Community-based Exercise Enhanced by a Self-management Programme to Promote Independent Living in Older Adults

A Pragmatic Randomised Controlled Trial

Pia Øllgaard Olsen; Mark A Tully; Borja Del Pozo Cruz; Manfred Wegner; Paolo Caserott

Disclosures

Age Ageing. 2022;51(7):afac137 

In This Article

Background

The evidence of the benefits of physical activity (PA) for health, well-being, function and prevention of disability for older adults is overwhelming.[1–3] Therefore, increasing the PA-level of the older population has become a key primary prevention target.[4,5] Regardless, older adults still constitute the most inactive population group in Europe.[6] Behaviour-change strategies used in combination with exercise may successfully contribute to increasing PA.[7–9] Especially, self-regulation strategies including personal goal-setting and self-monitoring, capability-enhancing strategies such as visits to resources where exercise can take place after exercise intervention,[8] and strategies to increase self-efficacy and positive expectancies to the outcome of PA,[10,11] have been previously linked to increasing PA in older adults.

However, maintenance of PA-level and the desired health benefits after removing the intervention period remains a challenge,[7] and it has been suggested that combined exercise and behaviour-change interventions should take whole-system approaches.[7] This implies that when designing an intervention this should be person-centred (i.e. tailored to participant's goals, preferences and needs), and be linked to the available resources in the community and health care sector. Also, interventions should incorporate earlier identified promoters of long-term engagement with PA-programmes including nearby facilities, low fees, enjoyment of exercise and use formats that spur social support and commitment.[12–14] Finally, long-term effects may increase by adding behaviour-change strategies aiming to simultaneously tackle multiple risk-factors for functional decline and disability[15,16] and well-known barriers for PA such as inadequate health literacy,[17] incontinence,[18] loneliness,[19] chronic pain,[20] fear of falling,[21] lack of company and interest or motivation for exercising.[13,22]

This article presents an innovative whole-system oriented intervention combining 12 weeks group-based progressive exercise in parallel with a 24-week multi-factorial self-management programme to tackle several potential barriers for PA.

The aim of this study is to assess the effects of this intervention in a nationally regulated preventive care framework for community-dwelling older adults on objective and self-report measures of functional capacity, and self-report disability.

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