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.
| Original language | English |
|---|---|
| Article number | e054229 |
| Pages (from-to) | 1-12 |
| Number of pages | 12 |
| Journal | BMJ Open |
| Volume | 12 |
| Issue number | 10 |
| Early online date | 5 Oct 2022 |
| DOIs | |
| Publication status | Published - Oct 2022 |
Bibliographical note
Funding Information:This work was supported by the European Union (EU)-funded project PreventIT (2016–2018, grant number 689238) responding to the Horizon 2020, Personalized Health and Care call PHC-21: Advancing Active and Healthy Aging with ICT: Early Risk Detection and Intervention. The EU was not actively responsible or involved in the study design, collection, management, analysis or interpretation of data. The writing of reports and the decision to submit for publication was not authorised by the EU.
Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.
Funding
This work was supported by the European Union (EU)-funded project PreventIT (2016–2018, grant number 689238) responding to the Horizon 2020, Personalized Health and Care call PHC-21: Advancing Active and Healthy Aging with ICT: Early Risk Detection and Intervention. The EU was not actively responsible or involved in the study design, collection, management, analysis or interpretation of data. The writing of reports and the decision to submit for publication was not authorised by the EU.
| Funders | Funder number |
|---|---|
| European Commission | |
| Horizon 2020 Framework Programme | 689238 |
Keywords
- geriatric medicine
- public health
- sports medicine
- telemedicine