Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process

BACKGROUND

Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology.

METHODS

Two hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1-10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%).

RESULTS

In round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate.

DISCUSSION AND IMPLICATIONS

The results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article.

Expert-based controllability assessment of control transitions from automated to manual driving

Up to a level of full vehicle automation, drivers will have to be available as a fallback level and take back manual control of the vehicle in case of system limits or failures. Before introducing automated vehicles to the consumer market, the controllability of these control transitions has to be demonstrated. This paper presents a novel procedure for an expert-based controllability assessment of control transitions from automated to manual driving. A standardized rating scheme is developed that allows trained raters to integrate different aspects of driving performance during control transitions (e.g., quality of lateral and longitudinal control, adequateness of signalling to other road users, etc.) into one global controllability measure based on video material of the driving situation. The method is adapted from an existing assessment procedure that has been successfully applied to assess the criticality of driving situations in manual driving conditions (e.g., assessment of substance-induced impairments, assessment of fitness-to-drive of novice drivers). This paper presents the rating procedure, including instructions of how to code relevant qualities of the drivers’ performance with accompanying video-demonstrations, and material used for rater training.

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A rating procedure for an expert-based controllability assessment of control transitions from automated to manual driving based on observation of video material was adapted from an existing method used in studies on manual driving.

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The advantage of this method consists in an integration of different dimensions of driving performance (e.g., operational and tactical driving behaviour, criticality of the situation) into one global controllability measure.

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The method allows an assessment and comparison of diverse take-over scenarios, detached from driver performance variables.

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The accompanying video-based training material allows reproducible and reliable execution of the rating procedure.