PTCohortJournal of geriatric physical therapy (2001)2019

Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness).

Sarah Fishleder, Miruna Petrescu-Prahova, Jeffrey R Harris and 5 others

PMID 29979352

WHAT IT FOUND

Older adults in EnhanceFitness gained strength, chair-stand performance, and walking balance over two program cycles.

More weeks of full attendance was linked to greater gains. Those with worse health, falls, disability, or age over 75 gained less, but still improved.

Key findings

01Mean total improvement across the study period was 2.7 arm curls, 2.1 chair stands, and 1.1 seconds faster on the eight-foot up-and-go.

02Each additional complete week of attendance was associated with 0.16 more arm curls, 0.12 more chair stands, and a 0.08-second reduction in eight-foot up-and-go time.

03Older age, fair or poor health, disability, and 1 or more falls were associated with less gain per program cycle, yet similar improvement was observed in every subgroup.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only 7,483 of the initial 25,584 participants were analyzed, because 14,050 had no follow-up and 4,052 were excluded for test timing outside the allowed range. The paper reports changes within EnhanceFitness participants and associations with attendance, not a randomized comparison with a non-EF group. Health status, disability, and falls were self-reported, and the fall question did not capture cause. Most participants were in at least good health (83%) and had not fallen in the past 4 months (71%), so the findings may apply less well to frailer older adults. No minimal clinically important difference was available for arm curls or the eight-foot up-and-go, so some improvements cannot be compared with a patient-reported meaningful change threshold. Attendance dropped after the second program cycle, so long-term involvement was not analyzed.

Declared interests

The authors reported no conflict of interest.

The easy way to misread this

Do not read this as proof that EnhanceFitness caused the physical function gains. The paper analyzed existing program records, excluded most of the initial participants, and reported associations with attendance rather than a randomized comparison.

Read it on PubMed →