Aging
Conditions
Keywords
Attentional Bias, Exercise, Sedentary Behavior
Brief summary
Most individuals are aware of the benefits to health of regular physical activity and have good intentions to exercise. Yet, 1.4 billion people worldwide are inactive, which suggests that turning intention into action can be challenging. Recent findings show that the intention-action gap could be explained by negative automatic reactions (which is a component of dual-task theory) to stimuli associated with physical activity. This gap is particularly concerning in older adults, who are more likely to spontaneously associate physical activity with fear, pain, or discomfort. To promote physical activity, the current project proposes to train older adults to suppress their automatic attraction toward sedentary stimuli and to respond positively to physical-activity stimuli. This evidence-based and low-cost intervention aims to improve physical functioning and quality of life for these population. The results will inform public-health policies and improve clinical interventions that aim to counteract a global health problem: the pandemic of physical inactivity.
Detailed description
Physical activity is one of the top contributors to health, reducing rates of cardiovascular disease, cancer, hypertension, diabetes, obesity, and depression. This wide spectrum of benefits is particularly important for older adults, who often suffer structural and functional deterioration in several physiological systems. Physical activity can reduce and delay the impact of this age-related deterioration in health and functional independence. Current interventions to enhance physical activity in older adults rely mainly on reflective processes by providing rational information about the health benefits of a physically active lifestyle. While these interventions successfully increase intention, their effect on actual behavior is weak. That is, most individuals are now aware of the positive effects of regular physical activity and have the intention to exercise. However, this intention is not sufficient and exercise plans are often not executed. This gap between intention and action is a challenge that health professionals need to address to counteract the pandemic of physical inactivity. Recent findings suggest that this inability to turn the intention into action is explained by negative automatic reactions to stimuli associated with physical activity. These automatic reactions could be particularly strong in older adults, who are more likely to associate physical activity with fear, pain, or discomfort. This study aims to test the effect of an intervention that targets the automatic processes underlying physical inactivity in older adults. The intervention is expected to reduce physical inactivity during the intervention and at follow-up, thereby improving physical functioning and quality of life.
Interventions
The intervention of the proposed project is based on a go/no-go task in which older adults need to quickly decide whether or not they should react to the stimulus. A rectangle containing an image, or a word will be presented on a screen. In the intervention group, older adults will be instructed to restrain their actions when the rectangle is tilted to the right and to react by pressing a key on the keyboard when the rectangle is tilted to the left, irrespective of the content of the rectangle (because the training is meant to be implicit). In order to train inhibitory processes counteracting the automatic attraction to sedentary behavior, 90% of the rectangles tilted to the right (counterbalanced across participants) will contain a picture or a word related to sedentary behavior. To foster the automatic attraction toward physical activity, 90% of the rectangles tilted to the left will contain a picture or a word related to physical activity.
In the comparison group, instructions will be identical, but the percentage of physical activity and sedentary stimuli will be equal in each tilt condition (i.e., 50% sedentary stimuli and 50% physical activity stimuli in both right- and left-tilted rectangles)
Sponsors
Study design
Masking description
Participants and research assistant will be blinded to the groups' allocation. The participant blinding success will be appraised by asking them to guess in what group there were at the trial termination. Besides, the research assistant blinding success will be appraised via detecting the group allocation (Experimental vs. Control) by research assistant at the end of data collection phase. The randomization will be generated on a computer and an independent coworker will carry out the randomization. The participant's identification number will be used to determine the sequence of randomization. Participants will be randomized in a 1:1 ratio between the intervention and active control condition.
Eligibility
Inclusion criteria
\- 60 years of age or older and able to understand instructions in English.
Exclusion criteria
* Diagnosed psychiatric disorders or neurological condition (e.g., stork, Parkinson's disease, Alzheimer's disease, dementia) * Unable to carry out the training program * Unable to understand the protocol * Motor deficit preventing physical activity without external help * Physical health status preventing physical activity * Alcohol or substance dependence.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Physical activity Tracker | 7 days, at least 7 hours per day (not to used it during shower or when they sleep at night). | Assessing the number of step. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| International Physical Activity Questionnaire (Short Form) | Before and after intervention (10 minutes to fill out) | The usual level of moderate-to-vigorous physical activity in minutes per week will be assessed. |
| Six-Minute Walk Test | Before and after intervention (6 minutes to carry out) | Total distance walked in 6 minutes will be documented. The outcome is the distance walked during the 6 minutes. |
| Hand grip strength | Before and after intervention ( One minute to carry out) | The grip strength will be evaluated using a dynamometer. The higher the value obtained by the participant, the stronger the grip. |
| World Health Organization Quality of Life (BREF) | Before and after intervention ( 20 minutes to carry out) | Assessing quality of life over four domains. Scores for each domain can range from zero to 100, with higher scores indicating better quality of life. |
| Approach-avoidance task | Before and after intervention, and at the beginning of each intervention session (30 minutes to carry out) | To measure automatic approach and avoidance tendencies toward physical activity and sedentary behaviors. Faster and the more accurate reaction toward a stimuli (e.g., physical activity) indicates a stronger tendency to approach that specific stimuli. |
| Explicit Affective Attitude Toward Physical Activity | Before and after intervention (2-5 minute to carry out) | Mean of two items based on two 7-point scales (unpleasant-pleasant; unenjoyable-enjoyable). A higher score indicates more positive attitudes toward physical activity. |