GROUP-BASED VS HOME-BASED EXERCISE TRAINING IN HEALTHY OLDER MEN AND WOMEN - A COMMUNITY-BASED CLINICAL-TRIAL

Objective. - To determine the effectiveness of group- vs home-based exercise training of higher and lower intensities among healthy, sedentary older adults. Design. - Year-long randomized, controlled trial comparing (1) higher-intensity group-based exercise training; (2) higher-intensity home-based exercise training; (3) lower-intensity home-based exercise training; or (4) assessment-only control. Setting. - General community located in northern California. Participants. - One hundred sixty women and 197 men 50 to 65 years of age who were sedentary and free of cardiovascular disease. One out of nine persons contacted through a community random-digit-dial telephone survey and citywide promotion were randomized. Interventions. - For higher-intensity exercise training, three 40-minute endurance training sessions per week were prescribed at 73% to 88% of peak treadmill heart rate. For lower-intensity exercise training, five 30-minute endurance training sessions per week were prescribed at 60% to 73% of peak treadmill heart rate. Main Outcome Measures. - Treadmill exercise test performance, exercise participation rates, and heart disease risk factors. Results. - Compared with controls, subjects in all three exercise training conditions showed significant improvements in treadmill exercise test performance at 6 and 12 months (P < .03). Lower-intensity exercise training achieved changes comparable with those of higher-intensity exercise training. Twelve-month exercise adherence rates were better for the two home-based exercise training conditions relative to the group-based exercise training condition (P < .0005). There were no significant training-induced changes in lipid levels, weight, or blood pressure. Conclusions. - We conclude that (1) this community-based exercise training program improved fitness but not heart disease risk factors among sedentary, healthy older adults; (2) home-based exercise was as effective as group exercise in producing these changes; (3) lower-intensity exercise training was as effective as higher-intensity exercise training in the home setting; and (4) the exercise programs were relatively safe.