Evaluation of stAPP: a smartphone-based intervention to reduce prolonged sitting among Belgian adults.

Excessive uninterrupted sitting, also known as sedentary behavior, has been detrimentally associated with several health outcomes. However, the general population is often unaware of these health risks. Mobile phone technology offers great potential to increase awareness and to initiate behavior change. This study examined the short-term effects of stAPP, a smartphone-based intervention, on prolonged sitting behavior. Fifty-eight participants were randomly assigned to an intervention group (IG, n = 31) or a control group (CG, n = 27). After 1 week of baseline assessment, the IG received stAPP (i.e. smartphone, smartphone app and corresponding motion sensor) and used it during the following week. CG participants were monitored during 2 weeks without receiving stAPP. Total daily sitting time and prolonged sitting bouts (>30 min bouts of sitting) were objectively assessed using activPAL3 inclinometers. Although no significant changes emerged in the CG in any of the sitting parameters, total sitting time (on weekdays; p = 0.032), number of prolonged sitting bouts (>30 min of sitting) [both on week- (p < 0.001) and weekend days (p = 0.008)] and average duration of prolonged sitting bouts [both on week- (p = 0.004) and weekend days (p = 0.029)] decreased significantly in the IG. The stAPP smartphone-based intervention constitutes a promising intervention tool to interrupt and reduce prolonged sitting behavior. Further long-term studies on a larger scale are needed to further explore the effectiveness of a smartphone-based intervention aimed at reducing prolonged sitting behavior.

Short- and long-term effectiveness of a three-month individualized need-supportive physical activity counseling intervention at the workplace.

BACKGROUND: The objective of the present study was to evaluate the short- and long-term intervention and mediation effects of a 3-month individualized need-supportive physical activity (PA) counseling intervention on employees' PA and sedentary behavior. METHODS: Insufficiently active employees (n = 300; mean age 42 ± 9 years; 78% female) were recruited from a large pharmaceutical company in Flanders, Belgium. A quasi-experimental design was used in which the intervention group (N = 246) was recruited separately from the reference group (N = 54). Intervention group participants received a 3-month behavioral support intervention, which consisted of two one-hour face-to-face counseling sessions and three follow-up counseling contacts by e-mail or telephone at weeks three, six and nine. PA counseling, delivered by qualified PA counselors, aimed to satisfy participants' basic psychological needs for autonomy, competence, and relatedness. Reference group participants did not receive individualized PA counseling. Outcome measures included objectively assessed and self-reported PA and sedentary time and psychological need satisfaction. Assessments were held at baseline, immediately after the intervention (short-term) and 6 months post-intervention (long-term). Mixed model analyses and bootstrapping analyses were used to determine intervention and mediation effects, respectively. RESULTS: The intervention group increased weekday daily steps both in the short- and long-term, while the reference group showed reductions in daily step count (ES = .65 and ES = .48 in the short- and long-term, respectively). In the short-term, weekday moderate-to-vigorous PA increased more pronouncedly in the intervention group compared to the reference group (ES = .34). Moreover, the intervention group demonstrated reductions in self-reported sitting time during weekends both in the short- and long-term, whereas the reference group reported increased sitting time (ES = .44 and ES = .32 in the short- and long-term, respectively). Changes in perceived autonomy and competence need satisfaction mediated the long-term intervention effects on daily step count. CONCLUSIONS: A 3-month individualized need-supportive PA counseling intervention among employees resulted in significant and sustained improvements in weekday daily step count and in decreased self-reported sitting during weekends. Our findings contribute to the growing evidence of the long-term effectiveness of need-supportive PA counseling. TRIAL REGISTRATION: ClinicalTrials.gov NCT01759927 . Registered December 30, 2012.

Effects of a Six-Month Local Vibration Training on Bone Density, Muscle Strength, Muscle Mass, and Physical Performance in Postmenopausal Women.

The aim of the study was to investigate the effect of 6 months' local vibration training on bone mineral density (BMD), muscle strength, muscle mass, and physical performance in postmenopausal women (66-88 years). The study was organized as a randomized controlled trial for postmenopausal women who lived in daily care service flats and rest homes. Thirty-five postmenopausal women were randomly assigned to either a vibration (n = 17) or a control group (n = 18). The vibration group received 6-month local vibration treatment with frequency between 30 and 45 Hz and acceleration between 1.71 and 3.58g. The vibration was applied on the midthigh and around the hip in supine-lying position once per day, 5 d·wk. The participants of the control group continued their usual activities and were not involved in any additional training program. The primary outcome variables were the isometric and dynamic quadriceps muscle strength and the BMD of the hip. We assessed the muscle mass of the quadriceps and physical performance. Additionally, the feasibility, side effects, and compliance were evaluated after 6 months of local vibration training. Overall, the results showed a net benefit of 13.84% in isometric muscle strength at 60° knee angle in favor of the vibration group compared with controls (p < 0.01). No changes in BMD, muscle mass, or physical performance were found in both groups (p > 0.05). Six months of local vibration training improved some aspects of muscle strength but had no effect on BMD, muscle mass, and physical performance in postmenopausal women. The specific vibration protocol used in this study can be considered as safe and suitable for a local vibration training program.

Effects of intensive whole-body vibration training on muscle strength and balance in adults with chronic stroke: a randomized controlled pilot study.

OBJECTIVES: To investigate the effects of a 6-week whole body vibration (WBV) training program in patients with chronic stroke. DESIGN: Randomized controlled pilot trial with 6 weeks' follow-up. SETTING: University hospital. PARTICIPANTS: Adults with chronic stroke (N=15) were randomly assigned to an intervention (n=7) or a control group (n=8). INTERVENTIONS: Supervised, intensive WBV training. The vibration group performed a variety of static and dynamic squat exercises on a vibration platform with vibration amplitudes of 1.7 and 2.5mm and frequencies of 35 and 40Hz. The vibration lasted 30 to 60 seconds, with 5 to 17 repetitions per exercise 3 times weekly for 6 weeks. Participants in the control group continued their usual activities and were not involved in any additional training program. MAIN OUTCOME MEASURES: The primary outcome variable was the isometric and isokinetic muscle strength of the quadriceps (isokinetic dynamometer). Additionally, hamstrings muscle strength, static and dynamic postural control (dynamic posturography), and muscle spasticity (Ashworth Scale) were assessed. RESULTS: Compliance with the vibration intervention was excellent, and the participants completed all 18 training sessions. Vibration frequencies of both 35 and 40Hz were well tolerated by the patients, and no adverse effects resulting from the vibration were noted. Overall, the effect of intensive WBV intervention resulted in significant between-group differences in favor of the vibration group only in isometric knee extension strength (knee angle, 60°) (P=.022) after 6 weeks of intervention and in isokinetic knee extension strength (velocity, 240°/s) after a 6-week follow-up period (P=.005), both for the paretic leg. Postural control improved after 6 weeks of vibration in the intervention group when the patients had normal vision and a sway-referenced support surface (P<.05). Muscle spasticity was not affected by vibration (P>.05). CONCLUSIONS: These preliminary results suggest that intensive WBV might potentially be a safe and feasible way to increase some aspect of lower limb muscle strength and postural control in adults with chronic stroke. Further studies should focus on evaluating how the training protocol should be administered to achieve the best possible outcome, as well as comparing this training protocol to other interventions.

The long-term effectiveness of need-supportive physical activity counseling compared with a standard referral in sedentary older adults.

This study compared the long-term effectiveness of three physical activity counseling strategies among sedentary older adults: a 1-contact referral (REFER), a 1-contact individualized walking program (WALK), and multiple-contact, individually tailored, and need-supportive coaching based on the self-determination theory (COACH). Participants (n = 442) completed measurements before (pretest), immediately after (posttest), and 1 yr after (follow-up test) a 10-wk intervention. Linear mixed models demonstrated significant time-by-condition interaction effects from pre- to posttest. More specifically, WALK and COACH yielded larger increases in daily steps and self-reported physical activity than REFER. Similarly, self-reported physical activity increased more from pre- to follow-up test in WALK and COACH compared with REFER. Autonomous motivation mediated the effect of perceived need-support on physical activity, irrespective of counseling strategy. These results demonstrate the long-term effectiveness of both a 1-contact individualized walking program and a more time-consuming, need-supportive coaching, especially in comparison with a standard referral to local opportunities.

Long-term impact of strength training on muscle strength characteristics in older adults.

OBJECTIVE: To evaluate the long-term preventive impact of strength training on muscle performance in older adults. DESIGN: A 7-year follow-up on a 1-year randomized controlled trial comparing the effects of combined resistance training and aerobic training and whole-body vibration training on muscle performance. SETTING: University training center. PARTICIPANTS: Men and women (N=83; control [CON] group, n=27; strength-training intervention [INT] group, n=56) between 60 and 80 years of age. INTERVENTIONS: The INT group exercised 3 times weekly during 1 year, performing a combined resistance training and aerobic training program or a whole-body vibration training program. The former training program was designed according to American College of Sports Medicine guidelines. The whole-body vibration training program included unloaded static and dynamic leg exercises on a vibration platform. The CON group did not participate in any training program. MAIN OUTCOME MEASURES: Static strength (STAT), dynamic strength at 60°/s (DYN60) and at 240°/s (DYN240), speed of movement at 20% (S20). RESULTS: From baseline to postintervention, muscle performance did not change in the CON group, except for S20 (+6.55%±2.88%, P<.001). One year of strength training increased (P≤.001) STAT (+11.46%±1.86%), DYN60 (+6.96%±1.65%), DYN240 (+9.25%±1.68%), and S20 (+7.73%±2.19%) in the INT group. Between baseline and follow-up, muscle performance decreased (P<.001) in both groups. However, STAT and DYN60 showed a significantly lower loss in the INT group (-8.65%±2.35% and -7.10%±2.38%, respectively) compared with the CON group (-16.47%±2.69% and -15.08%±2.27%, respectively). This positive impact might be due to the preservation of the training-induced gains, given the similar annual decline rates in both groups from postintervention to follow-up. Additionally, in trained participants, aging seems to impact velocity-dependent strength and power more compared with basic strength, as the total losses in DYN240 (CON, -15.93%±2.64%; INT, -11.39%±1.95%) and S20 (CON, -14.39%±2.10%; INT, -13.16%±1.72%) did not differ significantly between the groups. CONCLUSIONS: A 1-year strength-training intervention results in an improved muscle performance in older adults 7 years after their enrollment in the intervention. However, an extensive exercise program cannot attenuate the age-related decline once the intervention stops.

Effects of fitness and vibration training on muscle quality: a 1-year postintervention follow-up in older men.

OBJECTIVE: To evaluate the residual effects of fitness and whole-body vibration (WBV) training in older men 1 year after completion of the interventions. DESIGN: A 1-year follow-up of a randomized controlled trial comparing the effects of 1 year of fitness training, including combined resistance and aerobic (R+A) training and WBV training, with a control (CON) group. SETTING: University training center. PARTICIPANTS: Adult men (N=72) between 60 and 80 years of age. Response rate was 80%, 92%, and 90% in the R+A training (n=20), WBV training (n=23), and CON (n=29) groups, respectively. INTERVENTIONS: The intervention groups exercised 3 times weekly during 1 year. The R+A training group performed a standard training program, combining resistance exercises and aerobic training, following the American College of Sports Medicine guidelines. The WBV training group performed unloaded static and dynamic leg exercises on a vibration platform. The CON group did not participate in any training program. MAIN OUTCOME MEASURES: Muscle volume, isometric and concentric muscle strength, muscle quality, and muscle power. RESULTS: Both interventions had resulted in comparable increases in muscle quality characteristics. No significant changes had been found in the CON group. During the 1-year follow-up period, the R+A (-4.05%, P=.006) and WBV (-2.45%, P<.0001) training groups had lost most of their gains in muscle volume. However, isometric muscle strength was preserved in the R+A training group (+1.65%, P=.745), resulting in an increase in muscle quality (+7.97%, P=.034). In the WBV training group, muscle power decreased (-6.10%, P<.0001) but remained significantly higher than at baseline (P=.038). Except for a strong decrease in muscle power, no significant changes were found in the CON group. CONCLUSIONS: One year of R+A and/or WBV training can equally reverse the adverse effects of aging on muscle quality in older men, but their residual impact after follow-up is different.

Force-velocity characteristics of the knee extensors: an indication of the risk for physical frailty in elderly women.

OBJECTIVES: To examine the relationship between muscle strength, speed of movement, muscle mass (MM), and functional performance in elderly women and to determine optimal threshold values below which physical frailty occurs. DESIGN: Survey. SETTING: University-based laboratory. PARTICIPANTS: Institutionalized women (N=123; mean age, 79.67 ± 5.2y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Force-velocity characteristics of the knee extensors were evaluated by using isometric, isokinetic, and ballistic tests on a motor-driven dynamometer. Isometric (ISOM) strength, dynamic strength, maximal speed of movement (SoM, unloaded), and speed of movement with standardized resistance of 20% (S(20)), 40% (S(40)), and 60% (S(60)) of the isometric maximum were recorded. MM of the upper leg was determined by using computed tomography. The modified Physical Performance Test (mPPT) was used to assess functional performance. RESULTS: Force-velocity characteristics (r varied from .31-.68) and MM (r=.41) correlated significantly with functional performance (P<.05). In a forward stepwise regression model, only SoM and ISOM strength remained independently associated with mPPT score (R(2)=.49), with SoM accounting for most of the variance. The threshold value that optimally differentiates between women with mild (mPPT score, 25-31) or without (mPPT score ≥32) physical frailty was 350°/s for SoM and 1.46N m/kg for ISOM strength. Sensitivity and specificity ranged from 74% to 77% and 71% to 77%, respectively. CONCLUSIONS: SoM is a key component in the onset of functional difficulties in elderly women. Exercise interventions specifically targeting muscle power (by including exercises at high velocities) thus might be crucial to prevent functional decline.

The Genetic Effect on Muscular Changes in an Older Population: A Follow-Up Study after One-Year Cessation of Structured Training.

Older adults lose muscle mass and strength at different speeds after the cessation of physical exercise, which might be genotype related. This study aimed to explore the genetic association with changes in muscle mass and strength one year after the cessation of structured training in an older population. Participants (n = 113, aged between 61 and 81 years) who performed one-year of combined fitness (n = 44) or whole-body vibration (n = 69) training were assessed one year after the cessation of the training. Whole-body skeletal muscle mass and knee strength were measured. Data-driven genetic predisposition scores (GPSs) were calculated and analysed in a general linear model with sex, age, body mass index and post-training values of skeletal muscle mass or muscle strength as covariates. Forty-six single nucleotide polymorphisms (SNPs) from an initial 170 muscle-related SNPs were identified as being significantly linked to muscular changes after cessation. Data-driven GPSs and over time muscular changes were significantly related (p < 0.01). Participants with higher GPSs had less muscular declines during the cessation period while data-driven GPSs accounted for 26-37% of the phenotypic variances. Our findings indicate that the loss of training benefits in older adults is partially genotype related.

Effects of whole body vibration training on cardiorespiratory fitness and muscle strength in older individuals (a 1-year randomised controlled trial).

BACKGROUND: whole body vibration (WBV) training appears to be an efficient alternative for conventional resistance training in older individuals. So far, no data exist about the vibratory effect on cardiorespiratory fitness. OBJECTIVES: this randomised controlled trial assessed the effects of 1-year WBV training on cardiorespiratory fitness and muscle strength in community-dwelling adults over the age of 60. METHODS: a total of 220 adults (mean age 67.1 years) were randomly assigned to a WBV group, fitness group or control group. The WBV group exercised on a vibration platform, and the fitness group performed cardiovascular, resistance, balance and stretching exercises. The control group did not participate in any training. Heart rate was measured during a single WBV session. Peak oxygen uptake (VO(2peak)) and time-to-peak exercise (TPE) were measured during progressive bicycle ergometry. Muscle strength was assessed by a dynamometer. RESULTS: heart rate increased significantly during WBV training. After 1 year, VO(2peak), TPE and muscle strength increased significantly in the WBV and fitness groups. Both training groups improved similarly in VO(2peak) and muscle strength. The fitness group improved significantly more in TPE than the WBV group. CONCLUSION: WBV training in community-dwelling elderly appears to be efficient to improve cardiorespiratory fitness and muscle strength.

Increasing Employees' Health by Workplace Physical Activity Counseling: The Mediating Role of Step-Based Physical Activity Behavior Change.

BACKGROUND: This study evaluated the effects of a 3-month workplace physical activity (PA) intervention on employees' health-related fitness and well-being. Moreover, mediational pathways were examined. METHODS: A longitudinal, quasi-experimental trial was evaluated in Belgian employees. The intervention group (IG: n = 246) received 3-months individualized, tailored PA counseling, consisting of face-to-face counseling and follow-up e-mail and telephone contacts. The reference group (n = 54) received no PA counseling. Outcome measures (assessed at baseline, 3 mo [short term], and 9 mo [long term]) included body composition, cardiorespiratory fitness, well-being, and step-based PA. RESULTS: With no changes in the reference group, the IG showed short-term improvements in body mass index (-0.24 kg/m2, P < .001), body fat (-0.88%, P < .001), waist circumference (-1.47 cm, P < .001), and muscle percentage (+0.47%, P < .001). Moreover, with respect to cardiorespiratory fitness, IG participants improved on perceived exertion, both in the short term (-0.91, P < .001) and long term (-0.83, P < .001). Furthermore, perceived physical well-being increased in the IG, both in the short term (+0.57, P < .001) and long term (+0.57, P < .001). The observed intervention effects on body composition, perceived exertion, and well-being were mediated by (increases in) step-based PA. CONCLUSIONS: Workplace PA counseling programs have the potential to enhance employees' health-related fitness and well-being. Importantly, step-based PA behavior change was found to contribute to the postintervention improvements.

Acknowledgement Correction: Face-to-Face Versus Mobile Versus Blended Weight Loss Program: Randomized Clinical Trial.

[This corrects the article DOI: 10.2196/mhealth.7713.].

Face-to-Face Versus Mobile Versus Blended Weight Loss Program: Randomized Clinical Trial.

BACKGROUND: Conventional face-to-face weight loss and weight control programs are very labor intensive for both the patient and the provider. It is unclear to what extent conventional programs can be (partially) completed by mobile health (mHealth) apps. OBJECTIVE: The aim of this study was to compare the effectiveness of different weight loss programs using a combination of conventional and mobile programs among adults who are overweight (body mass index [BMI]>29 kg/m²). METHODS: A single-blinded randomized controlled trial among obese adults was performed from September 2015 to March 2016. The study took place in Leuven, Belgium. Of the 102 eligible (BMI >29 kg/m²) adults, 81 (79%) completed the study. The three intervention groups consisted of a conventional face-to-face weight loss program, a weight loss app program (app group), and a partial face-to-face and partial app program (combi group). All intervention groups received the same advice from a dietician and a physical activity coach during a 12-week period. The control group did not receive any information during the same period. Primary outcomes were weight reduction (5% decrease of baseline weight in kg), BMI, metabolic risk factors, dietary pattern, and physical activity. RESULTS: Significant more participants in all three intervention groups lost at least 5% or more of their weight at baseline compared with the control group. No significant difference was found between the combi group and the conventional group. A trend was found that more participants in the combi group lost 5% or more compared with the app group (19%), P=.06. A significant time x group effect was found for BMI and metabolic risk factors, with the control group having the worst results and the combi group being significantly better with regard to BMI compared with the app group. No significant group x time effects were found for the intake of different food and drinks and moderate to vigorous physical activity (MVPA). CONCLUSIONS: The results of this study show that a conventional weight loss program could partially be completed with an mHealth program without affecting the effectiveness. TRIAL REGISTRATION: Clinicaltrials.gov NCT02595671; https://clinicaltrials.gov/ct2/show/NCT02595671 (Archived by WebCite at http://www.webcitation.org/6w1H0x1Q6).

Genetic predisposition score predicts the increases of knee strength and muscle mass after one-year exercise in healthy elderly.

This study aims to identify a genetic predisposition score from a set of candidate gene variants that predicts the response to a one-year exercise intervention. 200 participants (aged 60-83 years) were randomly assigned to a fitness (FIT), whole-body vibration (WBV) and control group. Participants in the exercise (FIT and WBV) groups performed a one-year intervention program. Whole-body skeletal muscle mass (SMM) and isometric knee extension strength (PTIM60) were measured before and after the intervention. A set of 170 muscle-related single nucleotide polymorphisms (SNPs) were genotyped. Stepwise regression analysis was applied to select significantly contributing SNPs for baseline and relative change parameters. A data-driven genetic predisposition score (GPS) was calculated by adding up predisposing alleles for each of the phenotypes. GPS was calculated based on 4 to 8 SNPs which were significantly related to the corresponding phenotypes. These SNPs belong to genes that are involved in myoblast differentiation, muscle and bone growth, myofiber contraction, cytokines and DNA methylation. GPS was related to baseline PTIM60 and relative changes of SMM and PTIM60 in the exercise groups, explaining the variance of the corresponding parameter by 3.2%, 14% and 27%, respectively. Adding one increasing allele in the GPS increased baseline PTIM60 by 4.73 Nm, and exercise-induced relative changes of SMM and PTIM60 by 1.78% and 3.86% respectively. The identified genetic predisposition scores were positively related to baseline knee extension strength and muscle adaptations to exercise in healthy elderly. These findings provide supportive genetic explanations for high and low responders in exercise-induced muscle adaptations.

Impact of whole-body vibration training versus fitness training on muscle strength and muscle mass in older men: a 1-year randomized controlled trial.

BACKGROUND: This randomized controlled study investigated the effects of 1-year whole-body vibration (WBV) training on isometric and explosive muscle strength and muscle mass in community-dwelling men older than 60 years. METHODS: Muscle characteristics of the WBV group (n = 31, 67.3 +/- 0.7 years) were compared with those of a fitness (FIT) group (n = 30, 67.4 +/- 0.8 years) and a control (CON) group (n = 36, 68.6 +/- 0.9 years). Isometric strength of the knee extensors was measured using an isokinetic dynamometer, explosive muscle strength was assessed using a counter movement jump, and muscle mass of the upper leg was determined by computed tomography. RESULTS: Isometric muscle strength, explosive muscle strength, and muscle mass increased significantly in the WBV group (9.8%, 10.9%, and 3.4%, respectively) and in the FIT group (13.1%, 9.8%, and 3.8%, respectively) with the training effects not significantly different between the groups. No significant changes in any parameter were found in the CON group. CONCLUSION: WBV training is as efficient as a fitness program to increase isometric and explosive knee extension strength and muscle mass of the upper leg in community-dwelling older men. These findings suggest that WBV training has potential to prevent or reverse the age-related loss in skeletal muscle mass, referred to as sarcopenia.

Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n=94), a fitness group (n=60) or a control group (n=66). The whole body vibration and fitness groups trained three times a week for 1 year. The vibration group performed exercises on a vibration platform and the fitness group performed cardiovascular, strength, balance and stretching exercises. Balance was measured using dynamic computerized posturography at baseline and after 6 and 12 months. Whole body vibration training was associated with reduced falls frequency on a moving platform when vision was disturbed and improvements in the response to toes down rotations at the ankle induced by the moving platform. The fitness group showed reduced falls frequency on the moving surface when vision was disturbed. Thus, whole body vibration training may improve some aspects of postural control in community dwelling older individuals.

Short- and long-term effects of a need-supportive physical activity intervention among patients with type 2 diabetes mellitus: A randomized controlled pilot trial.

OBJECTIVE: This pilot trial evaluated the short- and long-term effects of a six-week need-supportive physical activity (PA) intervention among patients with type 2 diabetes mellitus, on health-related (HbA1c and physical fitness) and behavioral (objectively-measured and self-reported PA) outcomes. METHODS: To support the basic psychological needs for autonomy, relatedness and competence, the intervention included one in- and outtake session with a PA coach, an individualized PA program and a weekly PA group session. The intervention was set up in collaboration with a health insurance fund and with general practitioners. A total of forty-eight patients participated in the study and were randomly assigned to an intervention (n = 27) or a waiting-list control condition (n = 21). RESULTS: Linear mixed models did not reveal any significant interaction effects between time and condition (ps > .05). However, significant time effects across conditions were found: a decrease in HbA1c at short term and increases in self-reported PA at both short and long term and in physical fitness at long term (ps < .05). CONCLUSION: Although the intervention as a whole did not produce the expected impact, there seems a potential for brief but regular expert visit and measurement.

Effects of need-supportive physical activity counseling on well-being: a 2-year follow-up among sedentary older adults.

BACKGROUND: This study evaluated the long-term effectiveness of multiple physical activity counseling strategies on subjective health among older adults. METHODS: Sedentary older adults (n = 442) were randomized to 3 programs: (1) a one-contact referral to locally organized physical activities, (2) a one-contact provision of a walking program, (3) a 10-week multiple-contact physical activity coaching based on the Self-Determination Theory. Self-reports on well-being, trait anxiety and physical activity were completed at baseline (pretest), and 10 weeks after (10-week follow-up), 1 year after (1-year follow-up) and 2 years after (2-year follow-up) pretests. RESULTS: All 3 programs yielded improvements in well-being and trait anxiety from pretest to 10-week follow-up and to 1-year follow-up. From pretest to 2-year follow-up, no changes emerged in well-being whereas trait anxiety increased significantly. Changes over time in well-being and anxiety were not significantly different between the programs. Changes in physical activity contributed significantly to the prediction of changes in well-being and trait anxiety. CONCLUSIONS: The findings demonstrate the year-round effectiveness of physical activity counseling on subjective health among older adults, irrespective of counseling strategy. However, a relapse to baseline level occurred 2 years after the intervention. Physical activity appears to be an important determinant of older adults' well-being.

The effects of whole-body vibration training and vitamin D supplementation on muscle strength, muscle mass, and bone density in institutionalized elderly women: a 6-month randomized, controlled trial.

Sarcopenia and osteoporosis represent a growing public health problem. We studied the potential benefit of whole-body vibration (WBV) training given a conventional or a high dose of daily vitamin D supplementation in improving strength, muscle mass, and bone density in postmenopausal women. In a 2 × 2 factorial-design trial, 113 institutionalized elderly females aged over 70 years (mean age 79.6 years) were randomly assigned either to a WBV or a no-training group, receiving either a conventional dose (880 IU/day) or a high dose (1600 IU/day) of vitamin D(3). The primary aim was to determine the effects of 6 months of WBV and/or vitamin D supplementation on isometric and dynamic strength, leg muscle mass, and hip bone mineral density (BMD). Additionally, the increase in 25-hydroxyvitamin D [25(OH)D] levels between conventional and high-dose supplementation was compared. After 6 months of treatment, dynamic muscle strength, hip BMD, and vitamin D serum levels improved significantly in all groups, whereas isometric strength and muscle mass did not change. When compared with no training, the WBV program did not result in additional improvements. When compared with 880 IU, a high dose of 1600 IU of vitamin D did result in higher serum vitamin D levels but did not result in additional improvements. In institutionalized women older than 70 years, the WBV training protocol tested is not more efficient in enhancing muscle mass, strength, and hip BMD compared with vitamin D supplementation. A higher dose of 1600 IU of vitamin D does not provide additional musculoskeletal benefit in this population compared with conventional doses.

Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.

Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity.