Automatic Reaction to Physical Activity and Sedentary Stimuli in Aging

Aging Clinical Trial

Official title:

Retraining the Automatic Reaction to Physical Activity and Sedentary Stimuli in Adults 60 Years of Age or Older

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05704660
• Other study ID #: H-09-22-8453
• Status: Not yet recruiting
• Phase: N/A
• Start date: September 2023
• Est. completion date: September 2025

Study information

• Verified date: January 2023
• Source: University of Ottawa
• Contact: Matthieu P. Boisgontier, PhD
• Phone: 6135625408
• Email: matthieu.boisgontier[@]uottawa.ca
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Most individuals are aware of the benefits to health of regular physical activity and have good intentions to exercise. Yet, 1.4 billion people worldwide are inactive, which suggests that turning intention into action can be challenging. Recent findings show that the intention-action gap could be explained by negative automatic reactions (which is a component of dual-task theory) to stimuli associated with physical activity. This gap is particularly concerning in older adults, who are more likely to spontaneously associate physical activity with fear, pain, or discomfort. To promote physical activity, the current project proposes to train older adults to suppress their automatic attraction toward sedentary stimuli and to respond positively to physical-activity stimuli. This evidence-based and low-cost intervention aims to improve physical functioning and quality of life for these population. The results will inform public-health policies and improve clinical interventions that aim to counteract a global health problem: the pandemic of physical inactivity.

Description:

Physical activity is one of the top contributors to health, reducing rates of cardiovascular disease, cancer, hypertension, diabetes, obesity, and depression. This wide spectrum of benefits is particularly important for older adults, who often suffer structural and functional deterioration in several physiological systems. Physical activity can reduce and delay the impact of this age-related deterioration in health and functional independence. Current interventions to enhance physical activity in older adults rely mainly on reflective processes by providing rational information about the health benefits of a physically active lifestyle. While these interventions successfully increase intention, their effect on actual behavior is weak. That is, most individuals are now aware of the positive effects of regular physical activity and have the intention to exercise. However, this intention is not sufficient and exercise plans are often not executed. This gap between intention and action is a challenge that health professionals need to address to counteract the pandemic of physical inactivity. Recent findings suggest that this inability to turn the intention into action is explained by negative automatic reactions to stimuli associated with physical activity. These automatic reactions could be particularly strong in older adults, who are more likely to associate physical activity with fear, pain, or discomfort. This study aims to test the effect of an intervention that targets the automatic processes underlying physical inactivity in older adults. The intervention is expected to reduce physical inactivity during the intervention and at follow-up, thereby improving physical functioning and quality of life.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 216
• Est. completion date: September 2025
• Est. primary completion date: September 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 60 Years and older

Eligibility

Inclusion Criteria:

• 60 years of age or older and able to understand instructions in English.

Exclusion Criteria:

• Diagnosed psychiatric disorders or neurological condition (e.g., stork, Parkinson's disease, Alzheimer's disease, dementia)

• Unable to carry out the training program

• Unable to understand the protocol

• Motor deficit preventing physical activity without external help

• Physical health status preventing physical activity

• Alcohol or substance dependence.

Related Conditions & MeSH terms

• Aging

Intervention

Behavioral:
• Adjusted Cognitive-biased modification task
The intervention of the proposed project is based on a go/no-go task in which older adults need to quickly decide whether or not they should react to the stimulus. A rectangle containing an image, or a word will be presented on a screen. In the intervention group, older adults will be instructed to restrain their actions when the rectangle is tilted to the right and to react by pressing a key on the keyboard when the rectangle is tilted to the left, irrespective of the content of the rectangle (because the training is meant to be implicit). In order to train inhibitory processes counteracting the automatic attraction to sedentary behavior, 90% of the rectangles tilted to the right (counterbalanced across participants) will contain a picture or a word related to sedentary behavior. To foster the automatic attraction toward physical activity, 90% of the rectangles tilted to the left will contain a picture or a word related to physical activity.
• Cognitive-biased modification task
In the comparison group, instructions will be identical, but the percentage of physical activity and sedentary stimuli will be equal in each tilt condition (i.e., 50% sedentary stimuli and 50% physical activity stimuli in both right- and left-tilted rectangles)

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Ottawa

References & Publications (15)

Aulbach MB, Knittle K, Haukkala A. Implicit process interventions in eating behaviour: a meta-analysis examining mediators and moderators. Health Psychol Rev. 2019 Jun;13(2):179-208. doi: 10.1080/17437199.2019.1571933. Epub 2019 Feb 6. — View Citation

Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, Dempsey PC, DiPietro L, Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R, Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB, Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der Ploeg HP, Wari V, Willumsen JF. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020 Dec;54(24):1451-1462. doi: 10.1136/bjsports-2020-102955. — View Citation

Calitri R, Lowe R, Eves FF, Bennett P. Associations between visual attention, implicit and explicit attitude and behaviour for physical activity. Psychol Health. 2009 Nov;24(9):1105-23. doi: 10.1080/08870440802245306. — View Citation

Cheval B, Boisgontier MP. The Theory of Effort Minimization in Physical Activity. Exerc Sport Sci Rev. 2021 Jul 1;49(3):168-178. doi: 10.1249/JES.0000000000000252. — View Citation

Cheval B, Radel R, Neva JL, Boyd LA, Swinnen SP, Sander D, Boisgontier MP. Behavioral and Neural Evidence of the Rewarding Value of Exercise Behaviors: A Systematic Review. Sports Med. 2018 Jun;48(6):1389-1404. doi: 10.1007/s40279-018-0898-0. — View Citation

Cheval B, Sarrazin P, Isoard-Gautheur S, Radel R, Friese M. Reflective and impulsive processes explain (in)effectiveness of messages promoting physical activity: a randomized controlled trial. Health Psychol. 2015 Jan;34(1):10-9. doi: 10.1037/hea0000102. Epub 2014 Aug 18. — View Citation

Cheval B, Tipura E, Burra N, Frossard J, Chanal J, Orsholits D, Radel R, Boisgontier MP. Avoiding sedentary behaviors requires more cortical resources than avoiding physical activity: An EEG study. Neuropsychologia. 2018 Oct;119:68-80. doi: 10.1016/j.neuropsychologia.2018.07.029. Epub 2018 Jul 26. — View Citation

Conroy DE, Hyde AL, Doerksen SE, Ribeiro NF. Implicit attitudes and explicit motivation prospectively predict physical activity. Ann Behav Med. 2010 May;39(2):112-8. doi: 10.1007/s12160-010-9161-0. — View Citation

Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet Glob Health. 2018 Oct;6(10):e1077-e1086. doi: 10.1016/S2214-109X(18)30357-7. Epub 2018 Sep 4. Erratum In: Lancet Glob Health. 2019 Jan;7(1):e36. — View Citation

Haseler C, Crooke R, Haseler T. Promoting physical activity to patients. BMJ. 2019 Sep 17;366:l5230. doi: 10.1136/bmj.l5230. No abstract available. — View Citation

Kohl HW 3rd, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S; Lancet Physical Activity Series Working Group. The pandemic of physical inactivity: global action for public health. Lancet. 2012 Jul 21;380(9838):294-305. doi: 10.1016/S0140-6736(12)60898-8. — View Citation

Rhodes RE, Dickau L. Experimental evidence for the intention-behavior relationship in the physical activity domain: a meta-analysis. Health Psychol. 2012 Nov;31(6):724-7. doi: 10.1037/a0027290. Epub 2012 Mar 5. — View Citation

Taylor CT, Amir N. Modifying automatic approach action tendencies in individuals with elevated social anxiety symptoms. Behav Res Ther. 2012 Sep;50(9):529-36. doi: 10.1016/j.brat.2012.05.004. Epub 2012 May 23. — View Citation

Wiers RW, Eberl C, Rinck M, Becker ES, Lindenmeyer J. Retraining automatic action tendencies changes alcoholic patients' approach bias for alcohol and improves treatment outcome. Psychol Sci. 2011 Apr;22(4):490-7. doi: 10.1177/0956797611400615. Epub 2011 Mar 9. — View Citation

Wittekind CE, Feist A, Schneider BC, Moritz S, Fritzsche A. The approach-avoidance task as an online intervention in cigarette smoking: a pilot study. J Behav Ther Exp Psychiatry. 2015 Mar;46:115-20. doi: 10.1016/j.jbtep.2014.08.006. Epub 2014 Sep 16. — View Citation

* Note: There are 15 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Physical activity Tracker	Assessing the number of step.	"7 days", at least "7 hours" per day (not to used it during shower or when they sleep at night).
Secondary	International Physical Activity Questionnaire (Short Form)	The usual level of moderate-to-vigorous physical activity in minutes per week will be assessed.	Before and after intervention ("10 minutes" to fill out)
Secondary	Six-Minute Walk Test	Total distance walked in "6 minutes" will be documented. The outcome is the distance walked during the "6 minutes".	Before and after intervention ("6 minutes" to carry out)
Secondary	Hand grip strength	The grip strength will be evaluated using a dynamometer. The higher the value obtained by the participant, the stronger the grip.	Before and after intervention ( "One minute" to carry out)
Secondary	World Health Organization Quality of Life (BREF)	Assessing quality of life over four domains. Scores for each domain can range from zero to 100, with higher scores indicating better quality of life.	Before and after intervention ( "20 minutes" to carry out)
Secondary	Approach-avoidance task	To measure automatic approach and avoidance tendencies toward physical activity and sedentary behaviors. Faster and the more accurate reaction toward a stimuli (e.g., physical activity) indicates a stronger tendency to approach that specific stimuli.	Before and after intervention, and at the beginning of each intervention session ("30 minutes" to carry out)
Secondary	Explicit Affective Attitude Toward Physical Activity	Mean of two items based on two "7-point" scales (unpleasant-pleasant; unenjoyable-enjoyable). A higher score indicates more positive attitudes toward physical activity.	Before and after intervention ("2-5 minute" to carry out)

External Links

•   Government of Canada. Physical activity, sedentary behaviour and sleep (PASS) indicators