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Effects of a Long-Term Physical Activity Program on Activity Patterns in Older Adults

WANIGATUNGA, AMAL A.1; TUDOR-LOCKE, CATRINE2; AXTELL, ROBERT S.3; GLYNN, NANCY W.4; KING, ABBY C.5; MCDERMOTT, MARY M.6; FIELDING, ROGER A.7; LU, XIAOMIN8; PAHOR, MARCO9; MANINI, TODD M.9

Medicine & Science in Sports & Exercise: November 2017 - Volume 49 - Issue 11 - p 2167–2175
doi: 10.1249/MSS.0000000000001340
Epidemiology

Purpose: To examine the effect of a long-term structured physical activity (PA) intervention on accelerometer-derived metrics of activity pattern changes in mobility-impaired older adults.

Methods: Participants were randomized to either a PA or health education (HE) program. The PA intervention included a walking regimen with strength, flexibility, and balance training. The HE program featured health-related discussions and a brief upper body stretching routine. Participants (n = 1341) wore a hip-worn accelerometer for ≥10 h·d−1 for ≥3 d at baseline and again at 6, 12, and 24 months postrandomization. Total PA (TPA)—defined as movements registering 100+ counts per minute—was segmented into the following intensities: low-light PA (LLPA; 100–759 counts per minute), high light PA (HLPA; 760–1040 counts per minute), low moderate PA (LMPA; 1041–2019 counts per minute), and high moderate and greater PA (HMPA; 2020+ counts per minute). Patterns of activity were characterized as bouts (defined as the consecutive minutes within an intensity).

Results: Across groups, TPA decreased an average of 74 min·wk−1 annually. The PA intervention attenuated this effect (PA = −68 vs HE: −112 min·wk−1, P = 0.002). This attenuation shifted TPA composition by increasing time in LLPA (10+ bouts increased 6 min·wk−1), HLPA (1+, 2+, 5+, and 10+ bouts increased 6, 3, 2, and 1 min·wk−1, respectively), LMPA (1+, 2+, 5+, and 10+ bouts increased: 19, 17,16, and 8 min·wk−1, respectively), and HMPA (1+, 2+, 5+, and 10+ bouts increased 23, 21, 17, and 14 min·wk−1, respectively).

Conclusions: The PA intervention increased PA by shifting the composition of activity toward higher-intensity activity in longer-duration bouts. However, a long-term structured PA intervention did not completely eliminate overall declines in total daily activity experienced by mobility-impaired older adults.

1Department of Epidemiology, Johns Hopkins University, Baltimore, MD; 2Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA; 3Exercise Science Department, Southern Connecticut State University, New Haven, CT; 4Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; 5Department of Health Research and Policy and Department of Medicine, Stanford University, School of Medicine, Stanford, CA; 6Feinberg School of Medicine, Northwestern University, Evanston, IL; 7Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; 8Department of Biostatistics, University of Florida, Gainesville, FL; and 9Department of Aging and Geriatric Research, University of Florida, Gainesville, FL

Address for correspondence: Amal A. Wanigatunga, Ph.D., M.P.H., 2024 E. Monument Street, Room 2-724, Baltimore, MD 21205; E-mail: awaniga1@jhu.edu.

Submitted for publication February 2017.

Accepted for publication May 2017.

© 2017 American College of Sports Medicine