A community-based physical activity intervention to prevent mobility-related disability for retired older people (REtirement in ACTion (REACT)): study protocol for a randomised controlled trial.

Afroditi Stathi, Janet Withall, Colin J. Greaves, Janice L Thompson, Gordon Taylor, Antonieta Medina-Lara, Colin Green, James Bilzon, Selena Gray, Heidi Johansen-Berg, Claire E. Sexton, Max Western, Jolanthe De Koning, Jessica C. Bollen, Sarah Moorlock, Naiara Demnitz, Poppy Seager, Jack Guralnik, W. Jack Rejeski, Ken R. Fox

Research output: Contribution to journalArticle

Abstract

Background: The REtirement in ACTion (REACT) study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial (RCT) with an internal pilot phase. It aims to test the effectiveness and cost-effectiveness of a community, group-based physical activity intervention for reducing, or reversing, the progression of functional limitations in older people who are at high risk of mobility-related disability.
Methods/design: A sample of 768 sedentary, community-dwelling, older people aged 65 years and over with functional limitations, but who are still ambulatory (scores between 4 and 9 out of 12 in the Short Physical Performance Battery test (SPPB)) will be randomised to receive either the REACT intervention, delivered over a period of 12 months by trained facilitators, or a minimal control intervention. The REACT study incorporates comprehensive process and economic evaluation and a nested sub-study which will test the hypothesis that the REACT intervention will slow the rate of brain atrophy and of decline in cognitive function assessed using magnetic resonance imaging (MRI). Outcome data will be collected at baseline, 6, 12 and 24 months for the main study, with MRI sub-study data collected at baseline, 6
and 12 months. The primary outcome analysis (SPPB score at 24 months) will be undertaken blinded to group allocation. Primary comparative analyses will be on an intention-to-treat (ITT) basis with due emphasis placed on confidence intervals.
Discussion: REACT represents the first large-scale, pragmatic, community-based trial in the UK to target the non-disabled but high-risk segment of the older population with an intervention to reduce mobility-related disability. A programme that can successfully engage this population in sufficient activity to improve strength, aerobic capacity, coordination and balance would have a major impact on sustaining health and independence. REACT is also the first study of its kind to conduct a full economic and comprehensive process evaluation alongside the RCT. If effective and cost-effective, the REACT intervention has strong potential to be implemented widely in the UK and elsewhere.
LanguageEnglish
Article number228
Pages1-12
Number of pages12
JournalTrials
Volume19
Issue number228
DOIs
StatusPublished - 18 Apr 2018

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Retirement
Randomized Controlled Trials
Cost-Benefit Analysis
Magnetic Resonance Imaging
Independent Living
Cognition
Population
Atrophy
Economics
Confidence Intervals
Costs and Cost Analysis
Health
Brain

Keywords

  • Physical Activity
  • Disability
  • Prevention
  • Older Adults
  • Randomised controlled trial
  • Mobility disability
  • Physical function
  • Frailty

ASJC Scopus subject areas

  • Health Professions(all)
  • Medicine(all)

Cite this

A community-based physical activity intervention to prevent mobility-related disability for retired older people (REtirement in ACTion (REACT)): study protocol for a randomised controlled trial. / Stathi, Afroditi; Withall, Janet; Greaves, Colin J.; Thompson, Janice L; Taylor, Gordon; Medina-Lara, Antonieta; Green, Colin; Bilzon, James; Gray, Selena; Johansen-Berg, Heidi; Sexton, Claire E.; Western, Max; De Koning, Jolanthe; Bollen, Jessica C.; Moorlock, Sarah; Demnitz, Naiara; Seager, Poppy; Guralnik, Jack; Rejeski, W. Jack; Fox, Ken R.

In: Trials, Vol. 19, No. 228, 228, 18.04.2018, p. 1-12.

Research output: Contribution to journalArticle

Stathi, A, Withall, J, Greaves, CJ, Thompson, JL, Taylor, G, Medina-Lara, A, Green, C, Bilzon, J, Gray, S, Johansen-Berg, H, Sexton, CE, Western, M, De Koning, J, Bollen, JC, Moorlock, S, Demnitz, N, Seager, P, Guralnik, J, Rejeski, WJ & Fox, KR 2018, 'A community-based physical activity intervention to prevent mobility-related disability for retired older people (REtirement in ACTion (REACT)): study protocol for a randomised controlled trial.' Trials, vol. 19, no. 228, 228, pp. 1-12. https://doi.org/10.1186/s13063-018-2603-x
Stathi, Afroditi ; Withall, Janet ; Greaves, Colin J. ; Thompson, Janice L ; Taylor, Gordon ; Medina-Lara, Antonieta ; Green, Colin ; Bilzon, James ; Gray, Selena ; Johansen-Berg, Heidi ; Sexton, Claire E. ; Western, Max ; De Koning, Jolanthe ; Bollen, Jessica C. ; Moorlock, Sarah ; Demnitz, Naiara ; Seager, Poppy ; Guralnik, Jack ; Rejeski, W. Jack ; Fox, Ken R. / A community-based physical activity intervention to prevent mobility-related disability for retired older people (REtirement in ACTion (REACT)): study protocol for a randomised controlled trial. In: Trials. 2018 ; Vol. 19, No. 228. pp. 1-12.
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AU - Stathi, Afroditi

AU - Withall, Janet

AU - Greaves, Colin J.

AU - Thompson, Janice L

AU - Taylor, Gordon

AU - Medina-Lara, Antonieta

AU - Green, Colin

AU - Bilzon, James

AU - Gray, Selena

AU - Johansen-Berg, Heidi

AU - Sexton, Claire E.

AU - Western, Max

AU - De Koning, Jolanthe

AU - Bollen, Jessica C.

AU - Moorlock, Sarah

AU - Demnitz, Naiara

AU - Seager, Poppy

AU - Guralnik, Jack

AU - Rejeski, W. Jack

AU - Fox, Ken R.

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N2 - Background: The REtirement in ACTion (REACT) study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial (RCT) with an internal pilot phase. It aims to test the effectiveness and cost-effectiveness of a community, group-based physical activity intervention for reducing, or reversing, the progression of functional limitations in older people who are at high risk of mobility-related disability.Methods/design: A sample of 768 sedentary, community-dwelling, older people aged 65 years and over with functional limitations, but who are still ambulatory (scores between 4 and 9 out of 12 in the Short Physical Performance Battery test (SPPB)) will be randomised to receive either the REACT intervention, delivered over a period of 12 months by trained facilitators, or a minimal control intervention. The REACT study incorporates comprehensive process and economic evaluation and a nested sub-study which will test the hypothesis that the REACT intervention will slow the rate of brain atrophy and of decline in cognitive function assessed using magnetic resonance imaging (MRI). Outcome data will be collected at baseline, 6, 12 and 24 months for the main study, with MRI sub-study data collected at baseline, 6and 12 months. The primary outcome analysis (SPPB score at 24 months) will be undertaken blinded to group allocation. Primary comparative analyses will be on an intention-to-treat (ITT) basis with due emphasis placed on confidence intervals.Discussion: REACT represents the first large-scale, pragmatic, community-based trial in the UK to target the non-disabled but high-risk segment of the older population with an intervention to reduce mobility-related disability. A programme that can successfully engage this population in sufficient activity to improve strength, aerobic capacity, coordination and balance would have a major impact on sustaining health and independence. REACT is also the first study of its kind to conduct a full economic and comprehensive process evaluation alongside the RCT. If effective and cost-effective, the REACT intervention has strong potential to be implemented widely in the UK and elsewhere.

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KW - Physical Activity

KW - Disability

KW - Prevention

KW - Older Adults

KW - Randomised controlled trial

KW - Mobility disability

KW - Physical function

KW - Frailty

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DO - 10.1186/s13063-018-2603-x

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JO - Trials

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