BACKGROUND Exercise referral schemes (ERS) are an effective strategy for increasing physical activity (PA) in older adults. Behavioural self-management strategies (SMS) may augment the maintenance of PA and associated benefits in this population, resulting in preservation of the functional capacity and prevention of disability over the long-term. AIM The primary aim was to investigate the long-term (22-months) effects of ERS enhanced with SMS on functional capacity assessed by the Short Physical Performance Battery (SPPB) compared to ERS (primary comparison) and a control condition (CTRL).Secondarily, between-group effects after 4 and 16 months on the SPPB and self-reported disability outcomes were investigated. METHODS 1360 physically inactive community-dwelling older adults ≥65 years from four European countries were randomized into (i) 16 weeks ERS enhanced with SMS (ERS-SMS), (ii) ERS alone and (iii) CTRL. In addition to SPPB, self-reported function and disability were assessed by the short-form late life function and disability index and with a six-item activity of daily living questionnaire. RESULTS No long-term effects were found for the SPPB-score in ERS-SMS vs ERS (0.21 point, 95% CI [-0.04, 0.46]). Significant group × time effects were observed for the SPPB-score after 4 months in favour of ERS-SMS over CTRL (0.51 point, 95% CI [0.29, 0.73]) and ERS (0.46 point, 95% CI [0.24, 0.68]). CONCLUSION The study did demonstrate differences, in favour of ERS + SMS, but on SPPB these were small, and not sustained over time. The additional effect of SMS was inconsistent and uncertain.

中文翻译：

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通过行为自我管理策略增强运动推荐计划对社区老年人功能能力和自我报告残疾的影响。SITLESS 多国三臂随机对照试验的次要结果。


背景 运动转介计划 （ERS） 是增加老年人身体活动 （PA） 的有效策略。行为自我管理策略 （SMS） 可能会增加该人群中 PA 的维持和相关益处，从而长期保持功能能力和预防残疾。目的 主要目的是研究 SMS 增强的 ERS 对短期体能电池 （SPPB） 与 ERS（主要比较）和控制条件 （CTRL） 相比评估的功能能力的长期 （22 个月） 影响。其次，调查了 4 个月和 16 个月后对 SPPB 和自我报告的残疾结局的组间影响。方法 来自四个欧洲国家的 1360 名身体不活跃的社区老年人 ≥65 岁）被随机分配到 （i） 16 周的 ERS 增强 SMS （ERS-SMS），（ii） 单独使用 ERS 和 （iii） CTRL。除 SPPB 外，通过简表晚年功能和残疾指数以及六项日常生活活动问卷评估自我报告的功能和残疾。结果 ERS-SMS与ERS的SPPB评分未发现长期影响（0.21分，95%CI [-0.04,0.46]）。4 个月后观察到 SPPB 评分的组×时间效应显著，ERS-SMS 优于 CTRL （0.51 分， 95% CI [0.29， 0.73]）和 ERS （0.46 分， 95% CI [0.24， 0.68]）。结论 该研究确实证明了差异，有利于 ERS + SMS，但在 SPPB 上，这些差异很小，并且不会随着时间的推移而持续。SMS 的额外效果不一致且不确定。