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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.