A randomized controlled clinical trial of the seattle protocol for activity in older adults

OBJECTIVES: To compare the efficacy of a physical activity program (Seattle Protocol for Activity (SPA)) for low-exercising older adults with that of an educational health promotion program (HP), combination treatment (SPA+HP), and routine medical care control conditions (RMC). DESIGN: Single-blind, randomized controlled trial with two-by-two factorial design. SETTING: Community centers in King County, Washington, from November 2001 to September 2004. PARTICIPANTS: Two hundred seventy-three community-residing, cognitively intact older adults (mean age 79.2; 62% women). INTERVENTIONS: SPA (in-class exercises with assistance setting weekly home exercise goals) and HP (information about age-appropriate topics relevant to enhancing health), with randomization to four conditions: SPA only (n=69), HP only (n=73), SPA+HP (n=67), and RMC control (n=64). Active-treatment participants attended nine group classes over 3 months followed by five booster sessions over 1 year. MEASUREMENTS: Self-rated health (Medical Outcomes Study 36-item Short-Form Survey) and depression (Geriatric Depression Scale). Secondary ratings of physical performance, treatment adherence, and self-rated health and affective function were also collected. RESULTS: At 3 months, participants in SPA exercised more and had significantly better self-reported health, strength, and general well-being (P<.05) than participants in HP or RMC. Over 18 months, SPA participants maintained health and physical function benefits and had continued to exercise more than non-SPA participants. SPA+HP was not significantly better than SPA alone. Better adherence was associated with better outcomes. CONCLUSION: Older adults participating in low levels of regular exercise can establish and maintain a home-based exercise program that yields immediate and long-term physical and affective benefits.