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Effect of a coaching intervention to enhance physical activity and prevent falls in community-dwelling people aged 60+ years: a cluster randomised controlled trial

指导 干预(咨询) 老年学 星团(航天器) 医学 整群随机对照试验 物理疗法 体力活动 随机对照试验 物理医学与康复 心理学 精神科 计算机科学 内科学 程序设计语言 心理治疗师
作者
Juliana S Oliveira,Catherine Sherrington,Chris Rissel,Kirsten Howard,Allison Tong,Dafna Merom,James Wickham,Adrian Bauman,Stephen R. Lord,Richard I. Lindley,Judy M. Simpson,Margaret Allman‐Farinelli,Catherine Kirkham,Elisabeth Ramsay,Sandra O’Rourke,Anne Tiedemann
出处
期刊:British Journal of Sports Medicine [BMJ]
卷期号:: bjsports-107027
标识
DOI:10.1136/bjsports-2023-107027
摘要

To evaluate the effect of a coaching intervention compared with control on physical activity and falls rate at 12 months in community-dwelling people aged 60+ years.Cluster randomised controlled trial.Community-dwelling older people.72 clusters (605 participants): 37 clusters (290 participants) randomised to the intervention and 35 (315 participants) to control.Intervention group received written information, fall risk assessment and prevention advice by a physiotherapist, activity tracker and telephone-based coaching from a physiotherapist focused on safe physical activity. Control group received written information and telephone-based dietary coaching. Both groups received up to 19 sessions of telephone coaching over 12 months.The co-primary outcomes were device-measured physical activity expressed in counts per minute at 12 months and falls rate over 12 months. Secondary outcomes included the proportion of fallers, device-measured daily steps and moderate-to-vigorous physical activity (MVPA), self-reported hours per week of physical activity, body mass index, eating habits, goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being and disability.The mean age of participants was 74 (SD 8) years, and 70% (n=425) were women. There was no significant effect of the intervention on device-measured physical activity counts per minute (mean difference 5 counts/min/day, 95% CI -21 to 31), or falls at 12 months (0.71 falls/person/year in intervention group and 0.87 falls/person/year in control group; incidence rate ratio 0.86, 95% CI 0.65 to 1.14). The intervention had a positive significant effect on device-measured daily steps and MVPA, and self-reported hours per week of walking, well-being, quality of life, and disability. No significant between-group differences were identified in other secondary outcomes.A physical activity and fall prevention programme including fall risk assessment and prevention advice, plus telephone-based health coaching, did not lead to significant differences in physical activity counts per minute or falls rate at 12 months. However, this programme improved other physical activity measures (ie, daily steps, MVPA, hours per week of walking), overall well-being, quality of life and disability.ACTRN12615001190594.

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