Aging Clinical and Experimental Research

, Volume 28, Issue 6, pp 1227–1235 | Cite as

Translating exercise interventions to an in-home setting for seniors: preliminary impact on physical activity and function

  • Christopher J. DondzilaEmail author
  • Ann M. Swartz
  • Kevin G. Keenan
  • Amy E. Harley
  • Razia Azen
  • Scott J. Strath
Original Article



The purpose of this study is to investigate whether an in-home, individually tailored intervention is efficacious in promoting increases in physical activity (PA) and improvements in physical functioning (PF) in low-active older adults.


Participants were randomized to two groups for the 8-week intervention. The enhanced physical activity (EPA) group received individualized exercise programming, including personalized step goals and a resistance band training program, and the standard of care (SoC) group received a general activity goal. Pre- and post-intervention PF measures included choice step reaction time, knee extension/flexion strength, hand grip strength, and 8 ft up and go test completion time.


Thirty-nine subjects completed this study (74.6 ± 6.4 years). Significant increases in steps/day were observed for both the EPA and SoC groups, although the improvements in the EPA group were significantly higher when including only those who adhered to weekly step goals. Both groups experienced significant PF improvements, albeit greater in the EPA group for the 8 ft up and go test and knee extension strength.


A low cost, in-home intervention elicited improvements in both PA and PF. Future research is warranted to expand upon the size and scope of this study, exploring dose thresholds (and time frames) for PA to improve PF and strategies to further bolster adherence rates to maximize intervention benefits.


Steps Resistance bands Physical functioning 



Physical activity


Physical functioning


Enhanced physical activity


Standard of care


Choice step reaction time



The authors would like to acknowledge Geeta Betrabet and Kimberly Winker for their assistance in data collection. This work was partially supported by the University of Wisconsin-Milwaukee Research Growth Initiative Award.

Compliance with ethical standards

Conflict of interest


Human and animal rights

All procedures utilized in this study were approved by the University’s Institutional Review Board.

Informed consent

Written and verbal consent was obtained from each participant prior to enrolling.


  1. 1.
    Crane JD, Macneil LG, Tarnopolsky MA (2013) Long-term aerobic exercise is associated with greater muscle strength throughout the life Span. J Gerontol A Biol Sci Med Sci 68:631–638CrossRefPubMedGoogle Scholar
  2. 2.
    Federal Interagency Forum on Aging-Related Statistics (2008) Older Americans 2008: Key indicators of well-being. Washington D.C. Accessed 12 July 2013
  3. 3.
    Wilson IB, Cleary PD (1995) Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 273:59–65Google Scholar
  4. 4.
    Guralnik JM, Ferrucci L, Simonsick EM et al (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332:556–561Google Scholar
  5. 5.
    Rantanen T, Guralnik JM, Sakari-Rantala R et al (1999) Disability, physical activity, and muscle strength in older women: the women’s health and aging study. Arch Phys Med Rehabil 80:130–135CrossRefPubMedGoogle Scholar
  6. 6.
    Dunn AL, Marcus BH, Kampert JB et al (1999) Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA 281:327–334Google Scholar
  7. 7.
    Chandler JM, Duncan PW, Kochersberger G et al (1998) Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? Arch Phys Med Rehabil 79:24–30CrossRefPubMedGoogle Scholar
  8. 8.
    Beyer N, Simonsen L, Bülow J et al (2007) Old women with a recent fall history show improved muscle strength and function sustained for six months after finishing training. Aging Clin Exp Res 19:300–309CrossRefPubMedGoogle Scholar
  9. 9.
    King AC, Pruitt LA, Phillips W et al (2000) Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. J Gerontol A Biol Sci Med Sci 55A:M74–M83Google Scholar
  10. 10.
    Ashworth NL, Chad KE, Harrison EL et al (2005) Home versus center based physical activity programs in older adults. Cochrane Database Syst Rev 1:CD004017Google Scholar
  11. 11.
    Clemson L, Singh MF, Bundy A et al (2010) LiFE pilot study: a randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Aust Occup Ther J 57:42–50CrossRefPubMedGoogle Scholar
  12. 12.
    Litt MD, Kleppinger A, Judge JO (2002) Initiation and maintenance of exercise behavior in older women: predictors from the social learning model. J Behav Med 25:83–97CrossRefPubMedGoogle Scholar
  13. 13.
    Moschny A, Platen P, Klaassen-Mielke R et al (2011) Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act 8:121CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Singh MAF (2000) Exercise and aging. In: exercise, nutrition, and the older woman: wellness for women over fifty. CRC Press, London, p 3–36Google Scholar
  15. 15.
    Tudor-Locke C, Craig CL, Aoyagi Y et al (2011) How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act 8:80CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Crouter SE, Schneider PL, Karabulut M et al (2003) Validity of 10 electronic pedometers for measuring steps, distance, and energy cost. Med Sci Sports Exerc 35:1455–1460CrossRefPubMedGoogle Scholar
  17. 17.
    Schneider PL, Crouter SE, Lukajic O et al (2003) Accuracy and reliability of pedometers for measuring steps over a 400-m walk. Med Sci Sports Exerc 35:1779–1784CrossRefPubMedGoogle Scholar
  18. 18.
    Martin HJ, Yule V, Syddall HE et al (2006) Is hand-held dynamometry useful for the measurement of quadriceps strength in older people? A comparison with the gold standard biodex dynamometry. Gerontology 52:154–159CrossRefPubMedGoogle Scholar
  19. 19.
    Syddall H, Cooper C, Martin F et al (2003) Is grip strength a useful single marker of frailty? Age Ageing 32:650–656CrossRefPubMedGoogle Scholar
  20. 20.
    Lord SR, Fitzpatrick RC (2001) Choice stepping reaction time: a composite measure of falls risk in older people. J Gerontol A Biol Sci Med Sci 56:M627–M632CrossRefPubMedGoogle Scholar
  21. 21.
    Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148Google Scholar
  22. 22.
    Shumway-Cook A, Brauer S, Woollacott M (2000) Predicting the probability for falls in community dwelling older adults using the timed up and go test. Phys Ther 80:896–903PubMedGoogle Scholar
  23. 23.
    Hart TL, Swartz AM, Cashin SE et al (2009) How many days of monitoring predict physical activity and sedentary behaviour in older adults? Int J Behav Nutr Phys Act 8:62CrossRefGoogle Scholar
  24. 24.
    Tudor-Locke C, Hart TL, Washington TL (2009) Expected values for pedometer-determined physical activity in older populations. Int J Behav Nutr Phys Act 6:59CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Asikainen TM, Miilunpalo S, Oja P et al (2002) Randomised, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness. Br J Sports Med 36:189–194CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Murtagh EM, Boreham CA, Nevill A et al (2005) The effects of 60 minutes of brisk walking per week, accumulated in two different patterns, on cardiovascular risk. Prev Med 41:91–97CrossRefGoogle Scholar
  27. 27.
    Quinn TJ, Klooster JR, Kenefick RW (2006) Two short, daily activity bouts vs. one long bout: are health and fitness improvements similar over twelve and twenty-four weeks? J Strength Cond Res 20:130–135PubMedGoogle Scholar
  28. 28.
    Tucker JM, Welk GJ, Beyler NK (2011) Physical activity in U.S.: adults compliance with the physical activity guidelines for Americans. Am J Prev Med 40:454–461CrossRefPubMedGoogle Scholar
  29. 29.
    Troiano RP, Berrigan D, Dodd KW et al (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40:181–188CrossRefPubMedGoogle Scholar
  30. 30.
    Winett RA, Williams DM, Davy BM (2009) Initiating and maintaining resistance training in older adults: a social cognitive theory-based approach. Br J Sports Med 43:114–119CrossRefPubMedGoogle Scholar
  31. 31.
    Bravata DM, Smith-Spangler C, Sundaram V et al (2007) Using pedometers to increase physical activity and improve health: a systematic review. JAMA 298:2296–2304CrossRefPubMedGoogle Scholar
  32. 32.
    King AC, Rejeski WJ, Buchner DM (1998) Physical activity interventions targeting older adults. A critical review and recommendations. Am J Prev Med 15:326–333CrossRefGoogle Scholar
  33. 33.
    Freidrich M, Cermak T, Maderbacher P (1996) The effect of brochure use versus therapist teaching on patients performing therapeutic exercise and on changes in impairment status. Phys Ther 76:1082–1088Google Scholar
  34. 34.
    Simek EM, McPhate L, Haines TP (2012) Adherence to and efficacy of home exercise programs to prevent falls: a systematic review and meta-analysis of the impact of exercise program characteristics. Prev Med 55:262–275Google Scholar
  35. 35.
    Linke SE, Gallo LC, Norman GJ (2011) Attrition and adherence rates of sustained vs. intermittent exercise interventions. Ann Behav Med 42:197–209CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Belza B, PRC-HAN Physical Activity Conference Planning Workgroup (2007) Moving ahead: strategies and tools to plan, conduct, and maintain effective community-based physical activity programs for older adults. Centers for Disease Control and Prevention, AtlantaGoogle Scholar
  37. 37.
    Bohannon RW (2006) Reference values for the timed up and go test: a descriptive meta analysis. J Geriatr Phys Ther 29:64Google Scholar
  38. 38.
    Gudlaugsson J, Gudnason V, Aspelund T et al (2012) Effects of a 6-month multimodal training intervention on retention of functional fitness in older adults: a randomized-controlled cross-over design. Int J Behav Nutr Phys Act 9:107CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Snyder A, Colvin B, Gammack JK (2011) Pedometer use increases daily steps and functional status in older adults. J Am Med Dir Assoc 12:590–594CrossRefPubMedGoogle Scholar
  40. 40.
    Hallage T, Krause MP, Haile L et al (2010) The effects of 12 weeks of step aerobics training on functional fitness of elderly women. J Strength Cond Res 24:2261–2266CrossRefPubMedGoogle Scholar
  41. 41.
    Sousa N, Mendes R, Silva S et al (2013) Effects of resistance and multicomponent training on body composition and physical fitness of institutionalized elderly women. Br J Sports Med 47:e3CrossRefGoogle Scholar
  42. 42.
    Straight CR, Dorfman LR, Cottell KE et al (2012) Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults. J Phys Act Health 9:875–883CrossRefPubMedGoogle Scholar
  43. 43.
    McMeeken J, Stillman B, Story I et al (1999) The effects of knee extensor and flexor muscle training on the timed-up-and-go test in individuals with rheumatoid arthritis. Physiother Res Int 4:55–67PubMedGoogle Scholar
  44. 44.
    Silva NL, Oliveira RB, Fleck SJ et al (2013) Influence of strength training variables on gains in adults over 55 years-old: a meta-analysis of dose-response relationships. J Sci Med Sport 17:337–344CrossRefPubMedGoogle Scholar
  45. 45.
    Kalapothrakos V, Smilios I, Parlavatzas A et al (2007) The effect of moderate resistance strength training and detraining on muscle strength and power in older men. J Geriatr Phys Ther 30:109–113CrossRefGoogle Scholar
  46. 46.
    Voukelatos A, Cumming RG, Lord SR et al (2007) A randomized, controlled trial of tai chi for the prevention of falls: the central sydney tai chi trial. J Am Geriatr Soc 55:1185–1191CrossRefPubMedGoogle Scholar
  47. 47.
    Pijnappels M, Delbaere K, Sturnieks DL et al (2010) The association between choice stepping reaction time and falls in older adults-a path analysis model. Age Ageing 39:99–104CrossRefPubMedGoogle Scholar
  48. 48.
    Seco J, Abecia LC, Echevarria E et al (2013) A long-term physical activity training program increases strength and flexibility, and improves balance in older adults. Rehabil Nurs 38:37–47CrossRefPubMedGoogle Scholar
  49. 49.
    Ip EH, Church T, Marshall SA et al (2013) Physical activity increases gains in and prevents loss of physical function: results from the lifestyle interventions and independence for elders pilot study. J Gerontol A Biol Sci Med Sci 68:426–432CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Christopher J. Dondzila
    • 1
    Email author
  • Ann M. Swartz
    • 2
    • 3
  • Kevin G. Keenan
    • 2
    • 3
  • Amy E. Harley
    • 4
  • Razia Azen
    • 5
  • Scott J. Strath
    • 2
    • 3
  1. 1.Department of Movement ScienceGrand Valley State UniversityAllendaleUSA
  2. 2.Department of KinesiologyThe University of Wisconsin-MilwaukeeMilwaukeeUSA
  3. 3.Center for Aging and Translational ResearchThe University of Wisconsin-MilwaukeeMilwaukeeUSA
  4. 4.Zilber School of Public HealthThe University of Wisconsin-MilwaukeeMilwaukeeUSA
  5. 5.Department of Educational PsychologyThe University of Wisconsin-MilwaukeeMilwaukeeUSA

Personalised recommendations