoms are common in older adults, but antidepressant medications may be contraindicated or poorly tolerated in this population. Intervention studies demonstrate that exercise may be an effective alternative. This meta-analysis included 41 randomized controlled trials of aerobic and nonaerobic exercise interventions investigating the effect of exercise on depressive symptoms in adults aged 60 or older. A random effects model demonstrated that exercise was associated with significantly lower depression severity (SMD = 0.57, 95% CI 0.36–0.78). This effect was not significantly different for different ages of participants, types of control groups, or types of exercise interventions. Studies requiring a diagnosis of depression had significantly greater mean effect sizes than studies that did not require a depression diagnosis (Qbet = 6.843, df = 1, p = .009). These findings suggest that exercise is an effective treatment option for older individuals with depressive symptoms.

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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.

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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.

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Colleen A. Cuthbert, Kathryn King-Shier, Dean Ruether, Dianne M. Tapp and S. Nicole Culos-Reed

Background:

Family caregivers are an important health care resource and represent a significant proportion of Canadian and US populations. Family caregivers suffer physical and psychological health problems because of being in the caregiver role. Interventions to support caregiver health, including physical activity (PA), are slow to be investigated and translated into practice.

Purpose:

To examine the evidence for PA interventions in caregivers and determine factors hampering the uptake of this evidence into practice.

Methods:

A systematic review and evaluation of internal and external validity using the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework was conducted. Randomized controlled trials or pretest/posttest studies of PA interventions were included.

Results:

Fourteen studies were published between 1997 and 2015. Methodological quality of studies and risk of bias was variable. External validity criteria were often not reported. Mean reporting levels were 1) reach, 53%; 2) efficacy/effectiveness, 73%; 3) adoption, 18%; 4) implementation, 48%; and 5) maintenance, 2%.

Conclusions:

The lack of reporting of components of internal and external validity hinders the integration of caregiver PA interventions into clinical or community settings. Researchers should focus on standardized outcomes, accepted reporting criteria, and balancing factors of internal and external validity, to advance the state of the science.

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Bruce A. Reeder, Karen E. Chad, Elizabeth L. Harrison, Nigel L. Ashworth, M. Suzanne Sheppard, Koren L. Fisher, Brenda G. Bruner, Brian G. Quinn, Punam Pahwa and M. Alomgir Hossain

Background:

The study aimed to compare the effectiveness of a class-based (CB) and home-based (HB) exercise program for older adults with chronic health conditions.

Methods:

172 sedentary older adults with overweight or obesity, type 2 diabetes, hypertension, dyslipidemia, or osteoarthritis were enrolled in a randomized controlled trial with a 3-month follow-up.

Results:

A significant increase was seen in the CB group in the Physical Activity Scale for the Elderly (PASE) scores and SF-12 Physical and Mental Health scores. In both groups, significant increases were seen in 6-minute walk distance, Physical Performance Test (PPT), and Functional Fitness Test (FFT), and significant reductions were seen in systolic and diastolic blood pressure but not body mass index or waist circumference. Except for a greater increment in the FFT in the CB group, the degree of improvement was not significantly different between the 2 groups.

Conclusion:

After a 3-month intervention, both the CB and HB program produced comparable significant improvements in outcome measures.

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Gary S. Goldfield

Objective:

To compare liking and other attitudes toward physical activity (PA) and television (TV) viewing versus PA behavior and time viewing TV at baseline as predictors of response to lifestyle intervention in 30, 8 to 12 year old overweight/obese children.

Method:

Secondary analyses from a randomized controlled trial designed to increase PA and reduce sedentary behavior. PA was measured by accelerometers worn by participants every day for 8 weeks. TV viewing at baseline and during intervention was assessed by self-report.

Results:

Multiple regression analyses showed that base rates of PA and TV viewing significantly predicted changes in PA (Beta = .39, P < .05) and TV viewing (Beta = .37, P < .05) during the intervention, even after statistically controlling for child age, gender, body mass index, as well as baseline attitudes and liking of PA and TV viewing. However, self-reported liking of TV viewing and PA, perceived adequacy, and predilection were not predictive of response to intervention.

Conclusions:

Baseline measure of PA and TV viewing behaviors may be better predictors of response to lifestyle intervention than measure of liking and other attitudinal variables of PA. The theoretical and clinical implications of these findings are discussed.