Recommendations for future long-term exercise interventions
RPE, fatigue
Pragmatic research trials are designed to assess the effectiveness of an intervention as it would be delivered in the real world, rather than under highly controlled conditions. More pragmatic research trials, embedded within a community setting, are needed to advance our understanding of the benefits of PA and exercise in public health. We support the recent call for action for better reporting of exercise interventions across a range of health conditions (When designing the 12 month REACT exercise intervention the basic principles of training were followed (the principles of specificity, overload and variation) (Clinically meaningful changes in physical function were demonstrated using bodyweight exercises at moderate intensities with minimal equipment. The strength and balance components of the supervised exercise sessions adopted a 3 × 2 superset block design (making session delivery more time efficient) in combination with easy to understand methods of monitoring exercise intensity (RPE and RIR) which are helpful when managing the expected fluctuations in energy levels or fatigue documented in this type of population (further details on exercise protocol can be found in The total SPPB score offers researchers a useful global measure of physical function, but hides the underlying mechanisms underpinning any functional changes demonstrated as a result of engaging in any form of exercise intervention. This study has highlighted potential limitations within the interpretation of the gait speed component of this commonly used outcome measure. Researchers/clinicians are encouraged to be mindful of how they report and interpret global physical function SPPB scores given this new insight. Breaking down the SPPB into its component parts and/or combining the SPPB with other objective markers of physical function may prove useful when trying the better understand the mechanisms underpinning functional changes to exercise intervention for older adults (