Group-Based and Individually Delivered LiFE: Content Evaluation and Predictors of Training Response - A Dose-Response Analysis

Clin Interv Aging. 2022 Apr 27:17:637-652. doi: 10.2147/CIA.S359150. eCollection 2022.

Abstract

Introduction: Lifestyle-integrated Functional Exercise (LiFE) is an effective, individually delivered fall prevention program but comes with substantial resource requirements; hence, a group-format was developed (gLiFE). This study 1) evaluates the program content of two different LiFE formats (group vs individual) and 2) examines the relationship between predictors of training response (dose) and improvements in balance, strength, and physical activity (PA) (response).

Material and methods: The analysis included n = 252 (gLiFE = 126, LiFE = 126) community-dwelling older adults (78.6±5.2 years). LiFE was administered in seven sessions either in a group (gLiFE: 8-12 participants) or individually at home (LiFE). Questionnaire-based, descriptive content evaluation (frequency distributions) included reported frequency of practice (days/week, number of activities), activity preferences, safety, intensity, integrability of activities, and acceptance after 6 months of LiFE practice. Predictors (ie, dose [reported frequency and intensity], safety, and integrability of activities) for improvements in balance, strength, and PA were analyzed using radar charts.

Results: In both formats, 11.2 activities were practiced on average. Strength activities were more frequently selected than balance. Content evaluation showed some marginal advantages for the LiFE participants for selected aspects. The effects on balance, strength, and PA were nearly similar in both groups. Participants who performed balance activities more frequently (≥4 days/week) scored better in the balance and PA domain. Those who performed strength activities more frequently (≥4 days/week) performed better in all three outcomes. Higher perceived safety was associated with better performance. Those who reported activities as "not physically exhausting" performed better in all three outcomes. Those who found activities easily integrable into daily routines scored higher in the balance and strength domain.

Discussion and conclusion: Overall, both program formats are comparable with respect to content evaluation and effects. Participants need to perceive the activities as safe, not exhausting, and should practice ≥4 days/week to generate a high benefit from the intervention.

Trial registration: ClinicalTrials.gov, NCT03462654. Registered on 12 March 2018.

Keywords: LiFE; dose-response analysis; fall prevention; health behavior intervention; home exercise program.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Aged
  • Exercise Therapy* / methods
  • Exercise* / physiology
  • Humans
  • Independent Living
  • Life Style
  • Postural Balance / physiology

Associated data

  • ClinicalTrials.gov/NCT03462654

Grants and funding

This work was supported by the German Federal Ministry of Education and Research (BMBF) [grant number 01GL1705A-D] as part of the project “LiFE-is-LiFE: comparison of a Group-delivered and Individually Delivered Lifestyle integrated Functional Exercise (LiFE) Program in Older Persons”. The BMBF was not actively responsible or involved in the study concept and design, data collection, analysis and interpretation of data or the preparation and the decision to submit this manuscript for publication.