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United States Department of Agriculture

Agricultural Research Service

Research Project: NUTRITION, EXERCISE PHYSIOLOGY, AND SARCOPENIA Title: Interruption of Physical Activity Due to Illness in the The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Trial

Authors
item Phillips, Edward - SPAULDING REHAB HOSPITAL
item Katula, Jeffrey - WAKE FOREST UNIVERSITY
item Miller, Michael - WAKE FOREST UNIVERSITY
item Walkup, Michael - WAKE FOREST UNIVERSITY
item King, Abby - STANFORD UNIVERSITY
item Rejeski, Jack - WAKE FOREST UNIVERSITY
item Church, Tim - LOUISIANA STATE UNIV
item Brach, Jennifer - UNIVERSITY OF PITTSBURGH
item Fielding, Roger

Submitted to: Journal of Applied Physiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: December 29, 2008
Publication Date: January 18, 2010
Citation: Phillips, E., Katula, J., Miller, M.E., Walkup, M.P., King, A.C., Rejeski, J.W., Church, T., Brach, J., Fielding, R. 2010. Interruption of Physical Activity Due to Illness in the The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Trial. Journal of Applied Physiology. 18(1):61-74.

Interpretive Summary: The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) was a trial to examine the effects of physical activity (PA) compared to a health education control on measures of disability in sedentary older adults. Medical suspensions were examined for the first 12 months of the trial in the randomized study group. The PA intervention consisted of walking, strength, flexibility, and balance training supplemented with behavioral skills training modules, and utilized a phased center-based schedule of adoption while transitioning to primarily home-based physical activity. Subjects who were medically suspended and unable to return to complete the PA intervention in a trial of mobility limited sedentary older adults had baseline differences of slower walking speeds, lower Short Physical Performance Battery (SPPB) scores (a standardized measure of walking speed, power, and standing balance) and a higher number of prescribed medications. These results suggest that baseline measures of physical functioning and health status may predict medically related withdrawals in a long-term physical activity trial.

Technical Abstract: Background: Acute or chronic medical illness may affect adherence and/or the level of participation in a physical activity program. Purpose: The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) was a trial to examine the effects of physical activity (PA) compared to a health education control (SA) on measures of disability in sedentary older adults (N=424). We examined medical suspensions (MS) in the Physical Activity (PA) arm of the intervention in LIFE-P for the first 12 months of the trial. Methods: The PA intervention consisted of walking, strength, flexibility, and balance training supplemented with behavioral skills training modules, and utilized a phased center-based schedule of adoption (3x/wk, weeks 1-8), transition (2x/wk, weeks 9-24), and maintenance (1x/wk, weeks 25-end of trial) while transitioning to primarily home-based physical activity. Medical suspension was defined as missing three consecutive PA sessions in the adoption and transition phases or two weeks in the maintenance phase. Results: 122 of 213 (57.3%) completed the PA intervention without medical suspension (NS). The remaining 91 of 213 (42.7%) participants had their participation interrupted for medical reasons. 48 subjects were able to resume and complete the PA intervention (SR) while 43 subjects did not complete the PA intervention (SNR). SNR walked more slowly at baseline compared to NS and SR [400m walk times: SNR = 8.90 +/-2.24 min; SR = 7.88 +/- 1.68min; NS 8.01 +/- 1.79 min (P=0.02)], took more prescribed medications [SNR = 6.09 +/-3.48 meds, SR = 5.33 +/-3.84meds, NS = 4.80 +/- 2.69 meds (P=0.02)] and had lower scores on the Short Physical Performance Battery (SPPB) [SNR = 7.07 +/-1.64, SR = 7.60 +/-1.27 and NS = 7.74 +/-1.42 (P=0.01)]. Conclusions: Subjects who were medically suspended and unable to return to complete the physical activity intervention in a trial of mobility limited sedentary older adults had baseline differences of slower walking speeds, lower SPPB scores and a higher number of prescribed medications. These results suggest that baseline measures of physical functioning and health status may predict medically related withdrawals in a long-term physical activity trial.

Last Modified: 11/26/2014
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