1. A structured physical activity intervention, compared to health education, reduced the overall burden of major mobility disability (MMD) in older patients by 25%.
2. The structured physical activity program enhanced recovery after an MMD event and reduced risk for following MMD episodes.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Maintaining independent mobility has been shown to reduce rates of morbidity, mortality, and self-care disability among older persons. Recently, the Lifestyle Interventions and Independence for Elders (LIFE) study suggested that structured moderate-intensity physical activity programs are more effective than health education programs in reducing major mobility disability (MMD)—the inability to walk 400m. Disability is a dynamic process; therefore, it is possible for patients to recover from disability over time. The authors of this study aimed to evaluate the effectiveness of a long-term, structured physical activity program, compared to a health education program, on MMD burden and risk for transitions into and out of MMD. Generally, it was found that a structured physical activity program reduced the MMD burden over time, which was largely accomplished by enhancing recovery from MMD and reducing risk for subsequent MMD episodes. This study has several limitations. First, the intention-to-treat principle was maintained for MMD burden and first transition out of no MMD, but not for subsequent transitions. Second, as time assessments occurred every 6 months, some transitions to and from MMD recovery may not have been captured. Overall, this study suggests that regular exercise programs are effective at maintaining seniors’ mobility and independence.
Click to read the study in Annals of Internal Medicine
Relevant Reading: Effect of Structured Physical Activity on Prevention of Major Mobility Disability in Older Adults
In-Depth [randomized controlled trial]: In this randomized single-blinded control trial, sedentary patients aged 70 to 89 years old were randomly assigned to a physical activity or health education program. The physical activity group partook in a program that involved walking (around 150min/wk), strength, flexibility and balance training over the course of the study. In contrast, the health education group attended weekly workshops for the first 26 weeks of the study and monthly sessions afterwards. MMD was assessed every 6 months of this study for up to 3.5 years. The authors observed that proportion of patient assessments showing MMD was significantly lower in physical activity intervention patients (0.13 [95% CI, 0.11 to 0.15) compared to health education patients (0.17 [CI, 0.15 to 0.19]). Furthermore, the hazard ratio for comparing physical activity with health intervention for transition from MMD to no MMD was 1.33 (CI, 0.99 to 1.77).
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