Older Veterans EmpoweRed To Use Regular Exercise (OVERTURE) II: Design and methods of a randomized controlled trial among older veterans with chronic health conditions

There are physical and mental health benefits associated with regular physical activity across the life span [1]; however, individuals are less likely to engage in regular physical activity with advancing age. Recent statistics from the Federal Interagency Forum on Aging Related-Statistics (FIFA-RS) [2] suggest that only 12% of adults 65 years and older engage in regular physical activity that meets the Federal guidelines for physical activity. The guidelines recommend that U.S. adults engage in at least 150 min of moderate-intensity aerobic activity weekly and two to three alternating days of muscle-strengthening activities [3,4]. The guidelines further recommend that older adults with chronic health conditions strive to be as physically active as possible. Among older adults, veterans represent a special population that may not be able to meet the Federal government's guidelines for physical activity. As a result of military service, older veterans who once were considered to be in optimal physical and mental condition as active duty service members, often live with multiple chronic conditions (MCCs) that may limit physical activity [5,6]. For example, older veterans receiving care through the Veterans Affairs (VA) often report a high degree of functional limitations and mental health issues [5,6], such as chronic knee and back pain [7], major depression [8], and post-traumatic stress disorder [8]. Consequentially, the presence of MCCs increases the risk for poor quality of life (QOL) [9,10] and wellbeing (WB) [11] and limits physical activity. In spite of the evidence that physical activity is beneficial to QOL [9] and WB [11], there is scant evidence in the research literature of exercise interventions for older adults with MCCs, specifically for older veterans. Older adults, regardless of veteran status, who have MCCs are often excluded from exercise interventions [12]. OVERTURE II endeavors to determine the feasibility of an exercise intervention that may promote QOL and WB among older veterans with MCCs.