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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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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.

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Elissa Burton, Gill Lewin and Duncan Boldy

The proportion of older people living in our communities is rising and, to live independently, some require assistance from home care services. Physical activity can improve and maintain function, strength, and balance, which are important for those receiving home care. This study reviewed the evidence on physical activity/exercise interventions trialed with older people receiving a home care service. A systematic review of studies published from January 1982 to September 2012, from five databases, was undertaken. Inclusion criteria were: aged 65+ years; community dwelling; no dementia diagnosis; receiving home care services; and a physical activity/exercise program. Eight articles were included and results show there were few consistencies between intervention types, groups, outcome measures, and follow-up. Study quality was mixed. Future studies should include pragmatic randomized controlled trials involving home care practitioners and their clients to gain “real-world” knowledge of what interventions are effective and can be delivered within this setting.

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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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Edward M. Phillips, Jeffrey Katula, Michael E. Miller, Michael P. Walkup, Jennifer S. Brach, Abby C. King, W. Jack Rejeski, Tim Church and Roger A. Fielding

Objectives:

To examine baseline characteristics and change in gait speed and Short Physical Performance Battery (SPPB) scores in participants medically suspended (MS) from a physical activity intervention (PA).

Design:

Randomized controlled trial.

Setting:

University and community centers.

Participants:

Sedentary older adults (N = 213) randomized to PA in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P).

Measurements:

MS was defined as missing 3 consecutive PA sessions in adoption and transition phases or 2 wk in maintenance phase because of a health event.

Results:

In all, 122 participants completed PA without MS (NMS subgroup), 48 participants underwent MS and resumed PA (SR subgroup), and 43 participants underwent MS and did not complete PA (SNR subgroup). At baseline, SNR walked slower (p = .03), took more prescribed medications (p = .02), and had lower SPPB scores than NMS and SR (p = .02). Changes from baseline to Month 12 SPPB scores were affected by suspension status, adjusted mean (SE) SPPB change: SNR 0.0957 (0.3184), SR 0.9413 (0.3063), NMS 1.0720 (0.1871); p = .03.

Conclusions:

MS participants unable to return to complete the PA in a trial of mobility-limited sedentary older adults had slower walking speeds, lower SPPB scores, and a higher number of prescribed medications at baseline. Change in SPPB scores at 12 months was related to suspension status.

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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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Dorothy Pekmezi, Shira Dunsiger, Ronnesia Gaskins, Brooke Barbera, Becky Marquez, Charles Neighbors and Bess Marcus

Background:

Due to high rates of inactivity and related chronic illnesses among Latinas,1 the current study examined the feasibility and acceptability of using pedometers as an intervention tool in this underserved population.

Methods:

Data were taken from a larger randomized, controlled trial2 and focused on the subsample of participants (N = 43) who were randomly assigned to receive a physical activity intervention with pedometers and instructions to log pedometer use daily and mail completed logs back to the research center each month for 6 months.

Results:

Retention (90.7% at 6 months) and adherence to the pedometer protocol (68.89% returned ≥ 5 of the 6 monthly pedometer logs) were high. Overall, participants reported increased physical activity at 6 months and credited pedometer use for helping them achieve these gains (75.7%). Participants who completed a high proportion (≥ 5/6) of pedometer logs reported significantly greater increases in physical activity and related process variables (stages of change, self-efficacy, behavioral processes of change, social support from friends) than those who were less adherent (completed < 5 pedometer logs).

Conclusions:

Pedometers constitute a low-cost, useful tool for encouraging self-monitoring of physical activity behavior in this at-risk group.

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Jakob Tarp, Lars B. Andersen and Lars Østergaard

Background:

Cycling to and from school is an important source of physical activity (PA) in youth but it is not captured by the dominant objective method to quantify PA. The aim of this study was to quantify the underestimation of objectively assessed PA caused by cycling when using accelerometry.

Methods:

Participants were 20 children aged 11 to 14 years from a randomized controlled trial performed in 2011. Physical activity was assessed by accelerometry with the addition of heart rate monitoring during cycling to school. Global positioning system (GPS) was used to identify periods of cycling to school.

Results:

Mean minutes of moderate-to-vigorous physical activity (MVPA) during round-trip commutes was 10.8 (95% CI: 7.1−16.6). Each kilometer of cycling meant an underestimation of 9314 (95% CI: 7719−11238) counts and 2.7 (95% CI: 2.1−3.5) minutes of MVPA. Adjusting for cycling to school increased estimates of MVPA/day by 6.0 (95% CI: 3.8−9.6) minutes.

Conclusions:

Cycling to and from school contribute substantially to levels of MVPA and to mean counts/min in children. This was not collected by accelerometers. Using distance to school in conjunction with self-reported cycling to school may be a simple tool to improve the methodology.

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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.

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Rachel S. Mark and Ryan E. Rhodes

Background:

Interactive stationary bikes provide positive affective experiences and physiological benefits; however, research is limited.

Methods:

This study compared usage of GameBikes to traditional stationary bikes among families in the home following a 6-week randomized, controlled trial design. Parents completed questionnaires featuring constructs of the theory of planned behavior (TPB). Usage was tracked by all family members and belief elicitation with GameBike families followed the trial.

Results:

Usage across the trial was significantly different for children in favor of the GameBike group (t 36 = 2.61, P = .01, d = .85). No differences were identified for parents. Significant time effects for parents’ (F 5,48 = 5.07, P < .01; η2 = .35) and children’s (F 5,32 = 8.24, P < .01; η2 = .56) usage were found with declines across 6 weeks. Affective attitude was the only significant TPB variable between groups at both time one (t 57 = 2.53, P = .01; d = .65) and follow-up (t 52 = 2.70, P = .01; d = .74) in favor of the GameBike group. Elicited beliefs were primarily affective- and control-based.

Conclusions:

The results provide support for use of interactive video games to augment current PA initiatives. Larger-scale trials with longer durations are warranted.