Physical inactivity is the fourth leading cause of mortality in the world; as such, the World Health Organization (WHO) recommends that adults engage in at least 150 minutes of moderate-intensity physical activity every week. In addition, the WHO further recommends that older adults (i.e., those 65 years or above) engage in activities that promote functional balance and muscular strength to reduce the risks of falls. This is important because falls are the leading cause of injury-related deaths among older adults. Research has also shown that having good physical function (i.e., activity level, balance, and strength) is associated with better health, well-being, and quality of life. As suggested by results from the Hong Kong Health Behaviour Survey 2018/19, older adults in Hong Kong are generally active, with 85% of the population doing more than 150 minutes of activity on a weekly basis. The survey, however, did not include questions about whether respondents engaged in functional balance training. The above figures suggest that older adults may be unaware of the importance of functional balance and strength training and may not be attaining their optimal levels of physical function. Our proposed study aims to address this issue by delivering an intervention program aimed at increasing retirees' physical activity levels, with emphasis placed on functional balance and muscular strength training. Retirees in Hong Kong are generally healthy, active, and capable of self-learning and self-regulation. Provision of knowledge and support could lead to positive behavior change. Also, as mobile-based messaging (e.g., WhatsApp) has become mainstream, retirees have a good level of competence in using mobile phones as a means of communication. This mode of communication has become increasingly important since face-to-face contact could be impeded by pandemic-led social distancing. Therefore, the proposed project will be delivered primarily through e-platforms. Our previous work has shown that adults' behaviors and attitudes could be enhanced through an internet-based program. Preliminary results of our ongoing retiree-focused program also suggest that older adults are receptive to mobile-based interventions.
A series of educational videos will be produced and placed on the project website to provide participants with knowledge on the importance of having good physical function. Coach-led videos will also be produced for participants to exercise by following on-screen instructions. The exercises included will incorporate activities to improve activity levels, functional balance, and muscular strength. To maximize adherence, a group of participants will first be recruited and trained to serve as "captains" of the program. Each captain will then be assigned to lead a group of participants (5 to 10), ideally recruited through their own social circles, where they will coordinate co-activity sessions (virtual or in-person) by following the provided materials together. Research using a similar peer-led mode has been found to be effective in enhancing behavior and increasing perceived support.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
300
Participants will be intervened after the baseline measurements, including two training classes.
The Chinese University of Hong Kong
Hong Kong, Hong Kong
Moderate-to-vigorous physical activity
measured by ActiGraph GT3X+. The unit of measure is the mean time spent in MVPA per day. Participants will be asked to wear the devices on their waist over a seven-day period, except during water-based activities. Data will be considered valid if participants worn the devices for eight hours on at least two weekdays and one weekend day. Age-appropriate cut-off values will be used for PA intensity classification, i.e., cutpoints by Freedson, Melanson, and Sirard (1998). The mean time participants spent in MVPA during valid days will be used as a measure for MVPA.
Time frame: baseline, 2-week before intervention
Moderate-to-vigorous physical activity
measured by ActiGraph GT3X+. The unit of measure is the mean time spent in MVPA per day. Participants will be asked to wear the devices on their waist over a seven-day period, except during water-based activities. Data will be considered valid if participants worn the devices for eight hours on at least two weekdays and one weekend day. Age-appropriate cut-off values will be used for PA intensity classification, i.e., cutpoints by Freedson, Melanson, and Sirard (1998). The mean time participants spent in MVPA during valid days will be used as a measure for MVPA.
Time frame: 4 months
Lower limb strength
Use handheld dynamometer to test partipants lower limb strength. Two trials for each leg.
Time frame: baseline, 2-week before intervention
Lower limb strength
Use handheld dynamometer to test partipants lower limb strength. Two trials for each leg.
Time frame: 4 months
Upper limb strength
Hand grip strength test will also be used as a measure of upper limb strength of participants.
Time frame: baseline, 2-week before intervention
Upper limb strength
Hand grip strength test will also be used as a measure of upper limb strength of participants.
Time frame: 4 months
Muscular strength
The tests for lower limb strength, reaction time, and standing balance from the Physiological Profile Assessment will also be administered to participants. Hand grip strength test will also be used as a measure of upper limb strength of participants.
Time frame: baseline, 2-week before intervention
Muscular strength
The tests for lower limb strength, reaction time, and standing balance from the Physiological Profile Assessment will also be administered to participants. Hand grip strength test will also be used as a measure of upper limb strength of participants.
Time frame: 4 months
The Timed Up and Go test
The Timed Up and Go test will be used to assess the level of balance in adults. Participants will be timed as they stand up from a standard armchair, walk 3 meters away, and return. An older adult who takes ≥12 seconds to complete the TUG is at risk for falling
Time frame: baseline, 2-week before intervention
The Timed Up and Go test
The Timed Up and Go test will be used to assess the level of balance in adults. Participants will be timed as they stand up from a standard armchair, walk 3 meters away, and return. An older adult who takes ≥12 seconds to complete the TUG is at risk for falling
Time frame: 4 months
The Sit-to-Stand Test
The Sit-to-Stand Test, requires participants to repeatedly sit down and stand up as quickly as possible. The time required to complete five repetitions will be used as the score for the test.
Time frame: baseline, 2-week before intervention
The Sit-to-Stand Test
The Sit-to-Stand Test, requires participants to repeatedly sit down and stand up as quickly as possible. The time required to complete five repetitions will be used as the score for the test.
Time frame: 4 months
The Four Stage Balance Test
The four stage balance test requires participants to stand in a side-by-side-stance, semi-Tandem stance, and a full Tandem stance. The time participants could maintain in a balance position will be scored using a specific scoring rubric. Not being able to hold the tandem stance (task number 3) for 10 seconds is an indication of increased risk of fall.
Time frame: baseline, 2-week before intervention
The four stage balance test
The four stage balance test requires participants to stand in a side-by-side-stance, semi-Tandem stance, and a full Tandem stance. The time participants could maintain in a balance position will be scored using a specific scoring rubric. Not being able to hold the tandem stance (task number 3) for 10 seconds is an indication of increased risk of fall.
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Time frame: 4 months
Gait pattern
Participants' gait pattern will be assessed by GAITRite system walkway. Participants will be asked to walk as usual on a 4.6m long mat twice.
Time frame: baseline, 2-week before intervention
Gait pattern
Participants' gait pattern will be assessed by GAITRite system walkway. Participants will be asked to walk as usual on a 4.6m long mat twice.
Time frame: 4 months
Hand reaction time
Participants' dominant hand reaction time will be assessed by the reaction timer. Participants will be asked to pay attention to the light on a mouse. Once the light is on, participants should press the button on the mouse as quickly as possible. Ten trials will be conducted.
Time frame: baseline, 2-week before intervention
Hand reaction time
Participants' dominant hand reaction time will be assessed by the reaction timer. Participants will be asked to pay attention to the light on a mouse. Once the light is on, participants should press the button on the mouse as quickly as possible. Ten trials will be conducted.
Time frame: 4 months
Life satisfaction
Life satisfaction will be measured by WHOQOL-BREF (World Health Organization Quality of Life-BREF) questionnaire. Twenty-six items will be rated on a 5-point Likert scale, ranging from 1 (not at all) to 5 (completely). All items will be added up including Item 3 will be reverse-coded first. Higher total scores indicate a higher quality of life.
Time frame: baseline, 2-week before intervention
Life satisfaction
Life satisfaction will be measured by WHOQOL-BREF (World Health Organization Quality of Life-BREF) questionnaire. Twenty-six items will be rated on a 5-point Likert scale, ranging from 1 (not at all) to 5 (completely). All items will be added up including Item 3 will be reverse-coded first. Higher total scores indicate a higher quality of life.
Time frame: 4 months
Social support for exercise
Social support for exercise is assessed by Social Support and Exercise Survey. Higher scores indicate higher support from family and friends on exercise.
Time frame: baseline, 2-week before intervention
Social support for exercise
Social support for exercise is assessed by Social Support and Exercise Survey. Higher scores indicate higher support from family and friends on exercise.
Time frame: 4 months
eHealth Literacy
eHealth Literacy is assessed by eHealth Literacy Scale (eHEALS）. Higher scores of eight items indicate better eHealth Literacy.
Time frame: baseline, 2-week before intervention
eHealth Literacy
eHealth Literacy is assessed by eHealth Literacy Scale (eHEALS）. Higher scores of eight items indicate better eHealth Literacy.
Time frame: 4 months
Perceived falling risk
Participants are asked to report how much they are concerned about falling when engaging in seven daily activities, e.g.take on/off clothes, taking bath/shower. Higher total scores on seven items indicate higher perceived falling risk.
Time frame: baseline, 2-week before intervention
Perceived falling risk
Participants are asked to report how much they are concerned about falling when engaging in seven daily activities, e.g.take on/off clothes, taking bath/shower. Higher total scores on seven items indicate higher perceived falling risk.
Time frame: 4 months
Self-report physical activity frequency
Participants are asked to answer two items about how frequent they engage in PA to enhance muscular strength and functional balance.
Time frame: baseline, 2-week before intervention
Self-report physical activity frequency
Participants are asked to answer two items about how frequent they engage in PA to enhance muscular strength and functional balance.
Time frame: 4 months
Sports motivation
Participants' sports motivation will be measured by 24 items on a five-point scale (0- completely not suitable for me, 4-completely suitable for me), such as I think doing exercise is a joyful thing.
Time frame: baseline, 2-week before intervention
Sports motivation
Participants' sports motivation will be measured by 24 items on a five-point scale (0- completely not suitable for me, 4-completely suitable for me), such as I think doing exercise is a joyful thing.
Time frame: 4 months