Home and Community Care Digest

Home and Community Care Digest 6(2) May 2007 : 0-0

A physical activity exercise program for seniors that brings a lasting benefit

Abstract

With the increasing elderly population, the maintenance of independence among older seniors has become a key clinical and public health priority. Physical activity has been shown to improve mobility and reduce the risk of disability, therefore promoting independence among the elderly. This study compares the effects of two treatment models - Physical Activity, and Successful Aging - over a one-year period on the mobility status of sedentary seniors at risk for disability. The results suggest that compared to the Successful Aging strategy, the Physical Activity intervention generated significant improvements in seniors' walking capacity and might also reduce the risk of mobility-related disability one year after the start of treatment. The findings are indicative of a simple and practical exercise program that facilitates successful transition from institution-based to home-based treatment.
Background: The maintenance of seniors' independence has become a key clinical and public health priority with the increasing elderly population. Prior research has found that the lack of mobility (or sedentary behaviour) is a strong risk factor for institutionalization, disability, and death among nondisabled seniors. Currently, while exercise and health education are common components in most adult day programs for older adults, there are no standardized programs. Although a few studies have demonstrated the benefits of physical activity programs on improved mobility, evidence from large, multi-centre studies that a program model can have long-lasting effects in promoting functional mobility in seniors is lacking. This study aims to fill this void by comparing the effectiveness of a Physical Activity program versus a Successful Aging health education program on the mobility of a non-disabled but sedentary elderly population.

Methods: The effectiveness of two treatment models - a Physical Activity intervention and a Successful Aging health education program - on the mobility status of a sedentary community-dwelling elderly population were compared. Mass mailing and media advertising were used to recruit participants from four areas in the US. Four hundred and twenty-four seniors (aged 70-89 years) were eligible for participation in the study and were randomly assigned to one of the two treatment groups for a period of one year. Characteristics of participants (e.g., medical status) were matched in the two groups. The mobility status of participants in each group was assessed at the start of the study period, and then again at the 6th and 12th month. Mobility status was assessed using a standardized measure of lower extremity physical performance: the Short Physical Performance Battery (SPPB), which measures standing, balance, walking speed, and ability to rise from a chair, and a 400-metre walk test. Performance was ranked on a scale of 0 to 4 (0=inability to complete task; 4=highest level of performance). The Physical Activity intervention (n=213) consisted of a combination of aerobic, strength, balance, and flexibility exercises to promote mobility, and focused on walking as the primary mode of exercise. The intervention started in an institution and was gradually integrated to the participants' home. The Successful Aging health education intervention (n=211) consisted of weekly educational group meetings designed to encourage healthy living and an instructor-led 5-10 minute upper extremity stretching exercise.

Findings: The participants in the two groups were similar in gender (68% women), age (average=76.8 years), race (25.5% racial/ethnic minority), educational level, and health history. At the start of the study, participants in both groups were similar in physical performance and physical activity level. At 6 months, participants in the Physical Activity group performed significantly more moderate exercises and burned more calories performing their exercises than the Successful Aging group. At 12 months, the Physical Activity group showed significant improvement in mobility (i.e., both the SPPB score and 400-metre walk improved), while mobility declined in the Successful Aging group. The Physical Activity group was also less likely to experience major disability or death at the 12-month measure point.

Conclusions: This study suggests that a simple and practical Physical Activity intervention program (i.e., treatment that focuses on walking capacity, moderate leg strengthening, and balance exercises) can improve the mobility status, reduce the risk of disability, and reduce the death rate in sedentary seniors over a 12-month period. Moreover, the study demonstrates that the intervention can successfully transition from the health care institutional setting to the home setting. The findings suggest a treatment protocol for the incorporation of physical exercises in adult day centers and home care treatment programs for the long-term maintenance of the physical well-being of older adults.

Reference: Pahor M, Blair SN, Espeland M, Fielding R., et al. "Effects of a physical activity intervention on measures of physical performance: Results of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Study." The Journals of Gerontology. 2006;61A(11):1157-1165.

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