Please use this identifier to cite or link to this item: https://doi.org/10.1136/bmjopen-2021-054229
Title: 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
Authors: Mikolaizak, A Stefanie
Taraldsen, Kristin
Boulton, Elisabeth
Gordt, Katharina
Maier, Andrea Britta 
Mellone, Sabato
Hawley-Hague, Helen
Aminian, Kamiar
Chiari, Lorenzo
Paraschiv-Ionescu, Anisoara
Pijnappels, Mirjam
Todd, Chris
Vereijken, Beatrix
Helbostad, Jorunn L
Becker, Clemens
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
telemedicine
geriatric medicine
public health
sports medicine
EXERCISE PROGRAM
DISABILITY INSTRUMENT
FALL PREVENTION
INTERVENTIONS
COMMUNITY
BALANCE
PEOPLE
STRENGTH
Issue Date: 1-Oct-2022
Publisher: BMJ PUBLISHING GROUP
Citation: Mikolaizak, A Stefanie, Taraldsen, Kristin, Boulton, Elisabeth, Gordt, Katharina, Maier, Andrea Britta, Mellone, Sabato, Hawley-Hague, Helen, Aminian, Kamiar, Chiari, Lorenzo, Paraschiv-Ionescu, Anisoara, Pijnappels, Mirjam, Todd, Chris, Vereijken, Beatrix, Helbostad, Jorunn L, Becker, Clemens (2022-10-01). 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. BMJ OPEN 12 (10). ScholarBank@NUS Repository. https://doi.org/10.1136/bmjopen-2021-054229
Abstract: CONTEXT: Long-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. OBJECTIVES: To (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 PARTICIPANTS: A multicentre, feasibility randomised controlled trial including participants aged 61-70 years conducted in three European cities. INTERVENTIONS: Six-month trainer-supported aLiFE or eLiFE compared with a control group, which received written PA advice. OUTCOME MEASURES: Self-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. RESULTS: We 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. CONCLUSION: PA 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 NUMBER: NCT03065088.
Source Title: BMJ OPEN
URI: https://scholarbank.nus.edu.sg/handle/10635/234865
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2021-054229
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