Feasibility of combining noninvasive brain stimulation and personalized counseling to increase physical activity

Abstract Few older adults meet recommended physical activity guidelines. Behavioral interventions may be more effective when combined with other modalities to promote activity. Transcranial direct current stimulation (tDCS) designed to increase the excitability of the left dorsolateral prefrontal cortex (dlPFC) — a brain region subserving motivation and executive function — has the potential to augment behavioral interventions. We designed a randomized, double-blinded trial to examine the feasibility of combining personalized behavioral counseling and tDCS targeting the left dlPFC to improve physical activity and related outcomes in sedentary older adults living within the supportive housing. Participants wore a Fit-Bit throughout the study period. Baseline step counts were determined for two weeks, then participants completed four bi-weekly personalized counseling sessions over eight weeks. They were also randomized to receive 10 sessions of tDCS or sham stimulation over the two weeks after the baseline. Physical, cognitive, and patient-reported outcomes were assessed at baseline, after ten brain stimulation sessions, and after four behavioral sessions. 33 individuals were screened and 16 enrolled (age=80±7, 13 females). 13 participants completed the study, including 100% of study assessments, 99±5% of brain stimulation sessions, and 98±7% of behavioral sessions. Fit-Bit adherence rate was 93±13%. Daily step counts were 3197±1480 at baseline and 4722±2553 over the last two weeks of the intervention. While the study is ongoing and blinded, these preliminary results indicate that it is feasible to conduct a controlled study of tDCS combined with personalized behavioral counseling to increase physical activity in sedentary older adults living within supportive housing.

Download Full-text

Every step counts: synthesising reviews associating objectively measured physical activity and sedentary behaviour with clinical outcomes in community-dwelling older adults

The Lancet Healthy Longevity ◽

10.1016/s2666-7568(21)00203-8 ◽

2021 ◽

Vol 2 (11) ◽

pp. e764-e772

Author(s):

Keenan A Ramsey ◽

Carel G M Meskers ◽

Andrea B Maier

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Behaviour ◽

Clinical Outcomes ◽

Community Dwelling ◽

Step Counts ◽

Objectively Measured ◽

Community Dwelling Older Adults ◽

Objectively Measured Physical Activity

Download Full-text

Objectively assessed physical activity patterns and physical function in community-dwelling older adults: a cross-sectional study in Taiwan

BMJ Open ◽

10.1136/bmjopen-2019-034645 ◽

2020 ◽

Vol 10 (8) ◽

pp. e034645

Author(s):

Ming-Chun Hsueh ◽

Ru Rutherford ◽

Chien-Chih Chou ◽

Jong-Hwan Park ◽

Hyun-Tae Park ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Function ◽

Older Women ◽

Handgrip Strength ◽

Older Men ◽

Daily Step ◽

Cross Sectional ◽

Step Counts ◽

Single Leg Stance

ObjectivesTo objectively assess light physical activity (PA), moderate-to-vigorous PA (MVPA), step counts and number of 10 min MVPA bouts and their association with physical function among older adults.DesignCross-sectional design.SettingUrban community setting in Taiwan.Participants127 Taiwanese older adults aged over 65 years (mean age=70.8±5.3 years; 72% women).Primary and secondary outcome measuresTriaxial accelerometers were used to measure PA variables for 10 hours/day for seven consecutive days. Then, five physical function components (handgrip strength, single-leg stance, 5-metre walk speed, timed up and go and sit-to-stand test) were measured. Multiple linear regressions were used to perform separate analyses for older men and women.ResultsFor older women, daily MVPA time (β: 0.39, 95% CI: 0.12, 0.64; p=0.004), daily step counts (β: 0.46, 95% CI: 0.12, 0.78; p=0.009) and number of 10 min MVPA bouts (β: 0.27, 95% CI: 0.001, 0.53; p=0.049) were positively associated with handgrip strength after adjusting for accelerometer wear time, sedentary time and other confounders. Furthermore, daily MVPA time was positively associated with a single-leg stance (β: 0.25, 95% CI: 0.02, 0.49; p=0.036) and higher daily step counts were associated with shorter walking speed performance (β: −0.31, 95% CI: −0.57, −0.001; p=0.049). None of the variables of the objectively assessed PA patterns was associated with physical function outcomes among older men due to their small sample size.ConclusionsDaily MVPA, MVPA bouts of at least 10 min and accumulated daily steps are important for improving physical function among older women. Future prospective research should establish causal associations between PA patterns and functional ability among older adults.

Download Full-text

Social Influence in Promoting Change Among Older Adults: Group-Mediated Cognitive Behavioral Interventions

Kinesiology Review ◽

10.1123/kr.2015-0051 ◽

2016 ◽

Vol 5 (1) ◽

pp. 39-49 ◽

Cited By ~ 2

Author(s):

L.R. Brawley ◽

P.K. Flora ◽

S.R. Locke ◽

M.S.H. Gierc

Keyword(s):

Physical Activity ◽

Older Adults ◽

Social Influence ◽

Older Adult ◽

Behavioral Interventions ◽

Physical Activity Intervention ◽

Well Being ◽

Specific Model ◽

Cognitive Behavioral ◽

Basic Model

In this paper, we argue that the social influence of the group is a supportive medium for older adult thriving. To promote the physical well-being aspect of thriving, we discuss groups as one means of offering social support. We present a specific model of physical activity intervention (i.e., group-mediated cognitive behavioral intervention) that uses deliberately-formed interactive groups to help motivate older adults to engage in and sustain physical activity. Our article includes four sections that concern the GMCB intervention model. The first serves as background as to why groups can be powerful behavior change agents and describes the basic model of group motivated intervention. The second section provides a generic description of the intervention structure and how the GMCB intervention is conducted. The third section presents a meta-analytic summary of results of older adult GMCB physical activity interventions across three levels of outcomes: adherence to physical activity, functional and physiological, and social cognitive. The fourth section concludes with commentary about the translational perspective for the GMCB in the future.

Download Full-text

LONELINESS AND PHYSICAL ACTIVITY IN OLDER AGE: RESULTS OF THE RANDOMISED CONTROLLED STUDY OF PHYSICAL ACTIVITY INTERVENTION FOR LONELINESS (PAIL) IN COMMUNITY-DWELLING OLDER ADULTS

SCIENCE AND SPORT: current trends ◽

10.36028/2308-8826-2020-8-4-99-107 ◽

2020 ◽

Vol 8 (4) ◽

pp. 99-107

Author(s):

Anastasia Shvedko

Keyword(s):

Physical Activity ◽

Older Adults ◽

At Risk ◽

Physical Activity Intervention ◽

Retention Rate ◽

Community Dwelling ◽

Feasibility Trial ◽

Controlled Study ◽

Study Objective ◽

Community Dwelling Older Adults

Study objective. The aim of this study was to examine the feasibility of a Physical Activity Intervention for Loneliness (PAIL) in community-dwelling older adults at risk of loneliness. Methods. Study design was a 12-week randomized controlled feasibility trial (RCT). Participants were 25 (mean age 68.5(8.05) years, range 60-92) healthy, inactive, community-dwelling older adults at risk for loneliness. The intervention consisted of group outdoor walking sessions with health education workshops once weekly, with a wait-list control condition. Estimation of recruitment, retention and adherence were feasibility outcomes. Body mass index, blood pressure, physical activity, and psychosocial variables were secondary outcomes. Results. Forty-eight participants were recruited over 4 months with a recruitment rate of 52.1% (25/48); 52% (25/48) met the inclusion criteria and 100% (25/25) were randomized into the intervention (N=12) and wait-listed (WL) control groups (N=13). At 12 weeks, 10/12 (83.3%; 95% CI 55.20 to 95.30) intervention and 10/13 (76.9%; 95% CI 49.74 to 91.82) control participants completed final assessments. The average attendance rate was 69.2% for the intervention group (range 25% – 91.7%) and 55% (range 25% – 91.7%) among controls. The a priori recruitment criteria for progression was not met. The retention rate satisfied the criteria of the study. No serious adverse events occurred. Conclusions. Community-dwelling older adults at risk of loneliness can safely participate in physical activity intervention for loneliness. However, to progress into a large-scale RCT, the design and methodology would need to be changed.

Download Full-text

Self-Selected and Prescribed Intensity Exercise to Improve Physical Activity Among Inactive Retirees

Western Journal of Nursing Research ◽

10.1177/0193945918791647 ◽

2018 ◽

Vol 40 (9) ◽

pp. 1301-1318 ◽

Cited By ~ 1

Author(s):

Zhinan Yang ◽

Marcia A. Petrini

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Waist Circumference ◽

Negative Affect ◽

Controlled Study ◽

Daily Step ◽

Exercise Programs ◽

Exercise Interventions ◽

Step Counts

A randomized controlled study explored the effects of two intensity-oriented exercise interventions on affect to exercise and physical activity behavior. Inactive retirees finished the 12-week group-based exercise intervention and 3-month telephone follow-up with 27 in self-selected intensity group and 26 in prescribed intensity group. Repeated measures of daily step counts (measured by Yamax pedometers), positive and negative affect to exercise, weight, height, waist circumference, and blood pressure were done at baseline, postintervention, and 3-month follow-up. Increased daily step counts and positive affect, and reduced body mass index, waist circumference, blood pressure of both groups, and negative affect of self-selected intensity group were found at different measuring times. Although self-selected intensity group had no significantly different daily step counts from prescribed intensity group, the former had a more positive and less negative affect to exercise. Findings suggest that future exercise programs use self-selected intensity exercise programs to improve pleasure affect to exercise.

Download Full-text

Beneficial Influence of Mindfulness Training Promoted by Text Messages on Self-Reported Aerobic Physical Activity in Older Adults: A Randomized Controlled Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0002 ◽

2020 ◽

Vol 28 (3) ◽

pp. 406-414

Author(s):

Nicolas Robin ◽

Lucette Toussaint ◽

Stéphane Sinnapah ◽

Olivier Hue ◽

Guillaume R. Coudevylle

Keyword(s):

Physical Activity ◽

Older Adults ◽

Positive Impact ◽

Text Message ◽

Text Messages ◽

Mindfulness Training ◽

Controlled Study ◽

Control Group ◽

Physical And Mental Health ◽

Experimental Conditions

Inactivity is known to have harmful effects on the physical and mental health of older adults. This study used a randomized, parallel trial design to evaluate whether daily text prompts to practice mindfulness would have a positive impact on the time that adults aged 50 years or older spend in aerobic physical activity. The participants were recruited from a certified fitness center and divided into mindfulness and control groups. For 4 weeks, they were exposed to the experimental conditions, with or without the morning text message. In the morning message condition, the mindfulness groups received a text message with the instruction to practice audio-guided mindfulness for 10 min, and the control group received a placebo message. The participants practicing mindfulness reported significantly more weekly minutes of aerobic physical activity and higher intrinsic motivation than the control participants. Mindfulness training was effective at increasing aerobic physical activity duration and might complement physical activity programs.

Download Full-text

Within-Person Dynamics of Older Adults’ Physical Activity, Sedentary Behavior, and Sit-to-Stand Transitions

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2018-0024 ◽

2018 ◽

Vol 1 (4) ◽

pp. 159-164 ◽

Cited By ~ 1

Author(s):

Jaclyn P. Maher ◽

David E. Conroy

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Behavior ◽

Multilevel Modeling ◽

Daily Physical Activity ◽

Daily Step ◽

Step Counts ◽

Sit To Stand ◽

Naturally Occurring ◽

Standing Up

This study evaluated how older adults’ daily physical activity covaries with naturally occurring variation in both the duration and patterning of daily sedentary behavior. Older adults (n = 95) wore activPAL3 monitors for 15 consecutive days. Multilevel modeling regressed daily step counts on the frequency of sit-to-stand transitions and the duration of sedentary behavior. At the person-level, older adults who sat less (b = −14.31, p < .001) and stood up more frequently (b = 41.08, p = .01) took more steps on average. At the within-person level, older adults took more steps on days when they sat less than usual (b = −8.29, p < .001) and stood up more frequently than usual (b = 52.75, p < .001). Older adults’ daily physical activity may be influenced by interrupting sedentary behavior more frequently as well as reducing total sedentary behavior. It may be easier to monitor the frequency of discrete behaviors, like standing up, than it is to monitor the duration of continuous behaviors (e.g., walking, sitting).

Download Full-text

Effects of a Group-Based Behavioral Intervention on Dietary Behaviors in Older Adults

Journal of Aging and Health ◽

10.1177/0898264316668936 ◽

2016 ◽

Vol 30 (1) ◽

pp. 105-117 ◽

Cited By ~ 4

Author(s):

Rebecca A. Schlaff ◽

Meghan Baruth ◽

Valerie J. Adams ◽

Tatum M. Goldufsky ◽

Nathan A. Peters ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Repeated Measures ◽

Behavioral Interventions ◽

Physical Activity Intervention ◽

Low Cost ◽

Nutrition Intervention ◽

Dietary Behaviors ◽

Gender And Education ◽

Behavioral Nutrition

Objective: The aim of this study is to examine the effects of a 12-week, behavioral nutrition intervention on dietary behaviors. Method: Inactive older adults ( N = 50) were randomized to a 12-week, behavioral nutrition or physical activity intervention, delivered in a group-based format. Questionnaires assessed fruit and vegetable (FV) consumption, and fat- and fiber-related behaviors at baseline and postintervention. Height and weight were measured. Repeated-measures ANOVAs examined changes in dietary behaviors over time between groups, controlling for age, gender, and education. Results: Participants averaged 64.1 ± 8.4 years of age and had a body mass index (BMI) of 33.3 ± 7.5 kg/m2. Group × Time interactions were significant for FV consumption ( p = .003), and fat- ( p = .02) and fiber-related ( p = .008) behaviors at 12 weeks. At 12 weeks, dietary behaviors improved significantly in the nutrition but not in the physical activity group. Effect sizes were medium to large. Discussion: A 12-week, behavioral nutrition intervention improved dietary behaviors. Behavioral interventions may be a low-cost way to improve dietary behaviors among older adults, potentially affecting population health significantly.

Download Full-text

Measuring Physical Activity with Pedometers in Older Adults with Intellectual Disability: Reactivity and Number of Days

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-50.4.343 ◽

2012 ◽

Vol 50 (4) ◽

pp. 343-351 ◽

Cited By ~ 16

Author(s):

Thessa Hilgenkamp ◽

Ruud Van Wijck ◽

Heleen Evenhuis

Keyword(s):

Physical Activity ◽

Older Adults ◽

Intellectual Disability ◽

Repeated Measures ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Step Counts ◽

Severe Intellectual Disability ◽

Steps Per Day ◽

Minimum Number

Abstract The minimum number of days of pedometer monitoring needed to estimate valid average weekly step counts and reactivity was investigated for older adults with intellectual disability. Participants (N = 268) with borderline to severe intellectual disability ages 50 years and older were instructed to wear a pedometer for 14 days. The outcome measure was steps per day. Reactivity was investigated with repeated measures analysis of variance, and monitoring frame was assessed by comparing combinations of days with average weekly step counts (with intraclass correlation coefficients [ICCs] and regression analyses). No reactivity was present. Any combination of 4 days resulted in ICCs of 0.96 or higher and 90% of explained variance. The study concludes that any 4 days of wearing a pedometer is sufficient to validly measure physical activity in older adults with intellectual disability.

Download Full-text