60 Sustainable impact of an outdoor exercise program on health outcomes of older adults: a quasi-randomized controlled trial with a 3-month follow-up

TL;DR

An outdoor exercise program for older adults improved health outcomes and remained effective even after participants took over leading the sessions.

Contribution

This study demonstrates the sustainability of health benefits from an outdoor exercise program through mentor-led continuation.

Findings

Neurocognitive performance improved significantly during instructor-led exercise and remained stable during mentor-led sessions.

Participants maintained walking distance improvements even after transitioning to self-organized exercise sessions.

Mentor-led continuation ensured long-term sustainability of health benefits in older adults.

Abstract

Older people benefit in several health-promoting outcomes from needs-oriented exercise programs in their immediate living environment. For a low-threshold, and thus sustainable and cost-effective design of exercise programs a transfer to self-organisation is favourable. The aim of our study is to examine the health-promoting impacts of an outdoor exercise program developed for older persons, as well as its sustainability after 3 months.

Ninety-five persons aged 60+ were randomized according to their residence (IG: n = 40, mean age = 72.35 years, 24 female; KG: n = 55, mean age = 75.05 years, 34 female). An age-adjusted exercise program was carried out over 12 weeks (2x/week á 45-60min; adherence: 90.9%) by professional exercise instructors in urban parks. During this instructor-led exercise phase, seven participants were trained as mentors, and thus, enabled to continue the exercise program for further 12 weeks (1-2x/week á 45-60min; adherence: 2-3x/month = 11.5%, 1-2x/week = 88.5%). Before (T1) and after the instructor-led exercise phase (T2) as well as after the mentor-led exercise phase (T3), health outcomes (e.g., walking distance/6MWT, neurocognitive performance/DSST) of IG and CG (no intervention) were assessed and analysed using paired t-Tests.

75.1% of IG participants completed both phases of the exercise program. Neurocognitive performance improved significantly for IG between T1 and T2 (+2.32 correct number-symbol matches; p = .003; d = -.509) and remained stable between T2 and T3 (+0.15 correct matches; p = .863; d = -.028) while for CG the opposite development was observed (T1-T2: -0.6 correct matches; p = .451; d = .102; T2-T3: +2.18 correct matches; p = .004; d = -.423). IG improved their walking distance for T1-T2 by 21.39m (p = .172; d = -.223), which could be maintained for T2-T3 (+5,1m; p = .648; d = -.074). Improvements in CG for walking distance were smaller (T1-T2: +2.8m; p = .690; d = -.055; T2-T3: +14.26m, p = .315; d = -.147).

The mentoring of the exercise groups proved to be very successful, as evidenced by the maintained effects in the mentor-led phase, ensuring sustainability of health-promoting interventions.

(Funded by the Free State of Saxony, “Demographics” #100535625)