Home-based Physical Activity Intervention Research Articles

A 12-week Home-based Physical Activity Intervention in Early Stage Breast CancerSurvivors

1989 PURPOSE. To evaluate the feasibility of a home-based walking intervention among early-stage breast cancer (BC) survivors and to describe the influence of the intervention on physical activity (PA), body composition, fatigue, and quality of life (QOL) outcomes. METHODS. In this ongoing randomized 12-week pilot study, participants were randomized to a home-based walking intervention adapted from the Stanford model (n = 17), or a wait-list control group (n = 9). Intervention participants received a 30 minute in-person counseling visit and up to five telephone-counseling calls (mean = 4.1 calls, 15 min/call) that focused on goal setting, reinforcement, social support, problem solving, safety, and self monitoring. Outcome measures were selfreported PA (CHAMPS), body composition, and the SF-36. In a study sub-sample (n = 13), fatigue (FACT-F) and objective measures of PA (MTI Actigraph) were obtained. Repeated measures models were used to estimate treatment effects over time. RESULTS. To date, 24 of 26 (92%) women have been retained in the study (age 55 ± 12 years; BMI 29.3 ± 4.6, time since diagnosis 0.80 ± 0.18 yrs). Self-reported walking increased from baseline to 6- and 12-weeks in the intervention (4.5, 13.5, 16.9 MET-hrs/wk, p < 0.01 vs. baseline) but not control participants (4.5, 4.6, 6.6 METhrs/wk, p = 0.65 vs. baseline); group × time p = 0.16. Objectively measured walking increased from baseline to 6- and 12-weeks in the intervention (7.4, 11.1, 25.6 min/d, p < 0.01) but not control participants (8.1, 12.0, 15.5 min/d, p = 0.18). Increased walking resulted in greater total PA on both measures. In these preliminary analyses, fatigue decreased from baseline to 12-weeks in the intervention (10.3 to 8.1, p < 0.01) but not control participants (10.5 to 10.6, p = 0.89). No body composition or QOL changes were observed. No adverse events were reported. CONCLUSION. Home-based walking programs are feasible for early-stage BC survivors and they can facilitate increased walking that increases overall PA levels. They may also reduce fatigue. Such programs have the potential to assist women in combating the adverse emotional and physical outcomes associated with BC treatment. Funding: South Carolina Cancer Center; Vanderbilt-Ingram Cancer Center

A 12-week Home-based Physical Activity Intervention in Early Stage Breast CancerSurvivors

A 12-week Home-based Physical Activity Intervention in Early Stage Breast CancerSurvivors

Exercise training for African Americans with disabilities residing in difficult social environments

Objective To examine the feasibility, efficacy, and safety of a structured 12-week exercise training program for a predominantly African-American group of adults with multiple health conditions who reside in difficult social environments. Methods A total of 37 females and 7 males (mean age, 54.1 years) participated in an exercise training regimen 3 days per week for 60 minutes per day (cardiovascular, 30 minutes; strength, 20 minutes; and flexibility, 10 minutes). Outcome measures included peak VO 2 (mL min −1, mL kg −1 min −1); upper and lower body strength (strength); hand-grip strength (GS); body weight (BW); total skin folds (TS); waist-to-hip ratio (WHR); hamstring/low-back flexibility (HLBF); and shoulder flexibility (SF). Results Compared to the control group, the exercise group showed significant gains in peak VO 2 ( p < 0.01); strength ( p < 0.01); and body composition (TS, p < 0.01). There was no significant difference between the exercise and control groups on BW, WHR, HLBF, and GS. Of a total 1116 exercise sessions (31 experimental participants × 36 sessions), 87% of the sessions were attended. Conclusion A structured exercise-training program can provide substantial improvement in strength and cardiovascular fitness in low-income, sedentary adults with multiple chronic conditions and/or risk factors for chronic conditions. Future research should explore simple home-based and community-based physical activity interventions that provide ongoing support for increasing and maintaining physical activity participation in this cohort.

Effectiveness of physical activity interventions for older adults: a review

Objective: This review evaluates the effectiveness of physical activity interventions among older adults. Methods: Computerized searches were performed to identify randomized controlled trials. Studies were included if: (1) the study population consisted of older adults (average sample population age of ≥50 years and minimum age of 40 years); (2) the intervention consisted of an exercise program or was aimed at promoting physical activity; and (3) reported on participation (i.e., adherence/compliance) or changes in level of physical activity (e.g., pre-post test measures and group comparisons). Results: The 38 studies included 57 physical activity interventions. Three types of interventions were identified: home-based, group-based, and educational. In the short-term, both home-based interventions and group-based interventions achieved high rates of participation (means of 90% and 84%, respectively). Participation declined the longer the duration of the intervention. Participation in education interventions varied widely (range of 35% to 96%). Both group-based interventions and education interventions were effective in increasing physical activity levels in the short-term. Information on long-term effectiveness was either absent or showed no difference of physical activity level between the study groups. Conclusions: Home-based, group-based, and educational physical activity interventions can result in increased physical activity, but changes are small and short-lived. Participation rates of home-based and group-based interventions were comparable, and both seemed to be unrelated to type or frequency of physical activity. The beneficial effect of behavioral reinforcement strategies was not evident. Comparative studies evaluating the effectiveness of diverse interventions are needed to identify the interventions most likely to succeed in the initiation and maintenance of physical activity.