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Physical Activity Guidelines

Physical Activity Guidelines Advisory Committee Report
Part G. Section 6: Functional Health

Table G6.A1. Summary Table of Studies Investigating Whether Regular Physical Activity Prevents or Delays the Onset of Substantial Functional Limitations and/or Role Limitations in Middle-Aged and Older Adults Who Do Not Have Severe Functional or Role Limitations

Author/Year Outcome Category Name of Measure Referent Group OR 2nd Level of PA 3rd Level of PA 4th Level of PA 5th Level of PA
Ward et al., 1995 (1) Global Health Assessment Questionnaire (HAQ) 1.0 0.61;
95% CI (0.40-0.93)
Strawbridge et al.,1996 (2) Global disability ADL, IADL, Rosow‑Breslau 1.0 0.59;
95% CI (0.34-1.02)a
Rantanen et al., 1997 (3) Strength change
Expressed as % strength change in multiple muscle groups, inconsistent resultsb Expressed as % strength change in multiple muscle groups, inconsistent resultsb Expressed as % strength change in multiple muscle groups, inconsistent resultsb Expressed as % strength change in multiple muscle groups, inconsistent resultsb Expressed as % strength change in multiple muscle groups, inconsistent resultsb
Schroll et al., 1997 (4) Mobility Mobility dependency
Men
1.0 0.24
(Inverse of 4.14)a,b
95% CI not provided
Schroll et al., 1997 (4) Mobility Mobility dependency
Women
1.0 0.23
(Inverse of 4.32)a,b
95% CI not provided
Sarna et al., 1997 (5) Global Occupational role limitations Average working life expectancy was higher in habitually active adults than in the reference group Average working life expectancy(LE) was higher in habitually active adults than in the reference group Average working life expectancy was higher in habitually active adults than in the reference group Average working life expectancy was higher in habitually active adults than in the reference group Average working life expectancy was higher in habitually active adults than in the reference group
Unger et al., 1997 (6) Change in ADL/IADL
1.0 Decreased slope of decline in people doing several forms of PA Decreased slope of decline in people doing several forms of PA Decreased slope of decline in people doing several forms of PA Decreased slope of decline in people doing several forms of PA
Huang et al., 1998 (7) Functional limitation, Men
1.0 0.7; 95% CI (0.5-0.9)b 0.5; 95% CI (0.3-0.8)b
Huang et al., 1998 (7) Functional limitation, Women
1.0 0.7; 95% CI (0.5-1.10) 0.7; 95% CI (0.4-1.20)
Ferrucci et al., 1999 (8) Disabled LE ADL More years of disabled LE in sedentary More years of disabled LE in sedentary More years of disabled LE in sedentary More years of disabled LE in sedentary More years of disabled LE in sedentary
Kujala et al., 1999 (9) Hip disability
1.0 0.46;
95% CI (0.22-0.93)
Kujala et al., 1999 (9) Knee disability
1.0 0.69;
95% CI (0.39-1.21)
Leveille et al., 1999 (10) ADL before death
1.0 0.67; 95% CI (0.47‑0.98)a [Inverse of 1.25 (0.87‑1.82)] 0.53 95% CI (0.36‑0.80)a [Inverse of 1.86 (1.24‑2.79)]
Wu et al., 1999 (11) ADL ADL 1.0 0.52 (0.39-0.68)
Brill et al., 2000 (12) Strength, Men
1.0 0.56 (0.34-0.93)c
Brill et al., 2000 (12) Strength, Women
1.0 0.54 (0.21-1.39)c
Hirvensalo et al., 2000 (13) ADL Dependence, Men 1.0 1.10 (0.27-4.55) [Inverse of
0.91 (0.22-3.70)]a
In adults with no or mild limitation at baseline
Hirvensalo et al., 2000 (13) ADL Dependence, Women 1.0 0.85 (0.45-1.59) [Inverse of 1.17
(0.63-2.22)]a
In adults with no or mild limitation at baseline
Miller et al., 2000 (14) Mobility Ability to walk, climb stairs, stand, and stoop 1.0 0.68 (0.58-0.80)
Miller et al., 2000 (14) IADL/ADL Selected IADL and ADL items 1.0 0.74 (0.62-0.89)
Ostbye et al., 2002 (15) Mobility Difficulty walking 1.0 0.53 (0.44-0.64) 0.35 (0.30-0.41) 0.21 (0.17-0.25)
Ostbye et al., 2002 (15) ADL ADL 1.0 0.53 (0.43-0.66) 0.44 (0.36-0.52) 0.28 (0.22-0.36)
Ostbye et al., 2002 (15) Mobility Difficulty climbing stairs 1.0 0.72 (0.61-0.85) 0.50 (0.43-0.58) 0.26 (0.22-0.31)
Ostbye et al., 2002 (15) Global Role limitation = inability to do paid work 1.0 0.51 (0.40-0.64) 0.46 (0.37-0.55) 0.25 (0.19-0.33)
Ostbye et al., 2002 (15) Other Hospitalization 1.0 0.83 (0.70-0.97) 0.70 (0.61-0.81) 0.60 (0.51-0.71)
Stessman et al., 2002 (16) ADL ADL 1.0 0.23 (0.09-0.56) [Inverse of 4.30 (1.80-10.6)]a Subgroup analysis found significant effects in both men and women
Stessman et al., 2002 (16) IADL IADL 1.0 0.43 (0.20-0.91) [Inverse of 2.30 (1.10-5.10)]a Subgroup analysis found significant effect in men but non-significant trend in women
Wang et al., 2002 (17) Global Health Assessment Questionnaire (HAQ) Non-runners had more worsening of HAQ scores over 13 years than did runners Non-runners had more worsening of HAQ scores over 13 years than did runners Non-runners had more worsening of HAQ scores over 13 years than did runners Non-runners had more worsening of HAQ scores over 13 years than did runners Non-runners had more worsening of HAQ scores over 13 years than did runners
Brach et al., 2003 (18) ADL, global, and mobility Any ADL  difficulty, Physical Performance Test (PPT), and gait speed The higher the level of PA over time (assessed in both 1985 and 1995), the better the functional performance and role performance as judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across PA levels were significant)b The higher the level of PA over time (assessed in both 1985 and 1995), the better the functional performance and role performance as judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across PA levels were significant)b The higher the level of PA over time (assessed in both 1985 and 1995), the better the functional performance and role performance as judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across PA levels were significant)b The higher the level of PA over time (assessed in both 1985 and 1995), the better the functional performance and role performance as judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across PA levels were significant)b The higher the level of PA over time (assessed in both 1985 and 1995), the better the functional performance and role performance as judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across PA levels were significant)b
He et al., 2004 (19) (“Light PA”) Mobility Difficulty walking/ climbing stairs 1.0 0.89 (0.65-1.16) 0.78 (0.56-1.03) 0.69 (0.49-0.92) 0.75 (0.53-1.01)
He et al., 2004 (19) (“Vigorous PA/household chores”) Mobility Difficulty walking/ climbing stairs 1.0 0.83 (0.69-0.97) 0.73 (0.59-0.89) 0.58  (0.48-0.70) 0.57 (0.43-0.76)
Haight et al., 2005 (20) Functional limitations at any of 4 surveys, Men
1.0 0.63;
95% CI (0.00-0.92)
Haight et al., 2005 (20) Functional limitations at any of 4 surveys, Women
1.0 0.47;
95% CI (0.14-0.92)
Hillsdon et al., 2005 (21) Not having highest SF‑36 SF-36 1.0 0.91;
95% CI (0.74-1.14)
0.63;
95% CI (0.5-0.77)
Simonsick et al., 2005 (22) LE performance
1.0 Greater decline in walkers > 8 blocks vs. non-walkers Greater decline in walkers > 8 blocks vs. non-walkers Greater decline in walkers > 8 blocks vs. non-walkers Greater decline in walkers > 8 blocks vs. non-walkers
Visser et al., 2005 (23) Mobility, Men
1.0 0.70;
95% CI (0.54-0.85)[Inverse of 1.47 (0.56‑0.89)]a
0.48;
95% CI (0.30-0.63)[Inverse of 2.08 (1.60‑2.70)]a
Visser et al., 2005 (23) Mobility, Women
1.0 0.73;
95% CI (0.57-0.93) [Inverse of 1.44 (1.12‑1.84)]a
0.51;
95% CI (0.38‑0.66)  [Inverse of 1.98 (1.51‑2.60)]a
Wannamethee et al., 2005 (24) Mobility Any of 3 mobility problems 1.0 0.90 (0.68-1.19) 0.88 (0.64-1.21) 0.77 (0.58-1.03)
Backmand et al., 2006 (25) Daily activities
1.0 0.89; 95% CI (0.83-0.95) Risk per MET
Berk et al., 2006 (26) Global Health Assessment Questionnaire “Sedentary” and “Exercise Decreasers” had more worsening of HAQ scores over 16 years compared to “Exercisers” and “Exercise Increasers” “Sedentary” and “Exercise Decreasers” had more worsening of HAQ scores over 16 years compared to “Exercisers” and “Exercise Increasers” “Sedentary” and “Exercise Decreasers” had more worsening of HAQ scores over 16 years compared to “Exercisers” and “Exercise Increasers” “Sedentary” and “Exercise Decreasers” had more worsening of HAQ scores over 16 years compared to “Exercisers” and “Exercise Increasers” “Sedentary” and “Exercise Decreasers” had more worsening of HAQ scores over 16 years compared to “Exercisers” and “Exercise Increasers”
Christensen et al., 2006 (27) Mobility Mobility-Tiredness Scale 1.0 0.18; 95% CI (0.05-0.60) [Inverse of 5.65 (1.66-19.28)]a
Patel et al., 2006 (28) Mobility, Men 400-meter walk 1.0 0.37;
95% CI (0.15-0.93)
0.23;
95% CI (0.09‑0.63)
Patel et al., 2006 (28) Mobility, Women 400-meter walk 1.0 0.69;
95% CI (0.37-1.28)
0.70;
95% CI (0.31‑1.59)
Tessier et al., 2007 (29) Physical Function SF-36 Modest but significant association between change in PA and change in physical function domain Modest but significant association between change in PA and change in physical function domain Modest but significant association between change in PA and change in physical function domain Modest but significant association between change in PA and change in physical function domain Modest but significant association between change in PA and change in physical function domain

ADL, activities of daily living; CI, confidence interval; HAQ, health assessment questionnaire; IADL, instrumental activities of daily living; LE, life expectancy; MET, metabolic equivalent; PA, physical activity; PPT, physical performance test; SF-36, short form health survey with 36 questions
a Odd ratios (ORs) were recalculated to use the least active group as the reference category.
b Both physical activity and fitness were measured.
c The study by Brill et al., 2000 (12) was not included in the review for the overall conclusions because it did not include any measure of physical activity. It was considered in the limitations section because it provided information about muscle strength and function.

Reference List

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