Combination of self-management strategies for reducing sedentary behavior with multicomponent exercise on sedentary behavior patterns and physical function in community-dwelling older adults: a randomized, blinded clinical trial with 40-week follow-up

Purpose The aim of this study was to evaluate the effects of combining self-management strategies (SMS) for reducing sedentary behavior (SB) with multicomponent exercise (ME) compared to ME alone on SB patterns and physical function among community-dwelling older adults. Methods A randomized, blinded, clinical trial was conducted with 46 older adults (73.5 +/- 6.71 years, 73.9% female) allocated to two groups: receiving ME program + SMS (ME + SMS = 23) or receiving only the ME program (ME = 23). ME lasted 40 weeks and SMS was incorporated in the first 16 weeks. SB patterns (via accelerometry) and physical function (30-s sit-to-stand test, handgrip strength, and Timed Up and Go test) were assessed at baseline, 16 weeks, and at 40 weeks (24 weeks after SMS withdrawal). Effects of the interventions were analyzed using a generalized linear mixed model. Results Both groups significantly reduced mean % of daily time spent in SB, time spent in SB, and sitting time after 16 weeks (p < 0.05), returning to baseline levels after 40 weeks. Interaction effect was identified only in handgrip strength after 40 weeks in favor of the ME + SMS group compared to the ME group (Mean difference = 1.94 [0.92], 95%CI = 0.13 to 3.74, p = 0.035). Conclusion The inclusion of SMS in a ME program was not more effective than the ME program alone in reducing SB patterns among community-dwelling older adults after 16 weeks. Both groups initially reduced SB; however, the effects were not maintained after 40-week follow-up period. Trial registration Brazilian Registry of Clinical Trials RBR-10zs97gk. Registered 17 June 2021, https://ensaiosclinicos.gov.br/rg/RBR-10zs97gk.