Iliffe S, Kendrick D, Morris R, Griffin M, Haworth D, Carpenter H, Masud T, Skelton DA, Dinan-Young S, Bowling A, Gage H. Promoting physical activity in older people in general practice: ProAct65+ cluster randomised controlled trial.
Br J Gen Pract 2015;
65:e731-8. [PMID:
26500320 PMCID:
PMC4617267 DOI:
10.3399/bjgp15x687361]
[Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 06/05/2015] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND
Regular physical activity reduces falls, hip fractures, and all-cause mortality, but physical activity levels are low in older age groups.
AIM
To evaluate two exercise programmes promoting physical activity among older people.
DESIGN AND SETTING
Pragmatic three-arm, parallel-design cluster randomised controlled trial involving 1256 people aged ≥65 years (of 20 507 invited) recruited from 43 general practices in London, Nottingham, and Derby.
METHOD
Practices were randomised to the class-based Falls Management Exercise programme (FaME), the home-based Otago Exercise Program (OEP), or usual care. The primary outcome was the proportion reaching the recommended physical activity target 12 months post-intervention. Secondary outcomes included falls, quality of life, balance confidence, and costs.
RESULTS
In total, 49% of FaME participants reached the physical activity target compared with 38% for usual care (adjusted odds ratio 1.78, 95% confidence interval [CI] =1.11 to 2.87, P = 0.02). Differences between FaME and usual care persisted 24 months after intervention. There was no significant difference comparing those in the OEP (43% reaching target at 12 months) and usual-care arms. Participants in the FaME arm added around 15 minutes of moderate-to-vigorous physical activity per day to their baseline level; this group also had a significantly lower rate of falls (incident rate ratio 0.74, 95% CI = 0.55 to 0.99, P = 0.042). Balance confidence was significantly improved in both intervention arms. The mean cost per extra person achieving the physical activity target was £1740. Attrition and rates of adverse reactions were similar.
CONCLUSION
The FaME programme increases self-reported physical activity for at least 12 months post-intervention and reduces falls in people aged ≥65 years, but uptake is low. There was no statistically significant difference in reaching the target, or in falls, between the OEP and usual-care arms.
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