Skip to main content

Advertisement

SpringerLink
Log in

Translating exercise interventions to an in-home setting for seniors: preliminary impact on physical activity and function

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Aims

The purpose of this study is to investigate whether an in-home, individually tailored intervention is efficacious in promoting increases in physical activity (PA) and improvements in physical functioning (PF) in low-active older adults.

Methods

Participants were randomized to two groups for the 8-week intervention. The enhanced physical activity (EPA) group received individualized exercise programming, including personalized step goals and a resistance band training program, and the standard of care (SoC) group received a general activity goal. Pre- and post-intervention PF measures included choice step reaction time, knee extension/flexion strength, hand grip strength, and 8 ft up and go test completion time.

Results

Thirty-nine subjects completed this study (74.6 ± 6.4 years). Significant increases in steps/day were observed for both the EPA and SoC groups, although the improvements in the EPA group were significantly higher when including only those who adhered to weekly step goals. Both groups experienced significant PF improvements, albeit greater in the EPA group for the 8 ft up and go test and knee extension strength.

Conclusion

A low cost, in-home intervention elicited improvements in both PA and PF. Future research is warranted to expand upon the size and scope of this study, exploring dose thresholds (and time frames) for PA to improve PF and strategies to further bolster adherence rates to maximize intervention benefits.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

PA:

Physical activity

PF:

Physical functioning

EPA:

Enhanced physical activity

SoC:

Standard of care

CSRT:

Choice step reaction time

References

  1. Crane JD, Macneil LG, Tarnopolsky MA (2013) Long-term aerobic exercise is associated with greater muscle strength throughout the life Span. J Gerontol A Biol Sci Med Sci 68:631–638

    Article  PubMed  Google Scholar 

  2. Federal Interagency Forum on Aging-Related Statistics (2008) Older Americans 2008: Key indicators of well-being. Washington D.C. http://agingstats.gov/agingstatsdotnet/Main_Site/Data/2008_Documents/OA_2008.pdf. Accessed 12 July 2013

  3. Wilson IB, Cleary PD (1995) Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 273:59–65

  4. Guralnik JM, Ferrucci L, Simonsick EM et al (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332:556–561

  5. Rantanen T, Guralnik JM, Sakari-Rantala R et al (1999) Disability, physical activity, and muscle strength in older women: the women’s health and aging study. Arch Phys Med Rehabil 80:130–135

    Article  CAS  PubMed  Google Scholar 

  6. Dunn AL, Marcus BH, Kampert JB et al (1999) Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA 281:327–334

  7. Chandler JM, Duncan PW, Kochersberger G et al (1998) Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? Arch Phys Med Rehabil 79:24–30

    Article  CAS  PubMed  Google Scholar 

  8. Beyer N, Simonsen L, Bülow J et al (2007) Old women with a recent fall history show improved muscle strength and function sustained for six months after finishing training. Aging Clin Exp Res 19:300–309

    Article  PubMed  Google Scholar 

  9. King AC, Pruitt LA, Phillips W et al (2000) Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. J Gerontol A Biol Sci Med Sci 55A:M74–M83

    Google Scholar 

  10. Ashworth NL, Chad KE, Harrison EL et al (2005) Home versus center based physical activity programs in older adults. Cochrane Database Syst Rev 1:CD004017

  11. Clemson L, Singh MF, Bundy A et al (2010) LiFE pilot study: a randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Aust Occup Ther J 57:42–50

    Article  PubMed  Google Scholar 

  12. Litt MD, Kleppinger A, Judge JO (2002) Initiation and maintenance of exercise behavior in older women: predictors from the social learning model. J Behav Med 25:83–97

    Article  PubMed  Google Scholar 

  13. Moschny A, Platen P, Klaassen-Mielke R et al (2011) Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act 8:121

    Article  PubMed  PubMed Central  Google Scholar 

  14. Singh MAF (2000) Exercise and aging. In: exercise, nutrition, and the older woman: wellness for women over fifty. CRC Press, London, p 3–36

  15. Tudor-Locke C, Craig CL, Aoyagi Y et al (2011) How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act 8:80

    Article  PubMed  PubMed Central  Google Scholar 

  16. Crouter SE, Schneider PL, Karabulut M et al (2003) Validity of 10 electronic pedometers for measuring steps, distance, and energy cost. Med Sci Sports Exerc 35:1455–1460

    Article  PubMed  Google Scholar 

  17. Schneider PL, Crouter SE, Lukajic O et al (2003) Accuracy and reliability of pedometers for measuring steps over a 400-m walk. Med Sci Sports Exerc 35:1779–1784

    Article  PubMed  Google Scholar 

  18. Martin HJ, Yule V, Syddall HE et al (2006) Is hand-held dynamometry useful for the measurement of quadriceps strength in older people? A comparison with the gold standard biodex dynamometry. Gerontology 52:154–159

    Article  CAS  PubMed  Google Scholar 

  19. Syddall H, Cooper C, Martin F et al (2003) Is grip strength a useful single marker of frailty? Age Ageing 32:650–656

    Article  PubMed  Google Scholar 

  20. Lord SR, Fitzpatrick RC (2001) Choice stepping reaction time: a composite measure of falls risk in older people. J Gerontol A Biol Sci Med Sci 56:M627–M632

    Article  CAS  PubMed  Google Scholar 

  21. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148

  22. Shumway-Cook A, Brauer S, Woollacott M (2000) Predicting the probability for falls in community dwelling older adults using the timed up and go test. Phys Ther 80:896–903

    CAS  PubMed  Google Scholar 

  23. Hart TL, Swartz AM, Cashin SE et al (2009) How many days of monitoring predict physical activity and sedentary behaviour in older adults? Int J Behav Nutr Phys Act 8:62

    Article  Google Scholar 

  24. Tudor-Locke C, Hart TL, Washington TL (2009) Expected values for pedometer-determined physical activity in older populations. Int J Behav Nutr Phys Act 6:59

    Article  PubMed  PubMed Central  Google Scholar 

  25. Asikainen TM, Miilunpalo S, Oja P et al (2002) Randomised, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness. Br J Sports Med 36:189–194

    Article  PubMed  PubMed Central  Google Scholar 

  26. Murtagh EM, Boreham CA, Nevill A et al (2005) The effects of 60 minutes of brisk walking per week, accumulated in two different patterns, on cardiovascular risk. Prev Med 41:91–97

    Article  Google Scholar 

  27. Quinn TJ, Klooster JR, Kenefick RW (2006) Two short, daily activity bouts vs. one long bout: are health and fitness improvements similar over twelve and twenty-four weeks? J Strength Cond Res 20:130–135

    PubMed  Google Scholar 

  28. Tucker JM, Welk GJ, Beyler NK (2011) Physical activity in U.S.: adults compliance with the physical activity guidelines for Americans. Am J Prev Med 40:454–461

    Article  PubMed  Google Scholar 

  29. Troiano RP, Berrigan D, Dodd KW et al (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40:181–188

    Article  PubMed  Google Scholar 

  30. Winett RA, Williams DM, Davy BM (2009) Initiating and maintaining resistance training in older adults: a social cognitive theory-based approach. Br J Sports Med 43:114–119

    Article  CAS  PubMed  Google Scholar 

  31. Bravata DM, Smith-Spangler C, Sundaram V et al (2007) Using pedometers to increase physical activity and improve health: a systematic review. JAMA 298:2296–2304

    Article  CAS  PubMed  Google Scholar 

  32. King AC, Rejeski WJ, Buchner DM (1998) Physical activity interventions targeting older adults. A critical review and recommendations. Am J Prev Med 15:326–333

    Article  Google Scholar 

  33. Freidrich M, Cermak T, Maderbacher P (1996) The effect of brochure use versus therapist teaching on patients performing therapeutic exercise and on changes in impairment status. Phys Ther 76:1082–1088

    Google Scholar 

  34. Simek EM, McPhate L, Haines TP (2012) Adherence to and efficacy of home exercise programs to prevent falls: a systematic review and meta-analysis of the impact of exercise program characteristics. Prev Med 55:262–275

  35. Linke SE, Gallo LC, Norman GJ (2011) Attrition and adherence rates of sustained vs. intermittent exercise interventions. Ann Behav Med 42:197–209

    Article  PubMed  PubMed Central  Google Scholar 

  36. Belza B, PRC-HAN Physical Activity Conference Planning Workgroup (2007) Moving ahead: strategies and tools to plan, conduct, and maintain effective community-based physical activity programs for older adults. Centers for Disease Control and Prevention, Atlanta

  37. Bohannon RW (2006) Reference values for the timed up and go test: a descriptive meta analysis. J Geriatr Phys Ther 29:64

  38. Gudlaugsson J, Gudnason V, Aspelund T et al (2012) Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: a randomized-controlled cross-over design. Int J Behav Nutr Phys Act 9:107

    Article  PubMed  PubMed Central  Google Scholar 

  39. Snyder A, Colvin B, Gammack JK (2011) Pedometer use increases daily steps and functional status in older adults. J Am Med Dir Assoc 12:590–594

    Article  PubMed  Google Scholar 

  40. Hallage T, Krause MP, Haile L et al (2010) The effects of 12 weeks of step aerobics training on functional fitness of elderly women. J Strength Cond Res 24:2261–2266

    Article  PubMed  Google Scholar 

  41. Sousa N, Mendes R, Silva S et al (2013) Effects of resistance and multicomponent training on body composition and physical fitness of institutionalized elderly women. Br J Sports Med 47:e3

    Article  Google Scholar 

  42. Straight CR, Dorfman LR, Cottell KE et al (2012) Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults. J Phys Act Health 9:875–883

    Article  PubMed  Google Scholar 

  43. McMeeken J, Stillman B, Story I et al (1999) The effects of knee extensor and flexor muscle training on the timed-up-and-go test in individuals with rheumatoid arthritis. Physiother Res Int 4:55–67

    CAS  PubMed  Google Scholar 

  44. Silva NL, Oliveira RB, Fleck SJ et al (2013) Influence of strength training variables on gains in adults over 55 years-old: a meta-analysis of dose-response relationships. J Sci Med Sport 17:337–344

    Article  PubMed  Google Scholar 

  45. Kalapothrakos V, Smilios I, Parlavatzas A et al (2007) The effect of moderate resistance strength training and detraining on muscle strength and power in older men. J Geriatr Phys Ther 30:109–113

    Article  Google Scholar 

  46. Voukelatos A, Cumming RG, Lord SR et al (2007) A randomized, controlled trial of tai chi for the prevention of falls: the central sydney tai chi trial. J Am Geriatr Soc 55:1185–1191

    Article  PubMed  Google Scholar 

  47. Pijnappels M, Delbaere K, Sturnieks DL et al (2010) The association between choice stepping reaction time and falls in older adults-a path analysis model. Age Ageing 39:99–104

    Article  PubMed  Google Scholar 

  48. Seco J, Abecia LC, Echevarria E et al (2013) A long-term physical activity training program increases strength and flexibility, and improves balance in older adults. Rehabil Nurs 38:37–47

    Article  PubMed  Google Scholar 

  49. Ip EH, Church T, Marshall SA et al (2013) Physical activity increases gains in and prevents loss of physical function: results from the lifestyle interventions and independence for elders pilot study. J Gerontol A Biol Sci Med Sci 68:426–432

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge Geeta Betrabet and Kimberly Winker for their assistance in data collection. This work was partially supported by the University of Wisconsin-Milwaukee Research Growth Initiative Award.

Author information

Authors and Affiliations

  1. Department of Movement Science, Grand Valley State University, Kindschi Hall Room 4403, 1 Campus Drive, Allendale, MI, 49401, USA

    Christopher J. Dondzila

  2. Department of Kinesiology, The University of Wisconsin-Milwaukee, Enderis Hall, 2400 East Hartford, Milwaukee, WI, 53201, USA

    Ann M. Swartz, Kevin G. Keenan & Scott J. Strath

  3. Center for Aging and Translational Research, The University of Wisconsin-Milwaukee, Norwest Quadrant B, 2025 E Newport Ave #1427, Milwaukee, WI, 53211, USA

    Ann M. Swartz, Kevin G. Keenan & Scott J. Strath

  4. Zilber School of Public Health, The University of Wisconsin-Milwaukee, Zilber School of Public Health Building Room 409, 1240 North 10th Street, Milwaukee, WI, 53205, USA

    Amy E. Harley

  5. Department of Educational Psychology, The University of Wisconsin-Milwaukee, Enderis Hall Room 769, 2400 East Hartford, Milwaukee, WI, 53201, USA

    Razia Azen

Authors
  1. Christopher J. Dondzila
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ann M. Swartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kevin G. Keenan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amy E. Harley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Razia Azen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Scott J. Strath
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher J. Dondzila.

Ethics declarations

Conflict of interest

None.

Human and animal rights

All procedures utilized in this study were approved by the University’s Institutional Review Board.

Informed consent

Written and verbal consent was obtained from each participant prior to enrolling.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dondzila, C.J., Swartz, A.M., Keenan, K.G. et al. Translating exercise interventions to an in-home setting for seniors: preliminary impact on physical activity and function. Aging Clin Exp Res 28, 1227–1235 (2016). https://doi.org/10.1007/s40520-015-0518-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-015-0518-x

Keywords

Search

Navigation