Effects of a Long-Term Physical Activity Program on Activity Patterns in Older Adults.

Purpose: To examine the effect of a long-term structured physical activity intervention on accelerometer-derived metrics of activity pattern changes in mobility-impaired older adults. Methods: Participants were randomized to either a physical activity (PA) or health education (HE) program. The PA intervention included a walking regimen with strength, flexibility, and balance training. The HE program featured health-related discussions and a brief upper body stretching routine. Participants (n = 1,341) wore a hip-worn accelerometer for >=10 h/day for >=3 days at baseline and again at 6, 12 and 24 months post-randomization. Total physical activity (TPA)-defined as movements registering 100+ counts/min-was segmented into the following intensities: low light (LLPA; 100-759 counts/min), high light (HLPA; 760-1,040 counts/min), low moderate (LMPA; 1,041-2,019 counts/min), and high moderate and greater (HMPA; 2,020+ counts/min) physical activity. Patterns of activity were characterized as bouts (defined as the consecutive minutes within an intensity). Results: Across groups, TPA decreased an average of 74 minutes/week annually. The PA intervention attenuated this effect (PA= -68 vs. HE: -112 minutes/week, p=0.002). This attenuation shifted TPA composition by increasing time in LLPA (10+ bouts increased 6 min/week), HLPA (1+, 2+, 5+, and 10+ bouts increased 6, 3, 2, and 1 min/week, respectively), LMPA (1+, 2+, 5+, and 10+ bouts increased: 19, 17,16, and 8 min/week, respectively), and HMPA (1+, 2+, 5+, and 10+ bouts increased 23, 21, 17, and 14 min/week, respectively). Conclusion: The PA intervention increased physical activity by shifting the composition of activity toward higher intensity activity in longer duration bouts. However, a long-term structured physical activity intervention did not completely eliminate overall declines in total daily activity experienced by mobility-impaired older adults. (C) 2017 American College of Sports Medicine

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