title: Effect of Physical Activity versus Health Education on Physical Function, Grip Strength and Mobility.
abstract: BACKGROUND
  Physical activity (PA) reduces the rate of mobility disability, compared with health education (HE), in at risk older adults. It is important to understand aspects of performance contributing to this benefit.
  
  
  OBJECTIVE
  To evaluate intervention effects on tertiary physical performance outcomes.
  
  
  METHODS
  The Lifestyle Interventions and Independence for Elders (LIFE) was a multi-centered, single-blind randomized trial of older adults.
  
  
  METHODS
  Eight field centers throughout the United States.
  
  
  METHODS
  1635 adults aged 78.9 ± 5.2 years, 67.2% women at risk for mobility disability (Short Physical Performance Battery [SPPB] <10).
  
  
  METHODS
  Moderate PA including walking, resistance and balance training compared with HE consisting of topics relevant to older adults.
  
  
  RESULTS
  Grip strength, SPPB score and its components (balance, 4 m gait speed, and chair-stands), as well as 400 m walking speed.
  
  
  RESULTS
  Total SPPB score was higher in PA versus HE across all follow-up times (overall P = .04) as was the chair-stand component (overall P < .001). No intervention effects were observed for balance (overall P = .12), 4 m gait speed (overall P = .78), or grip strength (overall P = .62). However, 400 m walking speed was faster in PA versus HE group (overall P =<.001). In separate models, 29% of the rate reduction of major mobility disability in the PA versus HE group was explained by change in SPPB score, while 39% was explained by change in the chair stand component.
  
  
  CONCLUSIONS
  Lower extremity performance (SPPB) was significantly higher in the PA compared with HE group. Changes in chair-stand score explained a considerable portion of the effect of PA on the reduction of major mobility disability-consistent with the idea that preserving muscle strength/power may be important for the prevention of major mobility disability.
authors.affiliation: Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Santanasto
authors.affiliation: Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Nancy W
authors.initials: NW
authors.lastname: Glynn
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Lovato
authors.affiliation: Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
authors.affiliation: Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
authors.affiliation: Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Thomas M
authors.identifier: http://orcid.org/0000-0002-6450-0368
authors.initials: TM
authors.lastname: Gill
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Hsu
authors.affiliation: School of Medicine, Stanford University, Palo Alto, California.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
authors.affiliation: Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Elsa S
authors.initials: ES
authors.lastname: Strotmeyer
authors.affiliation: Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Manini
authors.affiliation: Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Marsh
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Mary M
authors.initials: MM
authors.lastname: McDermott
authors.affiliation: Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Sanford Burnham, Orlando, Florida.
authors.forename: Bret H
authors.initials: BH
authors.lastname: Goodpaster
authors.affiliation: Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida.
authors.forename: Marco
authors.initials: M
authors.lastname: Pahor
authors.affiliation: Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000368:Aged; D015444:Exercise / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006266:Health Education / Q000379:methods*; D006801:Humans; D008019:Life Style; D035002:Lower Extremity; D008297:Male; D051346:Mobility Limitation; D016037:Single-Blind Method; D014481:United States; D016138:Walking / Q000706:statistics & numerical data*
keywords: gait speed; physical activity; physical function; randomized clinical trial