Physical activity is effective in preventing and treating many of these age-related diseases. However, two thirds of Dutch older adults do not reach the recommended level of physical activity.... Show morePhysical activity is effective in preventing and treating many of these age-related diseases. However, two thirds of Dutch older adults do not reach the recommended level of physical activity. Current efforts to increase physical activity with professional led physical activity interventions are effective during the intervention period, but do not manage to have a sustainable effect. In this thesis we studied the possibility of peer coaching to sustainably increase physical activity in older adults. We do this by studying the effectiveness, implementation and organization of peer coach physical activity intervention. The conclusion of this thesis is that older adults can effectively and sustainably increase physical activity of older adults through peer coach physical activity interventions. After a small investment for implementation, a sustainable self-organising exercise intervention can be created which exist for years. The reach of the groups can be increased through an exercise referral scheme in primary care, but the effectivity needs to be improved through research. Nationwide implementation of exercise groups for older adults is possible, but it requires effort from a large (governmental) party. Show less
BackgroundThis study examines the association of both pain severity and within-person pain variability with physical activity (PA) in older adults with osteoarthritis (OA).MethodsData from the... Show moreBackgroundThis study examines the association of both pain severity and within-person pain variability with physical activity (PA) in older adults with osteoarthritis (OA).MethodsData from the European Project on OSteoArthritis were used. At baseline, clinical classification criteria of the American College of Rheumatology were used to diagnose OA in older adults (65-85years). At baseline and 12-18months follow-up, frequency and duration of participation in the activities walking, cycling, gardening, light and heavy household tasks, and sports activities were assessed with the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire. Physical activity was calculated in kcal/day, based on frequency, duration, body weight and the metabolic equivalent of each activity performed. At baseline and 12-18months follow-up, pain severity was assessed using the pain subscales of the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand OA Index. Within-person pain variability was assessed using two-week pain calendars that were completed at baseline, 6months follow-up and 12-18months follow-up.ResultsOf all 669 participants, 70.0% were women. Sex-stratified multiple linear regression analyses showed that greater pain severity at baseline was cross-sectionally associated with less PA in women (Ratio=0.95, 95% CI=0.90-0.99), but not in men (Ratio=0.99, 95% CI=0.85-1.15). The longitudinal analyses showed a statistically significant inverse association between pain severity at baseline and PA at follow-up in women (Ratio=0.94, 95% CI=0.89-0.99), but not in men (Ratio=1.00, 95% CI=0.87-1.11). Greater pain variability over 12-18months was associated with more PA at follow-up in men (Ratio=1.18, 95% CI=1.01-1.38), but not in women (Ratio=0.94, 95% CI=0.86-1.03).ConclusionsGreater pain severity and less pain variability are associated with less PA in older adults with OA. These associations are different for men and women. The observed sex differences in the various associations should be studied in more detail and need replication in future research. Show less
