Effect of physical activity counseling on disability in older people: a 2-year randomized controlled trial.
OBJECTIVE
To study the effect of a physical activity counseling intervention on instrumental activity of daily living (IADL) disability.


METHODS
Primary care-based, single-blind, randomized controlled trial.


METHODS
City of Jyväskylä, central Finland.


METHODS
Six hundred thirty-two people aged 75 to 81 who were able to walk 500 meters without assistance, were at most moderately physically active, had a Mini-Mental State Examination score greater than 21, had no medical contraindications for physical activity, and gave informed consent for participation.


METHODS
A single individualized physical activity counseling session with supportive phone calls from a physiotherapist every 4 months for 2 years and annual lectures on physical activity. Control group received no intervention.


METHODS
The outcome was IADL disability defined as having difficulties in or inability to perform IADL tasks. Analyses were carried out according to baseline IADL disability, mobility limitation, and cognitive status.


RESULTS
At the end of the follow-up, IADL disability had increased in both groups (P<.001) and was lower in the intervention group, but the group-by-time interaction effect did not reach statistical significance. Subgroup analyses revealed that the intervention prevented incident disability in subjects without disability at baseline (risk ratio=0.68, 95% confidence interval=0.47-0.97) but had no effect on recovery from disability.


CONCLUSIONS
The physical activity counseling intervention had no effect on older sedentary community-dwelling persons with a wide range of IADL disability, although it prevented incident IADL disability. The results warrant further investigation to explore the benefits of a primary care-based physical activity counseling program on decreasing and postponing IADL disability.
von Bonsdorff
Mikaela B
MB
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. mikaela.bonsdorff@sport.jyu.fi
Leinonen
Raija
R
Kujala
Urho M
UM
Heikkinen
Eino
E
Törmäkangas
Timo
T
Hirvensalo
Mirja
M
Rasinaho
Minna
M
Karhula
Sirkka
S
Mänty
Minna
M
Rantanen
Taina
T
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D037001:Directive Counseling; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D016037:Single-Blind Method; D013997:Time Factors