PT - JOURNAL ARTICLE AU - A Stefanie Mikolaizak AU - Kristin Taraldsen AU - Elisabeth Boulton AU - Katharina Gordt AU - Andrea Britta Maier AU - Sabato Mellone AU - Helen Hawley-Hague AU - Kamiar Aminian AU - Lorenzo Chiari AU - Anisoara Paraschiv-Ionescu AU - Mirjam Pijnappels AU - Chris Todd AU - Beatrix Vereijken AU - Jorunn L Helbostad AU - Clemens Becker TI - Impact of adherence to a lifestyle-integrated programme on physical function and behavioural complexity in young older adults at risk of functional decline: a multicentre RCT secondary analysis AID - 10.1136/bmjopen-2021-054229 DP - 2022 Oct 01 TA - BMJ Open PG - e054229 VI - 12 IP - 10 4099 - http://bmjopen.bmj.com/content/12/10/e054229.short 4100 - http://bmjopen.bmj.com/content/12/10/e054229.full SO - BMJ Open2022 Oct 01; 12 AB - Context Long-term adherence to physical activity (PA) interventions is challenging. The Lifestyle-integrated Functional Exercise programmes were adapted Lifestyle-integrated Functional Exercise (aLiFE) to include more challenging activities and a behavioural change framework, and then enhanced Lifestyle-integrated Functional Exercise (eLiFE) to be delivered using smartphones and smartwatches.Objectives To (1) compare adherence measures, (2) identify determinants of adherence and (3) assess the impact on outcome measures of a lifestyle-integrated programme.Design, setting and participants A multicentre, feasibility randomised controlled trial including participants aged 61–70 years conducted in three European cities.Interventions Six-month trainer-supported aLiFE or eLiFE compared with a control group, which received written PA advice.Outcome measures Self-reporting adherence per month using a single question and after 6-month intervention using the Exercise Adherence Rating Scale (EARS, score range 6–24). Treatment outcomes included function and disability scores (measured using the Late-Life Function and Disability Index) and sensor-derived physical behaviour complexity measure. Determinants of adherence (EARS score) were identified using linear multivariate analysis. Linear regression estimated the association of adherence on treatment outcome.Results We included 120 participants randomised to the intervention groups (aLiFE/eLiFE) (66.3±2.3 years, 53% women). The 106 participants reassessed after 6 months had a mean EARS score of 16.0±5.1. Better adherence was associated with lower number of medications taken, lower depression and lower risk of functional decline. We estimated adherence to significantly increase basic lower extremity function by 1.3 points (p<0.0001), advanced lower extremity function by 1.0 point (p<0.0001) and behavioural complexity by 0.008 per 1.0 point higher EARS score (F(3,91)=3.55, p=0.017) regardless of group allocation.Conclusion PA adherence was associated with better lower extremity function and physical behavioural complexity. Barriers to adherence should be addressed preintervention to enhance intervention efficacy. Further research is needed to unravel the impact of behaviour change techniques embedded into technology-delivered activity interventions on adherence.Trial registration number NCT03065088.Data are available upon reasonable request. The datasets presented in this article are not readily available because the datasets for this study are not openly accessible to all but shared only between project partners due to ethical approval guidelines in the three clinical sites that conducted the multicentre trial, and cannot be shared until 10 years after the end of the project. Requests to access the datasets should be directed to kristin.taraldsen@ntnu.no.