Community-based exercise enhanced by a self-management programme to promote independent living in older adults: a pragmatic randomised controlled trial

Pia Øllgaard Olsen, Mark A Tully, Borja Del Pozo Cruz, Manfred Wegner, Paolo Caserotti

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BACKGROUND: older adults face several modifiable barriers for engaging in physical activity (PA) programmes such as incontinence, loneliness and fear of falling. Enhancing PA programmes with behavioural components to support self-management of such barriers may increase the effectiveness to preserve functional capacity and independent living.

OBJECTIVE: this study aimed at assessing the effects of a complex active lifestyle intervention (CALSTI) on objective and self-report measures of functional capacity and disability in community-dwelling older adults.

SUBJECTS AND METHODS: about 215 older adults (79.9 ± 0.4 years) at increased risk of functional decline were randomly allocated to (i) CALSTI consisting of 12-weeks progressive explosive resistance training (24 sessions) enhanced by a 24-week multi-factorial self-management programme (8 sessions), or (ii) an extended version of the self-management intervention (SEMAI; 12 sessions) to reflect a reinforcement of usual care. The interventions were embedded in a nationally regulated preventive care pathway. Blinded assessors collected primary (the Short Physical Performance Battery; SPPB) and secondary outcome data (self-reported difficulty in activities of daily living, the short version of the Late-Life Function and Disability Index, and the EQ-health VAS scale) at baseline and after 12 and 24 weeks.

RESULTS: after 24 weeks, CALSTI led to a clinically superior increase in SPPB compared with SEMAI (+0.77 points, P < 0.01), and the CALSTI group also demonstrated improvements in selected self-reported outcomes.

CONCLUSIONS: a novel complex exercise and multi-factorial self-management intervention embedded in preventive care practice had large and clinically meaningful effects on a key measure of functional capacity and predictor of disability.

Original languageEnglish
Article numberafac137
Pages (from-to)1-10
Number of pages10
JournalAge and Ageing
Issue number7
Publication statusPublished (in print/issue) - 6 Jul 2022

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email:


  • Activities of Daily Living
  • Aged
  • Cost-Benefit Analysis
  • Exercise
  • Fear
  • Humans
  • Independent Living
  • Quality of Life
  • Self-Management
  • behaviour change
  • complex intervention
  • older people
  • physical function
  • resistance training


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