Enhancing the Physical Activity Levels of Frail Older Adults with a Wearable Activity Tracker-Based Exercise Intervention: A Pilot Cluster Randomized Controlled Trial
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SUBMITTER: Liu J
PROVIDER: S-EPMC8507976 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionPhysical activity (PA) is important for healthy ageing. Better insight into objectively measured PA levels in older adults is needed, since most previous studies employed self-report measures for PA assessment, which are associated with overestimation of PA.AimThis study aimed to provide insight in objectively measured indoor and outdoor PA of older adults, and in PA differences by frailty levels.MethodsData were collected among non-frail (N = 74) and frail (N = 10) subjects, aged 65 to 89 years. PA, measured for seven days with accelerometers and GPS-devices, was categorized into three levels of intensity (sedentary, light, and moderate-to-vigorous PA).ResultsOlder adults spent most time in sedentary and light PA. Subjects spent 84.7%, 15.1% and 0.2% per day in sedentary, light and moderate-to-vigorous PA respectively. On average, older adults spent 9.8 (SD 23.7) minutes per week in moderate-to-vigorous activity, and 747.0 (SD 389.6) minutes per week in light activity. None of the subjects met the WHO recommendations of 150 weekly minutes of moderate-to-vigorous PA. Age-, sex- and health status-adjusted results revealed no differences in PA between non-frail and frail older adults. Subjects spent significantly more sedentary time at home, than not at home. Non-frail subjects spent significantly more time not at home during moderate-to-vigorous activities, than at home.ConclusionsObjective assessment of PA in older adults revealed that most PA was of light intensity, and time spent in moderate-to-vigorous PA was very low. None of the older adults met the World Health Organization recommendations for PA. These levels of MVPA are much lower than generally reported based on self-reported PA. Future studies should employ objective methods, and age specific thresholds for healthy PA levels in older adults are needed. These results emphasize the need for effective strategies for healthy PA levels for the growing proportion of older adults.
| S-EPMC4409218 | biostudies-literature
Project description:BackgroundCancer survivors who meet physical activity (PA) recommendations (≥150 minutes of moderate-to-vigorous physical activity [MVPA] per week) experience better health outcomes. With the growing availability of wearable activity trackers (WATs), it may be easier to track PA. However, it is unknown what motivates survivors to use these devices.ObjectiveThe aim of this study is to investigate the associations among motivations for exercise, previous WAT use for tracking a health goal or activity, and meeting the recommended amount of PA among a cohort of cancer survivors.MethodsData on WAT users who reported having a previous cancer diagnosis were analyzed from the National Cancer Institute's Health Information National Trends Survey 5 Cycle 3. All survivors with complete information on demographics, exercise motivations (internal guilt, external pressure, physical appearance, and exercise enjoyment), previous WAT use (yes or no), and minutes of MVPA per week (N=608) were included. Multivariate logistic regression models were used to test these associations. A separate cluster analysis was conducted to identify the profiles of exercise motivation that were associated with reporting WAT use.ResultsThe mean age of the cohort was 66.9 years (SD 12.1). The majority were non-Hispanic White (473/608, 78.8%) and female (322/608, 54.9%), and skin cancer was the most commonly reported diagnosed cancer (154/608, 27.8%). Survivors who reported using WATs to track a health goal or activity were 1.6 times more likely to meet MVPA recommendations than those who did not use WATs (odds ratio [OR] 1.65, 95% CI 1.03-2.65; P=.04). When exercise motivations were assessed independently, survivors who reported not feeling any internal guilt as an exercise motivation were 73% less likely to report having used a WAT than those who felt any internal guilt (OR 0.27, 95% CI 0.14-0.54; P<.001). A total of 3 distinct motivational profiles emerged from the cluster analysis. WAT users had an increased probability of membership in profile 3, which was characterized as being strongly motivated to exercise by internal guilt, physical appearance, and exercise enjoyment (OR 4.5, 95% CI 2.1-9.7; P<.001).ConclusionsAmong this cohort, survivors who reported using WATs to track a health goal or activity were significantly more likely to report meeting PA recommendations. Survivors who reported feeling internal guilt as an exercise motivation were significantly more likely to report using WATs to track a health goal or activity. When examining clusters of motivation, survivors who reported previous WAT use were more likely to report being motivated to exercise by a mix of intrinsic and extrinsic motivations, including internal guilt, exercise enjoyment, and physical appearance. Given the health benefits of PA for cancer survivors, technology-focused interventions that use WATs and target exercise motivation may aid in cancer survivors meeting the level of recommended PA.
| S-EPMC8076994 | biostudies-literature
Project description:To determine whether combining behavioral urinary incontinence (UI) treatments with physical activity improves UI in frail older women.Single-blind, two-arm pilot randomized controlled trial.Senior apartments.Frail women (mean age 84.9 ± 6.4) without dementia (n = 42).Twelve-week program of customized behavioral UI treatments: 150 minutes of weekly walking and twice weekly strength training classes.UI was measured using 3-day bladder diaries, the International Consultation on Incontinence Questionnaire (ICIQ), and UI global improvement questions. Toileting skills were measured using the Performance Oriented Timed Toileting Instrument (POTTI) and the Minnesota Toileting Skills Questionnaire (MTSQ). Physical function was measured using the Short Physical Performance Battery. UI-related quality of life was measured using the Incontinence Impact Questionnaire and Urogenital Distress Inventory.The treatment group reported a 50% reduction in daily leaks using bladder diaries, and the control group reported no change (P = .04). Although there were no group differences in total ICIQ scores (P = .66), the treatment group reported significantly greater improvement on the ICIQ item for urine leakage (P = .01). More than 81% of the treatment group and 36% of the control group reported improvement in UI (?2 = 4.84, P = .01), with mean estimated percentage improvement of 65.3 ± 32.0 versus 34.1 ± 41.3 (P = .03). Although the difference was not statistically significant, treatment group participants improved their toileting skills, whereas those of the control group declined (P = .42 POTTI, P = .11 MTSQ). Balance (P = .33) and gait (P = .24) improved more in the treatment group, whereas chair stands improved more in the control group (P = .14).UI may be improved in frail older women by combining behavioral strategies for UI with physical activity, but larger trails are needed to determine whether these findings can be replicated and sustained.
| S-EPMC5478439 | biostudies-literature
Project description:It is unknown if physical activity and diet quality are associated with the risk of poor outcomes, such as mortality, among prefrail and frail older adults. This was a population-based cohort study among 1487 prefrail and frail older-adults from the Third National Health and Nutrition Survey. Compared to participants who were sedentary (0 bouts of physical activity per week), those who were physically inactive (1-4 bouts of physical activity per week) were 24% less likely to die [HR: 0.76 (95% CI: 0.58-0.98)], and those who were physically active (?5 bouts of physical activity per week) were 34% less likely to die [HR: 0.66 (95% CI: 0.51-0.86); Ptrend?=?0.002]. Compared to participants with poor diet quality, those with fair diet quality were 26% less likely to die [HR: 0.74 (95% CI: 0.52-0.98)], and those with good diet quality were 33% less likely to die [HR: 0.67 (95% CI: 0.55-1.00); Ptrend?=?0.050]. There was a synergistic interaction between physical activity and diet quality on the risk of mortality (Pinteraction?=?0.058). Participation in physical activity and consumption of a healthy diet is associated with a lower risk of mortality among prefrail and frail older adults.
| S-EPMC5149705 | biostudies-literature
Project description:ObjectivesTo identify factors associated with weekly adherence to a 12-week tracker-based activity intervention in older adults.MethodUsing generalized linear mixed models in a secondary analysis ( N = 35), we examined factors associated with weekly adherence (defined as wore the Jawbone Up24 tracker for ≥5 days and completed weekly calls). Factors examined included individual characteristics, gave and received virtual support, achieved step goals, barrier and task self-efficacy, and self-comment.ResultsParticipants' ( Mage = 61.7, SDage = 5.7) adherence changed from 86% (Week 1) to 74% (Week 12). Achieved the previous week's goal (β = 1.13, p = .01) and received virtual support (β = 0.01, p = .02) significantly increased the odds of weekly adherence.DiscussionAchieved step goals and received virtual support were associated with improved adherence to our tracker-based activity intervention, which has promising potential to be translated into the clinical setting to promote active lifestyles.
| S-EPMC8100986 | biostudies-literature
Project description:Objective:Wearable activity trackers can help older adults remain physically active. However, knowledge of the user experience during long-term use is scarce. Therefore, this study examined older adults' experiences with, and perceptions of, wearable activity trackers combined with health professional feedback after a year's use as part of a randomised controlled trial. Methods:Twenty older adults (73.6?±?5.5 years) who had used a Jawbone UP24 activity tracker for 12 months during a randomised controlled trial were recruited for this study. All participants had at least one chronic condition. Acceptability data relating to activity tracker wear time was combined with focus group data to explore participants experiences of long-term activity tracker use. Data was analysed using thematic analysis. Results:The activity tracker was well-accepted with the device worn on an average of 86% of possible days and participants reported an overall positive experience. Four themes were identified: (a) increased sense of awareness of activity levels is related to motivation; (b) the level of engagement with the activity tracker influences the user experience; (c) the role of feedback from a health professional in providing ongoing support; d) the role of habits in supporting long-term behaviour change. Conclusions:The use of an activity tracker combined with health professional support can assist older adults to maintain their activity levels over 12 months. Consideration should be given to the previous technology experience of users and the design and accuracy of an activity tracker when recommending their use in a research or clinical setting.
| S-EPMC7218318 | biostudies-literature
Project description:BackgroundFor older adults with severe aortic stenosis (AS) undergoing aortic valve replacement (AVR), recovery of physical function is important, yet few studies objectively measure it in real-world environments. This exploratory study explored the acceptability and feasibility of using wearable trackers to measure incidental physical activity (PA) in AS patients before and after AVR.MethodsFifteen adults with severe AS wore an activity tracker at baseline, and ten at one month follow-up. Functional capacity (six-minute walk test, 6MWT) and HRQoL (SF 12) were also assessed.ResultsAt baseline, AS participants (n = 15, 53.3% female, mean age 82.3 ± 7.0 years) wore the tracker for four consecutive days more than 85% of the total prescribed time, this improved at follow-up. Before AVR, participants demonstrated a wide range of incidental PA (step count median 3437 per day), and functional capacity (6MWT median 272 m). Post-AVR, participants with the lowest incidental PA, functional capacity, and HRQoL at baseline had the greatest improvements within each measure; however, improvements in one measure did not translate to improvements in another.ConclusionThe majority of older AS participants wore the activity trackers for the required time period before and after AVR, and the data attained were useful for understanding AS patients' physical function.
| S-EPMC10051559 | biostudies-literature
Project description:INTRODUCTION:Increasing children's cycling to school and physical activity are national health goals. The objective was to conduct an RCT of a bicycle train program to assess impact on students' school travel mode and moderate-to-vigorous physical activity (MVPA). STUDY DESIGN:Pilot cluster RCT with randomization at the school level and N=54 participants. SETTING/PARTICIPANTS:Fourth-fifth graders from four public schools serving low-income families in Seattle, WA in 2014 with analyses in 2015-2016. All participants were provided and fitted with bicycles, safety equipment (helmets, locks, and lights), and a 2- to 3-hour bicycle safety course. INTERVENTION:The intervention was a bicycle train offered daily (i.e., students volunteered to cycle with study staff to and from school). MAIN OUTCOME MEASURES:Time 1 assessments occurred prior to randomization. Time 2 assessments occurred after 3-5 weeks of the intervention (i.e., during Weeks 4-6 of the intervention period). The primary outcome was the percentage of daily commutes to school by cycling measured by validated survey. MVPA, measured by accelerometry and GPS units and processed by machine learning algorithms, was a secondary outcome. RESULTS:For two separate adjusted repeated measures linear mixed effects models in which students (N=54) were nested within schools (N=4), intervention participants had: (1) an absolute increase in mean percentage of daily commutes by cycling of 44.9%, (95% CI=26.8, 63.0) and (2) an increase in mean MVPA of 21.6 minutes/day, (95% CI=8.7, 34.6) from Time 1 to Time 2 compared with controls. CONCLUSIONS:A pilot bicycle train intervention increased cycling to school and daily MVPA in the short term among diverse, inner-city elementary school students. The bicycle train intervention appears promising and warrants further experimental trials among large, diverse samples with longer follow-up. TRIAL REGISTRATION:This study is registered at www.clinicaltrials.gov NCT02006186.
| S-EPMC5894119 | biostudies-literature
Project description:This cross-sectional study aimed to characterize the physical activity (PA) of older adults with pre-frail status by examining sedentary behavior (SB) and PA using triaxial accelerometer data, with non-frail older adults as the control group. In this study, we divided the study participants into older adults who regularly participated in self-initiated citizen group exercise activities and those who did not. Data were collected between September and December 2017. We analyzed data from 256 older adults (women: 86.3%) aged ≥65 years. The interaction effect of participation status (participation and non-participation group) and frailty status (pre-frail and non-frail group) for moderate-to-vigorous PA (F = 9.178, p = 0.003) and daily mean number of steps (F = 9.351, p = 0.002) was significant. For the participation group, there was no difference between pre-frail older adults and non-frail older adults regarding length of SB and PA time, indicating that PA level was maintained in the participating pre-frail older adults. In contrast, moderate-to-vigorous PA and daily mean number of steps were low in pre-frail older adults who did not participate in the activities. The opportunity to participate in self-initiated group exercise activities and other PAs in the community may help pre-frail older adults maintain their PA.
| S-EPMC8657243 | biostudies-literature
Project description:IntroductionFrailty is highly prevalent in adults with chronic kidney disease (CKD) and is associated with adverse health outcomes including falls, poorer health-related quality of life (HRQOL), hospitalisation and mortality. Low physical activity and muscle wasting are important contributors to physical frailty in adults with CKD. Exercise training may improve physical function and frailty status leading to associated improvements in health outcomes, including HRQOL. The EX-FRAIL CKD trial aims to inform the design of a definitive randomised controlled trial (RCT) that investigates the effectiveness of a progressive, multicomponent home-based exercise programme in prefrail and frail older adults with CKD.Methods and analysisThe EX-FRAIL CKD trial is a two-arm parallel group pilot RCT. Participants categorised as prefrail or frail, following Frailty Phenotype (FP) assessment, will be randomised to receive exercise or usual care. Participants randomised to the intervention arm will receive a tailored 12-week exercise programme, which includes weekly telephone calls to advise on exercise progression. Primary feasibility outcome measures include rate of recruitment, intervention adherence, outcome measure completion and participant attrition. Semistructured interviews with a purposively selected group of participants will inform the feasibility of the randomisation procedures, outcome measures and intervention. Secondary outcome measures include physical function (walking speed and Short Physical Performance Battery), frailty status (FP), fall concern (Falls Efficacy Scale-International tool), activities of daily living (Barthel Index), symptom burden (Palliative care Outcome Scale-Symptoms RENAL) and HRQOL (Short Form-12v2).Ethics and disseminationEthical approval was granted by a National Health Service (NHS) Regional Ethics Committee and the NHS Health Research Authority. The study team aims to publish findings in a peer-reviewed journal and presents the results at relevant national and international conferences. A summary of findings will be provided to participants, a local kidney patient charity and the funding body.Trial registration numberISRCTN87708989.
| S-EPMC7311028 | biostudies-literature