Exercise-Based Interventions to Enhance Long-Term Sustainability of Physical Activity in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Por:
Sansano-Nadal, O, Gine-Garriga, M, Brach, JS, Wert, DM, Jerez-Roig, J, Guerra-Balic, M, Oviedo, G, Fortuno, J, Gomara-Toldra, N, Soto-Bagaria, L, Perez, LM, Inzitari, M, Sola, I, Martin-Borras, C, Roque, M
Publicada:
2 jul 2019
Resumen:
Exercise is a form of physical activity ( PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis ( PROSPERO: CRD42017070892) of randomized clinical trials ( RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active ( e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active ( e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian-Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up ( standardized mean difference ( SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I-2 0%), but not at the one-or two-years follow-ups. No data were available on the mid-and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.
Filiaciones:
Sansano-Nadal, O:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Gine-Garriga, M:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Glasgow Caledonian Univ, Sch Hlth & Life Sci, Cowcaddens Rd, Glasgow G4 0BA, Lanark, Scotland
Ramon Llull Univ, Fac Hlth Sci FCS Blanquerna, Dept Phys Therapy, Padilla 326-332, Barcelona 08025, Spain
Brach, JS:
Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Phys Therapy, Forbes Tower,3600 Atwood St, Pittsburgh, PA 15260 USA
Wert, DM:
Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Phys Therapy, Forbes Tower,3600 Atwood St, Pittsburgh, PA 15260 USA
Jerez-Roig, J:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Glasgow Caledonian Univ, Sch Hlth & Life Sci, Cowcaddens Rd, Glasgow G4 0BA, Lanark, Scotland
Cent Univ Catalonia UVIC UCC, Univ Vic, Fac Hlth Sci & Welf, Res Grp Methodol Methods Models & Outcome Hlth &, Sagrada Familia 7, Vic 08500, Spain
Guerra-Balic, M:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Oviedo, G:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Fortuno, J:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Gomara-Toldra, N:
Ramon Llull Univ, Fac Hlth Sci FCS Blanquerna, Dept Phys Therapy, Padilla 326-332, Barcelona 08025, Spain
Univ Vic, Fac Hlth Sci & Welf, Dept Hlth Sci, Sagrada Familia 7, Vic 08500, Spain
Soto-Bagaria, L:
Intermediate Care Hosp, Parc Sanitari Pere Virgili, Barcelona 08023, Spain
VHIR, RE FiT Barcelona Res Grp, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Perez, LM:
Intermediate Care Hosp, Parc Sanitari Pere Virgili, Barcelona 08023, Spain
VHIR, RE FiT Barcelona Res Grp, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Inzitari, M:
Intermediate Care Hosp, Parc Sanitari Pere Virgili, Barcelona 08023, Spain
VHIR, RE FiT Barcelona Res Grp, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
Sola, I:
Inst Biomed Res St Pau IIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167,Pavil 18, Barcelona 08025, Spain
CIBERESP, CIBER Epidemiol & Publ Hlth, Madrid 28029, Spain
Martin-Borras, C:
Ramon Llull Univ, Fac Psychol Educ & Sport Sci FPCEE Blanquerna, Dept Phys Act & Sport Sci, Cister 34, Barcelona 08022, Spain
Ramon Llull Univ, Fac Hlth Sci FCS Blanquerna, Dept Phys Therapy, Padilla 326-332, Barcelona 08025, Spain
Roque, M:
Inst Biomed Res St Pau IIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167,Pavil 18, Barcelona 08025, Spain
CIBERESP, CIBER Epidemiol & Publ Hlth, Madrid 28029, Spain
UAB, Inst Hlth & Aging, St Antoni Maria Claret 171 Casa Convalecencia, Barcelona 08041, Spain
Gold, Green Published
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