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The Veterans Learning to Improve Fitness and Function in Elders Study: a randomized trial of primary care-based
Miriam C Morey1, Matthew J Peterson, Carl F Pieper
1Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina 27705, USA. morey@geri.duke.edu
Objectives:
To determine the effects of primary care-based, multicomponent physical activity counseling (PAC) promoting physical activity (PA) guidelines on gait speed and related measures of PA and function in older veterans.
Design:
Randomized controlled trial.
Setting:
Veterans Affairs Medical Center of Durham, North Carolina.
Participants:
Three hundred ninety-eight male veterans aged 70 and older.
Intervention:
Twelve months of usual care (UC) or multicomponent PAC consisting of baseline in-person and every other week and then monthly telephone counseling by a lifestyle counselor, one-time clinical endorsement of PA, monthly automated telephone messaging from the primary care provider, and quarterly tailored mailings of progress in PA.
Measurements:
Gait speed (usual and rapid), self-reported PA, function, and disability at baseline and 3, 6, and 12 months.
Results:
Although no between-group differences were noted for usual gait speed, rapid gait speed improved significantly more for the PAC group (1.56 +/- 0.41 m/s to 1.68 +/- 0.44 m/s) than with UC (1.57 +/- 0.40 m/sec to 1.59 +/- 0.42 m/sec, P=.04). Minutes of moderate/vigorous PA increased significantly in the PAC group (from 57.1 +/- 99.3 to 126.6 +/- 142.9 min/wk) but not in the UC group (from 60.2 +/- 116.1 to 69.6 +/- 116.1 min/wk, P<.001). Changes in other functional/disability outcomes were small.
Conclusion:
In this group of older male veterans, multicomponent PA significantly improved rapid gait and PA. Translation from increased PA to overall functioning was not observed. Integration with primary care was successful.
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