Abstract

Context

Long-term adherence to physical activity (PA) interventions is challenging. The Lifestyle-integrated Functional Exercise programmes were adapted Lifestyle-integrated Functional Exercise (aLiFE) to include more challenging activities and a behavioural change framework, and then enhanced Lifestyle-integrated Functional Exercise (eLiFE) to be delivered using smartphones and smartwatches.

Objectives

To (1) compare adherence measures, (2) identify determinants of adherence and (3) assess the impact on outcome measures of a lifestyle-integrated programme.

Design, setting and participants

A multicentre, feasibility randomised controlled trial including participants aged 61–70 years conducted in three European cities.

Interventions

Six-month trainer-supported aLiFE or eLiFE compared with a control group, which received written PA advice.

Outcome measures

Self-reporting adherence per month using a single question and after 6-month intervention using the Exercise Adherence Rating Scale (EARS, score range 6–24). Treatment outcomes included function and disability scores (measured using the Late-Life Function and Disability Index) and sensor-derived physical behaviour complexity measure. Determinants of adherence (EARS score) were identified using linear multivariate analysis. Linear regression estimated the association of adherence on treatment outcome.

Results

We included 120 participants randomised to the intervention groups (aLiFE/eLiFE) (66.3±2.3 years, 53% women). The 106 participants reassessed after 6 months had a mean EARS score of 16.0±5.1. Better adherence was associated with lower number of medications taken, lower depression and lower risk of functional decline. We estimated adherence to significantly increase basic lower extremity function by 1.3 points (p<0.0001), advanced lower extremity function by 1.0 point (p<0.0001) and behavioural complexity by 0.008 per 1.0 point higher EARS score (F(3,91)=3.55, p=0.017) regardless of group allocation.

Conclusion

PA adherence was associated with better lower extremity function and physical behavioural complexity. Barriers to adherence should be addressed preintervention to enhance intervention efficacy. Further research is needed to unravel the impact of behaviour change techniques embedded into technology-delivered activity interventions on adherence.

Trial registration number

NCT03065088.

Details

Title
Impact of adherence to a lifestyle-integrated programme on physical function and behavioural complexity in young older adults at risk of functional decline: a multicentre RCT secondary analysis
Author
Mikolaizak, A Stefanie 1   VIAFID ORCID Logo  ; Taraldsen, Kristin 2   VIAFID ORCID Logo  ; Boulton, Elisabeth 3   VIAFID ORCID Logo  ; Gordt, Katharina 1   VIAFID ORCID Logo  ; Maier, Andrea Britta 4   VIAFID ORCID Logo  ; Mellone, Sabato 5   VIAFID ORCID Logo  ; Hawley-Hague, Helen 6   VIAFID ORCID Logo  ; Aminian, Kamiar 7   VIAFID ORCID Logo  ; Chiari, Lorenzo 5   VIAFID ORCID Logo  ; Paraschiv-Ionescu, Anisoara 7   VIAFID ORCID Logo  ; Pijnappels, Mirjam 8   VIAFID ORCID Logo  ; Todd, Chris 9   VIAFID ORCID Logo  ; Vereijken, Beatrix 10   VIAFID ORCID Logo  ; Helbostad, Jorunn L 10   VIAFID ORCID Logo  ; Becker, Clemens 1   VIAFID ORCID Logo 

1  Department of Clinical Gerontology, Robert-Bosch-Krankenhaus GmbH, Stuttgart, Germany 
2  Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 
3  School of Health Sciences, The University of Manchester, Manchester, UK; Health & Care Policy, Age UK, London, UK; Manchester Academic Health Science Centre, Manchester, UK 
4  Department of Human Movement Sciences, The University of Melbourne, Melbourne, Victoria, Australia 
5  Department of Electrical, Electronic and Information Engineering, University of Bologna, Bologna, Italy 
6  School of Health Sciences, The University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK 
7  Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland 
8  Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands 
9  School of Health Sciences, The University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK 
10  Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway 
First page
e054229
Section
Geriatric medicine
Publication year
2022
Publication date
2022
Publisher
BMJ Publishing Group LTD
e-ISSN
20446055
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1136/bmjopen-2021-054229
ProQuest document ID
2724115932
Copyright
© 2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.