The purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia.
Objectives 1. To compare the difference of effects between supervised group-based walking and non-supervised individual-based walking on the primary outcomes, including frailty, cognitive functions, and health-related quality of life among inactive older adults in Saudi Arabia. 2. To compare the difference of effects between supervised group-based walking and non-supervised individual-based walking on the secondary outcomes, including physical activity enjoyment, health parameters consisting of resting heart rate, resting blood pressure, and body composition, as well as walking performance among inactive older adults in Saudi Arabia. 3. To formulate guidelines for achieving an effective walking intervention for inactive older adults in Saudi Arabia. 4. To recommend the government of Saudi Arabia on guidelines and policies for promoting walking and active ageing among the older adults in the country.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
126
Group exercise interventions tended to be systematic and supervised by professionals. The current intervention is proposing to conduct a randomized control trial that is not only examining the nature of walking on older adults' well-being but also involving the elements of group-based and professional supervision intervention, aiming at comparing with the individual-based intervention without professional supervision. Qualified professional fitness trainers (1 male and 1 female separately for male and female groups, respectively) will be involved in the group-based intervention programs in order to provide appropriate guidance and supervision to the participants. Whereas, the non-supervised individual-based intervention will be conducted by a research assistant (males and females) to ensure the attendance and general safety, but without providing professional advice or supervision.
Change from baseline Health-related quality of life at 4 months and at 7 months
The Short Form-36 (SF-36) is a widely used health survey questionnaire, especially for older adults to assess the health-related quality of life (HRQoL). The higher the scores mean a higher level of quality of life.
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Frailty level at 4 months and at 7 months
Physical Performance Test (PPT) is one of the tools which is used to assess the level of frailty. For our research we will use 9 item scale that includes 9 standardized tasks such as writing a sentence, simulated eating, turning 360 degrees, putting on and removing a jacket, lifting a book and putting it on a shelf, picking up a penny from the floor, a 50-foot walk test, and climbing stairs (scored as two items) (Reuben and Siu, 1990). The score range of each task is 0-4 and for 9 items it will be 36. A higher score indicates better performance (Villareal et al., 2017).
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Cognitive function at 4 months and at 7 months
The Mini-mental state examination (MMSE) is the most commonly used method to measure the level of cognitive impairment, especially in older adults. The score of Mini-mental state examination is calculated on a scale of 0-30 where score 24 or above is usually considered as the normal cognitive status or no cognitive impairment of the individual. The overall scorings are Severe cognitive impairment (0-17), Mild cognitive impairment (18-23) and No cognitive impairment (24-30).
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Health parameters - Body Composition at 4 months and at 7 months
The walking effects on participants' health parameters, namely body composition, will be assessed. The body composition will be assessed by Tanita MC780U (Tanita Corporation, 2020), by which the percent body fat and lean body mass of participants will be recorded. The body mass index (BMI) using participants' heights and weights (measured by the RA) will also be recorded.
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Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Health parameters - Resting Heart Rate at 4 months and at 7 months
The walking effects on participants' health parameters, namely resting heart rate, will be assessed. The wrist-worn Fitbit Charge 3 (Fitbit, Inc., 2020) will be used to record the resting heart rate of participants (also the heart rates during walking for reflecting the exercise intensity of the participants as well as the accumulated footsteps and the duration of the completed footsteps during each session of the intervention for performance analyses).
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Health parameters - Resting Blood Pressure at 4 months and at 7 months
The walking effects on participants' health parameters, namely resting blood pressure, will be assessed. The resting blood pressure of the participants will be recorded by Lenus Automatic Blood Pressure Monitor DP65 (MDF Instruments USA, 2020).
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Physical Activity Enjoyment at 4 months and at 7 months
The 8-item Physical Activity Enjoyment Scale (PACES; Chung \& Leung, 2019) will be applied to measure the participants' level of enjoyment after engaging in walking intervention programs. The 8-item Physical Activity Enjoyment Scale is rated by a 7 bipolar rating, with items such as " I enjoy it." (one extreme) to " I dislike it."(the other extreme). In the scale, the negative items (i.e., 1, 4, 5, and 7) requires reverse coding, and the Higher PACES scores the greater levels of physical activity enjoyment demonstrated.
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention
Change from baseline Walking Performance at 4 months and at 7 months
The time for completing the targeted steps in targeted heart rate zones of each participant in each training session will be recorded for analysis of performance and improvement on walking. All the data will be recorded by the wrist-worn Fitbit Charge 3 (Fitbit, Inc., 2020) and retrieve from the computer after each training session.
Time frame: Time 1: Baseline; TIme 2 after the 16-week intervention; Time 3 12-weeks after the intervention