The REtirement in ACTion exercise programme and its effects on elements of long term functionality in older adults

Peter Ladlow; Max J Western; Colin J Greaves; Janice L Thompson; Janet Withall; Jolanthe de Koning; Jessica C Bollen; Sarah J Moorlock; Jack M Guralnik; Kenneth R Fox; Afroditi Stathi

doi:10.3389/fpubh.2023.1151035

The REtirement in ACTion exercise programme and its effects on elements of long term functionality in older adults

Front Public Health. 2023 Jul 28:11:1151035. doi: 10.3389/fpubh.2023.1151035. eCollection 2023.

Authors

Affiliations

¹ Department for Health, Faculty of Humanities and Social Sciences, University of Bath, Bath, United Kingdom.
² Academic Department of Military Rehabilitation (ADMR), Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, United Kingdom.
³ School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
⁴ College of Medicine and Health, University of Exeter, Exeter, United Kingdom.
⁵ Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
⁶ Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD, United States.
⁷ Centre for Exercise, Sport and Health Science, University of Bristol, Bristol, United Kingdom.

Abstract

Background: The prevention of mobility-related disability amongst adults is a global healthcare priority. Cost-effective community-based strategies to improve physical function and independence in older adults with mobility limitations are needed. This study investigated the effectiveness of the REtirement in ACTion (REACT) exercise intervention on individual markers of physical function at 6-and 12-months.

Methods: The REACT multicentre randomised controlled trial assigned 777 older adults (female, 514; male 263) (mean age 77·6 [SD 6·8] years) with reduced lower limb physical functioning (Short Physical Performance Battery [SPPB] score 4-9) to receive brief healthy ageing advice or a 12-month, group-based, multimodal exercise programme delivered in local communities. Estimated differences in the three individual component scores of the SPPB (strength, balance, gait speed) and physical functional outcomes recorded at 6- and 12-months were assessed.

Results: The intervention group demonstrated significant improvements in strength (OR = 1.88, 95% CI = 1.36-2.59, p < 0.001) and balance (OR = 1.96, 95% CI = 1.39-2.67, p < 0.001) at 12-months, but not in gait speed (OR = 1.32, 95% CI = 0.91-1.90, p = 0.139). In comparison to the control group, at six-and 12-months, the intervention group reported statistically significant improvements in Mobility Assessment Tool-Short Form (MAT-SF), physical component score from SF-36 questionnaire, and strength and endurance items of subjectively reported physical activity (PASE 10-item). Greater than 75% adherence (attending ≥48 of the 64 exercise sessions delivered in 12-months) was associated with superior functional outcomes.

Conclusion: The REACT exercise programme provides local, regional and national service providers with an effective solution to increase muscle strength and balance in older adults at risk of mobility disability.

Keywords: ageing; balance; community; mobility disability; physical activity; strength.

Publication types

Randomized Controlled Trial
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / prevention & control
Exercise Therapy
Exercise* / physiology
Female
Humans
Male
Physical Therapy Modalities
Retirement*