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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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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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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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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.

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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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Seung-Youn Hong, Susan Hughes and Thomas Prohaska

Background:

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.

Methods:

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.

Results:

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).

Conclusions:

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.

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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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Harriet G. Williams and Gerhild Ullmann

Background:

Falls and fall-related injuries are critical issues for older adults; evidence indicates that multidimensional interventions that address modifiable risk factors can be successful in reducing falls. Few evidence-based fall prevention interventions exist due, in part, to complex issues associated with development and implementation. There is a need for a variety of such programs from which older adults may choose. We describe steps, outcomes, and issues involved in developing/implementing an evidenced-based fall prevention program in community settings.

Methods:

The Stay In Balance program (SIB), developed by a team of professionals, local service providers and active older adults, was carried out with total of 135 older adults in several steps: developing objectives and program content, laboratory-based randomized controlled trial (RCT), pilot program in the community, community-based RCT, and implementation at 2 community sites.

Results:

Each step in development provided useful and different insights into needed changes in program content, equipment, support materials, training, and appropriate outcome measures.

Conclusion:

Development of an evidenced-based fall prevention program requires a long term commitment on the part of all partners, University personnel, local service providers, and older adult participants; funding is also critical.

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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.