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Powter H, Lambert K, Nicholls N. Experiences and perspectives of integrating nutrition education into an exercise program for people with chronic medical conditions. Health Promot J Austr 2024. [PMID: 38200682 DOI: 10.1002/hpja.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
ISSUE ADDRESSED Community-based healthy eating and exercise programs are effective interventions to support some people with chronic conditions. This research aimed to explore the experiences and perceptions of participants regarding the integration of nutrition education into a successful group based exercise program for people with chronic medical conditions. METHODS Semi-structured interviews were conducted with past participants of a community based group exercise program (Health Moves) with embedded nutrition advice based in a regional area of New South Wales. A total of 60 individuals who had participated in the Health Moves program between 2017 and 2019 were invited to participate and 19 (32%) randomly selected participants consented to be interviewed. Interviews explored participants' experiences, program impacts, and barriers to sustaining changes post program. Similar concepts and patterns were grouped into themes. RESULTS Four themes were identified that described the experiences with a community-based group exercise intervention with a nutrition component. The major themes evident were that Health Moves facilitated motivation (via access to health professionals, peer support, accountability, affordability); and there were challenges identified to sustaining change (including cost, comorbidities, end of program support, environmental factors); Nutrition advice was valuable for some but not for all (difficulty recalling nutrition components, superficial coverage) Practical and interactive nutrition advice is desired. CONCLUSIONS Participants expressed a high degree of satisfaction with the program but require ongoing support to sustain changes post program. The position and integration of nutrition education within this exercise program was perceived by participants to be suboptimal. Increased access to practical, interactive nutrition education components may improve participant satisfaction and engagement. SO WHAT?: Key findings from this research include a desire for removal of didactic nutrition education sessions and request for increased peer support. Modifications to the program include the integration of interactive self-paced nutrition modules. Peer support partnerships are now encouraged by trainers to support ongoing motivation of participants to keep training together outside the structured exercise program and transition to managing their own exercise routine. Discussions between organisations involved about ongoing pathway/program support or reduced cost 'off peak' gym membership is underway to help with costs incurred by participants.
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Affiliation(s)
- Hannah Powter
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Natalie Nicholls
- Diabetes Service, Illawarra Shoalhaven Local Health District (ISLHD), Wollongong, New South Wales, Australia
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Ng YL, Hill KD, Burton E. Experiences of Older Adults With Mild Balance Dysfunction Who Participated in a Supervised Seniors Exercise Park Program Progressing to Independent Practice. J Aging Phys Act 2023; 31:600-610. [PMID: 36638811 DOI: 10.1123/japa.2022-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 01/15/2023]
Abstract
Older adults with mild balance dysfunction can benefit from early intervention. This research explored the experiences of older adults with mild balance dysfunction participating in an 18-week supervised outdoors Seniors Exercise Park program and 6 weeks of unsupervised independent practice. Factors influencing attendance and independent practice were also explored. Semistructured face-to-face interviews were conducted with 24 participants (mean age = 77.4 years, SD = 5.4) and 22 participants (mean age = 77.5 years, SD = 5.6) after 18 and 24 weeks, respectively. The data were analyzed using reflexive thematic analysis. Many participants perceived improvements in health and responded positively to the supervised Seniors Exercise Park program. Factors supporting attendance included building social connections and positive instructor personality. Barriers to training included competing time demands and poor health. These insights suggest that a group-based Seniors Exercise Park supervised program was well accepted and can be an option to improve the health of older adults with mild balance dysfunction.
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Affiliation(s)
- Yoke Leng Ng
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA,Australia
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore,Singapore
| | - Keith D Hill
- Rehabilitation, Ageing, and Independent Living (RAIL) Research Centre, Monash University, Melbourne, VIC,Australia
| | - Elissa Burton
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA,Australia
- enAble Institute, Curtin University, Perth, WA,Australia
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3
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Liang IJ, Francombe-Webb J, McGuigan PM, Perkin OJ, Thompson D, Western MJ. The acceptability of homebased exercise snacking and Tai-chi snacking amongst high and low function UK and Taiwanese older adults. FRONTIERS IN AGING 2023; 4:1180939. [PMID: 37593678 PMCID: PMC10428172 DOI: 10.3389/fragi.2023.1180939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/21/2023] [Indexed: 08/19/2023]
Abstract
Introduction: Exercise "snacking" and Tai-chi 'snacking' protocols are designed to overcome typical barriers to older adults' participation in muscle strength and balance exercise, using short bouts of home-based exercise. This study aimed to investigate the acceptability of homebred exercise- and Tai-chi snacking in British and Taiwanese older adults of high and low physical function. Methods: Thirty-three British and Thirty Taiwanese older adults took part in semi-structured interviews, after trying 1-week of exercise- and Tai-chi snacking. The interview schedule and deductive framework analysis was based on the seven components of the Theoretical Framework of Acceptability (TFA). Differences between the Taiwanese and United Kingdom participants and those considered high versus low physical function were also analysed. Results: Both snacking regimes were found to be convenient and easy to implement. Participants reported that no activity had to be given up, and considered the programmes would be beneficial to their physical and mental health. Interestingly, more UK-based participants preferred the elegant and relaxing movements of Tai-chi snacking, yet participants with low physical function experienced difficulties when mastering Tai-chi movements. A few high physical function participants perceived exercise snacking to be tedious. Discussion: Overall, the snacking exercise was found to be acceptable and useful. Personal affective attitude and different cultural backgrounds may affect exercise participation. Nevertheless, it is important to consider individuals' physical function when designing exercise regime. The findings indicate that making Tai-chi snacking easier to master initially, building in progression and adding some upper body movements in the exercise snacking may further enhance acceptability.
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Affiliation(s)
| | | | | | | | | | - Max J. Western
- Department for Health, University of Bath, Bath, England, United Kingdom
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Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the Lifespan. Healthcare (Basel) 2023; 11:healthcare11020274. [PMID: 36673642 PMCID: PMC9858934 DOI: 10.3390/healthcare11020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.
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Kim JS, Kim CJ, Schlenk EA. Psychometric properties of the barriers self-efficacy scale for physical activity–Korean. Arch Psychiatr Nurs 2023; 43:29-36. [PMID: 37032012 DOI: 10.1016/j.apnu.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
This study examined the psychometric properties of the Barriers Self-Efficacy Scale-Physical Activity for Korean-speaking adults with osteoarthritis at risk for metabolic syndrome (N = 150). Factor analysis identified three dimensions of the Korean Barriers scale, explaining 65.9 % of the total variance. Confirmatory factor analysis indicated that the structural validity adequately fits the data. Construct validity confirmed significant associations between the amount of physical activity and psychological variables. The test-retest reliability was 0.87; the alpha was 0.90. The standardized response mean (0.497) indicated responsiveness to medium-magnitude change. The Korean Barriers scale can assess self-efficacy to engage in regular physical activity in clinical settings.
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Affiliation(s)
- Jung-Suk Kim
- Department of Nursing, Hyejeon College, South Korea.
| | - Chun-Ja Kim
- College of Nursing and the Research Institute of Nursing Science, Ajou University, South Korea.
| | - Elizabeth A Schlenk
- School of Nursing, University of Pittsburgh, 3500 Victoria Street Suite 350, Pittsburgh, PA 15261-0001, United States of America.
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Maiers M, Salsbury SA. "Like Peanut Butter and Jelly": A Qualitative Study of Chiropractic Care and Home Exercise Among Older Adults With Spinal Disability. Arthritis Care Res (Hoboken) 2022; 74:1933-1941. [PMID: 33973398 DOI: 10.1002/acr.24636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 03/17/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE A mixed-methods, randomized controlled trial comparing short- and long-term chiropractic care and exercise therapy for spinal disability in older adults found no between-group differences in the primary outcome. However, those who received long-term management reported greater improvement in neck pain, self-efficacy, function, and balance. This nested qualitative study explored participants' perceptions of the benefits and drawbacks of chiropractic care and exercise for spine-related outcomes, with an emphasis on understanding what makes treatment for spine-related problems worthwhile. METHODS Of 171 individual interviews conducted after completing study treatment, 50 participants (25 per treatment group) were randomly selected for this analysis. Qualitative descriptive analysis included dual coding of verbatim transcripts by 2 investigators (MM and SAS), which was further distilled into a consensus-derived codebook of themes and organized using NVIVO software. RESULTS Participants described trial interventions as complementary to one another for spine-related disability. Chiropractic care was viewed as improving spinal pain and controlling symptoms, while exercise therapy was noted for its long-term impact on self-efficacy and self-management. These older adults considered changes in pain, global sense of improvement, and improved biomechanical function as making treatment worthwhile. CONCLUSION Older adults valued nonpharmacologic treatment options that aided them in controlling spine-related symptoms, while empowering them to maintain clinical benefit gained after a course of chiropractic spinal manipulation and exercise. The complementary nature of provider-delivered and active care modalities may be an important consideration when developing care plans. This study underscores the importance of understanding participants' values and experiences when interpreting study results and applying them to practice.
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Affiliation(s)
- Michele Maiers
- Northwestern Health Sciences University, Bloomington, Minnesota
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Olsen PØ, Tully MA, Del Pozo Cruz B, Wegner M, Caserotti P. Community-based exercise enhanced by a self-management programme to promote independent living in older adults: a pragmatic randomised controlled trial. Age Ageing 2022; 51:6632480. [PMID: 35797431 DOI: 10.1093/ageing/afac137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND older adults face several modifiable barriers for engaging in physical activity (PA) programmes such as incontinence, loneliness and fear of falling. Enhancing PA programmes with behavioural components to support self-management of such barriers may increase the effectiveness to preserve functional capacity and independent living. OBJECTIVE this study aimed at assessing the effects of a complex active lifestyle intervention (CALSTI) on objective and self-report measures of functional capacity and disability in community-dwelling older adults. SUBJECTS AND METHODS about 215 older adults (79.9 ± 0.4 years) at increased risk of functional decline were randomly allocated to (i) CALSTI consisting of 12-weeks progressive explosive resistance training (24 sessions) enhanced by a 24-week multi-factorial self-management programme (8 sessions), or (ii) an extended version of the self-management intervention (SEMAI; 12 sessions) to reflect a reinforcement of usual care. The interventions were embedded in a nationally regulated preventive care pathway. Blinded assessors collected primary (the Short Physical Performance Battery; SPPB) and secondary outcome data (self-reported difficulty in activities of daily living, the short version of the Late-Life Function and Disability Index, and the EQ-health VAS scale) at baseline and after 12 and 24 weeks. RESULTS after 24 weeks, CALSTI led to a clinically superior increase in SPPB compared with SEMAI (+0.77 points, P < 0.01), and the CALSTI group also demonstrated improvements in selected self-reported outcomes. CONCLUSIONS a novel complex exercise and multi-factorial self-management intervention embedded in preventive care practice had large and clinically meaningful effects on a key measure of functional capacity and predictor of disability.
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Affiliation(s)
- Pia Øllgaard Olsen
- Centre of Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry , UK
| | - Borja Del Pozo Cruz
- Centre of Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Manfred Wegner
- Department of Sports Psychology and Movement Science, Kiel University, Germany
| | - Paolo Caserotti
- Centre of Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Mundell NL, Owen PJ, Dalla Via J, Macpherson H, Daly RM, Livingston PM, Rantalainen T, Foulkes S, Millar J, Murphy DG, Fraser SF. Effects of a multicomponent resistance-based exercise program with protein, vitamin D and calcium supplementation on cognition in men with prostate cancer treated with ADT: secondary analysis of a 12-month randomised controlled trial. BMJ Open 2022; 12:e060189. [PMID: 35750461 PMCID: PMC9234801 DOI: 10.1136/bmjopen-2021-060189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The aim of this preplanned secondary analysis of a 12-month randomised controlled trial was to investigate the effects of a multicomponent exercise programme combined with daily whey protein, calcium and vitamin D supplementation on cognition in men with prostate cancer treated with androgen deprivation therapy (ADT). DESIGN 12-month, two-arm, randomised controlled trial. SETTING University clinical exercise centre. PARTICIPANTS 70 ADT-treated men were randomised to exercise-training plus supplementation (Ex+ Suppl, n=34) or usual care (control, n=36). INTERVENTION Men allocated to Ex + Suppl undertook thrice weekly resistance training with weight-bearing exercise training plus daily whey protein (25 g), calcium (1200 mg) and vitamin D (2000 IU) supplementation. PRIMARY AND SECONDARY OUTCOME MEASURES Cognition was assessed at baseline, 6 and 12 months via a computerised battery (CogState), Trail-making test, Rey auditory-verbal learning test and Digit span. Data were analysed with linear mixed models and an intention-to-treat and prespecified per-protocol approach (exercise-training: ≥66%, nutritional supplement: ≥80%). RESULTS Sixty (86%) men completed the trial (Ex + Suppl, n=31; control, n=29). Five (7.1%) men were classified as having mild cognitive impairment at baseline. Median (IQR) adherence to the exercise and supplement was 56% (37%-82%) and 91% (66%-97%), respectively. Ex + Suppl had no effect on cognition at any time. CONCLUSIONS A 12-month multicomponent exercise training and supplementation intervention had no significant effect on cognition in men treated with ADT for prostate cancer compared with usual care. Exercise training adherence below recommended guidelines does not support cognitive health in men treated with ADT for prostate cancer. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trial Registry (ACTRN12614000317695, registered 25/03/2014) and acknowledged under the Therapeutic Goods Administration Clinical Trial Notification Scheme (CT-2015-CTN-03372-1 v1).
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Affiliation(s)
- Niamh Liana Mundell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | | | - Timo Rantalainen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Faculty of Sport and Health Sciences, Department of Health Sciences, Jyvaskylan Yliopisto, Jyvaskyla, Finland
| | - Stephen Foulkes
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jerremy Millar
- Radiation Oncology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Meigh NJ, Davidson AR, Keogh JWL, Hing W. "If somebody had told me I'd feel like I do now, I wouldn't have believed them…" older adults' experiences of the BELL trial: a qualitative study. BMC Geriatr 2022; 22:481. [PMID: 35658902 PMCID: PMC9164186 DOI: 10.1186/s12877-022-03174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives This study examined older adults’ experiences of participating in the Ballistic Exercise of the Lower Limb (BELL) trial, involving 12-weeks of group-based hardstyle kettlebell training. Methods In the BELL trial, 28 insufficiently active older adults (15 women, 13 men, 59–79 years) completed six weeks of face-to-face group training, and six weeks of home-based training. In-depth semi-structured interviews were audio recorded, transcribed, and inductively coded, with themes constructed from patterns of shared meaning. Results Four higher-order themes were developed that reflect older adults’ experiences participating in a group-exercise program of hardstyle kettlebell training. These included: (1) “It’s one of the best things we’ve done”—enjoying the physical and psychosocial benefits, (2) “It’s improved it tremendously!”—change in a long-term health condition, (3) “It put me on a better course”—overcoming challenges, and (4) “I wasn’t just a number”—feeling part of a group/community. Discussion Findings highlight the perceived physical and psychological benefits of older adults participating in hardstyle group kettlebell training, and the value attributed to being part of an age-matched community of like-minded people engaged in group exercise. Implications for program design and delivery, and future research, are discussed. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03174-5.
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Affiliation(s)
- Neil J Meigh
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia.
| | - Alexandra R Davidson
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia.,Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand.,Kasturba Medical College, Manipal Academy of Higher Education Mangalore, Manipal, Karnataka, India
| | - Wayne Hing
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia
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Novak JR, Ellis FK. A framework for incorporating physical activity in treatment: Competencies, guidelines, and implications for family therapists. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:523-542. [PMID: 34480488 DOI: 10.1111/jmft.12550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Physical activity can have a profound impact on the cognitive, emotional, and social aspects of our clients' lives, and can even boost and sustain therapy outcomes. And yet, family therapists may not be trained or educated in the importance of physical activity nor how to assess, educate, and collaborate with health professionals to incorporate physical activity in treatment. As the evidence grows on the connection between physical activity and biopsychosocial functioning and more family therapists enter medical and healthcare settings, a framework for physical activity competencies is needed. As such, the purpose of this conceptual and empirical review paper is to (a) review the important brain-boosting benefits of physical activity for mental, cognitive, and social health, (b) provide a framework for the domains for family therapists for incorporating exercise in assessment and treatment, and finally, (c) outline recommendations for practice, education and supervision, and research for family therapists.
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Affiliation(s)
- Josh R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Faith K Ellis
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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Kumar A, Munirji L, Nayif S, Almotairy N, Grigoriadis J, Grigoriadis A, Trulsson M. Motor Performance and Skill Acquisition in Oral Motor Training With Exergames: A Pilot Study. Front Aging Neurosci 2022; 14:730072. [PMID: 35309890 PMCID: PMC8924593 DOI: 10.3389/fnagi.2022.730072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the effects of oral-motor training with exergames on motor performance and motor skill acquisition in two different age groups. Methods Thirty-two healthy participants were recruited in the current pilot study and divided equally into two groups (Gen Z and Baby Boomers) according to their age. A pair of electromyographic (EMG) electrodes were placed on the participants’ masseter muscles. The EMG device communicated via Bluetooth with a mobile video game in response to the electromyographic activity of the masseter muscles during clenching. During the experimental session, participants were asked to play a video game in five blocks of 5 min each, with a 3-min break between each time block. The goal of the game was to collect as many coins (game points) as possible and to dodge/avoid upcoming obstacles (game life). Motor performance was assessed by performance scores and the number of game lives. Skill acquisition was measured by task efficiency (ratio of performance scores and number of game lives) across time blocks. Results The results of the study showed significantly lower performance scores (p < 0.001), a higher number of game lives (p < 0.001), and lower task efficiency in the Baby Boomer group compared to the Gen Z group. Specifically, the results showed that there was a significant difference in task efficiency between the first and second, third and fourth, fourth- and fifth-time blocks in the Gen Z group (p < 0.002). However, there was only a significant difference between first- and second-time blocks in the Baby Boomer group (p = 1.012), suggesting that skill acquisition in the Baby Boomer group did not change significantly over the course of the time blocks. Conclusion The study showed higher motor performance and superior motor skill acquisition with novel exergame training in the Gen Z group compared to the Baby Boomer group. The results of the study indicate that there is an improvement in oral motor skills with short-term training, yet the differences in oral motor skills between the two groups are still evident. The Baby Boomer group, unlike the Gen Z group, did not show robust improvement in task efficiency over the course of the series.
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Affiliation(s)
- Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- *Correspondence: Abhishek Kumar,
| | - Linda Munirji
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sam Nayif
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nabeel Almotairy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | - Joannis Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Mats Trulsson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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12
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Gerards MHG, Sieben J, Marcellis R, de Bie RA, Meijer K, Lenssen AF. Acceptability of a perturbation-based balance training programme for falls prevention in older adults: a qualitative study. BMJ Open 2022; 12:e056623. [PMID: 35210345 PMCID: PMC8883254 DOI: 10.1136/bmjopen-2021-056623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Perturbation-based balance training (PBT) is reported to effectively reduce falls in older adults and may even be superior compared with various exercise programmes. Due to the nature of the intervention, requiring unpredictable balance perturbations, the question arises whether acceptability is an issue in PBT. OBJECTIVE To evaluate the acceptability of PBT in older adults with a recent history of falls. DESIGN, METHOD, PARTICIPANTS AND SETTING This is a qualitative study in which semistructured interviews were conducted in 16 older adults (14 women and 2 men, mean age 73.6±6.0 years) who completed a three-session PBT protocol as part of another study in a university medical centre in the Netherlands. Typical case and purposive sampling strategies were applied. Interviews were based on the theoretical framework of acceptability (TFA) alongside context-specific factors and analysed using a template analysis approach. RESULTS The results indicate that this PBT protocol is perceived as acceptable by older adults with a recent history of falls and highlight key areas for potential future modifications. Enjoyment of the novel training and technology, being able to feel safe during training, and perceived impact of increased self-efficacy and balance confidence were identified as facilitating factors. Potential issues included initial apprehension or anxiety during training and perceived impact being predominantly psychological instead of physical. Complementary to the TFA one additional theme emerged which described challenges regarding the training setting, such as preference for group training in some participants and travel to the training location. CONCLUSIONS The results suggest that PBT is perceived acceptable by older adults with a history of falls. Increasing the social aspect of training and sharing the experiences of peers may be considered to enhance acceptability to new participants who initially feel apprehensive or anxious about their ability to participate in future implementation of PBT. TRIAL REGISTRATION NUMBER The article is linked to a randomised clinical trial registered on https://www.trialregister.nl/trial/7680, NL7680; Results.
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Affiliation(s)
- Marissa H G Gerards
- Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Judith Sieben
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands
| | - Rik Marcellis
- Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Rob A de Bie
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Antoine F Lenssen
- Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, The Netherlands
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13
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Gumber L, Timmons S, Coupland C, Gladman JRF, Iliffe S, Kendrick D, Lafond N, Logan P, Masud T, Skelton DA, Timblin C, Orton E. 'It is designed for everybody to find their own level and to improve themselves'; views of older people and instructors of the Falls Management Exercise (FaME) programme. Age Ageing 2022; 51:6527371. [PMID: 35150581 DOI: 10.1093/ageing/afac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older adults are at increased risk of falls due to ageing, decreased muscle strength and impaired balance. Clinical trials have demonstrated the efficacy and effectiveness of the Falls Management Exercise (FaME) programme in improving functioning and preventing falls. However, programme completion is often low, impacting the potential benefits of FaME. OBJECTIVE To explore the barriers and facilitators for participation and completion of the FaME programme from an instructor and participant perspective. METHODS Semi-structured interviews were conducted with 20 FaME users and seven Postural Stability Instructors from the East Midlands region of England, UK. Interviews were conducted using a topic guide and explored their views of the programme, intended benefits, reasons for participating, instructor's approach and venue facilities. Data were transcribed verbatim and analysed using thematic analysis. Written informed consent was obtained from all participants and instructors. RESULTS Common themes identified by participants and instructors for adherence related to perceived health benefits, psychological well-being, intervention characteristics, cost, instructors' qualities, opportunity to socialise, venue accessibility and facilities. Further factors such as maintaining independence, discipline, relationship with peers and caring responsibilities influenced participants' engagement with the programme. Instructor factors such as progression were also reported as important predictors. CONCLUSIONS Instructor and participant factors influence uptake, attendance and adherence of FaME. The findings from this study can inform the development and improvement of additional falls-prevention programmes. It can also guide marketing strategies to promote uptake of exercise-based falls-prevention programmes among older adults.
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Affiliation(s)
| | | | | | | | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, UK
| | | | | | - Pip Logan
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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14
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Sánchez MFC, Ureta CR, BasualtoAlfaro P, García-Huidobro GB, Giné MC. Experiencia en el uso de videos para la promoción de ejercicio físico en el hogar en personas mayores en modalidad online en Chile durante la pandemia Covid19. Rev Esp Geriatr Gerontol 2022; 57:79-84. [PMID: 35339302 PMCID: PMC8825348 DOI: 10.1016/j.regg.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/20/2022] [Accepted: 01/31/2022] [Indexed: 11/15/2022]
Abstract
Objetivo Describir la usabilidad, la accionabilidad y la comprensión de videos para promover el ejercicio en el hogar de manera online durante la pandemia COVID-19, analizando las características de la población, su satisfacción, adherencia y barreras para realizar ejercicio físico. Material y métodos Estudio de diseño observacional descriptivo, no experimental y transversal, con enfoque cuantitativo. Se crearon videos de ejercicio físico y educación sobre dolor para personas mayores de 60 años, y fueron distribuidos en la Región Metropolitana (Chile) durante los meses de octubre a diciembre del 2020. La intervención consistió en el uso independiente en el hogar de estos videos, y tuvo una duración de 4 semanas. Luego, una muestra que recibió estos videos contestó una encuesta voluntariamente. Resultados Treinta y cuatro participantes evaluaron los videos como comprensibles y accionables. La usabilidad fue menor en las personas que percibían un nivel de manejo tecnológico menor. La adherencia promedio fue de 2 días a la semana durante 2,5 semanas. La principal barrera percibida fue la falta de voluntad, la cual mostró una mayor tendencia en las personas que realizaban ejercicio físico de manera grupal antes de las restricciones por la pandemia COVID-19. Conclusiones Los videos desarrollados fueron una herramienta bien evaluada por parte de la población mayor, sin embargo, la brecha tecnológica puede ser una limitante para favorecer un uso fácil y sencillo. Dentro de las estrategias se deberían considerar intervenciones que favorezcan la interacción social para promover la motivación interpersonal, en especial en las personas que prefieren modalidades grupales de ejercicio.
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15
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Parent-Reported Motivators and Barriers to Participation in a Community-Based Intervention Designed for Children With Motor Skill Difficulties: A Qualitative Program Evaluation. Adapt Phys Activ Q 2022; 39:109-128. [PMID: 34740990 DOI: 10.1123/apaq.2020-0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Parents play a critical role in their child's participation in community-based intervention programs. Yet, their perspectives remain largely overlooked in the literature. This qualitative program evaluation used social cognitive theory to understand parents' motivators and barriers to participation in a community-based intervention program designed for children with motor skill difficulties. METHOD Parents (n = 15) of children with motor skill difficulties enrolled in a community-based intervention program participated in semistructured interviews. RESULTS Thematic analysis revealed six motivators (child needs, satisfaction, perceived impact, affordability, design, and program culture) and three perceived barriers (parent knowledge, access, and accommodations). DISCUSSION Parents' motivators and barriers reflected a combination of personal and environmental factors consistent with social cognitive theory. This study revealed novel insight into program-related environmental motivators and barriers. Program leaders should consider ongoing evaluation and application of parental perspectives to optimize family participation and retention in community-based interventions.
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16
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Sidani S, Guruge S, Illanko K. The Experiences and Determinants of Sleep Problems of Immigrant and Canadian-Born Older Adults-Analysis of Canadian Longitudinal Study on Aging Baseline Data. Can J Nurs Res 2021; 54:168-176. [PMID: 34482751 DOI: 10.1177/08445621211009405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Although prevalent, limited knowledge is available on the experience of sleep problems (i.e., disturbance in sleep latency and in sleep maintenance) and their determinants in immigrant older adults. PURPOSE To compare immigrant and Canadian-born older adults' experiences of: 1) sleep problems, 2) determinants of sleep problems, categorized into precipitating and perpetuating factors, and 3) determinants most significantly contributing to each sleep problem. METHODS Baseline data obtained by the comprehensive cohort of the Canadian Longitudinal Study on Aging were analyzed. Participants 55+ years of age and with complete data on their country of birth comprised the sample, with 18,245 Canadian-born and 4,257 immigrant older adults. Single or multiple items were used to assess the precipitating (chronic condition, sleep disorders, pain, depressive symptoms, psychological distress, education, marital and socio-economic status) and perpetuating (smoking, alcohol consumption, physical activity) factors. Chi-square test and independent sample t-test were used in the comparison and multiple regression was applied to determine the most significant determinant of each sleep problem in each group of older adults. RESULTS Despite differences in a few determinants of sleep problems, the set of factors contributing to disturbance in sleep latency and maintenance was comparable for Canadian-born and immigrant older adults, and included: having a sleep disorder and high level of depressive symptoms and psychological distress. CONCLUSION The findings highlight the importance of public health campaigns to increase older adults' awareness of sleep problems, the factors that may contribute to disturbance in sleep, and strategies to prevent and/or manage sleep problems.
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Affiliation(s)
- Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Kandasamy Illanko
- Department of Computer and Electrical Engineering, Ryerson University, Toronto, ON, Canada
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17
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Lawlor ER, Cupples ME, Donnelly M, Tully MA. Implementing community-based health promotion in socio-economically disadvantaged areas: a qualitative study. J Public Health (Oxf) 2021; 42:839-847. [PMID: 31822896 DOI: 10.1093/pubmed/fdz167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 11/12/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is a gradient relationship between socio-economic status and health. We investigated the views and perceptions of health promotion service providers regarding factors that affect lack of engagement in public health initiatives by residents in socio-economically disadvantaged (SED) communities. METHODS We conducted semi-structured interviews with a purposive sample of key providers (n = 15) of community-based health promotion services to elicit their views about engagement-related factors and their experiences of the provision, delivery and impact of health promotion in SED areas. Interviews were analysed using thematic analysis. RESULTS Failure to (i) recognise within SED communities, socio-cultural norms of health-related behaviour and (ii) communicate to local residents an understanding of complex lifestyle influences appeared to affect adversely service engagement and contribute to the development of negative attitudes towards health promotion. Engagement is more likely when services are delivered within familiar settings, peer support is available, initiatives are organized within existing groups, external incentives are offered and there are options regarding times and locations. Collaborative working between providers and communities facilitates efficient, context-sensitive service delivery. CONCLUSIONS Knowledge of a local community and its socio-environmental context alongside a collaborative, facilitative and tailored approach to delivery are required to ensure successful engagement of SED communities in health promotion.
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Affiliation(s)
- Emma R Lawlor
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BA, UK.,MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0SL, UK
| | - Margaret E Cupples
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BA, UK.,Department of General Practice and Primary Care, Department of General Practice and Primary Care, Queen's University Belfast, Belfast BT9 7HR, UK
| | - Michael Donnelly
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BA, UK
| | - Mark A Tully
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BA, UK.,Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK
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18
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Furtado GE, Letieri RV, Silva-Caldo A, Trombeta JCS, Monteiro C, Rodrigues RN, Vieira-Pedrosa A, Barros MP, Cavaglieri CR, Hogervorst E, Teixeira AM, Ferreira JP. Combined Chair-Based Exercises Improve Functional Fitness, Mental Well-Being, Salivary Steroid Balance, and Anti-microbial Activity in Pre-frail Older Women. Front Psychol 2021; 12:564490. [PMID: 33841224 PMCID: PMC8026892 DOI: 10.3389/fpsyg.2021.564490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Regular exercise has long been shown to positively impact the immune system responsiveness and improve mental well-being (MWB). However, the putative links between biomarkers of mental health and immune efficiency in exercising subjects have been scarcely investigated. The aim of this study was to verify the effect of a 14-week combined chair-based exercise program (CEP) on salivary steroid hormones and anti-microbial proteins, functional fitness, and MWB indexes in pre-frail older women. Methods The participant women (82.8 4.6 years old; n = 32) were randomly divided into the exercising group (CEP, n = 17) and the non-exercising control group (CG, n = 15). The pre/post assessment included: (1) salivary anti-microbial proteins lysozyme; (Lys) and immunoglobulin-A (IgA); (2) salivary steroid hormones of testosterone (TT) and cortisol (COR); (3) functional fitness (gait speed, hand grip strength, and static balance); (4) MWB questionnaires (happiness, depression state, satisfaction with life, and stress). Results Significant differences with large Cohen's (d) effect sizes were found on increased salivary TT (p < 0.05; d = 0.60) after exercise intervention. The results revealed a decrease in IgA levels after CEP (p < 0.01, d = 0.30). The increase in subjective happiness levels (p < 0.05, d = 0.30) and decrease of stress perception (p < 0.01, d = 2.60) and depressive state (p < 0.05, d = 0.30) were found after intervention in the CEP group. Robust statistical differences in gait speed (p < 0.05; d = 0.60) and balance tests (p < 0.05; d = 0.80) were also found in the CEP group. In control, COR increased moderately (p < 0.05; d = 0.65) while no changes were found for the other indicators. Correlation analyses showed inter-dependence between pre-post variations of MWB, biochemical indexes, and fitness function (e.g., COR inverse correlation with hand grip strength and balance tests). Conclusion The CEP program was able to improve functional-fitness performance, decrease feelings of stress, and increase happiness. The CEP also induced clinically relevant hormonal and immune responses, which suggests that chair exercises that combine muscular strength, balance, and gait speed training are promising interventions to improve physical and mental health of older pre-frail adults.
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Affiliation(s)
- Guilherme Eustáquio Furtado
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal.,Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Rubens Vinícius Letieri
- Rehabilitation Sciences Program, Federal University of Alfenas (UNIFAL), Alfenas, Brazil.,Multidisciplinary Research Nucleus in Physical Education (NIMEF), Physical Education Department, Federal University of Tocantins (UFT), Tocantinópolis, Brazil
| | - Adriana Silva-Caldo
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - Joice C S Trombeta
- Exercise Physiology Laboratory (FISEX), Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Clara Monteiro
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos (UFscar), São Carlos, Brazil
| | - Rafael Nogueira Rodrigues
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - Ana Vieira-Pedrosa
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - Marcelo Paes Barros
- Institute of Physical Activity Sciences and Sports (ICAFE), Interdisciplinary Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Cláudia Regina Cavaglieri
- Exercise Physiology Laboratory (FISEX), Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil.,Graduate Program in Gerontology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Eef Hogervorst
- Applied Cognitive Research NCSEM, Loughborough University, Loughborough, United Kingdom
| | - Ana Maria Teixeira
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
| | - José Pedro Ferreira
- Research Unit in Sport and Physical Activity-CIDAF (UID/PTD/04213/2020), Faculty of Sport Sciences and Physical Education (FCDEF-UC), University of Coimbra, Coimbra, Portugal
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19
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See L, Rasiah RL, Laing R, Thompson SC. Considerations in Planning Physical Activity for Older Adults in Hot Climates: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031331. [PMID: 33540584 PMCID: PMC7908220 DOI: 10.3390/ijerph18031331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/26/2021] [Indexed: 12/25/2022]
Abstract
Regular physical activity has multiple health benefits for both the prevention and management of disease, including for older adults. However, additional precautions are needed with ageing given physiological changes and the increasing prevalence of comorbidities. Hot ambient temperatures increase the risks of exercise at any age, but are particularly important given thermoregulatory changes in older people. This narrative review informs planning of physical activity programs for older people living in rural areas with very hot climates for a period of the year. A multi-database search of peer-reviewed literature was undertaken with attention to its relevance to Australia, starting with definitions and standard advice in relation to physical activity programming and the incremental limitations imposed by age, rurality, and extreme heat. The enablers of and barriers to increasing physical activities in older adults and how they can be modified for those living in extreme hot climates is described. We describe multiple considerations in program design to improve safety, adherence and sustaining physical activity, including supervision, simple instructions, provision of reminders, social support, encouraging self-efficacy. Group-based activities may be preferred by some and can accommodate special populations, cultural considerations. Risk management is an important consideration and recommendations are provided to assist program planning.
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Affiliation(s)
- Lydia See
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
- Oral Health Centre of Western Australia, School of Dentistry, University of Western Australia, Nedlands 6009, Australia
- Correspondence: ; Tel.: +61-8-6457-4400
| | - Rohan L. Rasiah
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
| | - Rachael Laing
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Crawley 6009, Australia; (R.L.R.); (R.L.); (S.C.T.)
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20
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Ward K, Pousette A, Pelletier CA. "Not Everybody's an Athlete, But They Certainly Can Move": Facilitators of Physical Activity Maintenance in Older Adults in a Northern and Rural Setting. J Aging Phys Act 2020; 28:854-863. [PMID: 32498041 DOI: 10.1123/japa.2019-0393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 11/18/2022]
Abstract
Although the benefits of maintaining a physical activity regime for older adults are well known, it is unclear how programs and facilities can best support long-term participation. The purpose of this study is to determine the facilitating factors of physical activity maintenance in older adults at individual, program, and community levels. Nine semistructured interviews were conducted with individuals aged 60 years and older and long-term participants (>6 months) in community-based group exercise at a clinical wellness facility in northern British Columbia, Canada. Interviews were audio recorded, transcribed, and analyzed via inductive thematic analysis. Themes identified as facilitators of physical activity included (a) social connections, (b) individual contextual factors, and (c) healthy aging. Older adults are more likely to maintain physical activity when environments foster healthy aging and provide opportunity for social engagement.
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21
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Barrachina-Igual J, Martínez-Arnau FM, Pérez-Ros P, Flor-Rufino C, Sanz-Requena R, Pablos A. Effectiveness of the PROMUFRA program in pre-frail, community-dwelling older people: A randomized controlled trial. Geriatr Nurs 2020; 42:582-591. [PMID: 33189414 DOI: 10.1016/j.gerinurse.2020.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 01/10/2023]
Abstract
This study evaluated the effect of PROMUFRA program on physical frailty, kinanthropometric, muscle function and functional performance variables in pre-frail, community-dwelling older people. Participants (n = 50, 75 ± 7 years) were randomly assigned to two groups: intervention group (IG), and control group (CG). The IG performed multi-component exercise program, focused on high-intensity resistance training (HIRT) combined with self-massage for myofascial release (SMMR) for 12 weeks (2 d.wk-1). Two measurements were performed, at baseline and post-3 months. Participants (n = 43) were analyzed and significant differences were found in group-time interaction for muscle mass (p = 0.017), fat mass (p = 0.003), skeletal muscle mass index (p = 0.011), maximum isometric knee extension (p = 0.042), maximum dynamic knee extension (p = 0.001), maximum leg press (p < 0.001), Barthel Index (p = 0.039) and EuroQol 5-dimensions-3-levels (p = 0.012). We conclude that PROMUFRA program is an effective training method to achieve healthy improvements for the pre-frail community.
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Affiliation(s)
- Joaquín Barrachina-Igual
- Doctoral School, Universidad Católica de Valencia San Vicente Mártir, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain
| | - Francisco M Martínez-Arnau
- Department of Physiotherapy, Universitat de Valencia, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain
| | - Pilar Pérez-Ros
- Department of Nursing, Faculty of Nursing and Podiatry, Universitat de Valencia, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain; Nursing Department, Universidad Católica de Valencia San Vicente Mártir, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain
| | - Cristina Flor-Rufino
- Department of Physiotherapy, Universitat de Valencia, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain
| | - Roberto Sanz-Requena
- Radiology Department, Hospital Quironsalud Valencia, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain
| | - Ana Pablos
- Department of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, C/ Ramiro de Maeztu, 14, 46900, Torrente, Valencia, Spain.
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22
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Yang HJ, Chen KM, Hsu HF. Motivation theory-based physical activity programme for older adults in residential care facility: A modified Delphi and single-group pretest-posttest study. Int J Older People Nurs 2020; 16:e12355. [PMID: 33135323 DOI: 10.1111/opn.12355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/20/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical inactivity exposes older adults living in long-term care institutions to a high risk of health deterioration. Developing effective behaviour change interventions based on a theoretical framework is a pressing concern. AIMS This study developed an 'Easy Walking' intervention programme based on the Wheel of Motivation and aimed to: (1) develop the intervention programme for promoting self-efficacy of older adults living in long-term care facilities; and (2) examine the perceived helpfulness of the intervention programme for encouraging walking behaviours. METHODS This study consisted of two stages. In the first stage, a three-round modified Delphi process was conducted with ten experts to rate the eight motivators in the Wheel of Motivation. The Easy Walking programme was designed accordingly. In the second stage, a single-group pretest-posttest study design was employed to evaluate the Easy Walking programme. Structured questionnaires were used to collect data on the changes in self-efficacy and on the perceived helpfulness regarding the programme. RESULTS The Easy Walking intervention programme features eight factors that influence motivation. Thirty older adults participated in and evaluated the programme. The results showed a significant difference in self-efficacy (t = -7.02, p < .001) of the older adults. Regarding the perceived usefulness of the intervention, the mean scores for each item ranged from 3.73 to 4.93 points. 'Safe environment' was perceived to be the most helpful factor for encouraging walking behaviours. CONCLUSION The Easy Walking programme enhanced the self-efficacy of institutionalised older adults and was perceived as helpful in physical activity engagement. Nursing professionals in long-term care institutions could implement the Easy Walking programme to be part of daily nursing activities.
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Affiliation(s)
- Hui-Ju Yang
- School of Nursing, Tzu Hui Institute of Technology, Pingtung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Fen Hsu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
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23
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García-Sánchez E, Rubio-Arias JÁ, Ávila-Gandía V, López-Román FJ, Menarguez-Puche JF. Effects of Two Community-Based Exercise Programs on Adherence, Cardiometabolic Markers, and Body Composition in Older People with Cardiovascular Risk Factors: A Prospective Observational Cohort Study. J Pers Med 2020; 10:jpm10040176. [PMID: 33081361 PMCID: PMC7711811 DOI: 10.3390/jpm10040176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 12/02/2022] Open
Abstract
Cardiovascular disease is one of the leading causes of death globally, and cardiovascular risk factors (CRFs) are major behavioral risk factors. Therefore, community-based programs are being designed based on the prescription of physical exercise from primary care centers to improve people’s health through changes in lifestyle. The objective was to compare the effects of two types of community exercise on adherence, lipid profile, body composition and blood pressure. A prospective observational cohort study was designed with two cohorts of study depending on the duration and type of physical exercise program performed. Fifty-one participants (82.4% women) with CRF completed the observation period in which they carried out a short-term, non-individualized exercise program (3 months), and 42 participants (71.4% women) with CRF completed the observation period in which they conducted a long-term, individualized exercise program (6 months). The results suggest that participants who carried out the longer program with an individualized progression produced greater adherence to physical exercise and a decrease in diastolic blood pressure. In addition, LDL and insulin levels decreased in both groups. Therefore, our results suggest that a longer duration and individualized evolution of the loads of a community exercise program lead to higher levels of physical activity (PA) and improvements diastolic blood pressure.
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Affiliation(s)
- Esther García-Sánchez
- Fundación para la Formación e Investigación Sanitaria de la Región de Murcia (FFIS), Calle Luis Fontes Pagán 9, 1ª planta, 30003 Murcia, Spain;
| | - Jacobo Á. Rubio-Arias
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: or ; Tel.: +34-9106-77964
| | - Vicente Ávila-Gandía
- Sports Physiology Department, Catholic University of Murcia (UCAM), 30107 Murcia, Spain; (V.Á.-G.); (F.J.L.-R.)
| | - F. Javier López-Román
- Sports Physiology Department, Catholic University of Murcia (UCAM), 30107 Murcia, Spain; (V.Á.-G.); (F.J.L.-R.)
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30107 Murcia, Spain
| | - Juan F. Menarguez-Puche
- Primary Care Health Center, Jesús Marín, Calle Enrique Bernal Capel, 4, Molina de Segura, 30500 Murcia, Spain;
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André N, Agbangla NF. Are Barriers the Same Whether I Want to Start or Maintain Exercise? A Narrative Review on Healthy Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176247. [PMID: 32867337 PMCID: PMC7504162 DOI: 10.3390/ijerph17176247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/15/2020] [Accepted: 08/24/2020] [Indexed: 11/16/2022]
Abstract
To help older adults begin or adhere to regular physical exercise, several studies have endeavored to identify barriers to active behavior. However, there is a lack of information about barriers for active older people. In addition, most of the reviews of the literature compare only active people to inactive or sedentary people without examining in detail the barriers with respect to the degree of commitment to behavioral change. Finally, there is no consistency in the results of studies investigating the effects of barriers on the relationship between stages of change and exercise behavior. The first aim of this narrative review is to compare barriers that affect exercise stages of change from those that affect levels of exercise behavior in a healthy older population and the factors that can lead to relapse or dropout; the second aim is to identify the extent to which barriers hinder the relationships between stages of change and exercise behaviors. The results showed that barriers are well identified in sedentary people and in the first two stages of change (pre-contemplation and contemplation) compared to active seniors and other stages of change (preparation, action and maintenance). Consistency between the formulations of the different stages in comparison with the transtheoretical model and the definition of barriers and the limitations of measuring physical activity in the different studies are discussed. Finally, novel perspectives of research are proposed to address the flaws in the reviewed studies.
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Affiliation(s)
- Nathalie André
- Centre de Recherches sur la Cognition et l’Apprentissage (UMR CNRS 7295), Université de Poitiers, 86000 Poitiers, France
- Maison des Sciences de l’Homme et de la Société, USR CNRS 3565, Université de Poitiers, 86000 Poitiers, France
- Correspondence: (N.A.); (N.F.A.); Tel.: +33-549-454-679 (N.A.)
| | - Nounagnon Frutueux Agbangla
- Université de Paris, EA 3625-Institut des Sciences du Sport-Santé de Paris (I3SP), 75015 Paris, France
- Unité de Recherche Pluridisciplinaire Sport Santé Société (URePSSS), ULR 7369, Univ. Artois, Univ. Lille, Univ. Littoral Côte d’Opale, F-59000 Lille, France
- Correspondence: (N.A.); (N.F.A.); Tel.: +33-549-454-679 (N.A.)
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Fishleder S, Petrescu-Prahova M, Harris JR, Leroux B, Bennett K, Helfrich CD, Kohn M, Hannon P. Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness). J Geriatr Phys Ther 2020; 42:230-242. [PMID: 29979352 PMCID: PMC6318072 DOI: 10.1519/jpt.0000000000000202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Declines in strength, flexibility, and balance in older adults can lead to injuries and loss of independence and are particularly common in those of greater age and in worse health. EnhanceFitness (EF) is a nationally disseminated, evidence-based group exercise program for older adults that has been shown to improve function through cardiovascular, strength, flexibility, and balance exercises. This article examines changes in, and predictors of, participant physical function from baseline through 2 program cycles of EF as measured by 3 physical function tests: arm curls, chair stands, and 8-foot up-and-go. METHODS We analyzed data on participants who attended at least 2 consecutive 16-week program cycles between January 2005 and June 2016. We ran 3 random-effects linear regression models, 1 for each physical function test, and accounted for missing data and clustering by class site. Independent variables included attendance, demographics, and health status. RESULTS AND DISCUSSION A total of 7483 participants completed baseline and 2 sets of follow-up physical function tests. For all 3 physical function tests, participants showed some degree of improved physical function at each follow-up, and greater program attendance predicted clinically significant improvements. Some participants had less improvement: females, those less active at baseline, older than 75 years, not married or partnered, or in fair or poor health, those who had experienced at least 1 fall, and those with a disability. CONCLUSION EnhanceFitness program providers may need to implement additional measures to support the participants who could benefit most from EF, such as targeting messaging, coordinating with referring providers to emphasize attendance and general activity in specific participants, and offering additional support to groups who show less improvement during classes. The evidence presented here may inform clinical decision making for older adult patients and increase health care provider confidence in EF and similar exercise programs, thereby providing a mechanism to maintain and continue functional gains made in clinical or rehabilitation settings.
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Affiliation(s)
- Sarah Fishleder
- Health Promotion Research Center, University of Washington, Seattle, WA
- Department of Health Services, University of Washington, Seattle, WA
| | - Miruna Petrescu-Prahova
- Health Promotion Research Center, University of Washington, Seattle, WA
- Department of Health Services, University of Washington, Seattle, WA
| | - Jeffrey R. Harris
- Health Promotion Research Center, University of Washington, Seattle, WA
- Department of Health Services, University of Washington, Seattle, WA
| | - Brian Leroux
- Department of Biostatistics, University of Washington, Seattle, WA
- Department of Oral Health Sciences, University of Washington, Seattle, WA
| | - Kimberly Bennett
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA
| | | | - Marlana Kohn
- Health Promotion Research Center, University of Washington, Seattle, WA
| | - Peggy Hannon
- Health Promotion Research Center, University of Washington, Seattle, WA
- Department of Health Services, University of Washington, Seattle, WA
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Carter A, Alexander AC. A Qualitative Exploration of Womens’ Experiences Who Belong to a “Fitness Community”. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1687365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brown CS, Sloane R, Morey MC. Developing Predictors of Long-Term Adherence to Exercise Among Older Veterans and Spouses. J Appl Gerontol 2019; 39:1159-1162. [PMID: 31542972 DOI: 10.1177/0733464819874954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Behavior change theory was used to explore predictors of long-term adherence (≥2 years) to exercise. A retrospective analysis of data from participants (N = 97) who reached a 6-month follow-up, which served as the baseline, was evaluated for completion of yearly follow-up surveys. Variables examined at baseline, which included age, race, gender, body mass index (BMI), and self-report of comorbidities, symptoms, physical function, and a Barriers Specific Self-Efficacy Scale, were examined with significance set at p < .05. Lower BMI (29.1 ± 5.1 vs. 31.6 ± 6.5, p = .047) and higher self-efficacy to overcome environmental barriers (p = .016) and social isolation (p = .05) were associated with long-term adherence. Self-efficacy to overcome environmental and social barriers, such as inclement weather, access to exercise site, and opportunities for group-based exercise, should be addressed to promote long-term adherence to exercise among older adults.
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Affiliation(s)
- Candace S Brown
- University of North Carolina at Charlotte, USA.,Duke University, Durham, NC, USA.,Durham VA Health Care System, NC, USA
| | - Richard Sloane
- Durham VA Health Care System, NC, USA.,Duke Center for the Study of Aging and Human Development, Durham, NC, USA
| | - Miriam C Morey
- Durham VA Health Care System, NC, USA.,Duke Center for the Study of Aging and Human Development, Durham, NC, USA.,Duke University School of Medicine, Durham, NC, USA
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Lindsay-Smith G, Eime R, O’Sullivan G, Harvey J, van Uffelen JGZ. A mixed-methods case study exploring the impact of participation in community activity groups for older adults on physical activity, health and wellbeing. BMC Geriatr 2019; 19:243. [PMID: 31477054 PMCID: PMC6720859 DOI: 10.1186/s12877-019-1245-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 08/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity (PA) has many health benefits but declines with age. Community multi-activity groups offering volunteer-led socially-oriented activity programs could provide an opportunity for older people to maintain or increase PA levels and promote their health. The aim of this study was to examine the potential effect of becoming a member of an existing community activity group on PA levels, physical and mental health-related quality of life (HR QoL), comparing any impacts associated with participation in physical activity or social activity programs. METHODS This mixed-methods case study, combining a longitudinal quantitative-survey with qualitative focus groups to contextualise the survey results, focused on an Australian community organisation called Life Activities Clubs (LACs). LACs provide various physical activities (e.g. walking, cycling, dancing) and social activities (e.g. book groups, dine-outs, craft). Data were collected using a self-report survey administered at baseline, six and twelve-months after joining and group differences between participants of PA programs (PA group) and social programs (social group) were analysed using linear mixed-models. Two focus groups with LAC members were held, one representing each activity type and analysed using content and thematic analysis. RESULTS 35 people (mean age 67) completed the surveys and 11 people participated in the focus groups. PA levels and physical health-related QoL were maintained over 1 year in the PA group, and declined between baseline and 12-months in the social group. Focus groups suggested social aspects of PA programs increased motivation to maintain regular attendance and do more PA than participants would on their own and that physical activities provided health benefits. Mental HR QoL did not change in either group, focus groups suggested this was because the social aspects of both types of program provide benefits relating to mental health including stress relief, enjoyment and adapting to major life events, to prevent a decline in QoL. CONCLUSIONS Community PA programs appear to maintain PA levels and physical HR QoL in older adults, and both social and PA programs may maintain mental HR QoL. Incorporating both types of program into one organisation may also encourage less physically active members to try physical activities.
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Affiliation(s)
| | - Rochelle Eime
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- School of Health and Life Sciences, Federation University, Ballarat, Australia
| | - Grant O’Sullivan
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Jack Harvey
- School of Health and Life Sciences, Federation University, Ballarat, Australia
| | - Jannique G. Z. van Uffelen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven - University of Leuven, B-3000 Leuven, Belgium
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Abstract
Group-exercise instructors are a vital social determinant of exercise enjoyment, attendance, and adherence. Instructors also affect the degree to which physical cultures are socially inclusive. In order to elucidate the roles that instructors play in affecting these outcomes, we conducted a scoping review. Scoping reviews are a preliminary method for assessing the breadth and depth of existing literature in order to identify key themes and gaps therein. Based on Arksey and O'Malley's (2005) framework, we identified 52 articles and book chapters, 33 of which were older-adult specific, using a university search engine that simultaneously searches multiple databases. We conceptually mapped the literature, which revealed instructors' vital roles as: (1) constructors of group social cohesion, (2) cultural intermediaries, (3) competent practitioners, (4) leaders and communicators, and (5) educators. Of these, the instructor's educative role lacks empirical attention. We conclude with implications for future research, practice, and policy.
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Physical Activity Attitudes, Preferences, and Experiences of Regionally-Based Australia Adults Aged 65 Years and Older. J Aging Phys Act 2019; 27:446-451. [PMID: 30299206 DOI: 10.1123/japa.2017-0426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
An understanding of physical activity attitudes, preferences, and experiences in older adults is important for informing interventions. Focus groups were conducted with 46 regionally-based Australian adults aged 65 years and older, who were not currently meeting activity recommendations. Content analysis revealed that participants mainly engaged in incidental activities such as gardening and household chores rather than planned exercise; however, leisure-time walking was also mentioned frequently. Although participants valued the physical and mental health benefits of physical activity, they reported being restricted by poor physical health, extreme weather, and fear of injury. Participants were interested in exercise groups and physical activity programs tailored to their existing physical health. The majority of participants reported preferring to be active with others. The findings from this study are useful in for informing future interventions specifically tailored to the needs of older adults in Australia.
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Whipple MO, Schorr EN, Talley KMC, Lindquist R, Bronas UG, Treat-Jacobson D. A mixed methods study of perceived barriers to physical activity, geriatric syndromes, and physical activity levels among older adults with peripheral artery disease and diabetes. JOURNAL OF VASCULAR NURSING 2019; 37:91-105. [PMID: 31155168 PMCID: PMC6556121 DOI: 10.1016/j.jvn.2019.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 01/22/2023]
Abstract
Previous studies suggest a myriad of factors prevent individuals from engaging in physical activity; however, less is known about barriers faced by individuals with multiple chronic conditions, such as peripheral artery disease (PAD) and type 2 diabetes, and how these barriers may impact engagement in physical activity. To date, there are no studies that integrate simultaneous assessment of perceived barriers to physical activity and engagement in physical activity in older adults with PAD and diabetes. This integration is key to understanding the implications of barriers to physical activity and to developing strategies to address those barriers. Therefore, this study investigated the unique physical activity experiences of older adults with PAD and diabetes. This study used a concurrent mixed methods design. Ten adults aged 65 years and older with PAD and diabetes completed semistructured interviews about experiences with physical activity, self-reported questionnaires assessing quality of life and fear of falling, and measures of physical function (eg, 6-minute walk test, chair stand, gait speed). Physical activity was measured objectively with accelerometry. Inductive content analysis was used to identify themes, and integrated analysis was performed to evaluate patterns among qualitative and quantitative variables. On average, participants were 74 years old and spent 10% of their time in moderate or vigorous physical activity (range: 3%-18%); 80% of participants were men. Barriers to physical activity identified through qualitative interviews included lack of accessibility, lack of enjoyment of activity, lack of motivation, and pain and physical health. Facilitators to physical activity were social support, accessibility and convenience, and enjoyment of the activity. Participants with more sedentary time and less moderate or vigorous physical activity tended to report greater fear of falling and greater barriers to physical activity and achieved lower distances in 6-minute walk tests. This research provides insight into both the nature of perceived barriers to physical activity and engagement in physical activity among older adults with PAD and diabetes. The integration of self-reported measures and objective measures facilitates our understanding of the lived experiences of individuals with these conditions. Study findings can be used to support further investigation into factors that influence engagement in physical activity in individuals with PAD and diabetes and to assist in the development of strategies to address identified barriers.
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Affiliation(s)
- Mary O Whipple
- University of Minnesota, School of Nursing, Minneapolis, MN.
| | - Erica N Schorr
- University of Minnesota, School of Nursing, Minneapolis, MN
| | | | - Ruth Lindquist
- University of Minnesota, School of Nursing, Minneapolis, MN
| | - Ulf G Bronas
- College of Nursing, University of Illinois, Chicago, IL
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Lawlor ER, Cupples ME, Donnelly M, Tully MA. Promoting physical activity among community groups of older women in socio-economically disadvantaged areas: randomised feasibility study. Trials 2019; 20:234. [PMID: 31023329 PMCID: PMC6482492 DOI: 10.1186/s13063-019-3312-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a major public health issue. Whilst PA is an important contributor to disease prevention, engagement in PA decreases with age, particularly among women in socio-economically disadvantaged areas. Research using existing support networks to engage 'hard to reach' populations in PA interventions is sparse. We developed and tested the feasibility of a PA-promoting intervention for older women within existing community groups in socio-economically disadvantaged areas. METHODS The Medical Research Council guidelines for complex interventions were used to guide the intervention's development. We recruited participants (n = 40) from older (aged ≥50 years) women's groups from four different community centres. A 12-week programme was delivered during existing sessions, informed by Social Practice Theory. The sessions provided education about PA, social support in the form of a PA 'buddy', group discussion and follow-up telephone calls, as well as printed information about local opportunities to participate in PA. The main uncertainties tested were rates of participant recruitment, retention, and completion of assessments of PA by accelerometry and of mental health using the Hospital Anxiety and Depression Scale (HADS). Intervention acceptability was assessed by questionnaire, and focus group interviews elicited participants' views about the intervention. Qualitative data were subjected to framework analysis. RESULTS The recruitment rate was high; 87% (n = 40/46) of women consented to participate, and 78% (n = 31) attended all education sessions. Uptake of follow-up telephone calls and PA 'buddies' was low. Few participants provided valid accelerometer data, but 63% (n=25) completed the HADS questionnaire at all time points. The printed materials and education sessions were viewed positively; telephone calls and 'buddy' support were not valued. Participants believed that organised group activities would lead to increased PA engagement, and whilst participants disliked wearing a waist accelerometer, they thought that regular PA feedback would facilitate necessary goal-setting. CONCLUSIONS High recruitment and retention rates suggest that use of existing social support groups is an acceptable and attractive method of delivering a PA intervention to this population. A randomised controlled trial of the intervention appears feasible, but its design requires refinement of the social support component, facilitation of goal-setting and reconsideration of the assessment of PA. TRIAL REGISTRATION ClinicalTrials.gov, NCT02880449 . Registered on 26 August 2016.
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Affiliation(s)
- Emma R Lawlor
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.
| | - Margaret E Cupples
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.,Department of General Practice and Primary Care, Queen's University Belfast, 1 Dunluce Avenue, Belfast, BT9 7HR, Northern Ireland, UK
| | - Michael Donnelly
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK
| | - Mark A Tully
- UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.,School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland, UK
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Crandall KJ, Shake M, Ziegler U. Assessing the Impact of a Game-Centered Mobile App on Community-Dwelling Older Adults' Health Activation. ACTA ACUST UNITED AC 2019; 4. [PMID: 32743350 PMCID: PMC7394294 DOI: 10.21926/obm.icm.1903041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Older adults experience normative age-graded declines in physical and cognitive performance and many must manage one or more chronic conditions. Exercise programs can help to improve both their physical health and their knowledge, skill, and confidence in managing aspects of their own healthcare, yet a significant barrier is motivating them to adhere to such programs. The purpose of this investigation was to evaluate the impact of a game-centered mobile app (Bingocize®) on older adults’ knowledge, skill, and confidence for managing aspects of their healthcare. Methods: Community-dwelling older adults (N=84) with mobility and not engaged in any structured exercise program were recruited from rural community senior centers in Kentucky and Tennessee. Participants were randomly assigned to (a) a version that included health education, or (b) health education and an exercise component. Participants used the app in a group setting for 10 weeks, twice per week, for one hour. The Patient Activation Measure (PAM-10) was used to assess group changes in knowledge, skill, and confidence for managing aspects of their healthcare. The design was a two (Group: Exercise + Health Education vs. Health Education-only) x two (Time: Pre- vs. Post-intervention) and an analyses of variance, with significance p<.05, was used to detect within and between group differences. Results: PAM-10 values significantly increased from pre- to post-intervention for both groups, as did knowledge of the health topics (all p < 0.05). Attendance was >93% in both groups. Conclusions: Bingocize® engendered high attendance and improved health activation of older adults; however, additional research is needed to examine whether changes in activation result in long-term changes in health behaviour. The Bingocize® mobile app is an enjoyable and effective way to increase health activation in community-dwelling older adults.
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Affiliation(s)
- K Jason Crandall
- Western Kentucky University Center for Applied Science in Health and Aging, 2413 Nashville Road Suite, 123, Bowling Green, USA
| | - Matthew Shake
- Western Kentucky University Department of Psychological Sciences, 1906 College Heights Blvd, KTH 1002, Bowling Green, USA
| | - Uta Ziegler
- Western Kentucky University School of Engineering and Applied Science, 1906 College Heights Blvd., COHH 4036, Bowling Green, USA
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Valenzuela T, Razee H, Schoene D, Lord SR, Delbaere K. An Interactive Home-Based Cognitive-Motor Step Training Program to Reduce Fall Risk in Older Adults: Qualitative Descriptive Study of Older Adults' Experiences and Requirements. JMIR Aging 2018; 1:e11975. [PMID: 31518251 PMCID: PMC6716489 DOI: 10.2196/11975] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/08/2018] [Accepted: 11/10/2018] [Indexed: 12/21/2022] Open
Abstract
Background Falls are a major contributor to the burden of disease in older adults. Home-based exercise programs are effective in reducing the rate and risk of falls in older adults. However, adherence to home-based exercise programs is low, limiting the efficacy of interventions. The implementation of technology-based exercise programs for older adults to use at home may increase exercise adherence and, thus, the effectiveness of fall prevention interventions. More information about older adults’ experiences when using technologies at home is needed to enable the design of programs that are tailored to older adults’ needs. Objective This study aimed to (1) explore older adults’ experiences using SureStep, an interactive cognitive-motor step training program to reduce fall risk unsupervised at home; (2) explore program features that older adults found encouraged program uptake and adherence; (3) identify usability issues encountered by older adults when using the program; and (4) provide guidance for the design of a future technology-based exercise program tailored to older adults to use at home as a fall prevention strategy. Methods This study was part of a larger randomized controlled trial. The qualitative portion of the study and the focus of this paper used a qualitative descriptive design. Data collectors conducted structured, open-ended in-person interviews with study participants who were randomly allocated to use SureStep at home for 4 months. All interviews were audiotaped and ranged from 45 to 60 min. Thematic analysis was used to analyze collected data. This study was guided by Pender’s Health Promotion Model. Results Overall, 24 older adults aged 70 to 97 years were interviewed. Findings suggest older adults are open to use technology-based exercise programs at home, and in the context of optimizing adherence to home-based exercise programs for the prevention of falls, findings suggest that program developers should develop exercise programs in ways that provide older adults with a fun and enjoyable experience (thus increasing intrinsic motivation to exercise), focus on improving outcomes that are significant to older adults (thus increasing self-determined extrinsic motivation), offer challenging yet attainable exercises (thus increasing perceived self-competence), provide positive feedback on performance (thus increasing self-efficacy), and are easy to use (thus reducing perceived barriers to technology use). Conclusions This study provides important considerations when designing technology-based programs so they are tailored to the needs of older adults, increasing both usability and acceptability of programs and potentially enhancing exercise participation and long-term adherence to fall prevention interventions. Program uptake and adherence seem to be influenced by (1) older adults’ perceived benefits of undertaking the program, (2) whether the program is stimulating, and (3) the perceived barriers to exercise and technology use. Older adults shared important recommendations for future development of technologies for older adults to use at home.
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Affiliation(s)
- Trinidad Valenzuela
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.,Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Husna Razee
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Stephen Ronald Lord
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia.,Falls, Balance and Injury Research Centre, Neuroscience Research Australia, The University of New South Wales, Sydney, Australia
| | - Kim Delbaere
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia.,Falls, Balance and Injury Research Centre, Neuroscience Research Australia, The University of New South Wales, Sydney, Australia
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35
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Lee S, Smith ML, Towne SD, Ory MG. Effects of Sequential Participation in Evidence-Based Health and Wellness Programs Among Older Adults. Innov Aging 2018; 2:igy016. [PMID: 30480136 PMCID: PMC6177023 DOI: 10.1093/geroni/igy016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Evidence suggests participation in evidence-based programs by older adults is effective, yet most studies focus on participation in a single evidence-based program, leaving repeated participation insufficiently understood. We aimed to compare participation in multiple evidence-based programs (repeaters) versus a single evidence-based program (nonrepeaters). Research Design and Methods Secondary data analysis was conducted on pre–post longitudinal data targeting older adults participating in evidence-based program(s) in Texas (2013–2016). Surveys included sociodemographic and health-related indicators (e.g., self-rated health, health behaviors, and falls-risks). Mixed-effects models examined pre–post changes in health-related indicators. Results Of the 734 study-eligible participants, 145 (20%) participated in two or more evidence-based programs. The participants’ average age was 74 years, and the majority was female (80%), non-Hispanic White (79%), or lived in urban or large rural cities/towns (79%). At baseline, repeaters reported less depressive symptomology (p = .049), fewer chronic conditions (p = .048), and less concern of falling (p = .030) than nonrepeaters. Repeaters had better workshop attendance and completion rates (p < .001). Compared to nonrepeaters, repeaters showed significantly-better improvements in communication with physicians (p = .013). Discussion and Implications Study findings suggest potential benefits of participation in multiple evidence-based program workshops, but repeaters may have different health profiles than nonrepeaters in natural settings. Future evaluations should consider participants’ past participations in evidence-based programs. Further research is needed to build more comprehensive evidence about the incremental benefits of participation in multiple evidence-based programs.
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Affiliation(s)
- Shinduk Lee
- Center for Population Health & Aging, Texas A&M University, College Station.,Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station
| | - Matthew Lee Smith
- Center for Population Health & Aging, Texas A&M University, College Station.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station.,Department of Health Promotion & Behavior, University of Georgia, Athens
| | - Samuel D Towne
- Center for Population Health & Aging, Texas A&M University, College Station.,Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station.,Department of Health Management and Informatics, University of Central Florida, Orlando
| | - Marcia G Ory
- Center for Population Health & Aging, Texas A&M University, College Station.,Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station
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36
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Shake MC, Crandall KJ, Mathews RP, Falls DG, Dispennette AK. Efficacy of Bingocize®: A Game-Centered Mobile Application to Improve Physical and Cognitive Performance in Older Adults. Games Health J 2018; 7:253-261. [DOI: 10.1089/g4h.2017.0139] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Matthew C. Shake
- Department of Psychological Sciences; Western Kentucky University, Bowling Green, Kentucky
| | - K. Jason Crandall
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky
| | - Rilee P. Mathews
- Department of Psychological Sciences; Western Kentucky University, Bowling Green, Kentucky
| | - Dustin G. Falls
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky
| | - A. Kathryn Dispennette
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky
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Wayment HA, McDonald RL. Sharing a Personal Trainer: Personal and Social Benefits of Individualized, Small-Group Training. J Strength Cond Res 2018; 31:3137-3145. [PMID: 28353489 DOI: 10.1519/jsc.0000000000001764] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Wayment, HA and McDonald, RL. Sharing a personal trainer: personal and social benefits of individualized, small-group training. J Strength Cond Res 31(11): 3137-3145, 2017-We examined a novel personal fitness training program that combines personal training principles in a small-group training environment. In a typical training session, exercisers warm-up together but receive individualized training for 50 minutes with 1-5 other adults who range in age, exercise experience, and goals for participation. Study participants were 98 regularly exercising adult members of a fitness studio in the southwestern United States (64 women and 32 men), aged 19-78 years (mean, 46.52 years; SD = 14.15). Average membership time was 2 years (range, 1-75 months; mean, 23.54 months; SD = 20.10). In collaboration with the program directors, we developed a scale to assess satisfaction with key features of this unique training program. Participants completed an online survey in Fall 2015. Hypotheses were tested with a serial mediator model (model 6) using the SPSS PROCESS module. In support of the basic tenets of self-determination theory, satisfaction with small-group, individualized training supported basic psychological needs, which in turn were associated with greater autonomous exercise motivation and life satisfaction. Satisfaction with this unique training method was also associated with greater exercise self-efficacy. Autonomous exercise motivation was associated with both exercise self-efficacy and greater self-reported health and energy. Discussion focuses on why exercise programs that foster a sense of social belonging (in addition to motivation and efficacy) may be helpful for successful adherence to an exercise program.
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Affiliation(s)
- Heidi A Wayment
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona
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Motives to practice exercise in old age and successful aging: A latent class analysis. Arch Gerontol Geriatr 2018; 77:44-50. [PMID: 29665480 DOI: 10.1016/j.archger.2018.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/23/2018] [Accepted: 04/05/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim was to classify motives for exercising trying to find sets of related cases that share common motivations, and to relate these latent classes to markers of successful aging. METHODS 725 old adult aged 55 to 97 years were sampled in several Spanish towns. INSTRUMENTS Successful Aging Inventory (SAI), International Physical Activity Questionnaire (IPAQ), Health Survey SF-8, Satisfaction with Life Scale (SWLS), and motives to practice exercise, were used. Latent Class Analyses (LCAs) were estimated. The classes obtained were compared on markers of successful aging. RESULTS Three latent classes were deemed optimal. Significant differences for several markers of successful aging were found. CONCLUSION A main conclusion derived from the results is that not all old people do exercise for the same motives, and the class of motives you are in had an impact/relation on markers of successful aging. Motives related to internal rather than external pressures should be promoted in the old age.
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Miller CT, Teychenne M, Maple JL. The perceived feasibility and acceptability of a conceptually challenging exercise training program in older adults. Clin Interv Aging 2018; 13:451-461. [PMID: 29606858 PMCID: PMC5868626 DOI: 10.2147/cia.s154664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Exercise training is an essential component of falls prevention strategies, but they do not fully address components of physical function that leads to falls. The training approaches to achieve this may not be perceived as appropriate or even feasible in older adults. This study aims to assess the perceived feasibility and acceptability of novel exercise training approaches not usually prescribed to older adults. PATIENTS AND METHODS Fourteen adults were exposed to conceptually and physically demanding exercises. Interviews were then conducted to determine perceptions and acceptability of individual exercise tasks. Qualitative thematic analysis was used to identify themes. RESULTS Safety and confidence, acceptability, and population participation were the key themes identified. Staff knowledge, presence, program design, and overt safety equipment were important for alleviating initial apprehension. Although physically demanding, participants expressed satisfaction when challenged. Prior disposition, understanding the value, and the appeal of novel exercises were perceived to influence program engagement. CONCLUSION Given the evidence for acceptability, this type of training is feasible and may be appropriate as part of an exercise training program for older adults. Further research should be conducted to confirm that the physical adaptations to exercise training approaches as presented in this study occur in a similar manner to that observed in younger adults, and to also determine whether these adaptations lead to prolonged independence and reduced falls in older adults compared to usual care.
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Affiliation(s)
- Clint T Miller
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Megan Teychenne
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Jaimie-Lee Maple
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Martín-Borràs C, Giné-Garriga M, Puig-Ribera A, Martín C, Solà M, Cuesta-Vargas AI. A new model of exercise referral scheme in primary care: is the effect on adherence to physical activity sustainable in the long term? A 15-month randomised controlled trial. BMJ Open 2018; 8:e017211. [PMID: 29502081 PMCID: PMC5855315 DOI: 10.1136/bmjopen-2017-017211] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Studies had not yet overcome the most relevant barriers to physical activity (PA) adherence. An exercise referral scheme (ERS) with mechanisms to promote social support might enhance adherence to PA in the long term. SETTING A randomised controlled trial in 10 primary care centres in Spain. OBJECTIVE To assess the effectiveness of a primary care-based ERS linked to municipal resources and enhancing social support and social participation in establishing adherence to PA among adults over a 15-month period. PARTICIPANTS 422 insufficiently active participants suffering from at least one chronic condition were included. 220 patients (69.5 (8.4) years; 136 women) were randomly allocated to the intervention group (IG) and 202 (68.2 (8.9) years; 121 women) to the control group (CG). INTERVENTIONS The IG went through a 12-week standardised ERS linked to community resources and with inclusion of mechanisms to enhance social support. The CG received usual care from their primary care practice. OUTCOMES The main outcome measure was self-report PA with the International Physical Activity Questionnaire and secondary outcomes included stages of change and social support to PA practice. DATA COLLECTION Participant-level data were collected via questionnaires at baseline, and at months 3, 9 and 15. BLINDING The study statistician and research assessors were blinded to group allocation. RESULTS Compared with usual care, follow-up data at month 15 for the ERS group showed a significant increase of self-reported PA (IG: 1373±1845 metabolic equivalents (MET) min/week, n=195; CG: 919±1454 MET min/week, n=144; P=0.009). Higher adherence (in terms of a more active stage of change) was associated with higher PA level at baseline and with social support. CONCLUSIONS Prescription from ordinary primary care centres staff yielded adherence to PA practice in the long term. An innovative ERS linked to community resources and enhancing social support had shown to be sustainable in the long term. TRIAL REGISTRATION NUMBER NCT00714831; Results.
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Affiliation(s)
- Carme Martín-Borràs
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
- Department of Physical Therapy, Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, Barcelona, Spain
| | - Maria Giné-Garriga
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
- Department of Physical Therapy, Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, Barcelona, Spain
| | - Anna Puig-Ribera
- Department of Physical Activity and Sport Sciences, Universitat de Vic, Vic, Spain
| | - Carlos Martín
- Research Unit of Barcelona, Primary Healthcare Research Institution IDIAP Jordi Gol, Barcelona, Spain
| | - Mercè Solà
- Primary Health Center Les Planes, Sant Joan Despí, Barcelona, Spain
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Alley SJ, Schoeppe S, Rebar AL, Hayman M, Vandelanotte C. Age differences in physical activity intentions and implementation intention preferences. J Behav Med 2017; 41:406-415. [DOI: 10.1007/s10865-017-9899-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/20/2017] [Indexed: 12/30/2022]
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Chen TL, Bhattacharjee T, Beer JM, Ting LH, Hackney ME, Rogers WA, Kemp CC. Older adults' acceptance of a robot for partner dance-based exercise. PLoS One 2017; 12:e0182736. [PMID: 29045408 PMCID: PMC5646767 DOI: 10.1371/journal.pone.0182736] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 07/24/2017] [Indexed: 11/30/2022] Open
Abstract
Partner dance has been shown to be beneficial for the health of older adults. Robots could potentially facilitate healthy aging by engaging older adults in partner dance-based exercise. However, partner dance involves physical contact between the dancers, and older adults would need to be accepting of partner dancing with a robot. Using methods from the technology acceptance literature, we conducted a study with 16 healthy older adults to investigate their acceptance of robots for partner dance-based exercise. Participants successfully led a human-scale wheeled robot with arms (i.e., a mobile manipulator) in a simple, which we refer to as the Partnered Stepping Task (PST). Participants led the robot by maintaining physical contact and applying forces to the robot's end effectors. According to questionnaires, participants were generally accepting of the robot for partner dance-based exercise, tending to perceive it as useful, easy to use, and enjoyable. Participants tended to perceive the robot as easier to use after performing the PST with it. Through a qualitative data analysis of structured interview data, we also identified facilitators and barriers to acceptance of robots for partner dance-based exercise. Throughout the study, our robot used admittance control to successfully dance with older adults, demonstrating the feasibility of this method. Overall, our results suggest that robots could successfully engage older adults in partner dance-based exercise.
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Affiliation(s)
- Tiffany L. Chen
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Tapomayukh Bhattacharjee
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Jenay M. Beer
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, United States of America
- College of Social Work, University of South Carolina, Columbia, SC, United States of America
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Lena H. Ting
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
- Department of Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Madeleine E. Hackney
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Medicine, Atlanta VA Geriatric Research Education and Clinical Center, Atlanta, GA, United States of America
| | - Wendy A. Rogers
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, United States of America
- Department of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Charles C. Kemp
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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Arkkukangas M, Sundler AJ, Söderlund A, Eriksson S, Johansson AC. Older persons' experiences of a home-based exercise program with behavioral change support. Physiother Theory Pract 2017; 33:905-913. [PMID: 28812402 DOI: 10.1080/09593985.2017.1359869] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. PURPOSE This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. METHODS Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. RESULTS Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. CONCLUSION With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.
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Affiliation(s)
- Marina Arkkukangas
- a School of Health, Care and Social Welfare, Mälardalen University , Västerås , Sweden
| | - Annelie J Sundler
- b Faculty of Caring Science, Work Life and Social Welfare , University of Borås , Sweden
| | - Anne Söderlund
- c School of Health, Care and Social Welfare , Mälardalen University , Västerås , SE , Sweden
| | - Staffan Eriksson
- d Centre for Clinical Research Sörmland , Uppsala University , Eskilstuna , Sweden.,e Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.,f Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
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Telephone Care Management of Fall Risk:: A Feasibility Study. Am J Prev Med 2017; 52:S290-S294. [PMID: 28215383 DOI: 10.1016/j.amepre.2016.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/29/2016] [Accepted: 08/11/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. METHODS The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. RESULTS Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. CONCLUSIONS Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention.
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Petrescu-Prahova MG, Eagen TJ, Fishleder SL, Belza B. Enhance ®Fitness Dissemination and Implementation,: 2010-2015: A Scoping Review. Am J Prev Med 2017; 52:S295-S299. [PMID: 28215384 DOI: 10.1016/j.amepre.2016.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/11/2016] [Accepted: 08/10/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Physical activity has many benefits for older adult physical and mental health. Enhance®Fitness (EF) is an evidence-based group exercise program delivered by community-based organizations. The purpose of this study was to review recent evidence on the dissemination and implementation of EF. METHODS A scoping review of qualitative and quantitative studies with EF as main focus was conducted. CINAHL, PubMed, PubMed Central, SCOPUS, Web of Science, PsycINFO, and Google Scholar were searched between October and November 2015 for data-based studies on EF published in 2010-2015. Two team members abstracted each paper independently using a data abstraction tool. Results were summarized using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. RESULTS Seventeen publications met inclusion criteria. EF has reached and is effective across a broad population base, including individuals with low SES and diverse ethnic/racial backgrounds. EF participation may be associated with reduced risk for falls requiring medical care, and is associated with fewer hospital admissions. Analyses of medical cost savings from EF participation and program implementation costs suggest economic benefits of EF implementation for communities. Organization-level maintenance is facilitated by program-specific and organizational factors, such as instructor training and funding. Individual-level maintenance is facilitated by program structure, absence of pain, and increased quality of life. CONCLUSIONS More-rigorous evidence is needed about the association between participation in EF and conditions such as falls. Evaluation of program fidelity, adaptations, and sustainability is limited; more-systematic examination across population groups and types of organizations would help ensure older adults continue to benefit from EF participation.
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Affiliation(s)
| | - Thomas J Eagen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Sarah L Fishleder
- Health Promotion Research Center, University of Washington, Seattle, Washington
| | - Basia Belza
- Health Promotion Research Center, University of Washington, Seattle, Washington; School of Nursing, University of Washington, Seattle, Washington
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Anderson C, Seff LR, Batra A, Bhatt C, Palmer RC. Recruiting and Engaging Older Men in Evidence-Based Health Promotion Programs: Perspectives on Barriers and Strategies. J Aging Res 2016; 2016:8981435. [PMID: 27366330 PMCID: PMC4913010 DOI: 10.1155/2016/8981435] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 12/01/2022] Open
Abstract
Evidence-based health promotion programs are effective at reducing health risks and healthcare costs among older adults, but few men participate in the programs. This mixed methods study aimed to gain insight into the barriers to recruiting and engaging older men in evidence-based health promotion programs offered by the Healthy Aging Regional Collaborative of South Florida (HARC). Fourteen program coordinators participated in a focus group to identify barriers and strategies to improve male participation, and 49 instructors participated in a survey to triangulate the findings. Themes among barriers to male participation included women outnumbering men in the implementation sites and programs, conflict between male gender roles and the programs, and preference for other activities. Themes among strategies included public support of programs by male community leaders, program advertisements featuring males, and adapting program content. Survey results supported themes identified in the focus group. Nearly 78% of the survey respondents agreed that the perception of exercise programs as feminine was a barrier and over 90% of the survey respondents believed program advertisements featuring men would increase male participation. Findings indicate that health promotion programs and recruiting strategies need to be tailored to the unique needs and preferences of older men to improve participation.
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Affiliation(s)
| | - Laura R. Seff
- Florida International University, Miami, FL 33199, USA
| | - Anamika Batra
- Florida International University, Miami, FL 33199, USA
| | - Chintan Bhatt
- Florida International University, Miami, FL 33199, USA
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Adherence to community based group exercise interventions for older people: A mixed-methods systematic review. Prev Med 2016; 87:155-166. [PMID: 26921655 DOI: 10.1016/j.ypmed.2016.02.037] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/21/2016] [Accepted: 02/23/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Lifelong physical activity provides some of the best prospects for ageing well. Nevertheless, people tend to become less physically active as they age. This systematic review assessed the views and adherence of participants attending community based exercise programmes of ≥6month's duration. METHOD Searches were carried out in eight online scientific databases (January 1995-May 2014) to identify relevant primary studies. Studies were assessed for quality and data extracted. Results were synthesised thematically and narratively. Qualitative findings were compared against quantitative studies. RESULTS A total of 2958 studies were identified and screened against the inclusion/exclusion criteria. Ten studies met the inclusion criteria (five quantitative, three qualitative and two mixed-methods study designs). None were excluded on the basis of quality. Six key themes were identified from the qualitative studies as important for adherence to group exercise programmes: social connectedness, participant perceived benefits, programme design, empowering/energising effects, instructor and individual behaviour. The mean adherence rate of studies with comparable measures was (69.1% SD 14.6). When the views of participants from the qualitative synthesis were juxtaposed against the quantitative studies, programme design was a common feature across all studies. CONCLUSION Evidence surrounding these programmes is limited both in terms of long-term adherence measures and the views of participants. However, based on limited findings there is some indication that community based group exercise programmes have long-term adherence rates of almost 70%. Incorporating the views of older people into programme designs may provide guidance for innovative interventions leading to sustained adherence.
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Attwood S, Morton KL, Mitchell J, Van Emmenis M, Sutton S. Reasons for non-participation in a primary care-based physical activity trial: a qualitative study. BMJ Open 2016; 6:e011577. [PMID: 27217288 PMCID: PMC4885436 DOI: 10.1136/bmjopen-2016-011577] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore reasons for non-participation in a primary care-based physical activity trial and understand how these may contribute to recruitment of non-representative research samples. We also aimed to elicit non-participants' own recommendations for enhancing trial uptake in primary care. DESIGN Semistructured telephone interviews with non-participants to a randomised controlled trial of a very brief intervention for promoting physical activity conducted in primary care (the Very Brief Interventions trial), with thematic analysis of interview transcripts. SETTING 5 general practice (GP) surgeries in the East of England, UK. PARTICIPANTS Interviews were completed with 10 female and 6 male non-participants of white ethnicity and aged between 40 and 71 years. 13 of the 16 interviewees were either active or moderately active according to the GP Physical Activity Questionnaire (GPPAQ). RESULTS Interviewees discussed a range of reasons for non-participation. These included beliefs surrounding the personal relevance of the trial based on preconceptions of intervention content. Many interviewees considered themselves either sufficiently active or too functionally limited to increase activity levels further, so rendering participation pointless in their view. Other identified barriers included a lack of free time, for trial participation and for increasing physical activity, and dissatisfaction with appointment scheduling systems in place at GP surgeries. Interviewees questioned the appropriateness of primary care as a context for delivering interventions to promote physical activity. In general, interviewees were positively disposed towards the idea of trial participation, especially if personal benefits are made salient, but suggested that interventions could be delivered in a different setting such as the internet. CONCLUSIONS To increase participation in physical activity promotion trials conducted in primary care, the content of invitation materials and procedures for contacting potential participants require reconsideration. Specific recommendations include streamlining intervention materials and enhancing their relevance to the health concerns of invitees. TRIAL REGISTRATION NUMBER ISRCTN72691150; Pre-results.
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Affiliation(s)
- S Attwood
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - K L Morton
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - J Mitchell
- Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - M Van Emmenis
- Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - S Sutton
- Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
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Tan TX. Emotional and Behavioral Disorders in 1.5th Generation, 2nd Generation Immigrant Children, and Foreign Adoptees. J Immigr Minor Health 2016; 18:957-965. [PMID: 26972324 DOI: 10.1007/s10903-016-0388-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Existing theories (e.g., acculturative stress theory) cannot adequately explain why mental disorders in immigrants are less prevalent than in non-immigrants. In this paper, the culture-gene co-evolutionary theory of mental disorders was utilized to generate a novel hypothesis that connection to heritage culture reduces the risk for mental disorders in immigrant children. Four groups of children aged 2-17 years were identified from the 2007 United States National Survey of Children's Health: 1.5th generation immigrant children (n = 1378), 2nd generation immigrant children (n = 4194), foreign adoptees (n = 270), and non-immigrant children (n = 54,877). The 1.5th generation immigrant children's connection to their heritage culture is stronger than or similar to the 2nd generation immigrants, while the foreign adoptees have little connection to their birth culture. Controlling for age, sex, family type and SES, the odds for having ADD/ADHD, Conduct Disorder, Anxiety Disorder, and Depression diagnosis were the lowest for the 1.5th generation immigrant children, followed by the 2nd generation immigrant children and the foreign adoptees. The foreign adoptees and non-adopted children were similar in the odds of having these disorders. Connection to heritage culture might be the underlying mechanism that explained recent immigrants' lower rates of mental disorders.
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Affiliation(s)
- Tony Xing Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, 4202 E. Fowler Ave., Tampa, FL, 33620, USA.
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Allen NE, Song J, Paul SS, Sherrington C, Murray SM, O'Rourke SD, Lord SR, Fung VS, Close JC, Howard K, Canning CG. Predictors of Adherence to a Falls Prevention Exercise Program for People with Parkinson's Disease. Mov Disord Clin Pract 2015; 2:395-401. [PMID: 30363528 PMCID: PMC6178659 DOI: 10.1002/mdc3.12208] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/11/2015] [Accepted: 05/14/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Long-term benefits of exercise for people with Parkinson's disease (PD) require regular and sustained participation. This study aimed to investigate predictors of adherence to a minimally supervised exercise program designed to reduce falls in people with PD. METHOD People with idiopathic PD who participated in the exercise arm of a randomized, controlled trial were included. Exercises were prescribed three times per week for 6 months. Adherence was defined as the percentage of prescribed sessions participants reported as having undertaken. Potential predictors of adherence included baseline measures of demographic variables, disease severity and duration, falls and fear of falling, pain, self-reported health and quality of life, cognition, physical activity levels, freezing of gait, functional mobility and balance, and knee extensor strength. RESULTS The 108 participants included undertook a mean of 72% (standard deviation: 38%) of prescribed sessions. Participants had higher levels of adherence if they had shorter disease duration, less bodily pain, and better self-reported health and quality of life. A multivariate model (including disease duration, severity of bodily pain, self-reported physical well-being, the Frontal Assessment Battery, the Short Physical Performance Battery, and maximum walking time) explained 9% of the variance in exercise adherence, with shorter disease duration and less pain the strongest predictors (both predictors standardized β = -0.2; P = 0.04). CONCLUSION Disease duration and pain are likely to negatively influence exercise participation in people with PD. Given that most of the variance in adherence is unexplained, further work is required to determine other predictors of adherence to long-term exercise programs.
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Affiliation(s)
- Natalie E. Allen
- Clinical and Rehabilitation Sciences Research GroupFaculty of Health SciencesThe University of SydneySydneyAustralia
| | - Jooeun Song
- Clinical and Rehabilitation Sciences Research GroupFaculty of Health SciencesThe University of SydneySydneyAustralia
| | - Serene S. Paul
- Clinical and Rehabilitation Sciences Research GroupFaculty of Health SciencesThe University of SydneySydneyAustralia
- The George Institute for Global HealthSydney Medical SchoolThe University of SydneySydneyAustralia
| | - Catherine Sherrington
- The George Institute for Global HealthSydney Medical SchoolThe University of SydneySydneyAustralia
| | - Susan M. Murray
- Clinical and Rehabilitation Sciences Research GroupFaculty of Health SciencesThe University of SydneySydneyAustralia
| | - Sandra D. O'Rourke
- Clinical and Rehabilitation Sciences Research GroupFaculty of Health SciencesThe University of SydneySydneyAustralia
| | | | - Victor S.C. Fung
- Movement Disorder UnitWestmead HospitalSydneyAustralia
- Sydney Medical SchoolThe University of SydneySydneyAustralia
| | - Jacqueline C.T. Close
- Neuroscience Research AustraliaUNSWSydneyAustralia
- Prince of Wales Clinical SchoolUNSWSydneyAustralia
| | - Kirsten Howard
- Sydney School of Public HealthThe University of SydneySydneyAustralia
- Institute for ChoiceUniversity of South AustraliaSydneyAustralia
| | - Colleen G. Canning
- Clinical and Rehabilitation Sciences Research GroupFaculty of Health SciencesThe University of SydneySydneyAustralia
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