Community-based Physical Fitness Exercise on the Older Adults' Functional Fitness and Adherence to Physical Activity

Study Overview
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Brief Summary
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Maintaining adequate physical activity (PA) and regularly exercising are very important to promote the good physical and mental health of the elderly. According to the transtheoretical model (TTM) framework, previous research studies have formulated many strategies to promote exercise behaviors, such as incentive strategies, combines municipal resources and links up with the referral of primary care institutions, or including patients in the decision-making process about exercise choices to enable patients to have greater autonomy. In addition, in terms of the strategic aspects of achieving goals, competitive incentives are also an effective strategy. Therefore, this study aims to find out the effects of the community-based physical fitness exercise course, which is given according to TTM, on improving functional fitness and exercise persistence of the older adults.

Official Title
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The Influence of a New Intervention Model of Community-based Physical Fitness Exercise on the Older Adults' Adherence to Physical Activity and the Improvement of Functional Fitness

Conditions
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Older Adult

Intervention / Treatment
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* Behavioral: Structural exercise course
* Behavioral: Autonomous group class


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age between 65 to 90 years old can stand up from a chair without armrests can walk independently for 2 minutes without relying on any mechanical assistance no medical issues according to the PAR-Q+ form assessment can complete the Senior Fitness Test (SFT) Exclusion Criteria: diagnosed with severe dementia (unable to understand and/or follow verbal commands) suffering from stroke, severe hypertension, heart disease, and diabetes hip or knee replacement surgery in the past 6 months hip fracture having undergoing rehabilitation plan unable to complete the pre-tests or post-test

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 82 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Interventional Model Description: This is a single group trial, according to the pre-test result of the exercise stage of the change questionnaire, they were divided into the maintenance phase group (MP, N=15) and under the maintenance phase group (MPb, N=15). All subjects joined the community-based physical fitness exercise course for 24 weeks. To quantify the effect of this intervention method on functional fitness and exercise persistence of the elderly, this study analyzed the related exercise behavior changes of MPb and MP elderly.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Community-based physical fitness exercise course<br>Included 12-week structural exercise course (0-12 weeks) and 12-week autonomous group class (12-24 weeks). | Behavioral: Structural exercise course<br>* 12-week structured exercise class, team competition, social support, and incentive strategy<br>Behavioral: Autonomous group class<br>* 12-week autonomous group class, team competition, social support, and incentive strategy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exercise stage of change questionnaire | Exercise Change Stage Short Question Form is a 5 item scale. It has only one question, used to categorizes individuals into one of the five stages of change: (1) Precontemplation (2) Contemplation (3) Preparation (4) Action (5) Maintenance. | basal, 12, 24 weeks follow up | 
| Physical Activity Scale for the Elderly (PASE) | PASE is used to assess the physical activity level of elderly individuals, the factors affecting the activity level, the relationship between physical activity and health profile. The minimum and maximum score that can be obtained from the scale is 0 and 400.The higher score indicates better level of physical activity. | basal, 12, 24 weeks follow up | 
| Exercise Self-efficacy Scale | The Exercise Self-efficacy Scale measures an individual's perceived ability to overcome various obstacles to perform physical activity, with higher scores indicating more confidence in performing the exercise. | basal, 12, 24 weeks follow up | 
| Outcome Expectations for Exercise Scale | The Outcome Expectations for Exercise Scale contains 9 statements rated by participants using a 5-point Likert scale from 1 Strongly Disagree to 5 Strongly Agree. It can help identify older adults with low outcome expectations for exercise. | basal, 12, 24 weeks follow up | 
| Physical Activity Survey | The physical activity survey is measured according to the PASE items. It is calculated by the frequency value (hours per day in the one-week reporting period) for low-intensity, medium-intensity, high-intensity, and muscle strengthening exercise. The higher score indicates the more time spent on the physical activity at each level. | basal, 12, 24 weeks follow up | 
| Attendance rate | The attendance rate of the subjects participating in structured exercise courses and autonomous group classes | 12 and 24 weeks | 
| Senior Fitness Test - Body Mass Index (BMI) | Body Mass Index (BMI) is a person's weight in kilograms divided by the square of height in meters. | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - Waist-hip ratio | The waist-hip ratio is the dimensionless ratio of the circumference of the waist to that of the hips. | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - 30s Chair stand | Evaluates the lower body strength according to the number of times the individual stood up and sat down in 30 seconds. Characterized as continuous numeric variable | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - Chair Sit-&-Reach | Evaluates the lower back and hamstring flexibility according to the distance measured between the tip of the finger tips and the toes. Characterized as continuous numerical variable. | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - 8-Foot Up-&-Go | Assesses motor agility and dynamic balance. Evaluates the time in seconds and hundredths in an established path of 2.44 meters on the route to go and return to starting position. Characterized as continuous numerical variable. | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - 30s Arm curl | Evaluates the upper body strength and endurance according to the number of arm curls in 30 seconds. Characterized as continuous numeric variable. | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - Back scratch | Evaluates the flexibility of the upper limbs. It measures the distance in inches between the tips of the fingers in the back area. Characterized as continuous numeric variable | basal, 12, 24 weeks follow up | 
| Senior Fitness Test - 2-Minute Step | Evaluates aerobic endurance. Total double past stationary in 2 minutes. Characterized as continuous numeric variable. | basal, 12, 24 weeks follow up | 
| Open-eyes one leg stand | Evaluates the balance ability. The standing time on one leg, keep eyes open. Characterized as continuous numeric variable. | basal, 12, 24 weeks follow up |