Longitudinal comparison of a physiotherapist-led, home-based and group-based program for increasing physical activity in community-dwelling middle-aged adults
Nicole Freene A D , Gordon Waddington B , Rachel Davey C and Tom Cochrane CA Faculty of Health, University of Canberra, ACT 2601, Australia.
B Physiotherapy, Faculty of Health, University of Canberra, ACT 2601, Australia.
C Centre for Research and Action in Public Health, Faculty of Health, University of Canberra, ACT 2601, Australia.
D Corresponding author. Email: u3033443@uni.canberra.edu.au
Australian Journal of Primary Health 21(2) 189-196 https://doi.org/10.1071/PY13114
Submitted: 15 August 2013 Accepted: 30 October 2013 Published: 21 November 2013
Abstract
Few studies have compared the longer-term effects of physical activity interventions. Here we compare a 6-month physiotherapist-led, home-based physical activity program to a community group exercise program over 2 years. Healthy, sedentary community-dwelling 50–65 year olds were recruited to a non-randomised community group exercise program (G, n = 93) or a physiotherapist-led, home-based physical activity program (HB, n = 65). Outcomes included ‘sufficient’ physical activity (Active Australia Survey), minutes of moderate-vigorous physical activity (ActiGraph GT1M), aerobic capacity (2-min step-test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Outcome measures were collected at baseline, 6, 12, 18 and 24 months. Using intention-to-treat analysis, both interventions resulted in significant and sustainable increases in the number of participants achieving ‘sufficient’ physical activity (HB 22 v. 41%, G 22 v. 47%, P ≤ 0.001) and decreases in waist circumference (HB 90 v. 89 cm, G 93 v. 91 cm, P < 0.001) over 2 years. The home-based program was less costly (HB A$47 v. G $84 per participant) but less effective in achieving the benefits at 2 years. The physiotherapist-led, home-based physical activity program may be a low-cost alternative to increase physical activity levels for those not interested in, or unable to attend, a group exercise program.
This study has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), Clinical Trial Registration number ACTRN12611000890932.
Additional keywords: adherence, cost evaluation, exercise.
References
ActiGraph (2011) ActiLife 5 – user’s manual. (ActiGraph: Pensacole, FL). Available at http://dl.theactigraph.com/ActiLife5-PUB10DOC10-H.pdf [Verified 16 May 2013]Ashworth NL, Chad KE, Harrison EL, Reeder BA, Marshall SC (2005) Home versus center based physical activity programs in older adults. Cochrane Database Of Systematic Reviews 1, CD004017
Australian Bureau of Statistics (2008) Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia – data only 2006 (cat. no. 2033.0.55.001). (Australian Bureau of Statistics: Canberra) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/2033.0.55.001Main+Features12006?OpenDocument [Verified 16 May 2013]
Australian Institute of Health and Welfare (2003). The Active Australia Survey: a guide and manual for implementation, analysis and reporting. (Australian Institute of Health and Welfare: Canberra) Available at http://www.aihw.gov.au/publication-detail/?id=6442467449 [Verified 20 October 2013]
Cadilhac DA, Cumming TB, Sheppard L, Pearce DC, Carter R, Magnus A (2011) The economic benefits of reducing physical inactivity: an Australian example. The International Journal of Behavioral Nutrition and Physical Activity 8, 99
| The economic benefits of reducing physical inactivity: an Australian example.Crossref | GoogleScholarGoogle Scholar | 21943093PubMed |
Cobiac LJ, Vos T, Barendregt JJ (2009) Cost-effectiveness of interventions to promote physical activity: a modelling study. PLoS Medicine 6, e1000110
| Cost-effectiveness of interventions to promote physical activity: a modelling study.Crossref | GoogleScholarGoogle Scholar | 19597537PubMed |
Cox KL, Burke V, Gorely TJ, Beilin LJ, Puddey IB (2003) Controlled comparison of retention and adherence in home- vs center-initiated exercise interventions in women ages 40–65 years: the S.W.E.A.T. study (Sedentary Women Exercise Adherence Trial). Preventive Medicine 36, 17–29.
| Controlled comparison of retention and adherence in home- vs center-initiated exercise interventions in women ages 40–65 years: the S.W.E.A.T. study (Sedentary Women Exercise Adherence Trial).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38jhtF2isw%3D%3D&md5=73113b6c67505558c1a4bcabafb9cdfaCAS | 12473421PubMed |
Dhaliwal SS, Welborn TA (2009) Measurement error and ethnic comparisons of measures of abdominal obesity. Preventive Medicine 49, 148–152.
| Measurement error and ethnic comparisons of measures of abdominal obesity.Crossref | GoogleScholarGoogle Scholar | 19589354PubMed |
Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl III HW, Blair SN (1999) Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. Journal of the American Medical Association 281, 327–334.
| Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7is1Wltw%3D%3D&md5=85876196e330a8dc54e6abdea85578a0CAS | 9929085PubMed |
Efron B, Tibshirani R (1993) ‘An introduction to the bootstrap.’ (Chapman and Hall: London)
Elley CR, Garrett S, Rose SB, O’Dea D, Lawton BA, Moyes SA, Dowell AC (2010) Cost-effectiveness of exercise on prescription with telephone support among women in general practice over 2 years. British Journal of Sports Medicine 45, 1223–1229.
| Cost-effectiveness of exercise on prescription with telephone support among women in general practice over 2 years.Crossref | GoogleScholarGoogle Scholar | 21081641PubMed |
Freene N, Waddington G, Chesworth W, Davey R, Goss J (2011) ‘Physical activity at home (PAAH)’, evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design. BMC Public Health 11, 883
| ‘Physical activity at home (PAAH)’, evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.Crossref | GoogleScholarGoogle Scholar | 22112211PubMed |
Freene N, Waddington G, Chesworth W, Davey R, Cochrane T (2013) Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: quasi-experimental comparison. Open Journal of Preventive Medicine 3, 229–237.
| Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: quasi-experimental comparison.Crossref | GoogleScholarGoogle Scholar |
King AC, Haskell WL, Young DR, Oka RK, Stefanick ML (1995) Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Circulation 91, 2596–2604.
| Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK2MXms12nsr4%3D&md5=d89aec124d3a12b66e95aac746dfd9b0CAS | 7743622PubMed |
Opdenacker J, Boen F, Coorevits N, Delecluse C (2008) Effectiveness of a lifestyle intervention and a structured exercise intervention in older adults. Preventive Medicine 46, 518–524.
| Effectiveness of a lifestyle intervention and a structured exercise intervention in older adults.Crossref | GoogleScholarGoogle Scholar | 18405960PubMed |
Opdenacker J, Delecluse C, Boen F (2011) A 2-year follow-up of a lifestyle physical activity versus a structured exercise intervention in older adults. Journal of the American Geriatrics Society 59, 1602–1611.
| A 2-year follow-up of a lifestyle physical activity versus a structured exercise intervention in older adults.Crossref | GoogleScholarGoogle Scholar | 21883103PubMed |
Rikli RE, Jones CJ (1999) Development and validation of a functional fitness test for community-residing older adults. Journal of Aging and Physical Activity 7, 129–161.
Sevick MA, Dunn AL, Morrow MS, Marcus BH, Chen GJ, Blair SN (2000) Cost-effectiveness of lifestyle and structured exercise interventions in sedentary adults: results of Project ACTIVE. American Journal of Preventive Medicine 19, 1–8.
| Cost-effectiveness of lifestyle and structured exercise interventions in sedentary adults: results of Project ACTIVE.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3czptFSitw%3D%3D&md5=4edfca1c576f20e196d1ce0fe27762d2CAS | 10865157PubMed |
Warburton DER, Nicol CW, Bredin SSD (2006) Health benefits of physical activity: the evidence. CMAJ 174, 801–809.
| Health benefits of physical activity: the evidence.Crossref | GoogleScholarGoogle Scholar |
Ware J, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care 34, 220–233.
| A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.Crossref | GoogleScholarGoogle Scholar | 8628042PubMed |
Wilcox S, Dowda M, Wegley S, Ory MG (2009) Maintenance of change in the Active-for-Life initiative. American Journal of Preventive Medicine 37, 501–504.
| Maintenance of change in the Active-for-Life initiative.Crossref | GoogleScholarGoogle Scholar | 19944915PubMed |
World Health Organization (2004) Global strategy on diet, physical activity and health. (World Health Organization: Geneva) Available at http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf [Verified 16 May 2013]
Wu S, Cohen D, Shi Y, Pearson M, Sturm R (2011) Economic analysis of physical activity interventions. American Journal of Preventive Medicine 40, 149–158.
| Economic analysis of physical activity interventions.Crossref | GoogleScholarGoogle Scholar | 21238863PubMed |
