scholarly journals Transitions in Adherence Trajectories From Intervention to Maintenance of a Falls Prevention Exercise Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 448-449
Author(s):  
Pildoo Sung ◽  
May-Ling June Lee ◽  
Kok Yang Tan ◽  
Rahul Malhotra ◽  
Angelique Chan
Keyword(s):  
Older Adults ◽  
Self Efficacy ◽  
Latent Class ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Maintenance Phase ◽  
Falls Prevention ◽  
Successful Implementation ◽  
Intervention Phase ◽  
Active Intervention

Abstract The successful implementation of a falls prevention exercise program for older adults hinges on self-maintenance after active intervention. However, little is known about the pattern of adherence from the intervention to the maintenance phase of such programs, and the factors influencing adherence. We investigate transitions in exercise adherence trajectories from the active intervention to the maintenance phase of a falls prevention exercise program in Singapore, and whether exercise self-efficacy is associated with adherence in the maintenance phase. We analyze data of 143 older adults who participated in a 12-week, group-based falls prevention exercise program, followed by a 6-month maintenance phase, in 2018-2019. Sequential process latent class growth modeling identifies the distinct exercise adherence trajectories in the active intervention and the maintenance phase separately and their transition patterns. Multivariable regression examines whether baseline and change in self-efficacy during the active intervention predict adherence during the maintenance phase. The analysis reveals three exercise adherence trajectories— adherent (40% of participants), intermittent (38%), and disengaged (22%)—in the active intervention phase, and two trajectories—adherent (33%) and disengaged (67%)—in the maintenance phase. Those adherent in the maintenance phase comprise participants who were adherent (42%) or intermittent (58%) in the active intervention phase. Baseline and increase in exercise self-efficacy during the active intervention are positively associated with adherence in the maintenance phase. The findings capture the heterogeneity in exercise adherence patterns within and across the active intervention and maintenance phases of falls prevention exercise program, and the importance of exercise self-efficacy in continued adherence to exercise.

Predicting the Adoption and Maintenance of Exercise Participation Using Self-Efficacy and Previous Exercise Participation Rates

1998 ◽  
Vol 12 (3) ◽  
pp. 154-161 ◽  
Author(s):  
Roy F. Oman ◽  
Abby C. King
Keyword(s):  
Self Efficacy ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Maintenance Phase ◽  
Exercise Behavior ◽  
Exercise Participation ◽  
Home Based ◽  
Intensity Class ◽  
Independent Effects

Objectives. To investigate the relationships among self-efficacy, changes in self-efficacy, past exercise participation, future exercise adherence, and exercise program format. Methods. Two-year randomized trial involving subjects (n = 63) participating in an aerobic exercise program. Subjects were randomly assigned to one of three exercise conditions: higher-intensity home-based exercise, higher-intensity class-based exercise, or lower-intensity home-based exercise. Results. Results indicated that baseline self-efficacy and exercise format had significant (p <.02), independent effects on adherence during the adoption and early maintenance phases of exercise behavior. In contrast, in predicting long-term exercise program maintenance, a significant (p <.05) self-efficacy X exercise format interaction indicated that self-efficacy predicted adherence only in the supervised home-based exercise conditions. Results also suggest that baseline self-efficacy, independent of the effect of past adherence, significantly (p <.03) predicted exercise adherence during the adoption phase, but not early maintenance phase, of exercise behavior. Finally, adherence change during the adoption phase of exercise behavior significantly (p <.04) predicted Year-one levels of self-efficacy even after adjusting far the effect of baseline self-efficacy. Conclusions. These results suggest that exercise program format as well as an individual's initial cognitive and behavioral experiences in an exercise program play significant roles in determining exercise adherence.

The Effect of Theory-lead Intervention for Knee Osteoarthritis in Older Adults: A Cluster Randomized Trial

2020 ◽  
Author(s):  
Limin Wang ◽  
Hongbo Chen ◽  
Han Lu ◽  
Yunlin Wang ◽  
Congying Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Transtheoretical Model ◽  
Intervention Group ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Cluster Randomized Trial ◽  
Knee Function ◽  
Control Group ◽  
Cluster Randomized

Abstract Background: Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms and knee function in older adults with KOA. Methods: A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China via print and social media advertisements from April to October 2018. The intervention was a two-stage and 24-week transtheoretical model-based exercise program, and the control group underwent a same length but non-theory-based exercise program. Exercise adherence was measured by an 11-point numerical self-rating scale at weeks 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) and knee function (lower limb muscle strength and balance) were measured at baseline, week 24, and week 48. Latent growth model (GLM), repeated measures ANOVA and independent t-test were the main statistical tests.Results: A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.Conclusion: The TTM-HEI could improve the participants’ exercise adherence, knee osteoarthritis symptoms and knee function over time.

Tai Chi Enhances Self-Efficacy and Exercise Behavior in Older Adults

2001 ◽  
Vol 9 (2) ◽  
pp. 161-171 ◽  
Author(s):  
Fuzhong Li ◽  
Edward McAuley ◽  
Peter Harmer ◽  
Terry E. Duncan ◽  
Nigel R. Chaumeton
Keyword(s):  
Older Adults ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Intervention Program ◽  
Tai Chi ◽  
Controlled Trial ◽  
Exercise Adherence ◽  
Exercise Behavior ◽  
Control Group ◽  
Random Effects Models

The article describes a randomized, controlled trial conducted to examine the effects of a Tai Chi intervention program on perceptions of personal efficacy and exercise behavior in older adults. The sample comprised 94 low-active, healthy participants (mean age = 72.8 years. SD = 5.1) randomly assigned to either an experimental (Tai Chi) group or a wait-list control group. The study length was 6 months, with self-efficacy responses (barrier, performance efficacies) assessed at baseline, at Week 12, and at termination (Week 24) of the study. Exercise attendance was recorded as an outcome measure of exercise behavior. Random-effects models revealed that participants in the experimental group experienced significant improvements in self-efficacy over the course of the intervention. Subsequent repeated-measures ANOVA revealed that participants’ changes in efficacy were associated with higher levels of program attendance. The findings suggest that self-efficacy can be enhanced through Tai Chi and that the changes in self-efficacy are likely to improve exercise adherence.

scholarly journals Effect of quadriceps strengthening exercises alone and in combination with Baduanjin qigong on older adults with knee osteoarthritis: a quasi-experimental study

2020 ◽  
Author(s):  
fenglan wang ◽  
Xiaoli Zhang ◽  
Xiao Tong ◽  
Min Zhang ◽  
Fengmei Xing ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Physical Function ◽  
Self Efficacy ◽  
Exercise Program ◽  
Exercise Group ◽  
Strengthening Exercises ◽  
Quasi Experimental

Abstract BackgroundExercise is recommended as a core treatment for individuals with KOA. However, the optimal exercise program to promote long-term compliance for KOA patients is not clear. The aim of this study is to compare the effects of the combination exercise program (quadriceps strengthening exercises (QSE) plus Baduanjin qigong) versus QSE alone on older adults with knee osteoarthritis (KOA). MethodsA two-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from one community center were assigned to combination exercise group while participants from the other center were assigned to QSE group. We assessed pain intensity, physical function, self-efficacy, and HRQoL with standardized instruments at baseline, 3 and 6 months. Results87 participants with KOA who aged above 60 completed the study. Over the 6 months, There were significant time by group interaction effects on pain intensity (F = 44.419, p < 0.001), physical function (F = 46.904, p < 0.001) and self-efficacy (F = 49.754, p < 0.001), as well as in the physical component summary (F = 15.205, p < 0.001) and mental component summary of SF-12 (F = 19.205, p < 0.001), with the combination exercise group exhibiting significantly greater improvements in all outcomes than QSE group. ConclusionsCombination exercise treatment is more effective than QSE for relieving pain, increasing physical functioning, and improving self-efficacy, and quality of life in community-dwelling KOA older adults. Also, it could promote long-term compliance for KOA community patients.Trial registrationChinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020

The Effect of Transtheoretical Model-lead Intervention for Knee Osteoarthritis in Older Adults: A Cluster Randomized Trial

2020 ◽  
Author(s):  
Limin Wang ◽  
Hongbo Chen ◽  
Han Lu ◽  
Yunlin Wang ◽  
Congying Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Transtheoretical Model ◽  
Intervention Group ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Cluster Randomized Trial ◽  
Knee Function ◽  
Home Exercise ◽  
Control Group ◽  
Cluster Randomized

Abstract Background: Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the Transtheoretical Model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms, and knee function in older adults with KOA. Methods: A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China, via print and social media advertisements from April to October 2018. The present study lasted 48 weeks, with an intervention duration of 0–24 weeks and follow-up time of 24–48 weeks. The intervention was a two-stage and 24-week TTM-based exercise program, and the control group underwent a same-length exercise program guidance without any exercise-adherence interventions. The primary outcome was exercise adherence to the prescribed home exercise program and was measured using an 11-point numerical (0=not at all through and 10=completely as instructed) self-rating scale at week 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and knee function (lower limb muscle strength and balance) was measured using the Five-Times-Sit-to-Stand Test (FTSST) and the Timed Up and Go Test (TUG) at baseline, week 24 and week 48. Latent growth model (GLM), repeated measures ANOVA, and independent t-test were the main statistical tests used.Results: A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.Conclusion: Over time, TTM-HEI could improve participants’ exercise adherence, KOA symptoms, and knee function.Trial registration: This study was approved by the ethics committee (IRB00001052-17066) in July 2017 and was registered at Chinese Clinical Trails Registry (website: www.chictr.org.cn, registry number: ChiCTR1800015458).

scholarly journals Toward Monitoring and Increasing Exercise Adherence in Older Adults by Robotic Intervention: A Proof of Concept Study

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Prathik Gadde ◽  
Hadi Kharrazi ◽  
Himalaya Patel ◽  
Karl F. MacDorman
Keyword(s):  
Older Adults ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Cognitive Stimulation ◽  
Processing Unit ◽  
Assistive Robots ◽  
Socially Assistive Robots ◽  
Vision Processing ◽  
Personal Trainer ◽  
Pencil And Paper

Socially assistive robots have the potential to improve the quality of life of older adults by encouraging and guiding their performance of rehabilitation exercises while offering cognitive stimulation and companionship. This study focuses on the early stages of developing and testing an interactive personal trainer robot to monitor and increase exercise adherence in older adults. The robot physically demonstrates exercises for the user to follow and monitors the user's progress using a vision-processing unit that detects face and hand movements. When the user successfully completes a move, the robot gives positive feedback and begins the next repetition. The results of usability testing with 10 participants support the feasibility of this approach. Further extensions are planned to evaluate a complete exercise program for improving older adults' physical range of motion in a controlled experiment with three conditions: a personal trainer robot, a personal trainer on-screen character, and a pencil-and-paper exercise plan.

Effect of wearable sensor-based Otago Exercise Program biofeedback in older adults with moderate to high risk of falling

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A C Martins ◽  
D Francisco ◽  
D Guia
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Real Time ◽  
Self Efficacy ◽  
Exercise Program ◽  
Step Test ◽  
Control Group ◽  
Wearable Sensor ◽  
Post Intervention ◽  
Significant Difference

Abstract Introduction Falls remain a major public health issue. The ageing process is characterized by a progressive decrease in muscle strength, reaction time, postural control and changes in sensory systems. Wearable sensor-based biofeedback systems used in physiotherapy, particularly incorporated in exercise programs, are promising strategies to enhance the learning of strength and balance exercises and improve self-efficacy. Objectives To evaluate the effect of the wearable sensor-based Otago Exercise Program (OTAGO) biofeedback in older adults with moderate to high risk. Methodology Sixty participants (84.35 years) were distributed to the experimental group (26) and a control group (34). The EG underwent the OTAGO incorporated in a technological system using pressure and inertial sensors and biofeedback in real-time, administered by a physiotherapist for 5 weeks, with a frequency of 2 times a week. The CG kept doing their regular activities. Outcome measures included handgrip strength (HG), Time Up and Go (TUG), 30 seconds Sit to Stand, 10 meters Walking Speed (10m WS), 4 Stage Balance Test “Modified”, Step test and Questionnaire of Self-efficacy for exercise. Results At baseline, significant differences were observed regarding the 10m WS (p &lt; 0.001), TUG (p = 0.036) and HG (p = 0.001). Relatively to 4SBTM, in post-intervention was seen significant difference (p = 0.008) and in EG there was also substantial results (p &lt; 0.001). The same happens in SEE (p = 0.013 and p = 0.020, respectively). A significant increase was found in EG so that the post-intervention 10m WS was statistically higher compared with the CG (EG: 0.42±0.29; CG: 1.10±0.51; p = 0.003). In the CG worst results were observed in some of the functional tests. Conclusion Biofeedback in real-time facilitates the self-learning of the exercise program, and it is a useful tool for training strength, balance and self-efficacy for exercise, contributing to reducing the risk of falls.

scholarly journals Factors Influencing Walking and Exercise Adherence in Healthy Older Adults Using Monitoring and Interfacing Technology: Preliminary Evidence

2020 ◽  
Vol 17 (17) ◽  
pp. 6142
Author(s):  
Andrea Albergoni ◽  
Florentina J. Hettinga ◽  
Wim Stut ◽  
Francesco Sartor
Keyword(s):  
Older Adults ◽  
Self Efficacy ◽  
Perceived Risk ◽  
Exercise Intervention ◽  
Short Form ◽  
Exercise Adherence ◽  
Preliminary Evidence ◽  
Activity Levels ◽  
Healthy Older Adults ◽  
Program Adherence

Background: Monitoring and interfacing technologies may increase physical activity (PA) program adherence in older adults, but they should account for aspects influencing older adults’ PA behavior. This study aimed at gathering preliminary wrist-based PA adherence data in free-living and relate these to the influencing factors. Methods: Ten healthy older adults (4 females, aged 70–78 years) provided health, fatigue, activity levels, attitude towards pacing, and self-efficacy information and performed a 6 min-walk test to assess their fitness. After a baseline week they followed a two-week walking and exercise intervention. Participants saw their progress via a purposely designed mobile application. Results: Walking and exercise adherence did not increase during the intervention (p = 0.38, p = 0.65). Self-efficacy decreased (p = 0.024). The baseline physical component of the Short Form Health Survey was the most predictive variable of walking adherence. Baseline perceived risk of over-activity and resting heart rate (HRrest) were the most predictive variables of exercise adherence. When the latter two were used to cluster participants according to their exercise adherence, the fitness gap between exercise-adherent and non-adherent increased after the intervention (p = 0.004). Conclusions: Risk of over-activity and HRrest profiled short-term exercise adherence in older adults. If confirmed in a larger and longer study, these could personalize interventions aimed at increasing adherence.

Exergaming as a tool to enhance strength, balance, gait, mobility, participation, self-efficacy for exercise and adherence in older adults

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A C Martins ◽  
J Quatorze ◽  
D Guia
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Ability ◽  
Self Efficacy ◽  
Daily Living ◽  
Exercise Program ◽  
Community Dwelling ◽  
Step Test ◽  
Mobility Limitations ◽  
The Impact

Abstract Introduction It is projected that the number of adults aged 60 or above will be 1.4 billion in 2030 and 2.1 billion in 2050. With aging, mobility limitations can cause severe difficulties on being independent during activities of daily living. Exercise has been shown as effective to counteract the impact of aging, although it is hard to create adherence. Exergames, as they increase the appeal of exercise, show promising results in terms of participation and promotion of healthy behaviours. Objectives This study aimed at assessing the effectiveness of the Otago Exercise Program incorporated in FallSensing Exergames. Methodology Community-dwelling older adults aged 60 or over, were recruited from facilities in Coimbra, Portugal and randomized in two groups, 27 allocated to the intervention (IG) and 34 to the control (CG). Regular activities of daily living (CG) were compared to an Exergame program (IG). Assessments were made at baseline and re-assessments at 8 weeks/16 sessions, regarding strength, balance, walking speed, participation and self-efficacy for exercise. Results 61 older adults (77% female), mean ages were 82.22 (IG) and 87.26 (CG) years. After 8 weeks, CG demonstrated a decrease in functional ability. IG got improvement in Step test (p = 0.001), 4 Stage Balance Modified test (p = 0.001), Self-Efficacy for Exercise (p = 0.009) and Activities and Participation Profile Related to Mobility (p &lt; 0.001) questionnaires. Conclusion Exergaming was safe and effective in improving functional ability, participation and self-efficacy. Nevertheless, some considerations are necessary when prescribing an Exergames, mainly concerning frequency and intensity of the exercise program and participants’ age.

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