This study examined exercise-adherence rates and their predictors across 21 randomized controlled trials (RCTs) involving older adults (age ≥ 55 years). On average, participants completed 78% of their prescribed exercise bouts. Adherence tended to be greater in strength- and flexibility-exercise training programs (M = 87%) than in aerobic-exercise training programs (M = 75%). The best adherers were individuals who were fitter at baseline, had a history of a physically active lifestyle, were nonsmokers, and had higher exercise self-efficacy. Different variables predicted adherence (a) at different time points in a RCT. (b) to different types of exercise, and (c) to different aspects of the exercise prescription (i.e., frequency, intensity, and duration). The findings suggest that older adults might be more adherent to exercise prescriptions than younger adults are. There is also a need for more theory-based research to examine predictors of adherence to various aspects of the exercise prescription.
Kathleen A. Martin and Adrienne R. Sinden
Nicholas Gilson, Jim McKenna and Carlton Cooke
This study explored the experiences of university employees recruited to a 10-week randomized controlled trial (n = 64). The trial compared “walking routes” with “walking-while-working” on daily step totals, showing that, compared with controls, interventions resulted in around 1000 extra steps per day.
A subsample of 15 academic and administrative employees from intervention groups completed interviews at the end of intervention. Interviews were transcribed verbatim and subject to inductive coding within the major themes of benefits/positives and problems/barriers.
Both interventions benefited employee health and work productivity but were difficult to implement in the workplace. Involvement in walking routes was challenged by the difficulties of managing time pressures, and individuals assigned to walking-while-working had to deal with local management subcultures favoring physical presence and inactivity.
Findings highlight the need for further research, advocate the value of walking at work, and provide insights into the challenges that face staff in workplace interventions.
Scott J. Strath, Ann M. Swartz, Sarah J. Parker, Nora E. Miller, Elizabeth K. Grimm and Susan E. Cashin
Increasing physical activity (PA) levels in older adults represents an important public health challenge. The purpose of this study was to evaluate the feasibility of combining individualized motivational messaging with pedometer walking step targets to increase PA in previously inactive and insufficiently active older adults.
In this 12-week intervention study older adults were randomized to 1 of 4 study arms: Group 1—control; Group 2—pedometer 10,000 step goal; Group 3—pedometer step goal plus individualized motivational feedback; or Group 4—everything in Group 3 augmented with biweekly telephone feedback.
81 participants were randomized into the study, 61 participants completed the study with an average age of 63.8 ± 6.0 years. Group 1 did not differ in accumulated steps/day following the 12-week intervention compared with participants in Group 2. Participants in Groups 3 and 4 took on average 2159 (P < .001) and 2488 (P < .001) more steps/day, respectively, than those in Group 1 after the 12-week intervention.
In this 12-week pilot randomized control trial, a pedometer feedback intervention partnered with individually matched motivational messaging was an effective intervention strategy to significantly increase PA behavior in previously inactive and insufficiently active older adults.
Valter C. Barbosa Filho, Kelly Samara da Silva, Jorge Mota, Carmem Beck and Adair da Silva Lopes
Promoting physical activity (PA) in low- and middle-income countries is an important public health topic as well as a challenge for practice. This study aimed to assess the effect of a school-based intervention on different PA-related variables among students.
This cluster-randomized-controlled trial included 548 students in the intervention group and 537 in the control group (11–18 years-old) from 6 schools in neighborhoods with low Human Development Index (0.170–0.491) in Fortaleza, Brazil. The intervention included strategies focused on training teachers, opportunities for PA in the school environment and health education. Variables measured at baseline and again at the 4-months follow-up included the weekly time in different types of moderate-to-vigorous PA (MVPA), preference for PA during leisure-time, PA behavioral change stage and active commuting to school. Generalized linear models and binary logistic regressions were used.
An intervention effect was found by increasing the weekly time in MVPA (effect size = 0.17), popular games (effect size = 0.35), and the amount of PA per week (effect size = 0.27) among students (all P < .05).
The intervention was effective in promoting improvements in some PA outcomes, but the changes were not sufficient to increase the proportion of those meeting PA recommendations.
Lucas J. Carr, R. Todd Bartee, Chris M. Dorozynski, James F. Broomfield, Marci L. Smith and Derek T. Smith
Less than half of U.S. adults engage in the recommended amount of physical activity (PA). Internet-delivered PA programs increase short-term PA but long-term adherence is largely equivocal.
To determine whether increased PA following the 16-week internet-delivered Active Living Every Day (ALED-I) program is maintained 8 months later in sedentary and overweight rural adults.
In our previous randomized controlled trial (N = 32; 18 intent-to-treat controls, 14 ALED-I interventions), the ALED-I group increased PA (+1384 steps/day; E.S. = 0.95) and reduced central adiposity. Nine original intervention participants and ten delayed intent-to-treat control participants completed ALED-I and an 8-month follow-up. Pedometer-measured PA, anthropometric variables, and cardiometabolic disease risk factors were assessed at baseline, postintervention, and at 8 months.
Control crossover participants increased PA (+1337 steps/day; P = .04). Eight months following completion of ALED-I (N = 19), PA levels relapsed (–1340 steps/day) and were similar to levels before the intervention (6850 ± 471 steps/day vs. 6755 ± 543 steps/day; P = .89). Total cholesterol and triglycerides improved, –9.9% and –18.2%, respectively, and reductions in central adiposity were maintained (97.1 ± 2.2 cm vs. 97.2 ± 2.2 cm; P = .66).
The ALED-I intervention was efficacious in the short-term but did not produce longer-term adherence to PA. Future theory- based internet-delivered interventions that produce habituation of increased PA are warranted. Study conducted in Laramie, WY from January 2007 through November 2007.
Silvia Varela, José M. Cancela, Manuel Seijo-Martinez and Carlos Ayán
.R.L. , Coley , N. , Moll van Charante , E.P. , van Gool , W.A. , Richard , E. , & Andrieu , S. ( 2017 ). Determinants of dropout and nonadherence in a dementia prevention randomized controlled trial: The prevention of dementia by intensive vascular care trial . Journal of the American Geriatrics
Pedro Lopez, Mikel Izquierdo, Regis Radaelli, Graciele Sbruzzi, Rafael Grazioli, Ronei Silveira Pinto and Eduardo Lusa Cadore
). Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: A consensus report . Journal of the American Geriatrics Society, 52 , 625 – 634 . PubMed ID: 15066083 doi:10.1111/j.1532-5415.2004.52174.x 10.1111/j.1532-5415.2004.52174.x
Alexei Wong, Arturo Figueroa, Marcos A. Sanchez-Gonzalez, Won-Mok Son, Oksana Chernykh and Song-Young Park
. References Astin , J.A. , Berman , B.M. , Bausell , B. , Lee , W.L. , Hochberg , M. , & Forys , K.L. ( 2003 ). The efficacy of mindfulness meditation plus Qigong movement therapy in the treatment of fibromyalgia: A randomized controlled trial . Journal of Rheumatology, 30 ( 10 ), 2257 – 2262
Francini Vilela Novais, Eduardo J. Simoes, Chester Schmaltz and Luiz R. Ramos
in general practice for physical activity, smoking, alcohol consumption and diet in elderly: a randomized controlled trial . Arch Gerontol Geriatr . 2014 ; 58 ( 1 ): 160 – 169 . PubMed ID: 24012131 doi:10.1016/j.archger.2013.08.007 10.1016/j.archger.2013.08.007 24012131 40. Grandes G , Sanchez
Katja Linde and Dorothee Alfermann
Physical and cognitive activity seems to be an effective strategy by which to promote age-sensitive fluid cognitive abilities in older adults.
In this randomized controlled trial, 70 healthy senior citizens (age 60–75) were allocated to a physical, cognitive, combined physical plus cognitive, and waiting control group. The trial assessed information processing speed, short-term memory, spatial relations, concentration, reasoning, and cognitive speed.
In contrast to the control group, the physical, cognitive, and combined training groups enhanced their concentration immediately after intervention. Only the physical training group showed improved concentration 3 months later. The combined training group displayed improved cognitive speed both immediately and three months after intervention. The cognitive training group displayed improved cognitive speed 3 months after intervention.
Physical, cognitive, and combined physical plus cognitive activity can be seen as cognition-enrichment behaviors in healthy older adults that show different rather than equal intervention effects.