Effectiveness of physical activity interventions for older adults - A review

Centre for Quality of Care Research, University Medical Centre St Radboud, Nijmegen, The Netherlands.
American Journal of Preventive Medicine (Impact Factor: 4.53). 02/2002; 22(2):120-33. DOI: 10.1016/S0749-3797(01)00413-5
Source: PubMed


This review evaluates the effectiveness of physical activity interventions among older adults.
Computerized searches were performed to identify randomized controlled trials. Studies were included if: (1) the study population consisted of older adults (average sample population age of > or =50 years and minimum age of 40 years); (2) the intervention consisted of an exercise program or was aimed at promoting physical activity; and (3) reported on participation (i.e., adherence/compliance) or changes in level of physical activity (e.g., pre-post test measures and group comparisons).
The 38 studies included 57 physical activity interventions. Three types of interventions were identified: home-based, group-based, and educational. In the short-term, both home-based interventions and group-based interventions achieved high rates of participation (means of 90% and 84%, respectively). Participation declined the longer the duration of the intervention. Participation in education interventions varied widely (range of 35% to 96%). Both group-based interventions and education interventions were effective in increasing physical activity levels in the short-term. Information on long-term effectiveness was either absent or showed no difference of physical activity level between the study groups.
Home-based, group-based, and educational physical activity interventions can result in increased physical activity, but changes are small and short-lived. Participation rates of home-based and group-based interventions were comparable, and both seemed to be unrelated to type or frequency of physical activity. The beneficial effect of behavioral reinforcement strategies was not evident. Comparative studies evaluating the effectiveness of diverse interventions are needed to identify the interventions most likely to succeed in the initiation and maintenance of physical activity.

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Available from: Miranda GH Laurant, Oct 29, 2015
    • "None of the measures significantly changed over the 6 months, though three of the four trended toward improvement. Physical activity interventions have been criticised as changes in behaviour are often small and short lived (Van Der Bij, Laurant, & Wensing, 2002). It is therefore important to establish the effects not only of interventions designed to change levels of either physical activity or physical exercise, but also of habitual physical activity. "
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    ABSTRACT: Evidence from studies on healthy older adults and Mild Cognitive Impairment (MCI) populations suggests that physical activity interventions have a positive effect on executive function. In this study, we consider whether habitual physical activity is positively associated with executive function in Alzheimer's disease (AD). Eighty-two participants with a diagnosis of mild to moderate AD completed six measures of executive function. Objective measures of physical status were taken. In addition, informants completed questionnaires on the participants’ habitual physical activity and other lifestyle factors. A composite measure of executive function was the primary outcome. A multistage multiple regression was used to determine how much variance habitual physical activity accounted for. The final model comprised disease severity, cognitive reserve, cognitive activities, neuropsychiatric status and habitual physical activity status. The final model accounted for a total of 57% of the variance of executive performance, of which habitual physical activity itself accounted for 8% of the variance. Habitual physical activity status is associated executive performance in an AD population even after controlling for key covariates. The findings encourage clinicians to recommend habitual physical activity and its cognitive benefits to AD patients and their carers.
    No preview · Article · Jul 2014 · Archives of gerontology and geriatrics
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    • "Although the pain management program, which includes physical activity, has been shown to have health benefits and improve pain management among older adults [8], studies have found educational interventions to be effective among older adults only over the short term [9]. People who participated in these interventional programs often fell back into their old habits of inactivity after completing the program [10]. "
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    ABSTRACT: Background: Chronic pain is common among the older population. A literature review on pain management program showed that exercise, yoga, massage therapy, Tai Chi, and music therapy could significantly reduce pain. In spite of the proven benefits of pain management programs, these intervention programs were effective only in the short term, and older adults would resume their old habits. It has been suggested that interventions comprising some type of social support have great potential to increase the participation of older adults. Therefore, we propose the inclusion of peer volunteers in an integrated pain management program to relieve pain among frail older adults. This study aims to explore the effectiveness of an integrated pain management program supplemented with peer volunteers in improving pain intensity, functional mobility, physical activity, loneliness levels, happiness levels, and the use of non-pharmacological pain-relieving methods among frail older adults with chronic pain. Methods/design: We intend to recruit 30 nursing home residents and 30 peer volunteers from the Institute of Active Ageing in Hong Kong in a group trial for an 8-week group-based integrated pain management program. There will be 16 sessions, with two 1-hour sessions each week.The primary outcome will be pain levels, while secondary outcomes will be assessed according to functional mobility, physical activity, loneliness levels, happiness levels, the use of non-pharmacological pain-relieving methods, and through a questionnaire for volunteers. Discussion: In view of the high prevalence of chronic pain among older adults and its adverse impacts, it is important to provide older adults with tools to control their pain. We propose the use of peer volunteers to enhance the effects of an integrated pain management program. It is expected that pain can be reduced and improvements can be achieved among older adults in the areas of physical activity, functional mobility, loneliness levels, happiness levels, and the use of non-pharmacological pain relieving methods. Using these results, we will assess the need to conduct a larger study with a randomized controlled design. Trial registration: This trial was registered on 24 February 2014 at the Australian New Zealand Clinical Trials Registry (ANZCTR) with the trial number: ACTRN12614000195651.
    Full-text · Article · Jun 2014 · Trials
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    • "A number of health promotion strategies have been employed to increase the population's physical activity levels, including group and home-based physical activity programs [4] [5]. Yet few studies have directly compared group and home-based physical activity interventions, particularly over the longer term [6] [7]. Fewer studies have investigated the role the physiotherapist plays in physical activity promotion [8] and no studies appear to directly target individuals not interested in group exer- cise. "
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    ABSTRACT: Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a pragmatic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activity program (n = 65). The primary outcome was physical activity adherence derived from exercise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p < 0.05). Thirty-three percent of the group participants attended ≥ 70% of group exercise sessions. Ninety percent of home-based partici-pants received ≥ 4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of participants achieving self-reported “sufficient” physical activity (p ≤ 0.001) and significantly decreased waist circumference (p < 0.001) and WHR (p < 0.05). Conclusion: The physiotherapist- led home-based physical activity program, requiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program. Clinical Trial Registration number Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.
    Full-text · Article · Jan 2013 · Open Journal of Preventive Medicine
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