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Group exercise has long-term positive impacts for over-65s with mobility limitations - Mar 2022.

Results from a major study into the effectiveness of a community-based group exercise programme designed for people aged 65 and over with mobility limitations shows that an in innovative behaviour change programme prevents physical decline and is cost-effective to run. The team behind it, involving the University of Exeter, say it should be rolled out nationwide.

A decline in mobility associated with ageing can greatly reduce quality of life, lead to loss of independence, generate substantial health and social care costs, and reduce overall life expectancy. Pressure on healthcare systems is set to be exacerbated by the rapid expansion of the older population. Currently, three in 10 people of state pension age are classified as disabled due to mobility limitations.

REACT – otherwise known as the REtirement in ACTion programme – is an innovative, behaviour change intervention targeted specifically at older adults who are beginning to experience mobility limitations (e.g., those who are beginning to find climbing upstairs, walking to the shop, or getting up from a chair more of a challenge). It aims to prevent further decline in mobility through exercises that target lower limb strength, balance, and stamina.

The programme focuses on fun, social interaction and building a community through the group-based sessions whilst providing accessible strength, balance, mobility, and cardio-vascular exercises tailored to each participant’s needs.

Based on results from a large, randomised control trial, the international research team from the universities of Bath, Birmingham, Exeter, and the University of the West of England (UWE) (UK) and the University of Maryland School of Medicine and Wake Forest (US) say that REACT can help older people avoid a downward spiral of declining mobility, which can accelerate and lead to social isolation and loss of independence.

Their results, which are published in two papers in the Lancet Public Health, show that:

  • At 24-months (12 months after the completion of the REACT intervention), the participants who had attended sessions had significantly greater mobility than those who did not, suggesting both a short and long-term positive effect.
  • This meant REACT participants found it easier walking, climbing stairs, and had greater independence performing daily activities.
  • At least one strength, balance, and mobility exercise session per week (a fairly low level of commitment) was sufficient to provide meaningful benefits on lower limb physical function.
  • Per person, the cost of delivering the programme was £622, but the health care savings were £725 over two years. Longer-term savings could be far higher.

Dr Tristan Snowsill of the University of Exeter, who examined the economic data from the study with Professor Antonieta Medina-Lara, said: “We found clear evidence that quality of life was improved in the REACT group. This alone would most likely have been enough to justify the cost of the programme using the standard rule for cost-effectiveness. To also find that REACT participants used fewer health and care services makes the REACT programme one of the clearest cases of value for money I have come across.”

The team now hope REACT can be rolled out nationwide via community activity providers based in local areas. 

REACT delivery partners included: Bath and North East Somerset Council; Exeter and Solihull City Councils; Westbank Charity; St Monica Trust, Bristol; Bristol Ageing Better; St John’s Hospital, Bath; Age UK Birmingham; Agewell, West Midlands; Sandwell and West Birmingham Hospitals NHS Trust; the Portway Lifestyle Centre and Solihull Borough Council, Birmingham.

 

Further details:

Stathi A, Greaves CJ, Thompson JL, Withall J, Ladlow P, Taylor G, Medina-Lara A, Snowsill TM, Gray S, Green C, Johansen-Berg H, Sexton CE, Bilzon JLJ, de Koning JL, Bollen JC, Moorlock SJ, Western MJ, Demnitz N, Seager P, Guralnik JM, Rejeski WJ, Hillsdon M, Fox KR. Effect of a physical activity and behaviour maintenance programme on prevention of mobility decline in older adults: The REACT (REtirement in ACTion) randomised controlled trial. Lancet Public Health

Snowsill TM, Stathi A, Green C, Withall J, Greaves CJ, Thompson JL, Taylor G, Gray S, Johansen-Berg H, Bilzon JLJ, de Koning JL, Bollen JC, Moorlock SJ, Western MJ, Guralnik JM, Rejeski WJ, Fox KR, Medina-Lara A. Cost-effectiveness of a community-based physical activity and behaviour maintenance intervention for preventing decline in physical functioning in older people: an economic evaluation of the REACT (Retirement in Action) intervention. Lancet Public Health

Date: 31 March 2020