A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial

Kamada, Masamitsu; Kitayuguchi, Jun; Inoue, Shigeru; Ishikawa, Yoshiki; Nishiuchi, Hiromu; Okada, Shimpei; Harada, Kazuhiro; Kamioka, Hiroharu; Shiwaku, Kuninori

doi:10.1186/1479-5868-10-44

International Journal of Behavioral Nutrition and Physical Activity

Table 3 Changes in physical activity and musculoskeletal pain from baseline to 1-year follow-up: COMMUNICATE Study

From: A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial

	Control (n = 1078)	Intervention								Intracluster correlation coefficient^b
		All (n = 3336)		Group A (n = 1107)		Group FM (n = 1107)		Group AFM (n = 1122)
	No (%)	No (%)	Effect size^a	No (%)	Effect size^a	No (%)	Effect size^a	No (%)	Effect size^a
			(95%CI)		(95%CI)		(95%CI)		(95%CI)
Regular physical activity^c
Engaging at follow-up	451 (60.3)	1400 (58.7)	0.97 (0.84-1.14)	482 (60.3)	1.02 (0.84-1.23)	429 (55.9)	0.94 (0.77-1.14)	489 (60.0)	0.97 (0.80-1.17)	0.0014
Change from not engaging to engaging^d	58 (26.9)	196 (27.3)		59 (27.6)		63 (23.9)		74 (30.7)
Specific physical activity
Total walking time, mins/week
Median (IQR) change	0 (−60-45)			0 (−60-40)	11.1^e (−7.02-29.3)			0 (−45-40)	−13.4^e (−29.9-3.13)	0.0012
≥150 at follow-up	232 (34.3)			264 (35.4)				252 (34.0)
Change from not ≥150 to ≥150^d	66 (18.9)			63 (17.3)				66 (17.1)
Flexibility activity
Daily at follow-up	190 (22.9)					167 (19.6)	0.95 (0.75-1.19)	208 (23.2)	1.44 (0.59-3.53)	0.0047
Change from not daily to daily^d	69 (11.6)					65 (9.8)		70 (11.0)
Muscle-strengthening activity, days/week
Median (IQR) change	0 (0–0)					0 (0–0)	−0.14^e (−0.30-0.02)	0 (−1-0)	0.24^e (−0.15-0.64)	0.0081
≥2 at follow-up	261 (32.5)					226 (27.5)		314 (36.3)
Change from not ≥2 to ≥2^d	52 (12.8)					60 (12.6)		86 (19.2)
VAS pain score
Median (IQR) change in low back pain	0 (−8-4)	0 (−10-4)	0.66^e (−0.63-1.95)	0 (−11-4)	1.53^e (−0.62-3.69)	0 (−10-4)	0.54^e (−1.03-2.11)	0 (−8-5)	0.59^e (−0.98-2.17)	<0.0001
Median (IQR) change in knee pain	0 (0–0)	0 (−1-0)	0.49^e (−0.61-1.59)	0 (−1-0)	0.81^e (−0.57-2.19)	0 (−1-0)	−0.15^e (−1.77-1.47)	0 (−1-0)	0.37^e (−0.98-1.72)	<0.0001
Chronic musculoskeletal pain
Low back pain at follow-up	125 (15.1)	378 (14.5)	0.92 (0.74-1.14)	125 (14.2)	0.91 (0.66-1.25)	128 (15.2)	1.04^f (0.63-1.72)	125 (14.1)	1.05^f (0.60-1.84)	<0.0001
New incidence of low back pain in 1 year	48 (7.0)	144 (6.8)		49 (6.8)		51 (7.6)		44 (6.0)
Knee pain at follow-up	81 (9.9)	313 (12.1)	1.20 (0.93-1.54)	106 (12.2)	1.23 (0.91-1.66)	92 (11.0)	1.00 (0.73-1.38)	115 (13.0)	1.25 (0.93-1.70)	<0.0001
New incidence of knee pain in 1 year	28 (3.9)	121 (5.4)		43 (5.7)		35 (4.8)		43 (5.6)

Note. Group A = aerobic activity; Group FM = flexibility and muscle-strengthening activities; Group AFM = aerobic, flexibility, and muscle-strengthening activities. CI = confidence interval; VAS = visual analog scale; IQR = interquartile range. Sample sizes (denominators) of number counts vary due to missing values, although the effect sizes were calculated by the intention-to-treat analyses.
^aEffect size estimates adjusted for sex, age, body mass index, self-rated health, years of education, employment status, engagement in farming, (chronic low back and knee pain for the analyses of physical activity outcomes), chronic disease history, category of population density of each cluster, and outcome variable at baseline, and clustering effects. Effect size are adjusted odds ratios unless stated otherwise. Larger than one means that the intervention had a positive effect (favorable for physical activity and not favorable for pain).
^bIntracluster correlation coefficient (ICC) of each outcome variable at follow-up was calculated by using per-protocol samples without imputation as follows: ICC = (BMS - WMS)/(BMS + [K - 1] WMS), where BMS is the between-cluster mean square, WMS is the within-cluster mean square, and K is the average number of respondents per cluster.
^cEngagement in regular aerobic, flexibility, and/or muscle-strengthening activities. If respondents met any one of three following conditions, the respondents are defined as “engaging in regular physical activity”: (1) engaging in 150 mins/week or more of walking, (2) engaging in daily flexibility activity, or (3) engaging 2 or more days/week in muscle-strengthening activities.
^dChange from baseline to follow-up.
^eEffect size is adjusted difference (linear regression coefficient) for continuous variable. Larger than zero means that the intervention had positive effect (favorable for physical activity and not favorable for pain).
^fResult from per protocol analysis. The model did not converge in the intention-to-treat analysis.

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ISSN: 1479-5868

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