Home versus center based physical activity programs in older adults

Area of Science:

• Gerontology
• Exercise Physiology
• Public Health

Background:

• Physical inactivity is a major preventable cause of death and disease.
• Exercise programs can treat conditions like cardiovascular disease, osteoarthritis, and COPD.
• Programs vary from home-based to supervised center-based interventions.

Purpose of the Study:

• To compare the effectiveness of home-based versus center-based physical activity programs for older adults.
• To evaluate health outcomes in older adults participating in different exercise program settings.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials.
• Searched multiple databases including CENTRAL, MEDLINE, EMBASE, CINAHL, Health Star, Dissertation Abstracts, Sport Discus, and Science Citation Index.
• Included studies of adults aged 50+ with cardiovascular risk factors, cardiovascular disease, COPD, or osteoarthritis, excluding cardiac/post-operative programs within one year.

Main Results:

• Six trials (372 participants) were included; five medium quality, one poor.
• Center-based programs improved walking distance and pain-free time in peripheral vascular disease short-term, but with potential bias.
• Home-based programs demonstrated significantly higher long-term adherence (68% vs. 36%) in sedentary older adults; no differences in treadmill performance or risk factors.
• Conflicting evidence exists for chronic obstructive pulmonary disease (COPD) effectiveness.
• No studies addressed osteoarthritis, cost, or healthcare utilization.

Conclusions:

• Center-based programs offer short-term advantages for peripheral vascular disease, though potential bias exists.
• Home-based programs show superior long-term exercise adherence.
• Evidence for chronic obstructive pulmonary disease (COPD) is inconclusive regarding program effectiveness.
• Further research is needed, particularly for osteoarthritis and cost-effectiveness.