Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing

Franziska Kramer; Sarah Labudek; Carl-Philipp Jansen; Corinna Nerz; Lena Fleig; Lindy Clemson; Clemens Becker; Michael Schwenk

doi:10.1186/s40814-019-0539-x

Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing

Pilot Feasibility Stud. 2020 Jan 22:6:6. doi: 10.1186/s40814-019-0539-x. eCollection 2020.

Authors

Franziska Kramer^#¹, Sarah Labudek^#¹, Carl-Philipp Jansen¹, Corinna Nerz², Lena Fleig³, Lindy Clemson⁴, Clemens Becker², Michael Schwenk¹

Affiliations

¹ 1Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany.
² 2Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany.
³ 3Faculty of Natural Sciences, Department of Psychology, Health Psychology, Medical School Berlin, Berlin, Germany.
⁴ 4Faculty of Health Sciences, University of Sydney, Sydney, Australia.

^# Contributed equally.

Abstract

Background: The Lifestyle-integrated Functional Exercise (LiFE) programme is a fall prevention programme originally taught in a resource-intensive one-to-one format with limited feasibility for large-scale implementation. The aim of this paper is to present the conceptual framework and initial feasibility evaluation of a group-based LiFE (gLiFE) format developed for large-scale implementation.

Methods: The conceptual gLiFE framework (part I) is based on three pillars, LiFE Activities and Principles, Theory of Behaviour Change and Behaviour Change Techniques, and Instruction. The feasibility of gLiFE was tested (part II) within a multimodal approach including quantitative questionnaires measuring safety, acceptability (1 = best to 7 = insufficient), and adherence to the LiFE activities (range = 0-14) as well as a focus group interview. Exploratory self-reported measures on behaviour change including self-determined motivation (range = 1-5), intention, planning, action control, and habit strength (range = 1-6) were assessed pre and post intervention. Data analyses were performed using descriptive statistics and qualitative content analysis.

Results: The development process resulted in a manualised gLiFE concept containing standardised information on gLiFE's content and structure. Feasibility testing: Six older adults (median = 72.8 years, 5 female) completed the feasibility study and rated safety (median = 7.0, IQR = 0.3) and acceptability as high (median = 1, IQR = 1). Participants implemented 9.5 LiFE activities (IQR = 4.0) into their daily routines. No adverse events occurred during the study. In the focus group, the group format and LiFE activities were perceived as positive and important for maintaining strength and balance capacity. Self-determined motivation intention, planning, and habit strength were rated higher post intervention.

Conclusion: The developed conceptual gLiFE framework represents the basis for a gLiFE format with potential for standardised large-scale implementation. Proof-of-concept could be demonstrated in a group of community-dwelling older adults at risk of falling. The public health potential of gLiFE in terms of (cost-)effectiveness is currently being evaluated in a large trial.

Trial registration: ClinicalTrials.gov NCT03412123. Registered on January 26, 2018.

Keywords: Fall prevention; Functional balance and strength training; Habit formation; Health behaviour change; LiFE; Lifestyle-integrated exercise; Older adults.

Associated data

ClinicalTrials.gov/NCT03412123