Physical Activity and Sedentary Behavior of Residents in Assisted Living: A Preliminary Study.

Low physical activity (PA) and high sedentary behavior (SB) place residents in assisted living at risk for physical decline, but little is known about factors that influence PA/SB in this setting. In the current cross-sectional study, we described objectively measured PA/SB (activPAL™) and examined the relationships between PA/SB and use of an assistive walking device, depression, sleep disturbance, pain, fatigue, social isolation, and the tendency to make social comparisons. Fifty-four residents from eight assisted living facilities participated. Mean time spent in PA was 252.9 (SD = 134.3) minutes/day. Mean time spent in SB was 660.8 (SD = 181.4) minutes/day. Depression predicted PA (R2 = 0.16). Residents using an assistive device spent significantly more time in SB (p = 0.02). Fatigue correlated with time in longer bouts of SB (r = 0.19, p = 0.04). The tendency to make social comparisons correlated with SB (r = 0.22, p = 0.04). Findings show residents in assisted living are inactive and further research is needed to fully understand factors that influence PA/SB. [Research in Gerontological Nursing, 15(3), 117-123.].

The Experience and Meaning of Physical Activity in Assisted Living Facility Residents.

Assisted living (AL) residents engage in very low levels of physical activity (PA), placing them at increased risk for mobility disability and frailty. But many residents in AL may not perceive the need to increase their PA. This study explored the experience, meaning, and perceptions of PA in 20 older adults in AL. The factors associated with PA were also examined. Qualitative data were collected using semistructured interviews and analyzed using phenomenological methodology. Six themes were identified: PA was experienced as planned exercise, activities of daily living, and social activities based on a schedule or routine; PA meant independence and confidence in the future; residents perceived themselves as being physically active; social comparisons influenced perception of PA; personal health influenced PA; motivations and preferences influenced PA. The findings highlight the importance of residents' personal perceptions of PA and effects of the social milieu in the congregate setting on PA.

Interventions to increase physical activity in people with COPD: systematic review.

People with chronic obstructive pulmonary disease (COPD) are very sedentary and this contributes to their health problems. The aim of this systematic review was to examine the effects of interventions designed to increase physical activity (PA) in people with COPD. Studies were included when PA was the primary outcome and measured objectively. Six databases were searched and 15 studies with a total of 761 subjects were identified that met inclusion criteria. Nine of the studies were quasi-experimental (QE) and six were randomized controlled trials (RCT). Interventions included pulmonary rehabilitation (n = 7), exercise only (n = 2), behavioral only (n = 2) and a combination of both behavioral and pulmonary rehabilitation/exercise interventions (n = 4). Methodological quality was evaluated using the Downs and Black checklist. The quality of the pulmonary rehabilitation studies was the lowest with a fair rating and the quality of exercise only studies was the highest with a good rating. Eight of the 15 studies demonstrated statistically significant increases in PA: two pulmonary rehabilitation (QE = 2), two exercise only (RCT = 2), two behavioral only (RCT = 1, QE = 1), and two combined behavioral and pulmonary rehabilitation/exercise (RCT = 2). The magnitude of increase was modest in all but one study; and in many studies the increase in PA was not clinically meaningful. Longer interventions demonstrated a higher success rate and only three studies examined longer term effects of the interventions. Existing interventions are promising, but the small number of randomized controlled trials makes it difficult to draw conclusion. Further research is needed to identify a range of interventions that are effective and could be used to promote PA in people with COPD.