Move with Meaning for Middle Age Fitness

Overseen By Christopher M Celano, MD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Physical limitations, Cardiac programs, Cognitive disturbance, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 8 weeks

30 Participants Needed

Trial Summary

What is the purpose of this trial?

This is a randomized, controlled pilot trial (N=30) to examine the feasibility, acceptability, and preliminary efficacy of the Move with Meaning program, an 8- week, text message- and audio-based intervention to promote physical activity in midlife adults.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on promoting physical activity, so it's unlikely that your medications would be affected, but you should confirm with the trial organizers.

What data supports the effectiveness of the Move with Meaning treatment?

Research shows that physical activity programs, like EnhanceFitness, improve strength, flexibility, and balance in older adults, which suggests that similar programs could benefit middle-aged adults too. Additionally, physical activity interventions have been found to enhance lower limb strength and balance, reducing the risk of falls in middle-aged adults. ^{1 2 3 4 5}

Is the Move with Meaning program safe for humans?

The available research does not provide specific safety data for the Move with Meaning program, but similar community-based physical activity programs for older adults, like MOVE UP, have been safely implemented with trained community health workers and have shown positive health outcomes without reported safety concerns. ^{6 7 8 9 10}

How is the Move with Meaning program different from other treatments for middle age fitness?

The Move with Meaning program is unique because it focuses on improving functional mobility in middle-aged adults through a low-volume, vigorous intensity step exercise program, which is often overlooked in this age group. This approach aims to proactively enhance movement control and independence, unlike other programs that may not specifically target this demographic or use this intensity level. ^{11 12 13 14 15}

Research Team

Christopher Celano, MD

Principal Investigator

Massachusetts General Hospital

Eligibility Criteria

This trial is for midlife adults aged 45-64 who aren't very active physically, as shown by a score of less than 6 on a specific activity scale. They must have a smartphone to receive texts and listen to audio files but can't join if they have health issues that limit exercise, are in other wellness programs, have cognitive problems, are pregnant or don't speak English well.

Inclusion Criteria

Suboptimal physical activity (score < 6 on the Medical Outcomes Study Specific Adherence Scale physical activity item)

Access to a phone capable of receiving text messages and listening to audio files (i.e., a smartphone)

I am between 45 and 64 years old.

Exclusion Criteria

I cannot speak or write fluently in English.

I have a health issue that restricts my physical activity.

Participation in any other programs focused on cardiac prevention or well-being

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in the Move with Meaning program, an 8-week text message- and audio-based intervention to promote physical activity

8 weeks

Weekly audio and text message sessions

Follow-up

Participants are monitored for changes in physical activity, psychological health, and physical health-related outcomes

8 weeks

Assessments at 8 weeks and 16 weeks

Treatment Details

Interventions

• Move with Meaning

Trial Overview The 'Move with Meaning' program is being tested. It's an 8-week course using text messages and audio to encourage people in their middle ages to be more active. The study randomly assigns participants into groups: one will use the program while the control group may not.

Participant Groups

Group I: Move with Meaning Experimental Treatment 1 Intervention

In Move with Meaning, participants will engage in twice weekly, interactive text message sessions, which are accompanied by audio content to promote engagement in the program. In the first session of each week, participants will review their physical activity goal and positive psychology topic from last week, then learn about a new positive psychology and physical activity topic and ultimately set a new physical activity goal for the week. In the second session, participants will either be reminded of the content of the audio file and the goal they set earlier that week. The program will run for eight weeks.

Group II: Wait-list control Active Control 1 Intervention

Participants in the wait-list control condition will engage in usual medical care for eight weeks, then will complete the Move with Meaning program.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Findings from Research

The SPRINT physical activity program significantly improved walking speed, balance, and functional mobility in hospitalized older patients, demonstrating its efficacy in enhancing functional capacities during hospitalization.

Patients participating in the SPRINT program had a much shorter length of stay in the hospital (5 days) compared to those who did not participate (36 days), suggesting that this unsupervised and pragmatic approach can effectively reduce hospitalization time and improve discharge outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Potential Efficacy of Pragmatic Exercise Program (SPRINT) during Hospitalization in Older Adults on Health Care and Physical Performance: A Pilot Study. Peyrusqué, E., Buckinx, F., Bolduc, A., et al.[2021]

The Enhance®Fitness program has been shown to effectively reach a diverse population of older adults, including those with low socioeconomic status, and is associated with reduced risks of falls and fewer hospital admissions.

Implementing EF can lead to economic benefits for communities, as it not only improves health outcomes but also potentially reduces medical costs, although more rigorous studies are needed to confirm these associations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhance&#174;Fitness Dissemination and Implementation,: 2010-2015: A Scoping Review. Petrescu-Prahova, MG., Eagen, TJ., Fishleder, SL., et al.[2019]

The EnhanceFitness program significantly improved physical function in older adults, as evidenced by 7483 participants showing improvements in strength, flexibility, and balance over two 16-week cycles.

Greater attendance in the program was linked to more substantial improvements, highlighting the importance of consistent participation, especially for those who may be at higher risk for less improvement, such as older adults in poorer health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness). Fishleder, S., Petrescu-Prahova, M., Harris, JR., et al.[2022]

Research shows that much of the physical decline associated with aging is actually due to sedentary lifestyles and medical conditions, rather than aging itself.

Active older adults, including elite athletes, demonstrate that regular physical activity can significantly mitigate age-related deterioration, suggesting that encouraging a more active lifestyle can greatly benefit sedentary older individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of fitness on the aging process. Vopat, BG., Klinge, SA., McClure, PK., et al.[2014]

Structured physical activity (PA) significantly improves lower limb strength and postural balance in middle-aged adults (ages 40-60), with strong effects observed in various training types, including strength and strength-aerobic training.

Despite the positive findings, the overall methodological quality of the studies was low, and there was considerable variability in results, indicating a need for more rigorous long-term trials to better understand the impact of PA on falls and functional decline.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Physical Activity Interventions on Strength, Balance and Falls in Middle-Aged Adults: A Systematic Review and Meta-Analysis. Adams, M., Gordt-Oesterwind, K., Bongartz, M., et al.[2023]

The MOVE UP program, a behavioral weight-management intervention for older adults, effectively improved weight loss and lower extremity function over 13 months, involving 303 participants and 22 community health workers (CHWs).

Submitting weekly Lifestyle Logs for self-monitoring was found to be a more significant factor for adherence and health outcomes than simply attending sessions, highlighting the importance of self-monitoring in weight loss interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Program Factors Affecting Weight Loss and Mobility in Older Adults: Evidence From the Mobility and Vitality Lifestyle Program (MOVE UP). Liu, X., Kieffer, LA., King, J., et al.[2023]

In a study of 303 older adults participating in a 12-week group exercise program, improvements in mobility, specifically gait speed and 6-minute walk distance, were linked to a significant reduction in falls, with each 0.05 m/s increase in gait speed leading to an 11% decrease in fall risk.

Participants who improved their gait speed experienced 61 falls per 1,000 person-months compared to 135 falls for those with no change or a decline, highlighting the importance of mobility in preventing falls among older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association Between Improved Mobility and Distal Health Outcomes. Shuman, V., Coyle, PC., Perera, S., et al.[2021]

The Ready Steady 3.0 trial will involve 308 adults aged 70 and older, testing the effects of different behavior change strategies over an 8-week physical activity intervention to increase their activity levels.

This study aims to identify which motivational strategies—interpersonal or intrapersonal—are most effective in promoting physical activity and improving quality of life, while also assessing outcomes like falls, using objective measures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-based intervention effects on older adults' physical activity and falls: Protocol and rationale for a randomized optimization trial (Ready Steady3.0). McMahon, SK., Lewis, BA., Guan, W., et al.[2022]

A study analyzing data from the 1996 Behavioral Risk Factor Surveillance System found that individuals who perceive their neighborhoods as unsafe are more likely to be physically inactive.

Addressing concerns about neighborhood safety could be crucial in promoting physical activity, especially among high-risk populations such as older adults and racial/ethnic minorities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neighborhood safety and the prevalence of physical inactivity--selected states, 1996. [2022]

In a study of 235 older adults, participants who engaged in the Choose to Move intervention maintained improvements in mobility, loneliness, and muscle strength 12 months after the program ended, indicating the intervention's lasting impact.

However, while younger participants showed a decrease in physical activity levels after the intervention, older participants did not experience a change in physical activity but did see an increase in social isolation, highlighting the need for ongoing support to sustain health benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Status Quo or Drop-Off: Do Older Adults Maintain Benefits From Choose to Move-A Scaled-Up Physical Activity Program-12 Months After Withdrawing the Intervention? McKay, HA., Nettlefold, L., Sims-Gould, J., et al.[2022]

In a study of 57 older adults averaging 78.2 years, maximal walking velocity was found to be significantly correlated with functional fitness, while usual walking velocity was not, indicating that maximal speed may be a better indicator of overall fitness in this age group.

For high-functioning older adults, both usual and maximal walking velocities were correlated, but the correlations were stronger for maximal walking velocity, suggesting that different assessment strategies may be needed for varying levels of functional fitness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maximal, Not Habitual, Walking Velocity is More Highly Correlated to Functional Fitness of Community-Dwelling Older Adults. Gray, M., Paulson, S., Powers, M.[2017]

The 12-week YMCA Move for Health exercise program significantly improved disability, pain, fatigue, and health-related quality of life in adults with osteoarthritis, with 66 participants showing measurable benefits post-program.

Despite challenges from the COVID-19 pandemic, participants maintained most of their improvements in symptoms and quality of life three months after completing the program, indicating its effectiveness and feasibility for managing osteoarthritis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the YMCA Move for Health Program in Individuals With Osteoarthritis and Assessing Maintenance During the COVID-19 Pandemic. Neudorf, B., Hughes, C., Ellis, C., et al.[2022]

The 'Men on the Move' pilot study successfully increased physical activity levels among 41 African American men aged 35 to 70, with 68% meeting the recommended 150 minutes of weekly activity by the end of the 10-week program, up from 40% at baseline.

Participants showed significant improvements in self-efficacy, endurance, overall health status, and stress levels, indicating that targeted interventions can effectively engage this demographic in physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Men on the move: a pilot program to increase physical activity among African American men. Griffith, DM., Allen, JO., Johnson-Lawrence, V., et al.[2022]

A scoping review of 52 studies identified key factors affecting mobility in older adults, including environmental, physical, cognitive, psychosocial, and a new technological determinant, highlighting the complexity of mobility issues.

To improve mobility in seniors, it's essential to address these factors collectively, particularly through the integration of smart technologies and the design of age-friendly environments, while also considering the financial barriers to accessing these solutions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Challenges and opportunity in mobility among older adults - key determinant identification. Maresova, P., Krejcar, O., Maskuriy, R., et al.[2023]

A four-week vigorous intensity stepping exercise program for 33 healthy, sedentary middle-aged adults showed a significant reduction in trunk acceleration during the walk-to-sit phase, indicating improved movement control.

Although the program did not lead to significant changes in overall functional mobility measures like the TUG test or balance, it highlights the potential for targeted exercise to enhance mobility in middle-aged adults over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a low-volume, vigorous intensity step exercise program on functional mobility in middle-aged adults. Doheny, EP., McGrath, D., Ditroilo, M., et al.[2013]

References

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Potential Efficacy of Pragmatic Exercise Program (SPRINT) during Hospitalization in Older Adults on Health Care and Physical Performance: A Pilot Study. [2021]

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Enhance&#174;Fitness Dissemination and Implementation,: 2010-2015: A Scoping Review. [2019]

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Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness). [2022]

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The effects of fitness on the aging process. [2014]

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Effects of Physical Activity Interventions on Strength, Balance and Falls in Middle-Aged Adults: A Systematic Review and Meta-Analysis. [2023]

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Program Factors Affecting Weight Loss and Mobility in Older Adults: Evidence From the Mobility and Vitality Lifestyle Program (MOVE UP). [2023]

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Association Between Improved Mobility and Distal Health Outcomes. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Community-based intervention effects on older adults' physical activity and falls: Protocol and rationale for a randomized optimization trial (Ready Steady3.0). [2022]

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Neighborhood safety and the prevalence of physical inactivity--selected states, 1996. [2022]

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Status Quo or Drop-Off: Do Older Adults Maintain Benefits From Choose to Move-A Scaled-Up Physical Activity Program-12 Months After Withdrawing the Intervention? [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Maximal, Not Habitual, Walking Velocity is More Highly Correlated to Functional Fitness of Community-Dwelling Older Adults. [2017]

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Evaluating the YMCA Move for Health Program in Individuals With Osteoarthritis and Assessing Maintenance During the COVID-19 Pandemic. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

Men on the move: a pilot program to increase physical activity among African American men. [2022]

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Effects of a low-volume, vigorous intensity step exercise program on functional mobility in middle-aged adults. [2013]