Group- vs Home-Based Exercise Training in Healthy Older Men and Women: A Community-Based Clinical Trial

Abstract

Objective. —To determine the effectiveness of group- vs home-based exercise training of higher and lower intensities among healthy, sedentary older adults. Design. —Year-long randomized, controlled trial comparing (1) higher-intensity group-based exercise training; (2) higher-intensity home-based exercise training; (3) lower-intensity home-based exercise training; or (4) assessment-only control. Setting. —General community located in northern California. Participants. —One hundred sixty women and 197 men 50 to 65 years of age who were sedentary and free of cardiovascular disease. One out of nine persons contacted through a community random-digit-dial telephone survey and citywide promotion were randomized. Interventions. —For higher-intensity exercise training, three 40-minute endurance training sessions per week were prescribed at 73% to 88% of peak treadmill heart rate. For lower-intensity exercise training, five 30-minute endurance training sessions per week were prescribed at 60% to 73% of peak treadmill heart rate. Main Outcome Measures. —Treadmill exercise test performance, exercise participation rates, and heart disease risk factors. Results. —Compared with controls, subjects in all three exercise training conditions showed significant improvements in treadmill exercise test performance at 6 and 12 months (P<.03). Lower-intensity exercise training achieved changes comparable with those of higher-intensity exercise training. Twelve-month exercise adherence rates were better for the two home-based exercise training conditions relative to the group-based exercise training condition (P<.0005). There were no significant training-induced changes in lipid levels, weight, or blood pressure. Conclusions. —We conclude that (1) this community-based exercise training program improved fitness but not heart disease risk factors among sedentary, healthy older adults; (2) home-based exercise was as effective as group exercise in producing these changes; (3) lower-intensity exercise training was as effective as higher-intensity exercise training in the home setting; and (4) the exercise programs were relatively safe. (JAMA. 1991;266:1535-1542)