Automatic Reaction to Physical Activity and Sedentary Stimuli in Aging

Study Overview
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Brief Summary
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Most individuals are aware of the benefits to health of regular physical activity and have good intentions to exercise. Yet, 1.4 billion people worldwide are inactive, which suggests that turning intention into action can be challenging. Recent findings show that the intention-action gap could be explained by negative automatic reactions (which is a component of dual-task theory) to stimuli associated with physical activity. This gap is particularly concerning in older adults, who are more likely to spontaneously associate physical activity with fear, pain, or discomfort. To promote physical activity, the current project proposes to train older adults to suppress their automatic attraction toward sedentary stimuli and to respond positively to physical-activity stimuli. This evidence-based and low-cost intervention aims to improve physical functioning and quality of life for these population. The results will inform public-health policies and improve clinical interventions that aim to counteract a global health problem: the pandemic of physical inactivity.

Detailed Description
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Physical activity is one of the top contributors to health, reducing rates of cardiovascular disease, cancer, hypertension, diabetes, obesity, and depression. This wide spectrum of benefits is particularly important for older adults, who often suffer structural and functional deterioration in several physiological systems. Physical activity can reduce and delay the impact of this age-related deterioration in health and functional independence. Current interventions to enhance physical activity in older adults rely mainly on reflective processes by providing rational information about the health benefits of a physically active lifestyle. While these interventions successfully increase intention, their effect on actual behavior is weak. That is, most individuals are now aware of the positive effects of regular physical activity and have the intention to exercise. However, this intention is not sufficient and exercise plans are often not executed. This gap between intention and action is a challenge that health professionals need to address to counteract the pandemic of physical inactivity. Recent findings suggest that this inability to turn the intention into action is explained by negative automatic reactions to stimuli associated with physical activity. These automatic reactions could be particularly strong in older adults, who are more likely to associate physical activity with fear, pain, or discomfort. This study aims to test the effect of an intervention that targets the automatic processes underlying physical inactivity in older adults. The intervention is expected to reduce physical inactivity during the intervention and at follow-up, thereby improving physical functioning and quality of life.

Official Title
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Retraining the Automatic Reaction to Physical Activity and Sedentary Stimuli in Adults 60 Years of Age or Older

Conditions
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Aging

Intervention / Treatment
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* Behavioral: Adjusted Cognitive-biased modification task
* Behavioral: Cognitive-biased modification task


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - 60 years of age or older and able to understand instructions in English. Exclusion Criteria: Diagnosed psychiatric disorders or neurological condition (e.g., stork, Parkinson's disease, Alzheimer's disease, dementia) Unable to carry out the training program Unable to understand the protocol Motor deficit preventing physical activity without external help Physical health status preventing physical activity Alcohol or substance dependence.

Ages Eligible for Study
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Minimum Age: 60 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Adjusted and modified Cognitive-Biased Modification Task<br>The intervention is based on a Go/No-Go task. | Behavioral: Adjusted Cognitive-biased modification task<br>* The intervention of the proposed project is based on a go/no-go task in which older adults need to quickly decide whether or not they should react to the stimulus. A rectangle containing an image, or a word will be presented on a screen. In the intervention group, older adults will be instructed to restrain their actions when the rectangle is tilted to the right and to react by pressing a key on the keyboard when the rectangle is tilted to the left, irrespective of the content of the rectangle (because the training is meant to be implicit). In order to train inhibitory processes counteracting the automatic attraction to sedentary behavior, 90% of the rectangles tilted to the right (counterbalanced across participants) will contain a picture or a word related to sedentary behavior. To foster the automatic attraction toward physical activity, 90% of the rectangles tilted to the left will contain a picture or a word related to physical activity.<br>|
| Placebo Comparator: Normal Cognitve-Biased modification Task<br>The Sham-intervention is based on a Go/No-Go task. | Behavioral: Cognitive-biased modification task<br>* In the comparison group, instructions will be identical, but the percentage of physical activity and sedentary stimuli will be equal in each tilt condition (i.e., 50% sedentary stimuli and 50% physical activity stimuli in both right- and left-tilted rectangles)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical activity Tracker | Assessing the number of step. | 7 days, at least 7 hours per day (not to used it during shower or when they sleep at night). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| International Physical Activity Questionnaire (Short Form) | The usual level of moderate-to-vigorous physical activity in minutes per week will be assessed. | Before and after intervention (10 minutes to fill out) | 
| Six-Minute Walk Test | Total distance walked in 6 minutes will be documented. The outcome is the distance walked during the 6 minutes. | Before and after intervention (6 minutes to carry out) | 
| Hand grip strength | The grip strength will be evaluated using a dynamometer. The higher the value obtained by the participant, the stronger the grip. | Before and after intervention ( One minute to carry out) | 
| World Health Organization Quality of Life (BREF) | Assessing quality of life over four domains. Scores for each domain can range from zero to 100, with higher scores indicating better quality of life. | Before and after intervention ( 20 minutes to carry out) | 
| Approach-avoidance task | To measure automatic approach and avoidance tendencies toward physical activity and sedentary behaviors. Faster and the more accurate reaction toward a stimuli (e.g., physical activity) indicates a stronger tendency to approach that specific stimuli. | Before and after intervention, and at the beginning of each intervention session (30 minutes to carry out) | 
| Explicit Affective Attitude Toward Physical Activity | Mean of two items based on two 7-point scales (unpleasant-pleasant; unenjoyable-enjoyable). A higher score indicates more positive attitudes toward physical activity. | Before and after intervention (2-5 minute to carry out) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Attentional Bias, Exercise, Sedentary Behavior