Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial. Efficacy of a web-based, center-based or combined physical activity intervention among older adults. Development and evaluation of two web-based interventions for the promotion of physical activity in older adults: study protocol for a community-based controlled intervention trial Cost-effectiveness of the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability. Short- and Long-Term Effects of Balance Training on Physical Activity in Older Adults With Osteoporosis: A Randomized Controlled Trial Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a better life: a physical activity intervention for black women. Promoting community readiness for physical activity among older adults in Germany – protocol of the ready to change intervention trial Development of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: OncoActive Cluster randomized controlled trial of a multilevel physical activity intervention for older adults The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Effects of multidomain lifestyle intervention, omega-3 supplementation or their combination on physical activity levels in older adults: secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT) randomised controlled trial Effect of physical activity guidelines on physical function in older adults. Vitamin d and physical activity status: associations with five-year changes in body composition and muscle function in community-dwelling older adults. Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care. Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. Effects of activity strategy training on pain and physical activity in older adults with knee or hip osteoarthritis: a pilot study. Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial Promoting physical activity for elders with compromised function: the lifestyle Interventions and Independence for elders (LIFE) study physical activity intervention Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial. Increasing uptake of physical activity: a social ecological approach Activity adherence and physical function in older adults with functional limitations. A cost analysis of a physical activity intervention for older adults. Web-based Intervention to Promote Physical Activity by Sedentary Older Adults: Randomized Controlled Trial
INTRODUCTION Increased physical activity ( PA ) is a crucial factor in the prevention of physical deterioration , and resistance training ( RT ) is also a common and effective intervention for older adults . However , the effects of PA as an adjunct to RT on frailty status remains unclear ; therefore , we clarified the effect of a PA intervention with feedback , as an adjunct to resistance strength training , on the physical and mental outcomes of frail older adults . MATERIAL S AND METHODS We employed a r and omized controlled trial . Community-dwelling frail older adults in Japan were recruited to participate . Forty-one participants ( mean age 81.5 ) were r and omly assigned to engage in a resistance training with PA ( RPA group ) or RT group for six months . Frailty status and frailty scores , which were measured according to the Cardiovascular Health Study criteria -muscle strength , mobility , instrumental activities of daily living , and health-related quality of life-were assessed . RESULTS Participants in the RPA group exhibited a significant increase in light-intensity PA , the number of steps taken daily ( p < 0.05 ) , and lower-limb muscle strength ( p < 0.05 ) and a significant decrease in frailty scores . However , pre- and postintervention frailty status , instrumental activities of daily living , and health-related quality of life did not differ significantly . CONCLUSIONS Implementation of a PA intervention as an adjunct to RT is feasible , as it reduced frailty scores and increased lower-limb muscle strength and mobility in older adults with frailty symptoms With more social support and environment-centered interventions being recommended in web-based interventions , this study examined the efficacy of three intervention conditions aim ed at promoting physical activity ( PA ) in older adults . The efficacy analyses included the self-reported PA level , stage of change for PA and awareness about PA among participants . Eligible participants ( N = 149 ; M = 65 years old , SD = 6 ) , recruited in a unique Belgian French-speaking municipality , were r and omized in four research arms for a 3-month intervention : ( i ) web-based ; ( ii ) center-based ; ( iii ) mixed ( combination of web- and center-based ) ; and ( iv ) control ( no intervention ) . Web-based condition included a PA website and monthly tailored emails whereas center-based condition comprised 12 sessions ( 1 per week ) of group exercising . With a significant increase in PA , the PA stage of change and the PA awareness at 12 months , the mixed intervention condition seemed to include the key social and motivating elements for sustainable behavior change . Center-based intervention was more likely to produce significant improvements of the PA level and the stage of change for PA change whereas web-based intervention was more likely to extend the awareness about PA Background Regular physical activity ( PA ) is a key contributor to healthy ageing . However , despite known health benefits , only one third of older adults in Germany reach the PA levels recommended for persons aged 65 years and above by the World Health Organization . The aim of the current study is to evaluate the effectiveness of two web-based interventions for the initiation and maintenance of regular PA ( i.e. , intervention groups 1 and 2 ) compared to a delayed intervention control group of older adults aged 65 to 75 years . Methods / Design Study participants will be r and omly assigned to one of three study arms in five communities in the Bremen-Oldenburg metropolitan region : a ) Participants in the first arm will receive access to a web-based intervention for 10 weeks allowing them to track their weekly PA ( subjective self-monitoring , intervention group 1 ) ; b ) participants in the second arm will receive access to the web-based intervention for 10 weeks and , in addition , track PA using Fitbit Zips ( objective self-monitoring , intervention group 2 ) ; c ) participants in the delayed intervention control group will receive access to the intervention implemented in the first study arm after completion of the 12-week follow-up in the other two groups within each community . In addition , weekly group meetings in the communities will be offered to study participants in the intervention groups providing the opportunity to address questions related to the use of the website and to practice PA in groups ( e.g. , neighborhood walks , strength and balance exercises ) . To evaluate short-term effects of the intervention on physical and psychological health , PA , physical fitness , and cognitive and psychological variables will be assessed at baseline and 12-week follow-up . Discussion This study will provide answers regarding acceptance and effectiveness of web-based interventions promoting uptake and maintenance of regular PA in persons aged 65–75 years . Study findings will contribute to a growing body of evidence in Germany concerning the role of community-based interventions for the promotion of PA and healthy ageing in older adults . Trial registration German Clinical Trials Register DRKS00010052 ( Date of registration 07–11 - 2016 ) BACKGROUND Losing the ability to walk safely and independently is a major concern for many older adults . The Lifestyle Interventions and Independence for Elders study recently demonstrated that a physical activity ( PA ) intervention can delay the onset of major mobility disability . Our objective is to examine the re sources required to deliver the PA intervention and calculate the incremental cost-effectiveness compared with a health education intervention . METHODS The Lifestyle Interventions and Independence for Elders study enrolled 1,635 older adults at risk for mobility disability . They were recruited at eight field centers and r and omly assigned to either PA or health education . The PA program consisted of 50-minute center-based exercise 2 × weekly , augmented with home-based activity to achieve a goal of 150 min/wk of PA . Health education consisted of weekly workshops for 26 weeks , and monthly sessions thereafter . Analyses were conducted from a health system perspective , with a 2.6-year time horizon . RESULTS The average cost per participant over 2.6 years was US$ 3,302 and US$ 1,001 for the PA and health education interventions , respectively . PA participants accrued 0.047 per person more Quality -Adjusted Life-Years ( QALYs ) than health education participants . PA interventions costs were slightly higher than other recent PA interventions . The incremental cost-effectiveness ratios were US$ 42,376/major mobility disability prevented and US$ 49,167/QALY . Sensitivity analyses indicated that results were relatively robust to varied assumptions . CONCLUSIONS  The PA intervention costs and QALYs gained are comparable to those found in other studies . The ICERS are less than many commonly recommended medical treatments . Implementing the intervention in non- research setting s may reduce costs further Background and Purpose : We have developed a 12-week balance training program for older adults shown to improve fall-related concerns , gait speed , balance performance , and physical function . We hypothesized that this balance training would also contribute to higher habitual physical activity ( PA ) levels and improved health-related quality of life ( HRQoL ) . The primary aim was to evaluate short- and long-term effects of the balance training program on objective ly measured habitual PA in older adults with osteoporosis . Secondary aims were to assess the effects of the balance training on HRQoL , and to study whether any effects on PA were associated with changes in HRQoL , gait speed , balance performance , fall-related concerns , and physical function . Methods : A r and omized controlled trial with follow-up at 3 , 9 , and 15 months , including 91 participants with osteoporosis ( 75.6 ± 5.4 years ) , compared a balance training group  ( n = 61 ) with a control group ( n = 30 ) . The primary outcome was effect on habitual PA measured as steps/day , dichotomized into less than 5000 or 5000 or more steps/day . Physical activity was assessed with pedometers ( Yamax ) and accelerometers ( Actigraph ) , HRQoL with the Short Form-36 ( SF-36 ) , gait with a GAITRite walkway , balance performance with Modified-Figure-Eight test and one-leg stance , fall-related concerns with Falls Efficacy Scale International , and physical function with the advanced lower extremity subscale of the question naire Late Life Function and Disability Instrument . Statistical methods used were multivariate logistic regression and logistic generalized estimating equation . Results : Sixty-eight participants completed the short-term follow-up at 3 months , and 53 participants completed the long-term follow-up at 15 months . Per- protocol analysis ( n = 68 ) showed that the odds ratio for having a daily step count of 5000 or more at 3 months was 6.17 ( 95 % confidence interval , 1.23 - 30.91 ) , P = .027 , for the intervention group compared with the control group . The longitudinal analysis ( n = 91 ) showed that the odds ratio for having a daily step count of 5000 or more at 15 months was 2.02 ( 95 % confidence interval , 0.88 - 4.64 ) , P = .096 , for the intervention group compared with the control group . The mental component sum of the SF-36 improved significantly from baseline to 3 months in the intervention group , and the physical component sum improved in both groups , but no statistically significant differences were found between groups . No associations were found between PA and changes in covariates . Discussion and Conclusions : The short-term evaluation showed that balance training increased habitual PA in community-dwelling older adults with osteoporosis . A significantly higher proportion of participants in the intervention group reached a level of 5000 or more steps/day , which is important for overall health . This effect was not associated with improvements in HRQoL , gait speed , balance performance , or fall-related concerns , and did not persist through the long-term follow-up . To accomplish a sustained PA change , a prolonged intervention or more support regarding habitual PA may be required , such as reinforcement with personalized behavior change counseling or PA on prescription Physical  activity ( PA )  is low among African American women despite awareness of its positive impact on health . Learning and Developing Individual Exercise Skills for a Better Life ( L.A.D.I.E.S. ) compares three strategies for increasing PA among African American women using a cluster r and omized , controlled trial . Underactive adult women from 30 churches ( n=15 participants /church ) were recruited . Churches were r and omized to a faith-based intervention , a non-faith based intervention , or an information only control group . Intervention groups will meet 25 times in group sessions with other women from their church over a 10-month period . Control group participants will receive st and ard educational material promoting PA . All participants will be followed for an additional 12 months to assess PA maintenance . Data will be collected at baseline , 10 , and 22 months . The primary outcome is PA ( steps/day , daily moderate-to-vigorous PA ) . We expect treatment effects indicating that assignment to either of the active interventions is associated with greater magnitude of change in PA compared to the control group . In exploratory analyses , we will test whether changes in the faith-based intervention group are greater than changes in the non-faith-based intervention group . L.A.D.I.E.S. focuses on a significant issue-increasing  PA levels-in a segment of the population most in need of successful strategies for improving health . If successful , L.A.D.I.E.S. will advance the field by providing an approach that is successful for initiating and sustaining change in physical activity , which has been shown to be a primary risk factor for a variety of health outcomes , using churches as the point of delivery Background Healthy ageing is an important concern for many societies facing the challenge of an ageing population . Physical activity ( PA ) is a major contributor to healthy ageing ; however insufficient PA levels are prevalent in old age in Germany .  Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion . However , evidence for the effectiveness of these strategies is scarce . This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups . Methods / Design We design ed a mixed method intervention trial comprising three study modules . The first module includes an assessment of  community readiness for PA interventions in older adults . The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews . In the second module , eight municipalities with the low community readiness are selected from the sample and r and omly assigned to one of two study groups : active enhancement of community readiness ( intervention ) versus no enhancement ( control ) . After enhancing community readiness in the active enhancement group , older adults in both study groups will be recruited for participation in a PA intervention .  Participation rates are compared between the study groups to evaluate the effects of the intervention . In addition , a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups . In the third module , qualitative interviews are conducted with participants and non- participants of the PA intervention exploring reasons for participation or non-participation . Discussion This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers . Its findings will inform governmental authorities , professionals , academics , and NGOs with an estimate of re sources necessary to achieve equitable access to physical activity programs for vulnerable older adults . Trial registration German Clinical Trials Register DRKS00009564 ( Date of registration 03 - 11 - 2015 Background Cancer and cancer treatment coincide with substantial negative physical , psychological and psychosocial problems .  Physical activity ( PA ) can positively affect the negative effects of cancer and cancer treatment and thereby increase quality of life in CPS . Nevertheless , only a minority of CPS meet PA guidelines . We developed the OncoActive ( OncoActief in Dutch ) intervention : a computer-tailored PA program to stimulate PA  in prostate and colorectal CPS , because to our knowledge there are only a few PA interventions for these specific cancer types in the Netherl and s Methods The OncoActive intervention was developed through systematic adaptation of a proven effective , evidence -based , computer-tailored PA  intervention for adults over fifty , called Active Plus . The Intervention Mapping ( IM ) protocol was used to guide the systematic adaptation . A literature study and interviews with prostate and colorectal CPS and health care professionals revealed that both general and cancer-specific PA determinants are important and should be addressed . Change objectives , theoretical methods and applications and the actual program content were adapted to address the specific needs , beliefs and cancer-related issues of prostate and colorectal CPS . Intervention participants  received tailored PA advice three times , on internet and with printed material s , and a pedometer to set goals to improve PA .  Pre- and pilot tests showed that the intervention was highly appreciated ( target group ) and regarded safe and feasible ( healthcare professionals ) . The effectiveness of the intervention is being evaluated in a r and omized controlled trial ( RCT ) ( n = 428 ) , consisting of an intervention group and a usual care waiting-list control group , with follow-up measurements at three , six and twelve months . Participants are recruited from seventeen hospitals and with posters , flyers and calls in several media . Discussion Using the Intervention Mapping protocol result ed in a systematic ally adapted , theory and evidence -based intervention providing tailored PA advice to prostate and colorectal CPS . If the intervention turns out to be effective in increasing PA , as evaluated in a RCT , possibilities for nationwide implementation and extension to other cancer types will be explored . Trial registration The study is registered in the Dutch Trial Register ( NTR4296 ) on November 23rd 2013 and can be accessed at http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=4296 Background Older adults are the least active population group . Interventions in residential setting s may support a multi-level approach to behavior change . Methods In a cluster r and omized control trial , 11 San Diego retirement communities were assigned to a physical activity ( PA ) intervention or a healthy aging attention control condition .  Participants were 307 adults over 65 years old . The multilevel PA intervention was delivered with the assistance of peer leaders , who were trained older adult from the retirement communities . Intervention components included individual counseling & self-monitoring with pedometers , group education sessions , group walks , community advocacy and pedestrian community change projects . Intervention condition by time interactions were tested using generalized mixed effects regressions . The primary outcomes was accelerometer measured physical activity . Secondary outcomes were blood pressure and objective ly measured physical functioning . Results Over 70 % of the sample were 80 years or older .  PA  significantly increased in the intervention condition ( 56 min of moderate-vigorous PA per week ; 119 min of light PA ) compared with the control condition and remained significantly higher across the 12 month study . Men and participants under 84 years old benefited most from the intervention . There was a significant decrease in systolic ( p < .007 ) and diastolic ( p < .02 ) blood pressure at 6 months . Physical functioning improved but the changes were not statistically significant . Conclusions Intervention fidelity was high demonstrating feasibility . Changes in PA and blood pressure achieved were comparable to other studies with much younger participants . Men , in particular , avoided a year-long decline in PA.Trial registration clincialtrials.gov Identifier : NCT01155011 Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population Background / objectives to investigate the effects of a 3-year multidomain lifestyle intervention , omega-3 supplementation or both on  physical activity  ( PA ) in older adults with subjective memory complaints . Design / setting s/subjects the Multidomain Alzheimer Preventive Trial was a 3-year r and omised controlled trial that enroled 1,680 community-dwelling adults aged 70 years or over , with subjective memory complaints . Participants were r and omised to omega-3 supplementation ( total daily dose of 800 mg docosahexanoic acid and up to 225 mg eicosapentanoic acid ) , multidomain intervention ( nutritional and exercise counselling and cognitive training ) , omega-3 plus multidomain intervention or placebo with usual care . Methods PA was assessed using a self-reported question naire . From this , global moderate-to-vigorous PA , leisure-time PA , non-leisure-time PA and light PA were measured in metabolic equivalent tasks-minutes per week ( MET-min/week ) . Results in the multidomain groups , participants significantly increased their moderate-to-vigorous and leisure-time PA at 6 months ( ≥300 MET-min/week for both in the multidomain groups ; P ≤ 0.002 ) before returning to baseline by the end of the trial . Activity in the placebo/usual care and omega-3/usual care groups declined overtime . Between-group differences remained significant for both multidomain groups for leisure-time physical activity at 2- and 3-year follow-ups . Compared to placebo/usual care , interventions had no significant effects on non-leisure-time PA and light PA . Omega-3 supplementation alone had no effects on PA . Conclusions a multidomain intervention focused on cognitive training , and nutritional and PA counselling increased PA in the short-term and limited its decline in the long-term among older adults with memory complaints . Clinical Trials.gov- Registration number : NCT0067268 OBJECTIVES To determine whether elderly people who meet national guidelines have higher physical function ( PF ) scores than those who do not and the effect on functional trajectory when physical activity ( PA ) levels change from above to below this threshold , or vice versa . DESIGN Pooled data . SETTING Two 6-month r and omized controlled trials aim ed at increasing PA in adults . PARTICIPANTS Adults aged 65 to 94 ( N=357 ) . INTERVENTION PA counseling over the telephone and through mailed material s. MEASUREMENTS  Self-reported PA  dichotomized at 150 minutes/week and PF using the Medical Outcomes Study 36-item Short Form Question naire PF subscale . RESULTS At baseline , individuals reporting 150 minutes or more of moderate PA/week had mean PF scores that were 20.3 points higher than those who did not ( P<.001 ) . Change in PA minutes from above threshold to below threshold or from below threshold to above threshold from baseline to 6 months result ed in an average change in PF of -11.18 ( P<.001 ) and + 5.10 ( P=.05 ) , respectively . CONCLUSION These findings suggest that PA is an important predictor of functional status . Older sedentary adults can improve PF by meeting recommended PA levels . Conversely , dropping below recommended PA levels has a deleterious effect on PF . Given the importance of PF in maintenance of independence and quality of life in older adults , adherence to recommended PA guidelines should be endorsed CONTEXT High vitamin D and physical activity ( PA ) levels are independently associated with improved body composition and muscle function in older adults . OBJECTIVE The objective of this study was to investigate the interaction of 25-hydroxyvitamin D ( 25OHD ) and PA status in maintenance of body composition and muscle function in older adults . DESIGN AND SETTING This was a 5-year prospect i ve population -based study of Australian community-dwelling older adults . PARTICIPANTS Participants in the study included 615 community-dwelling volunteers aged 50 years old or older [ 61.4 ± 6.9 ( mean ± SD ) y ; 48 % female ] r and omly selected from electoral rolls and categorized according to baseline serum 25OHD ( ≥ or < 50 nmol/L ) and PA ( ≥ or < 10,000 pedometer determined steps/d ) levels as follows : high 25OHD and high PA ( VitD+PA+ ) ; high 25OHD and low PA ( VitD+PA- ) ; low 25OHD and high PA ( VitD-PA+ ) ; and low 25OHD and low PA ( VitD-PA- ) . A subset of 518 participants completed accelerometer assessment s during follow-up . MAIN OUTCOME MEASURES Changes in dual-energy X-ray absorptiometry-assessed body composition and lower-limb muscle function were measured . RESULTS VitD+PA+ had significantly smaller increases in body fat over 5 years compared with other groups ( all P < .05 ) . Higher baseline pedometer-determined PA result ed in declines in total body fat ( β = -.23 kg per 100 steps/d , P = .001 ) over 5 years for participants with high 25OHD but not those with low 25OHD ( P > .05 ) . Among participants with accelerometer data , these associations were generally mediated by higher levels of moderate/vigorous PA . CONCLUSIONS High vitamin D status appears to enhance PA-related declines in body fat during aging , but the mechanism may be greater amounts of outdoor moderate/vigorous PA rather than a direct effect of 25OHD BACKGROUND Regular physical activity ( PA ) reduces the risk of falls and hip fractures , and mortality from all causes . However , PA levels are low in the older population and previous intervention studies have demonstrated only modest , short-term improvements . OBJECTIVE To evaluate the impact of two exercise promotion programmes on PA in people aged ≥ 65 years . DESIGN The ProAct65 + study was a pragmatic , three-arm parallel design , cluster r and omised controlled trial of class-based exercise [ Falls Management Exercise ( FaME ) programme ] , home-based exercise [ Otago Exercise Programme ( OEP ) ] and usual care among older people ( aged ≥ 65 years ) in primary care . SETTING Forty-three UK-based general practice s in London and Nottingham/Derby . PARTICIPANTS A total of 1256 people ≥ 65 years were recruited through their general practice s to take part in the trial . INTERVENTIONS The FaME programme and OEP . FaME included weekly classes plus home exercises for 24 weeks and encouraged walking . OEP included home exercises supported by peer mentors ( PMs ) for 24 weeks , and encouraged walking . MAIN OUTCOME MEASURES The primary outcome was the proportion that reported reaching the recommended PA target of 150 minutes of moderate to vigorous physical activity ( MVPA ) per week , 12 months after cessation of the intervention . Secondary outcomes included functional assessment s of balance and falls risk , the incidence of falls , fear of falling , quality of life , social networks and self-efficacy . An economic evaluation including participant and NHS costs was embedded in the clinical trial . RESULTS In total , 20,507 patients from 43 general practice s were invited to participate . Expressions of interest were received from 2752 ( 13 % ) and 1256 ( 6 % ) consented to join the trial ; 387 were allocated to the FaME arm , 411 to the OEP arm and 458 to usual care . Primary outcome data were available at 12 months after the end of the intervention period for 830 ( 66 % ) of the study participants . The proportions reporting at least 150 minutes of MVPA per week rose between baseline and 12 months after the intervention from 40 % to 49 % in the FaME arm , from 41 % to 43 % in the OEP arm and from 37.5 % to 38.0 % in the usual-care arm . A significantly higher proportion in the FaME arm than in the usual-care arm reported at least 150 minutes of MVPA per week at 12 months after the intervention [ adjusted odds ratio ( AOR ) 1.78 , 95 % confidence interval ( CI ) 1.11 to 2.87 ; p = 0.02 ] . There was no significant difference in MVPA between OEP and usual care ( AOR 1.17 , 95 % CI 0.72 to 1.92 ; p = 0.52 ) . Participants in the FaME arm added around 15 minutes of MVPA per day to their baseline physical activity level . In the 12 months after the close of the intervention phase , there was a statistically significant reduction in falls rate in the FaME arm compared with the usual-care arm ( incidence rate ratio 0.74 , 95 % CI 0.55 to 0.99 ; p = 0.042 ) . Scores on the Physical Activity Scale for the Elderly showed a small but statistically significant benefit for FaME compared with usual care , as did perceptions of benefits from exercise . Balance confidence was significantly improved at 12 months post intervention in both arms compared with the usual-care arm . There were no statistically significant differences between intervention arms and the usual-care arm in other secondary outcomes , including quality -adjusted life-years  . FaME is more expensive than OEP delivered with PMs ( £ 269 vs. £ 88 per participant in London ; £ 218 vs. £ 117 in Nottingham ) . The cost per extra person exercising at , or above , target was £ 1919.64 in London and £ 1560.21 in Nottingham ( mean £ 1739.93 ) . CONCLUSION The FaME intervention increased self-reported PA levels  among community-dwelling older adults 12 months after the intervention , and significantly reduced falls . Both the FaME and OEP interventions appeared to be safe , with no significant differences in adverse reactions between study arms . TRIAL REGISTRATION This trial is registered as IS RCT N43453770 . FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol . 18 , No. 49 . See the NIHR Journals Library website for further project information PURPOSE Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity , but few have assessed adherence and health outcomes long term . METHODS Between July 2005 and May 2007 , the Reach Out to Enhance Wellness ( RENEW ) trial accrued 641 locoregionally staged , long-term ( ≥ 5 years from diagnosis ) colorectal , breast , and prostate cancer survivors in the United States ( 21 states ) , Canada , and the United Kingdom . All participants were sedentary ( < 150 minutes of physical activity [ PA ] a week ) , overweight or obese ( body mass index , 25 to 40 kg/m(2 ) ) , and over age 65 years . The trial tested a diet-exercise intervention delivered via mailed print material s and telephone counseling . RENEW used a wait-list control , cross-over design ( ie , participants received the year-long intervention immediately or after a 1-year delay ) , which allowed the opportunity to assess program efficacy ( previously reported primary outcome ) , durability , and reproducibility ( reported herein ) . Measures included diet quality ( DQ ) , PA , BMI , and physical function ( PF ) . RESULTS No significant relapse was observed in the immediate-intervention arm for DQ , PA , and BMI ; however , rates of functional decline increased when the intervention ceased . From year 1 to year 2 , significant improvements were observed in the delayed-intervention arm ; mean change scores in behaviors and BMI and PF slopes were as follows : DQ score , 5.2 ( 95 % CI , 3.4 to 7.0 ) ; PA , 45.8 min/wk ( 95 % CI , 26.9 to 64.6 min/wk ) ; BMI , -0.56 ( 95 % CI , -0.75 to -0.36 ) ; and Short Form-36 PF , -1.02 versus -5.52 ( P < .001 for all measures ) . Overall , both arms experienced significant improvements in DQ , PA , and BMI from baseline to 2-year follow-up ( P < .001 ) . CONCLUSION Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss . These changes positively reorient functional decline trajectories during intervention delivery OBJECTIVE To examine effects of activity strategy training ( AST ) , a structured rehabilitation program taught by occupational therapists and design ed to teach adaptive strategies for symptom control and engagement in physical activity ( PA ) . METHODS A r and omized controlled pilot trial was conducted at 4 sites ( 3 senior housing facilities and 1 senior center ) in southeastern , lower Michigan . Fifty-four older adults with hip or knee osteoarthritis ( mean + /- SD age 75.3+/-7.1 years ) participated . At each site , older adults were r and omly assigned to 1 of 2 programs : exercise plus AST ( Ex + AST ) or exercise plus health education ( Ex + Ed ) . The programs involved 8 sessions over 4 weeks with 2 followup sessions over a 6-month period , and were conducted concurrently within each site . Pain , total PA and PA intensity ( measured objective ly by actigraphy and subjectively by the Community Healthy Activities Model Program for Seniors question naire ) , arthritis self-efficacy , and physical function were assessed at baseline and posttest . RESULTS At posttest , participants who received Ex + AST had significantly higher levels of objective peak PA ( P=0.02 ) compared with participants who received Ex + Ed . Although not statistically significant , participants in Ex + AST tended to have larger pain decreases , increased total objective and subjective PA , and increased physical function . No effects were found for arthritis self-efficacy . CONCLUSION Although participants were involved in identical exercise programs , participants who received AST tended to have larger increases in PA at posttest compared with participants who received health education . Future studies will be needed to examine larger sample s and long-term effects of AST Abstract Background Evidence from a limited number of short-term trials indicates the difficulty in achieving population -level improvements in physical activity ( PA ) through community-wide interventions ( CWIs ) . We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster r and omized design . Methods We r and omized 12 communities in Unnan , Japan , to either intervention ( 9 ) or control ( 3 ) . Additionally , intervention communities were r and omly allocated to three subgroups by different PA types promoted . R and omly sample d residents aged 40–79 years responded to the baseline survey ( n = 4414 ; 74 % ) and were followed at 1 , 3 and 5 years ( 78–83 % response rate ) . The intervention was a 5-year CWI using social marketing to promote PA . The primary outcome was a change in recommended levels of PA . Results Compared with control communities , adults achieving recommended levels of PA increased in intervention communities [ adjusted change difference = 4.6 percentage points ( 95 % confidence interval : 0.4 , 8.8 ) ] . The intervention was effective for promoting all types of recommended PAs , i.e. aerobic ( walking , 6.4 % ) , flexibility ( 6.1 % ) and muscle-strengthening activities ( 5.7 % ) . However , a bundled approach , which attempted to promote all forms of PAs above simultaneously , was not effective ( 1.3–3.4 % , P ≥ 0.138 ) . Linear dose – response relationships between the CWI awareness and changes in PA were observed ( P ≤ 0.02 ) . Pain intensity decreased in shoulder ( intervention and control ) and lower back ( intervention only ) but there was little change difference in all musculoskeletal pain outcomes between the groups . Conclusions The 5-year CWI using the focused social marketing strategy increased the population -level of PA The Lifestyle Interventions and Independence for Elders ( LIFE ) Study is a Phase III r and omized controlled clinical trial ( Clinical trials.gov identifier : NCT01072500 ) that will provide definitive evidence regarding the effect of physical activity ( PA ) on major  mobility disability in older adults ( 70–89 years old ) who have compromised physical function . This paper describes the methods employed in the delivery of the LIFE Study PA intervention , providing insight into how we promoted adherence and monitored the fidelity of treatment . Data are presented on participants ’ motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training . Prior to the onset of training , 31.4 % of participants noted slight conflict with being able to meet the dem and s of the program and 6.4 % indicated that the degree of conflict would be moderate . Accelerometry data collected during PA training revealed that the average intensity – 1,555 counts/minute for men and 1,237 counts/minute for women – was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults . Also , a sizable subgroup required one or more rest stops . These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function . Moreover , the concept of what constitutes “ moderate ” exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription QUESTIONS Does a 3-month behaviour change intervention targeting physical activity ( PA ) increase habitual physical activity in adults with ankylosing spondylitis ( AS ) ? Does the intervention improve health-related physical fitness , AS-related features , and attitude to exercise ? Are any gains maintained over a 3-month follow-up ? DESIGN Parallel-group , r and omised , controlled trial with concealed allocation , assessor blinding and intention-to-treat analysis . PARTICIPANTS Forty adults with a diagnosis of AS , on stable medication , and without PA-limiting comorbidities . INTERVENTION Over a 3-month period , the experimental group engaged in individually-tailored , semi-structured consultations aim ing to motivate and support individuals in participating in PA . The control group continued with usual care . OUTCOME MEASURES The primary outcome was PA measured by accelerometry over 1 week . Secondary outcomes included clinical question naires and measures of health-related physical fitness . Measures were taken at baseline , post-intervention , and after a 3-month follow-up period . RESULTS Baseline characteristics were similar across groups , except age and body composition . There were statistically significant , moderate-to-large time-by-group effects  in health-enhancing PA  ( mixed- design ANOVA for overall effect F(2 , 76)=14.826 , p<0.001 ) , spinal mobility ( F(2 , 76)=5.691 , p<0.005 ) and quality of life ( χ2(2)=8.400 , p<0.015 ) favouring the intervention group ; post-intervention improvements were sustained 3 months later . No significant effects were seen in other physical fitness outcomes or on clinical question naires . No adverse effects were reported during the study .  CONCLUSION Health-enhancing PA , spinal mobility and quality of life were significantly improved after the intervention , and improvements were maintained at 3-month follow-up . TRIAL REGISTRATION NCT02374502 . [ O'Dwyer T , Monaghan A , Moran J , O'Shea F , Wilson F ( 2016 ) Behaviour change intervention  increases physical activity , spinal mobility and quality of life in adults with ankylosing spondylitis : a r and omised trial . Journal of PhysiotherapyXX : XX-XX ] Aims : Increasing population physical activity ( PA )  is a public health priority . An approach to increasing PA in an urban community , based on the social ecology model , is presented and evaluated . Methods : A quasi-experimental ( non-equivalent control group ) design was chosen to test whether this approach can increase , significantly , the population proportion that is physically active . Two deprived inner-city electoral ward areas of Sheffield , UK , with similar socio-demographic and health profiles were selected . Implementation was carried out in five phases over 21 months : preparation and piloting , initial survey estimates , community awareness campaign , PA intervention and evaluation . Impact was evaluated by recording uptake and attendance at all sessions , and using a post-intervention postal survey . At follow-up , question naires were sent to 2500 r and omly selected addresses in both areas , which assessed changes in PA , health and PA participation over the last year . Results : A pilot baseline survey confirmed similar proportions taking some form of  PA  on most days : intervention 36 % ( 25—47 ) , control 33 % ( 21—45 ) . At follow-up , 38 different activity groups were in place and 1275 individuals had attended at least one activity . Satisfactorily completed responses were received from 1532 ( 31 % ) , 55 % ( 846 ) intervention , 45 % ( 686 ) control . Relative to the control , the intervention sample demonstrated trends towards : being more physically active compared with one year ago , greater readiness to take up PA , better general health and improved health compared with one year ago ( p ≤ 0.001 ) . Further , 30.6 % ( intervention ) vs 18.3 % ( control ) reported an increase in PA compared with one year ago , while 13.7 % ( intervention ) vs 24.5 % ( control ) reported no intention to exercise . These differences in proportions translated to an overall effect size estimate of 0.23 for the intervention . Relative to those whose PA had remained the same , intervention area residents were more likely to report being more active ( odds ratio ( 95 % confidence interval ) = 1.79 ( 1.38—2.32 ) , p < 60 ; 0.001 ) . Conclusion : These results suggest that , even within one of the most deprived inner-city areas in the UK , a community-based social ecological approach can positively change PA behaviour and attitudes PURPOSE Lifestyle Interventions and Independence for Elders Pilot ( LIFE-P ) was a trial to examine the effects of a physical activity intervention ( PA ) compared with a health education control ( SA ) on measures of disability risk in sedentary older adults ( N = 424 ) . We examined adherence to the LIFE-P PA intervention for the first 12 months of the trial . METHODS The PA intervention consisted of walking , strength , flexibility , and balance training supplemented with behavioral skills training modules , and it used a phased , center-based schedule of adoption ( 3x wk(-1 ) , weeks 1 - 8 ) , transition ( 2x wk(-1 ) , weeks 9 - 24 ) , and maintenance ( 1x wk(-1 ) , weeks 25 to end of trial ) while transitioning to primarily home-based physical activity . SA consisted of weekly ( weeks 1 - 26 ) transitioning to monthly health education workshops . RESULTS Participation in moderate-intensity physical activity increased from baseline to months 6 and 12 in PA compared with SA ( P < 0.001 ) . At 12 months , PA participants who reported > or = 150 min x wk(-1 ) of moderate activity demonstrated a significantly greater improvement in their Short Physical Performance Battery score compared with participants who reported < 150 min.wk of moderate activity ( P < 0.017 ) . For the PA arm , center-based attendance was 76.3 + /- 24.5 , 65.4 + /- 28.6 , and 49.8 + /- 35.8 % in the adoption , transition , and maintenance phases , respectively . CONCLUSIONS Adherence to physical activity in LIFE-P was associated with greater improvement in SPPB score and was consistent with adherence in physical activity trials of shorter duration in this subgroup of older adults . Older individuals at risk for disability can adhere to a regular program of physical activity in a long-term r and omized trial We examined the costs of a  physical activity ( PA ) and an educational comparison intervention .  424 older adults at risk for mobility disability were r and omly assigned to either condition . The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks , 2x weekly for weeks 9 to 24 and weekly behavioral counseling for 10 weeks . Optional sessions were offered during maintenance weeks ( 25 - 52 ) . The comparison intervention consisted of weekly education meetings for 24 weeks , and then monthly for 6 months . Cost analyses were conducted from the " payer 's " perspective , with a 1-year time horizon . Intervention costs were estimated by tracking personnel activities and material s used for each intervention and multiplying by national unit cost averages . The average cost/participant was $ 1134 and $ 175 for the PA and the comparison interventions , respectively . A preliminary cost/effectiveness analysis gauged the cost/disability avoided to be $ 28,206 . Costs for this PA program for older adults are comparable to those of other PA interventions . The results are preliminary and a longer study is required to fully assess the costs and health benefits of these interventions Background Physical activity ( PA ) for older adults has well-documented physical and cognitive benefits , but most seniors do not meet recommended guidelines for PA , and interventions are lacking . Objectives This study evaluated the efficacy of a 12-week Internet intervention to help sedentary older adults over 55 years of age adopt and maintain an exercise regimen . Methods A total of 368 sedentary men and women ( M=60.3 ; SD 4.9 ) were recruited , screened , and assessed online . They were r and omized into treatment and control groups and assessed at pretest , at 12 weeks , and at 6 months . After treatment group participants rated their fitness level , activity goals , and barriers to exercise , the Internet intervention program helped them select exercise activities in the areas of endurance , flexibility , strengthening , and balance enhancement . They returned to the program weekly for automated video and text support and education , with the option to change or increase their exercise plan . The program also included ongoing problem solving to overcome user-identified barriers to exercise . Results The multivariate model indicated significant treatment effects at posttest ( P=.001 ; large effect size ) and at 6 months ( P=.001 ; medium effect size ) . At posttest , intervention participation showed significant improvement on 13 of 14 outcome measures compared to the control participants . At 6 months , treatment participants maintained large gains compared to the control participants on all 14 outcome measures . Conclusions These results suggest that an online PA program has the potential to positively impact the physical activity of sedentary older adult participants . More research is needed to replicate the study results , which were based on self-report measures . Research is also needed on intervention effects with older population
Exercise interventions have small clinical benefits on  PA  levels in community-dwelling older adults , with a decline in the observed improvement after six months of the intervention cessation
Exercise is a form of physical activity ( PA ) .
PA is an important marker of health and quality of life in older adults .
The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure , and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65 + year-old adults .