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Effects of a long-term physical activity program on activity patterns in older adults
Wanigatunga AA, Tudor-Locke C, Axtell RS, Glynn NW, King AC, McDermott MM, Fielding RA, Lu X, Pahor M, Manini TM
Medicine and Science in Sports and Exercise 2017 Nov;49(11):2167-2175
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; 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*

PURPOSE: To examine the effect of a long-term structured physical activity (PA) intervention on accelerometer-derived metrics of activity pattern changes in mobility-impaired older adults. METHODS: Participants were randomized to either a PA or health education (HE) program. The PA intervention included a walking regimen with strength, flexibility, and balance training. The HE program featured health-related discussions and a brief upper body stretching routine. Participants (n = 1,341) wore a hip-worn accelerometer for >= 10 h/d for >= 3 d at baseline and again at 6, 12, and 24 months postrandomization. Total PA (TPA)-defined as movements registering 100+ counts per minute-was segmented into the following intensities: low-light PA (LLPA; 100 to 759 counts per minute), high light PA (HLPA; 760 to 1,040 counts per minute), low moderate PA (LMPA; 1,041 to 2,019 counts per minute), and high moderate and greater PA (HMPA; 2,020+ counts per minute). Patterns of activity were characterized as bouts (defined as the consecutive minutes within an intensity). RESULTS: Across groups, TPA decreased an average of 74 min/wk annually. The PA intervention attenuated this effect (PA -68 versus HE -112 min/wk, p = 0.002). This attenuation shifted TPA composition by increasing time in LLPA (10+ bouts increased 6 min/wk), HLPA (1+, 2+, 5+, and 10+ bouts increased 6, 3, 2, and 1 min/wk, respectively), LMPA (1+, 2+, 5+, and 10+ bouts increased: 19, 17, 16, and 8 min/wk, respectively), and HMPA (1+, 2+, 5+, and 10+ bouts increased 23, 21, 17, and 14 min/wk, respectively). CONCLUSIONS: The PA intervention increased PA by shifting the composition of activity toward higher-intensity activity in longer-duration bouts. However, a long-term structured PA intervention did not completely eliminate overall declines in total daily activity experienced by mobility-impaired older adults.

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