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

Abstract

ContextLong-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.ObjectivesTo (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 participantsA multicentre, feasibility randomised controlled trial including participants aged 61–70 years conducted in three European cities.InterventionsSix-month trainer-supported aLiFE or eLiFE compared with a control group, which received written PA advice.Outcome measuresSelf-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.ResultsWe 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.ConclusionPA 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 numberNCT03065088.

Imbalance and Falls in Patients with Parkinson’s Disease: Causes and Recent Developments in Training and Sensor-Based Assessment

“…Wearable devices and associated data analytics have the potential to provide parameters reflecting the patient's real performance in daily living and should be an outcome marker in clinical studies, since self-and laboratory-based assessments rather display self-perception and the patient's potential under direct investigation (i.e., perception and capacity) [62,65]. Thus, the gap between laboratory-based capacity (i.e., the potential of a patient) and performance may guide individual therapy to set improvements and to increase compliance [66]. The assessment of performance using wearables also compared to capacity and self-perception is currently under investigation.…”

The Work Lifestyle-integrated Functional Exercise Program for Preventing Functional Decline in Employees over 55 years: Development and Initial Evaluation

“…A recent review paper [23] shows evidence of LiFE for improving physical capacity in various target populations. The most relevant studies for the present topic are related to the adapted aLiFE for young retired seniors [14,24,25,26,27]. The exercises as well as the behavioural change techniques have been adjusted to this younger target population [25].…”

“…The exercises as well as the behavioural change techniques have been adjusted to this younger target population [25]. Studies have demonstrated the feasibility of aLiFE [14,24,26] and its effects on specific physical capacity measures such as balance and mobility [25] and the use of technology [26].…”