Background older adults face several modifiable barriers for engaging in physical activity (PA) programmes such as incontinence, loneliness and fear of falling. Enhancing PA programmes with behavioural components to support self-management of such barriers may increase the effectiveness to preserve functional capacity and independent living. Objective this study aimed at assessing the effects of a complex active lifestyle intervention (CALSTI) on objective and self-report measures of functional capacity and disability in community-dwelling older adults. Subjects and Methods about 215 older adults (79.9 ± 0.4 years) at increased risk of functional decline were randomly allocated to (i) CALSTI consisting of 12-weeks progressive explosive resistance training (24 sessions) enhanced by a 24-week multi-factorial self-management programme (8 sessions), or (ii) an extended version of the self-management intervention (SEMAI; 12 sessions) to reflect a reinforcement of usual care. The interventions were embedded in a nationally regulated preventive care pathway. Blinded assessors collected primary (the Short Physical Performance Battery; SPPB) and secondary outcome data (self-reported difficulty in activities of daily living, the short version of the Late-Life Function and Disability Index, and the EQ-health VAS scale) at baseline and after 12 and 24 weeks. Results after 24 weeks, CALSTI led to a clinically superior increase in SPPB compared with SEMAI (+0.77 points, P < 0.01), and the CALSTI group also demonstrated improvements in selected self-reported outcomes. Conclusions a novel complex exercise and multi-factorial self-management intervention embedded in preventive care practice had large and clinically meaningful effects on a key measure of functional capacity and predictor of disability.

中文翻译：

---

通过自我管理计划加强以社区为基础的锻炼，以促进老年人的独立生活：一项务实的随机对照试验

背景 老年人在参与体育活动 (PA) 计划时面临一些可改变的障碍，例如失禁、孤独和害怕跌倒。通过行为组件增强 PA 计划以支持对此类障碍的自我管理可能会提高保持功能能力和独立生活的有效性。目的 本研究旨在评估复杂积极生活方式干预 (CALSTI) 对社区老年人功能能力和残疾的客观和自我报告测量的影响。受试者和方法 大约 215 名功能衰退风险增加的老年人（79.9 ± 0.4 岁）被随机分配到 (i) CALSTI，包括 24 周多因素自我增强的 12 周渐进式爆发阻力训练（24 节课） -管理计划（8节），或 (ii) 自我管理干预的扩展版本（SEMAI；12 次会议），以反映常规护理的加强。这些干预措施嵌入了国家监管的预防保健途径。盲人评估者在基线和 12 周和 24 周后。结果 24 周后，与 SEMAI 相比，CALSTI 导致 SPPB 的临床显着增加（+0.77 分，P < 0.01），并且 CALSTI 组也显示出选定的自我报告结果的改善。