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Counseling for home-based walking and strength exercise in older primary care patients
Dubbert PM, Morey MC, Kirchner KA, Meydrech EF, Grothe K
Archives of Internal Medicine 2008 May 12;168(9):979-986
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: We evaluated the effects of counseling linked with primary care visits on walking and "strength exercise" (the combination of strength-building and flexibility exercise) in aging veterans. METHODS: Male veterans aged 60 to 85 years (N = 224) with physical function limitations were randomized to either counseling for home-based walking and strength exercise (EXC) or discussion of their choice of health education topics (EDUC) with a nurse at baseline, 1 month, and 5 months. The EXC participants recorded exercise on monthly calendars and received brief follow-up calls from the nurse; all participants received bimonthly newsletters throughout the 10-month trial. RESULTS: Retention was 83% in the EXC group and 97% in the EDUC group (p < 0.001). With analyses using the last observation carried forward approach, the EXC participants reported more walking time per week at 5 and 10 months (64.5 and 60.6 min/wk, respectively, for the EXC group versus 50.5 and 45.7 min/wk, respectively, for the EDUC group; 2.4 d/wk and 2.3 d/wk, respectively, for the EXC group versus 1.8 and 1.7 d/wk, respectively, for the EDUC group) (p < 0.001). The EXC participants also reported more strength exercise at 5 and 10 months (44.6 and 41.2 min/wk, respectively, for the EXC group versus 19.8 and 14.7 min/wk, respectively, for the EDUC group; 2.1 and 2.0 d/wk, respectively, for the EXC group versus 0.8 and 0.8 d/wk, respectively, for the EDUC group) (p < 0.001). The EXC participants reported more frequent moderate- or higher-intensity physical activity (7.1 versus 5.1 sessions/wk) (p < 0.001). Findings from accelerometer-measured physical activity indicated more EXC than EDUC participants (64% versus 46%), who averaged 30 min/d or more of moderate- or higher-intensity physical activity (p = 0.03). Participants engaging in strength exercise improved physical performance and reported positive changes in quality of life. CONCLUSION: Relatively brief counseling linked with primary care visits can increase home-based walking and strength exercise in aging male veterans. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00013195.

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