A multidimensional program including standing exercises, health education, and telephone support to reduce sedentary behavior in frail older adults: Randomized clinical trial

Tosi, F. Cassales; Lin, Sumika Mori; Gomes, Grace Angélica de Oliveira; Aprahamian, Ivan; Nakagawa, Naomi Kondo; Viveiro, Larissa Alamino Pereira de; Bacha, Jéssica Maria Ribeiro; Jacob‐Filho, Wilson; Pompeu, José Eduardo

doi:10.1016/j.exger.2021.111472

Cited by 5 publications

(5 citation statements)

References 35 publications

(54 reference statements)

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“…A previous study 44 reported that moderate-to-vigorous-intensity physical activity increases with reducing sedentary behaviour, which is similar to the results in this study. However, given the low moderate-to-vigorous-intensity physical activity in patients with minor ischaemic stroke, 45 it may be difficult to continue increasing moderate-to-vigorous-intensity physical activity until after follow-up. Sedentary behaviour and light-intensity physical activity are highly correlated 46 and it has also been reported that reducing sedentary behaviour increases light-intensity physical activity.…”

Section: Discussionmentioning

confidence: 99%

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

et al. 2022

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Objectives To determine the effects on sedentary behaviour of an approach that promotes reduction in sedentary behaviour in patients with minor ischaemic stroke after intervention and at follow-up. Design A randomised controlled trial. Setting During hospitalisation and after hospital discharge Subjects In total, 86 patients with minor ischaemic stroke admitted to an acute care hospital were assigned to the intervention (n = 43) and control (n = 43) groups. Intervention An intervention group that received an approach to reduce sedentary behaviour upon hospital admission until 3 months after discharge (education, self-monitoring, phone calls, etc.) and a control group that received the usual care during hospitalisation. From 3 to 6 months after discharge, no group received any intervention. Main Outcome The primary outcome was the change (%) in sedentary behaviour from baseline to post-intervention (3 months after discharge) and follow-up (6 months after discharge). Sedentary behaviour was measured at baseline (upon hospital admission), post-intervention, and at follow-up using accelerometers. Results At the post-intervention stage, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, −22.7%; control group, −14.9%; P = 0.013; effect size = 0.58). At follow-up too, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, −20.4%; control group, −13.6%; P = 0.025; effect size = 0.54). Conclusions An approach to reduce sedentary behaviour in patients with minor ischaemic stroke effectively reduces sedentary behaviour, which is sustained up to follow-up. Trial registration This study is registered at www.umin.ac.jp/ctr/index/htm UMIN000038616.

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Section: Discussionmentioning

confidence: 99%

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

et al. 2022

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“…The third context that was focused on in the review, are older adults' capabilities. In the context of limited physical (e.g., due to mobility impairments or pain) or mental capabilities (e.g., lack of energy, fatigue or fear of falling) older adults often experience a barrier to standing up for a longer period of time or performing physical activities 45,52,54,78,80,84,87,90,99 . In the study of Koltyn et al…”

Section: Under What Types Of Motivation Do Which Mechanisms Lead To C...mentioning

confidence: 99%

“…Second, next to motivation, older adults' capabilities play an important role in their SB. Physical and mental limitations are frequently mentioned barriers for older adults to stand up for a longer period 45,52,54,78,80,84,87,99 . A more appropriate strategy in this context would be to focus on interrupting SB instead of reducing it.…”

Section: Under What Types Of Motivation Do Which Mechanisms Lead To C...mentioning

confidence: 99%

Understanding for whom, under which circumstances and how sedentary behavior interventions for older adults work: A Realist Review

Van de Velde,

Cardon,

Chastin

et al. 2024

Preprint

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This realist review aims to identify the working mechanisms and contextual preconditions for sedentary behavior (SB) change in older adults to guide the development of future interventions. The review followed the iterative process of Pawson et al. (1997). First, research questions were defined and an initial program theory (IPT) was established. Second, evidence was searched in four scientific databases and the grey literature. Third, data from 58 studies (explained in 61 papers) that contained relevant information to refine, refute or confirm the IPT were coded. And based on these codes, context-mechanism-outcome configurations were made and a final program theory was developed. As a result, three contexts for SB change became clear: (1) motivation, (2) opportunities, and (3) capabilities of older adults. Depending on the context, other behavior change techniques should be used to trigger specific mechanisms and reduce SB. Especially, the impact of automatic processes of SB on the effectiveness of SB interventions became clear. Currently, the focus is primarily on the reflective processes guiding SB, without taking into account that SB is often an automatic response which makes SB an ingrained habit. It can be concluded that the effectiveness of SB interventions in older adults highly depends on the intervention context.

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“…This pilot study was also limited as it did not include a usual care control group and had a high dropout rate of 45% [ 25 ]. However, a powered RCT ( n = 43) in older adults with frailty did report a 30 ± 10 min/day reduction in sedentary time after a 16-week intervention consisting of home-based standing exercises, face-to-face health education, and telephone support [ 26 ]. Nevertheless, there was no change in the number of breaks in sedentary time, and standing time or physical activity were not reported so it is unclear what activities sedentary time was replaced with.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, there was no change in the number of breaks in sedentary time, and standing time or physical activity were not reported so it is unclear what activities sedentary time was replaced with. Furthermore, intervention effects on health and wellbeing outcomes were not evaluated [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

The Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention to improve sarcopenia and maintain independent living via reductions in prolonged sitting: a randomised controlled feasibility trial protocol

Bailey

Kilbride

Harper

et al. 2023

Pilot Feasibility Stud

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Background Sarcopenia is a progressive and generalised loss of muscle mass and function with advancing age and is a major contributor to frailty. These conditions lead to functional disability, loss of independence, and lower quality of life. Sedentary behaviour is adversely associated with sarcopenia and frailty. Reducing and breaking up sitting should thus be explored as an intervention target for their management. The primary aim of this study, therefore, is to examine the feasibility, safety, and acceptability of conducting a randomised controlled trial (RCT) that evaluates a remotely delivered intervention to improve sarcopenia and independent living via reducing and breaking up sitting in frail older adults. Methods This mixed-methods randomised controlled feasibility trial will recruit 60 community-dwelling older adults aged ≥ 65 years with very mild or mild frailty. After baseline measures, participants will be randomised to receive the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or serve as controls (usual care) for 6 months. Frail-LESS is a remotely delivered intervention comprising of tailored feedback on sitting, information on the health risks of excess sitting, supported goal setting and action planning, a wearable device that tracks inactive time and provides alerts to move, health coaching, and peer support. Feasibility will be assessed in terms of recruitment, retention and data completion rates. A process evaluation will assess intervention acceptability, safety, and fidelity of the trial. The following measures will be taken at baseline, 3 months, and 6 months: sitting, standing, and stepping using a thigh-worn activPAL4 device, sarcopenia (via hand grip strength, muscle mass, and physical function), mood, wellbeing, and quality of life. Discussion This study will determine the feasibility, safety, and acceptability of evaluating a remote intervention to reduce and break up sitting to support improvements in sarcopenia and independent living in frail older adults. A future definitive RCT to determine intervention effectiveness will be informed by the study findings. Trial registration ISRCTN, ISRCTN17158017; Registered 6 August 2021, https://www.isrctn.com/ISRCTN17158017

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A multidimensional program including standing exercises, health education, and telephone support to reduce sedentary behavior in frail older adults: Randomized clinical trial

Cited by 5 publications

References 35 publications

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

Understanding for whom, under which circumstances and how sedentary behavior interventions for older adults work: A Realist Review

The Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention to improve sarcopenia and maintain independent living via reductions in prolonged sitting: a randomised controlled feasibility trial protocol

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