title: Counseling for home-based walking and strength exercise in older primary care patients.
abstract: BACKGROUND
  We evaluated the effects of counseling linked with primary care visits on walking and "strength exercise" (the combination of strength-building and flexibility exercise) in aging veterans.
  
  
  METHODS
  Male veterans aged 60 to 85 years (N = 224) with physical function limitations were randomized to either counseling for home-based walking and strength exercise (EXC) or discussion of their choice of health education topics (EDUC) with a nurse at baseline, 1 month, and 5 months. The EXC participants recorded exercise on monthly calendars and received brief follow-up calls from the nurse; all participants received bimonthly newsletters throughout the 10-month trial.
  
  
  RESULTS
  Retention was 83% in the EXC group and 97% in the EDUC group (P < .001). With analyses using the last observation carried forward approach, the EXC participants reported more walking time per week at 5 and 10 months (64.5 and 60.6 min/wk, respectively, for the EXC group vs 50.5 and 45.7 min/wk, respectively, for the EDUC group; 2.4 d/wk and 2.3 d/wk, respectively, for the EXC group vs 1.8 and 1.7 d/wk, respectively, for the EDUC group) (P < .001). The EXC participants also reported more strength exercise at 5 and 10 months (44.6 and 41.2 min/wk, respectively, for the EXC group vs 19.8 and 14.7 min/wk, respectively, for the EDUC group; 2.1 and 2.0 d/wk, respectively, for the EXC group vs 0.8 and 0.8 d/wk, respectively, for the EDUC group) (P < .001). The EXC participants reported more frequent moderate- or higher-intensity physical activity (7.1 vs 5.1 sessions/wk) (P < .001). Findings from accelerometer-measured physical activity indicated more EXC than EDUC participants (64% vs 46%), who averaged 30 min/d or more of moderate- or higher-intensity physical activity (P = .03). Participants engaging in strength exercise improved physical performance and reported positive changes in quality of life.
  
  
  CONCLUSIONS
  Relatively brief counseling linked with primary care visits can increase home-based walking and strength exercise in aging male veterans.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00013195.
authors.affiliation: G. V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS 39216, USA. patricia.dubbert@med.va.gov
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dubbert
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
authors.forename: Kent A
authors.initials: KA
authors.lastname: Kirchner
authors.forename: Edward F
authors.initials: EF
authors.lastname: Meydrech
authors.forename: Karen
authors.initials: K
authors.lastname: Grothe
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D015444:Exercise; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011320:Primary Health Care; D011446:Prospective Studies; D014481:United States; D014728:Veterans; D016138:Walking