The Performance Enhancement Project: Improving physical performance in older persons

Objective: To determine the effects of center-based exercise on physical performance in older persons at risk for decline in physical functioning. Design: Randomized controlled trial. Setting: Senior centers. Participants: A total of 155 community-dwelling persons, 78.7% women, ages 70 years and older (mean standard deviation, 77.0 +/- 4.5y), with mobility impairments. Intervention: Intervention volunteers (n=80) exercised at a center (endurance, strength, balance, flexibility) 3 times weekly, for months 1 to 6; once weekly, for months 7 to 12 with home exercise 2 sessions a week; and at home only, for months 13 to 18. Home control volunteers (n=75) were instructed in home endurance exercise. Main Outcome Measures: MacArthur battery, Physical Performance Test (PPT-8), and 6-Minute Walk Test (6MWT) at baseline and 3, 6, 12, and 18 months. Results: MacArthur battery scores improved in intervention compared with home control at 3, 6, and 12 months (repeated-measures analysis of variance: group x time, P<.05) but not 18 months. PPT-8 and 6MWT did not improve. Intervention group assignment, younger age, and better baseline physical function and self-perceived health were independent predictors of long-term MacArthur battery score improvement. Conclusions: Compared with home control, center-based exercise improved gait, chair rise time, and balance over 1 year. Improvements were not sustained with transition to home exercise for months 13 to 18. Classes may be necessary to maintain improvements in older persons attending center-based exercise.