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一项为期12个月的数字同伴支持应用程序干预措施,以促进社区居住老年人的身体活动:非随机对照试验的随访研究。

A 12-Month Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Follow-Up Study of a Nonrandomized Controlled Trial.

作者信息

Tabira Kento, Oguma Yuko, Yoshihara Shota, Shibuya Megumi, Nakamura Manabu, Doihara Natsue, Hirata Akihiro, Manabe Tomoki, Yamashita Takashi

机构信息

Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-0061, Japan, 81 45-566-1090.

Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan.

出版信息

JMIR Aging. 2025 May 28;8:e66610. doi: 10.2196/66610.


DOI:10.2196/66610
PMID:40435519
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12136513/
Abstract

BACKGROUND: Mobile apps and peer support are known to effectively promote physical activity in older adults, which, in turn, improves physical function. Previously, we investigated the feasibility and impact of using digital peer-supported apps (DPSAs) to increase physical activity among older adults over a 3-month period. However, the long-term feasibility and impact on sustainable behavior change remain unknown. OBJECTIVE: This study aims to evaluate the 12-month feasibility of the DPSA and to obtain preliminary estimates of its effects on physical activity and physical function among older Japanese adults. METHODS: This nonrandomized controlled trial recruited older adults aged 65 years or older from 2 physical activity programs. Participants chose either the intervention (app program + exercise instruction) group or the control (exercise instruction only) group. Only those participants who had completed the 3-month intervention and wished to continue in the 12-month follow-up intervention study were included. DPSA feasibility was assessed using retention and adherence rates. Physical activity was assessed using accelerometers, capturing daily step count, light-intensity activity, moderate to vigorous intensity activity, and sedentary behavior. Physical function was evaluated using grip strength and the 30-second chair stand test (CS-30). Accelerometer measurements were collected every 3 months over 12 months (5 time points, including baseline), whereas physical function was measured at baseline, 3 months, and 12 months. RESULTS: The follow-up study included 44 of 66 participants from the 3-month intervention study, with 26 participants in the intervention group and 18 participants in the control group. The 12-month retention rate for participants in the DPSA intervention group was 73% (19/26), whereas the retention rate among all 41 participants, including those who chose not to participate in the follow-up study, was 46% (19/41). The adherence rate was 85.9%. The average number of steps per day (95% CI) in the intervention group changed before and after DPSA use (P=.048). We observed an increase of 1736 (β=1736, 95% CI 232-3241) steps per day compared with baseline. No significant change was observed in the control group. There were significant within-group differences in CS-30 scores for both intervention (P<.001) and control (P=.03) groups over the 12-month period. Specifically, there was a significant change in CS-30 scores (95% CI) between the baseline and 12-month assessments for the intervention (β=6.5, 95% CI 3.8-9.1; P<.001) and control (β=3.8, 95% CI 0.6-7.1; P=.02) groups. CONCLUSIONS: Participants with long-term DPSA use observed increases in average daily steps and CS-30 scores before and after DPSA use, although only a limited number of older adults had long-term access to the DPSA. Identifying ways to expand long-term DPSA use among older adults is necessary. Additionally, randomized controlled trials should be conducted to determine the long-term effects of DPSAs on physical activity and function in older adults.

摘要

背景:众所周知,移动应用程序和同伴支持能有效促进老年人的身体活动,进而改善身体功能。此前,我们调查了使用数字同伴支持应用程序(DPSA)在3个月内增加老年人身体活动的可行性和影响。然而,其长期可行性以及对可持续行为改变的影响仍不明确。 目的:本研究旨在评估DPSA的12个月可行性,并初步估计其对日本老年成年人身体活动和身体功能的影响。 方法:这项非随机对照试验从2个身体活动项目中招募了65岁及以上的老年人。参与者选择干预组(应用程序项目+运动指导)或对照组(仅运动指导)。仅纳入那些完成了3个月干预且希望继续参加12个月随访干预研究的参与者。使用留存率和依从率评估DPSA的可行性。使用加速度计评估身体活动,记录每日步数、轻度活动、中度至剧烈强度活动和久坐行为。使用握力和30秒椅子站立测试(CS-30)评估身体功能。在12个月内每3个月收集一次加速度计测量数据(共5个时间点,包括基线),而身体功能在基线、3个月和12个月时进行测量。 结果:随访研究包括来自3个月干预研究的66名参与者中的44名,其中干预组26名参与者,对照组18名参与者。DPSA干预组参与者的12个月留存率为73%(19/26),而包括那些选择不参加随访研究的所有41名参与者的留存率为46%(19/41)。依从率为85.9%。干预组在使用DPSA前后每日平均步数(95%CI)发生了变化(P=0.048)。与基线相比,我们观察到每日步数增加了1736步(β=1736,95%CI 232-3241)。对照组未观察到显著变化。在12个月期间,干预组(P<0.001)和对照组(P=0.03)的CS-30评分在组内均有显著差异。具体而言,干预组(β=6.5,95%CI 3.8-9.1;P<0.001)和对照组(β=3.8,95%CI 0.6-7.1;P=0.02)在基线和12个月评估之间的CS-30评分有显著变化。 结论:长期使用DPSA的参与者在使用前后观察到每日平均步数和CS-30评分增加,尽管只有有限数量的老年人能够长期使用DPSA。有必要确定扩大老年人长期使用DPSA的方法。此外,应进行随机对照试验以确定DPSA对老年人身体活动和功能的长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/03f2838c819f/aging-v8-e66610-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/ae5650ceb023/aging-v8-e66610-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/545181d5c3da/aging-v8-e66610-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/03f2838c819f/aging-v8-e66610-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/ae5650ceb023/aging-v8-e66610-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/545181d5c3da/aging-v8-e66610-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3387/12136513/03f2838c819f/aging-v8-e66610-g003.jpg

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本文引用的文献

[1]
Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Nonrandomized Controlled Trial.

JMIR Aging. 2024-5-30

[2]
Longitudinal analysis of physical function in older adults: The effects of physical inactivity and exercise training.

Aging Cell. 2024-1

[3]
Comparison of Grip Strength Measurements by Widely Used Three Dynamometers in Outpatients Aged 60 Years and Over.

J Clin Med. 2023-6-25

[4]
Perceived Neighborhood Conditions, Psychosocial Factors, and Sleep Problems Among Urban and Rural Older Adults in China.

J Aging Health. 2024-6

[5]
"It's not time for us to sit down yet": how group exercise programs can motivate physical activity and overcome barriers in inactive older adults.

Int J Qual Stud Health Well-being. 2023-12

[6]
Assessing the Pragmatic Nature of Mobile Health Interventions Promoting Physical Activity: Systematic Review and Meta-analysis.

JMIR Mhealth Uhealth. 2023-5-4

[7]
Impact of a public open-access community-based physical activity and fall prevention program on physical performance in older adults.

Eur J Public Health. 2023-2-3

[8]
Interventions Including Smart Technology Compared With Face-to-face Physical Activity Interventions in Older Adults: Systematic Review and Meta-analysis.

J Med Internet Res. 2022-10-31

[9]
Long-term Effects of the Use of a Step Count-Specific Smartphone App on Physical Activity and Weight Loss: Randomized Controlled Clinical Trial.

JMIR Mhealth Uhealth. 2022-10-24

[10]
Efficacy of Exercise on Muscle Function and Physical Performance in Older Adults with Sarcopenia: An Updated Systematic Review and Meta-Analysis.

Int J Environ Res Public Health. 2022-7-5

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