TY - JOUR
T1 - Dose of physical activity, physical functioning and disability risk in mobility-limited older adults
T2 - Results from the LIFE study randomized trial
AU - LIFE Study Group
AU - Fielding, Roger A.
AU - Guralnik, Jack M.
AU - King, Abby C.
AU - Pahor, Marco
AU - McDermott, Mary M.
AU - Tudor-Locke, Catrine
AU - Manini, Todd M.
AU - Glynn, Nancy W.
AU - Marsh, Anthony P.
AU - Axtell, Robert S.
AU - Hsu, Fang Chi
AU - Rejeski, W. Jack
N1 - Funding Information:
The Lifestyle Interventions and Independence for Elders Study is funded by a National Institutes of Health/National Institute on Aging Cooperative Agreement #UO1 AG22376 and a supplement from the National Heart, Lung and Blood Institute 3U01AG022376-05A2S, and sponsored in part by the Intramural Research Program, National Institute on Aging, NIH. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1 P30 AG028740), Wake Forest University (1 P30 AG21332), Tufts University (1P30AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30AG021342) and the NIH/NCRR CTSA at Stanford University (UL1 RR025744). Tufts University is also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688-01A1). Dr. Roger Fielding (Tufts University) is partially supported by the U.S. Department of Agriculture, under agreement No. 58-1950-4-003. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the U.S. Dept. of Agriculture. The LIFE Study Group Includes the Following (lead author: Marco Pahor, mpahor@ufl. edu): Administrative Coordinating Center, University of Florida, Gainesville, FL Marco Pahor, MD–Principal Investigator of the LIFE Study Jack M. Guralnik, MD, PhD–Co-Investigator of the LIFE Study (University of Maryland School of Medicine, Baltimore, MD) Christiaan Leeuwenburgh, PhD Connie Caudle Lauren Crump, MPH Latonia Holmes Jocelyn Lee, PhD Ching-ju Lu, MPH Data Management, Analysis and Quality Control Center, Wake Forest University, Winston Salem, NC Michael E. Miller, PhD–DMAQC Principal Investigator Mark A. Espeland, PhD–DMAQC Co-Investigator Walter T. Ambrosius, PhD William Applegate, MD Daniel P. Beavers, PhD, MS Robert P. Byington, PhD, MPH, FAHA Delilah Cook, CCRP Curt D. Furberg, MD, PhD Lea N. Harvin, BS Leora Henkin, MPH, Med John Hepler, MA Fang-Chi Hsu, PhD Laura Lovato, MS Wesley Roberson, BSBA Julia Rushing, BSPH, MStat Scott Rushing, BS Cynthia L. Stowe, MPM Michael P. Walkup, MS Don Hire, BS W. Jack Rejeski, PhD Jeffrey A. Katula, PhD, MA Peter H. Brubaker, PhD Shannon L. Mihalko, PhD Janine M. Jennings, PhD Shyh-Huei Chen, PhD June J. Pierce, AB National Institutes of Health, Bethesda, MD Evan C. Hadley, MD (National Institute on Aging) Sergei Romashkan, MD, PhD (National Institute on Aging) Kushang V. Patel, PhD (National Institute on Aging) National Heart, Lung and Blood Institute, Bethesda, MD Denise Bonds, MD, MPH Field Centers Northwestern University, Chicago, IL Mary M. McDermott, MD–Field Center Principal Investigator Bonnie Spring, PhD–Field Center Co-Investigator Joshua Hauser, MD–Field Center Co-Investigator Diana Kerwin, MD–Field Center Co-Investigator Kathryn Domanchuk, BS Rex Graff, MS Alvito Rego, MA Pennington Biomedical Research Center, Baton Rouge, LA Timothy S. Church, MD, PhD, MPH–Field Center Principal Investigator Steven N. Blair, PED (University of South Carolina) Valerie H. Myers, PhD Ron Monce, PA-C Nathan E. Britt, NP Melissa Nauta Harris, BS Ami Parks McGucken, MPA, BS Ruben Rodarte, MBA, MS, BS Heidi K. Millet, MPA, BS Catrine Tudor-Locke, PhD, FACSM Ben P. Butitta, BS Sheletta G. Donatto, MS, RD, LDN, CDE Shannon H. Cocreham, BS Stanford University, Palo Alto, CA Abby C. King, PhD–Field Center Principal Investigator Cynthia M. Castro, PhD William L. Haskell, PhD Randall S. Stafford, MD, PhD Leslie A. Pruitt, PhD Kathy Berra, MSN, NP-C, FAAN Veronica Yank, MD Tufts University, Boston, MA Roger A. Fielding, PhD–Field Center Principal Investigator Miriam E. Nelson, PhD–Field Center Co-Investigator Sara C. Folta, PhD–Field Center Co-Investigator Edward M. Phillips, MD Christine K. Liu, MD Erica C. McDavitt, MS Kieran F. Reid, PhD, MPH Dylan R. Kirn, BS Evan P. Pasha, BS Won S. Kim, BS Vince E. Beard, BS Eleni X. Tsiroyannis, BS Cynthia Hau, BS, MPH University of Florida, Gainesville, FL Todd M. Manini, PhD–Field Center Principal Investigator Marco Pahor, MD–Field Center Co-Investigator Stephen D. Anton, PhD Susan Nayfield, MD Thomas W. Buford, PhD Michael Marsiske, PhD Bhanuprasad D. Sandesara, MD Jeffrey D. Knaggs, BS Megan S. Lorow, BS William C. Marena, MT, CCRC Irina Korytov, MD Holly L. Morris, MSN, RN, CCRC (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Margo Fitch, PT (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Floris F. Singletary, MS, CCC-SLP (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Jackie Causer, BSH, RN (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Katie A. Radcliff, MA (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) University of Pittsburgh, Pittsburgh, PA Anne B. Newman, MD, MPH–Field Center Principal Investigator Stephanie A. Studenski, MD, MPH–Field Center Co-Investigator Bret H. Goodpaster, PhD Nancy W. Glynn, PhD Oscar Lopez, MD Neelesh K. Nadkarni, MD, PhD Kathy Williams, RN, BSEd, MHSA Mark A. Newman, PhD George Grove, MS Janet T. Bonk, MPH, RN Jennifer Rush, MPH Piera Kost, BA (deceased) Diane G. Ives, MPH Wake Forest University, Winston Salem, NC Stephen B. Kritchevsky, Ph.D.–Field Center Principal Investigator Anthony P. Marsh, PhD–Field Center Co-Investigator Tina E. Brinkley, PhD Jamehl S. Demons, MD Kaycee M. Sink, MD, MAS Kimberly Kennedy, BA, CCRC Rachel Shertzer-Skinner, MA, CCRC Abbie Wrights, MS Rose Fries, RN, CCRC Deborah Barr, MA, RHEd, CHES Yale University, New Haven, CT Thomas M. Gill, MD–Field Center Principal Investigator Robert S. Axtell, PhD, FACSM–Field Center Co-Investigator (Southern Connecticut State University, Exercise Science Department) Susan S. Kashaf, MD, MPH (VA Connecticut Healthcare System) Nathalie de Rekeneire, MD, MS Joanne M. McGloin, MDiv, MS, MBA Karen C. Wu, RN Denise M. Shepard, RN, MBA Barbara Fennelly, MA, RN Lynne P. Iannone, MS, CCRP Raeleen Mautner, PhD Theresa Sweeney Barnett, MS, APRN Sean N. Halpin, MA Matthew J. Brennan, MA Julie A. Bugaj, MS Maria A. Zenoni, MS Bridget M. Mignosa, AS Cognition Coordinating Center, Wake Forest University, Winston Salem, NC Jeff Williamson, MD, MHS–Center Principal Investigator Kaycee M Sink, MD, MAS–Center Co-Investigator Hugh C. Hendrie, MB, ChB, DSc (Indiana University) Stephen R. Rapp, PhD Joe Verghese, MB, BS (Albert Einstein College of Medicine of Yeshiva University) Nancy Woolard Mark Espeland, PhD Janine Jennings, PhD Valerie K. Wilson, MD Electrocardiogram Reading Center, University of Florida, Gainesville, FL Carl J. Pepine MD, MACC Mario Ariet, PhD Eileen Handberg, PhD, ARNP Daniel Deluca, BS James Hill, MD, MS, FACC Anita Szady, MD Spirometry Reading Center, Yale University, New Haven, CT Geoffrey L. Chupp, MD Gail M. Flynn, RCP, CRFT Thomas M. Gill, MD John L. Hankinson, PhD (Hankinson Consulting, Inc.) Carlos A. Vaz Fragoso, MD Cost Effectiveness Analysis Center Erik J. Groessl, PhD (University of California, San Diego and VA San Diego Healthcare System) Robert M. Kaplan, PhD (Office of Behavioral and Social Sciences Research, National Institutes of Health)
Publisher Copyright:
© 2017 Fielding et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/8
Y1 - 2017/8
N2 - Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70–89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10–0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes. Trial registration: ClinicalsTrials.gov NCT00116194.
AB - Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70–89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10–0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes. Trial registration: ClinicalsTrials.gov NCT00116194.
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U2 - 10.1371/journal.pone.0182155
DO - 10.1371/journal.pone.0182155
M3 - Article
C2 - 28820909
AN - SCOPUS:85027854597
SN - 1932-6203
VL - 12
JO - PloS one
JF - PloS one
IS - 8
M1 - e0182155
ER -
