Counseling for home-based walking and strength exercise in older primary care patients

Background: We evaluated the effects of counseling linked with primary care visits on walking and "strength exercise" (the combination of strength-building and flexibility exercise) in aging veterans. Methods: Male veterans aged 60 to 85 years (N = 224) with physical function limitations were randomized to either counseling for home-based walking and strength exercise (EXC) or discussion of their choice of health education topics (EDUC) with a nurse at baseline, 1 month, and 5 months. The EXC participants recorded exercise on monthly calendars and received brief follow-up calls from the nurse; all participants received bimonthly newsletters throughout the 10-month trial. Results: Retention was 83% in the EXC group and 97% in the EDUC group (P < .001). With analyses using the last observation carried forward approach, the EXC participants reported more walking time per week at 5 and 10 months (64.5 and 60.6 min/wk, respectively, for the EXC group vs 50.5 and 45.7 min/wk, respectively, for the EDUC group; 2.4 d/wk and 2.3 d/wk, respectively, for the EXC group vs 1.8 and 1.7 d/wk, respectively, for the EDUC group) (P < .001). The EXC participants also reported more strength exercise at 5 and 10 months (44.6 and 41.2 min/wk, respectively, for the EXC group vs 19.8 and 14.7 min/wk, respectively, for the EDUC group; 2.1 and 2.0 d/wk, respectively, for the EXC group vs 0.8 and 0.8 d/wk, respectively, for the EDUC group) (P < .001). The EXC participants reported more frequent moderate-or higher-intensity physical activity (7.1 vs 5.1 sessions/wk) (P < .001). Findings from accelerometer-measured physical activity indicated more EXC than EDUC participants (64% vs 46%), who averaged 30 min/d or more of moderate- or higher-intensity physical activity (P = .03). Participants engaging in strength exercise improved physical performance and reported positive changes in quality of life. Conclusion: Relatively brief counseling linked with primary care visits can increase home-based walking and strength exercise in aging male veterans. Trial Registration: clinicaltrials.gov Identifier: NCT00013195.