Promoting physical activity for elders with compromised function: the Lifestyle Interventions and Independence for Elders (LIFE) Study physical activity intervention

W Jack Rejeski,¹ Robert Axtell,² Roger Fielding,³ Jeffrey Katula,¹ Abby C King,⁴ Todd M Manini,⁵ Anthony P Marsh,¹ Marco Pahor,⁵ Alvito Rego,⁶ Catrine Tudor-Locke,⁷ Mark Newman,⁸ Michael P Walkup,⁹ Michael E Miller⁹ 

On behalf of the LIFE Study Investigator Group

¹Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, ²Exercise Science Department, Southern Connecticut State University, New Haven, CT, ³Nutrtion, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, ⁴Department of Health Research and Policy and Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, ⁵Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, ⁶Department of Internal Medicine, Northwestern School of Medicine, Chicago, IL, ⁷Pennington Biomedical Research Center, Baton Rouge, LA, ⁸Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, ⁹Department of Biostatistical Sciences, Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC, USA

Abstract: The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase III randomized controlled clinical trial (Clinicaltrials.gov identifier: NCT01072500) that will provide definitive evidence regarding the effect of physical activity (PA) on major mobility disability in older adults (70–89 years old) who have compromised physical function. This paper describes the methods employed in the delivery of the LIFE Study PA intervention, providing insight into how we promoted adherence and monitored the fidelity of treatment. Data are presented on participants' motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training. Prior to the onset of training, 31.4% of participants noted slight conflict with being able to meet the demands of the program and 6.4% indicated that the degree of conflict would be moderate. Accelerometry data collected during PA training revealed that the average intensity – 1,555 counts/minute for men and 1,237 counts/minute for women – was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults. Also, a sizable subgroup required one or more rest stops. These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function. Moreover, the concept of what constitutes "moderate" exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription.

Keywords: aging, accelerometry, physical disability, compromised physical function, older adults