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Randomized Controlled Trial
. 2017 Jul;65(7):1427-1433.
doi: 10.1111/jgs.14804. Epub 2017 Feb 21.

Effect of Physical Activity versus Health Education on Physical Function, Grip Strength and Mobility

Adam J Santanasto  1 , Nancy W Glynn  1 , Laura C Lovato  2 , Steven N Blair  3 , Roger A Fielding  4 , Thomas M Gill  5 , Jack M Guralnik  6 , Fang-Chi Hsu  2 , Abby C King  7 , Elsa S Strotmeyer  1 , Todd M Manini  8 , Anthony P Marsh  9 , Mary M McDermott  10 , Bret H Goodpaster  11 , Marco Pahor  8 , Anne B Newman  1 ; LIFE Study Group
Affiliations
Randomized Controlled Trial

Effect of Physical Activity versus Health Education on Physical Function, Grip Strength and Mobility

Adam J Santanasto et al. J Am Geriatr Soc. 2017 Jul.

Abstract

Background: Physical activity (PA) reduces the rate of mobility disability, compared with health education (HE), in at risk older adults. It is important to understand aspects of performance contributing to this benefit.

Objective: To evaluate intervention effects on tertiary physical performance outcomes.

Design: The Lifestyle Interventions and Independence for Elders (LIFE) was a multi-centered, single-blind randomized trial of older adults.

Setting: Eight field centers throughout the United States.

Participants: 1635 adults aged 78.9 ± 5.2 years, 67.2% women at risk for mobility disability (Short Physical Performance Battery [SPPB] <10).

Interventions: Moderate PA including walking, resistance and balance training compared with HE consisting of topics relevant to older adults.

Outcomes: Grip strength, SPPB score and its components (balance, 4 m gait speed, and chair-stands), as well as 400 m walking speed.

Results: Total SPPB score was higher in PA versus HE across all follow-up times (overall P = .04) as was the chair-stand component (overall P < .001). No intervention effects were observed for balance (overall P = .12), 4 m gait speed (overall P = .78), or grip strength (overall P = .62). However, 400 m walking speed was faster in PA versus HE group (overall P =<.001). In separate models, 29% of the rate reduction of major mobility disability in the PA versus HE group was explained by change in SPPB score, while 39% was explained by change in the chair stand component.

Conclusion: Lower extremity performance (SPPB) was significantly higher in the PA compared with HE group. Changes in chair-stand score explained a considerable portion of the effect of PA on the reduction of major mobility disability-consistent with the idea that preserving muscle strength/power may be important for the prevention of major mobility disability.

Keywords: gait speed; physical activity; physical function; randomized clinical trial.

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Conflict of interest statement

Conflicts of Interest: Dr. Roger Fielding (Tufts University) is partially supported by the U.S. Department of Agriculture, under agreement No. 58-1950-0-014. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Dept of Agriculture. All other authors have no conflicts to report.

Figures

Figure 1
Figure 1. Adjusted Least Square Mean for Total SPPB score at Baseline, 6- 12- 24- and 36 Months by Intervention Group in All (panel A) and Lower Functioning Participants (panel B)
Legend: The Physical Activity group had better lower extremity performance (SPPB score), compared with the Health Education group, over the course of the trial (Panel A). These effects were more pronounced in lower functioning participants (SPPB <9, Panel B). Error bars are standard errors. Abbreviations: SPPB: Short Physical Performance Battery.
Figure 2
Figure 2. Adjusted Least Square Mean for Chair Stand Score at Baseline, 6- 12- 24- and 36-Months by Intervention Group in All (panel A) and Lower Functioning Participants (panel B)
Legend: The Physical Activity group had better timed chair-stand scores, compared with the Health Education group, over the course of the trial (Panel A). These effects were more pronounced in lower functioning participants (SPPB <9, Panel B). Error bars are standard errors.
See this image and copyright information in PMC

References

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