Abstract
Lifestyle-integrated exercise is a promising approach to increase adherence levels of older adults compared to structured exercise programs as it saves time and effort and supports older adults in preventing falls and functional decline. The Lifestyle-integrated Functional Exercise (LiFE) program embodies this approach by integrating physical activity, balance, and strength activities into daily tasks of community-dwelling older adults aged 70+. A randomized controlled trial shows strong effectiveness of the original, resource-intensive one-on-one format of the LiFE program in terms of reducing falls, improving motor performance, and increasing physical activity. The positive effects of the original LiFE program have yet stimulated adaptions to group-based and information and communications technology-based formats, to younger seniors, for multicomponent interventions, and to populations with disabilities which resulted in 16 known studies about LiFE modifications. Evidence for the effectiveness of specific LiFE modifications exists for four programs, while seven adaptions are in the feasibility stage and one is still in the early development phase. A decade of existing LiFE research is summarized in this narrative review that, to the best of our knowledge, does not exist until now. The aim of this article is (1) to provide an overview of the number of LiFE modifications and their specifications, (2) to describe the current evidence regarding feasibility and effectiveness, and (3) to present challenges and potential of the different LiFE modifications. All adaptions of the LiFE program embody the benefits of the lifestyle-integrated approach and enable an enhancement of the successful LiFE concept.
Highlights
Falls and fall-related injuries are one main challenge for healthy aging given that 20–30% of older adults (≥ 65 years) who fall experience moderate to severe injuries and prevalence increases with age (WHO, 2021)
Lifestyle-integrated Functional Exercise (LiFE) incorporates a safe and feasible homebased exercise program with individual tailoring and evaluation of daily routines and individuals’ capacities that reduces fall rates; no adverse events were reported (Clemson et al, 2010); with regards to long-term effects, a significant reduction of 31% in the rate of falls was demonstrated for the LiFE program compared with controls (Clemson et al, 2012); LiFE should be a focus for fall prevention in older people
Recruitment was successful, 77% attended more than 5 sessions and 67% participate in the 6-month follow-up; no significant changes in physical activity (PA) and SPPB could observed; self-reported balance and strength improved significantly as well as selfhealth-related quality of life (Gibbs et al, 2019)
Summary
Falls and fall-related injuries are one main challenge for healthy aging given that 20–30% of older adults (≥ 65 years) who fall experience moderate to severe injuries and prevalence increases with age (WHO, 2021). Current interventions are typically grounded on standardized and structured exercises which do not achieve sustainable changes and long-term adherence levels (Bauman, Merom, Bull, Buchner, & Singh, 2016). Such exercises carried out in addition to routine tasks showed effects in the short term but failed to induce long-term behavioral changes. For many older adults, structured exercise is not appealing (Costello, Kafchinski, Vrazel, & Sullivan, 2011) and everyday activities such as gardening seem to be more suitable for being physically active in this target group (Burton, Lewin, Clemson, & Boldy, 2013)
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