A low-threshold intervention to increase physical activity and reduce physical inactivity in a group of healthy elderly people in Germany: Results of the randomized controlled MOVING study

Abstract

Background Lack of physical activity (PA) and a high level of physical inactivity (PI) are associated with a higher risk for mortality and responsible for several non-communicable diseases including cardiovascular disease. Higher age is associated with a decrease of PA and an increasing level of PI. Studies have shown that interventions in the elderly have the potential to increase the amount of PA and to decrease the level of PI. However, most interventions are complex, elaborated, time- and resource-consuming. Here, we examined the effect of individual feedback-letters reporting the measured PA and PI in a sample of elderly people in Germany. Primary outcomes of the study were overall PA and PI after 6 months in the intervention group compared to a control group. Methods We examined data from the MOVING intervention study (RCT) for people aged ≥ 65 years living in the northeast of Germany. At baseline, 3 and 6-months follow-up, all study participants wore a 3-axis accelerometer over a period of seven consecutive days. After the baseline measurement, the participants were randomized into intervention and control group. Participants in the intervention group received automatically generated, individualized feedback letters reporting their PA and PI by mail after the baseline measurement and after the 3-months follow-up. A Two-Way Mixed ANOVA with repeated measures was calculated with light, moderate and overall PA as well as PI as dependent variables, and group (between subject) and time (inner subject) as factors. The analysis based on retrospective data from the MOVING study (2016–2018). Results N = 258 patients were recruited. N = 166 participants could be included in the analysis, thereof N = 97 women (58.4%). The mean age was 70.8 years (SD 4.8). At baseline, the participants had a mean wearing time of 5,934.5 minutes (SD = 789.5) per week, which corresponds to about 14 hours daily on average. The overall PA in the intervention group at the 6-months follow up was 2488.8 (95% CI 2358.9–2618.2) minutes and 2408.2 (95% CI 2263.0–2553.4) minutes in the control group. There was no statistically significant interaction effect (time*group) between the intervention and control group for the depending variables. Sensitivity analyses showed significant small positive effects of the interaction time*partnership, F(2, 300) = 3.020, p = 0.05, partial η2 = 0.020. Discussion On average, study participants had high levels of PA at baseline and showed a good adherence in wearing the accelerometer. Both is likely due to selection in the convenience study sample. Thus, some ceiling effect reduced the overall intervention effect somewhat. At baseline, the weekly average of PI was 3436.7 minutes, which correspondents to about 8.2 hours per day and about 57% of participants’ daily waking time. The average level of PI could be slightly decreased in both study groups. Trial registration number DRKS00010410, 17 May 2017.

The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions

“…Ten studies [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ] referred to published protocols [ 79 , 80 , 81 , 82 , 83 , 84 ] or trial registry records (trial IDs reported in Table 1 ) which were consulted in these cases. Nine studies [ 69 , 70 , 73 , 76 , 77 , 78 , 85 , 86 , 87 ] were judged to be of high risk of bias and four studies [ 71 , 72 , 74 , 75 ] to have some concerns. No studies were judged to be of low risk of bias.…”

“…In two instances [ 88 , 89 ], the authors referred to an additional paper containing more detailed information on the respective study [ 90 , 91 ]. Of the 15 included studies, 14 studies [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 85 , 87 , 88 , 89 ] were published in peer-reviewed journals, 14 were written in English [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 85 , 87 , 88 , 89 ] and one [ 86 ] in German. The country of origin was Germany for 13 studies [ 69 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 78 , 85 , 86 , 87 , 88 ] and Belgium [ 89 ] and the UK [ 72 ] for one study each.…”

“…One study [ 72 ] did not report the exact number of participants included. One study focused on toddlers [ 89 ], three on preschoolers [ 75 , 88 , 89 ], three on school children [ 78 , 87 , 89 ], one on teenagers [ 76 ], two on adults [ 70 , 72 ], three on older adults [ 69 , 71 , 77 ], one on office workers [ 85 ] and three on people with chronic diseases [ 73 , 74 , 86 ].…”

“…The intervention duration was less than six months in nine studies [ 69 , 70 , 71 , 73 , 74 , 76 , 85 , 86 , 87 ], at least six months but less than twelve months in three cases [ 72 , 75 , 77 ] and it lasted twelve months or longer in three studies [ 78 , 88 , 89 ]. Five studies encompassed follow-up after the outcome assessment at the end of the intervention to assess long-term effects [ 70 , 73 , 74 , 75 , 86 ].…”

“…Five studies encompassed follow-up after the outcome assessment at the end of the intervention to assess long-term effects [ 70 , 73 , 74 , 75 , 86 ]. Six studies examined multicomponent interventions [ 75 , 76 , 78 , 85 , 88 , 89 ], eight studies focused on personal behavior interventions [ 69 , 70 , 71 , 72 , 73 , 74 , 77 , 86 ] and one targeted the physical environment [ 87 ]. No study examined the social environment.…”