scholarly journals Older adults preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

2019 ◽  
Author(s):  
Linda Mansson ◽  
Lillemor Lundin-Olsson ◽  
Dawn A Skelton ◽  
Rebecka Janols ◽  
Helena Lindgren ◽  
...  
Keyword(s):  
Fall Prevention ◽  
Exercise Programme ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Attrition Rate ◽  
Home Exercise ◽  
Intervention Period ◽  
Exercise Interventions ◽  
Significant Difference ◽  
Exercise Programmes

Abstract Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach to a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet. Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start at the introduction meeting, including a short introduction of the exercise programme, a short physical assessment and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences as well as post-assessments were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. Results: Sixty-seven participants, with a mean age of 77±4 years were included, 72% were women, and 43% chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group. In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p=.001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p=.026) degree of being content, and feeling supported by the programme (p=.044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p=.036). Conclusions: This study showed that both the digital and paper programme could be used as a self-managed, independent fall prevention exercise programme. The digital programme seems to facilitate long-term maintenance in regular exercise.

scholarly journals Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

2020 ◽  
Author(s):  
Linda Mansson ◽  
Lillemor Lundin-Olsson ◽  
Dawn A Skelton ◽  
Rebecka Janols ◽  
Helena Lindgren ◽  
...  
Keyword(s):  
Fall Prevention ◽  
Exercise Duration ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Attrition Rate ◽  
Home Exercise ◽  
Intervention Period ◽  
Exercise Interventions ◽  
Significant Difference ◽  
Exercise Programmes

Abstract Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet.Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start.Results: Sixty-seven participants, with mean age 77±4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p=.078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p=.001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p=.026) degree of being content, and feeling supported by the programme (p=.044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p=.036).Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise.Trial registration: ClinTrial: NCT02916849

scholarly journals Older adults preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

2020 ◽  
Author(s):  
Linda Mansson ◽  
Lillemor Lundin-Olsson ◽  
Dawn A Skelton ◽  
Rebecka Janols ◽  
Helena Lindgren ◽  
...  
Keyword(s):  
Fall Prevention ◽  
Exercise Duration ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Attrition Rate ◽  
Home Exercise ◽  
Intervention Period ◽  
Exercise Interventions ◽  
Significant Difference ◽  
Exercise Programmes

Abstract Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet. Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. Results: Sixty-seven participants, with mean age 77±4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p=.078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p=.001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p=.026) degree of being content, and feeling supported by the programme (p=.044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p=.036). Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise.

scholarly journals Gender Perspective on Older People’s Exercise Preferences and Motivators in the Context of Falls Prevention: A Qualitative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Marlene Sandlund ◽  
Petra Pohl ◽  
Christina Ahlgren ◽  
Dawn A. Skelton ◽  
Anita Melander-Wikman ◽  
...  
Keyword(s):  
Fall Prevention ◽  
Qualitative Content Analysis ◽  
Exercise Adherence ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Gender Perspective ◽  
Exercise Interventions ◽  
History Of ◽  
Exercise Programmes ◽  
The Individual

Background. Several factors have previously been identified to positively influence the uptake and adherence for fall prevention exercise programmes. There is, however, a lack of studies investigating if men and women differ in their views and preferences for fall prevention exercises. Aim. To explore exercise preferences and motivators of older community-dwelling women and men in the context of falls prevention from a gender perspective. Methods. Workshops including multistage focus group discussions were conducted with 18 older community-dwelling people with and without history of falls. Participants were purposively selected and divided into two groups. Each group met on six occasions over a period of five months. Participatory and Appreciative Action and Reflection methodology was used to guide the discussions. A qualitative content analysis approach was used in the analysis. Results. Older participants had many diverse preferences and confirmed that individually tailored exercise, in terms of mode, intensity, challenge, and social context, is important. Moreover, important factors for exercise adherence and maintenance included the experience of individual confirmation; different spirit lifters to increase enjoyment; and personal tricks to maintain exercise routines. The individual differences within genders were more diverse than the differences between women and men. Conclusion. Exercise interventions to prevent falls should be individually tailored, based on the specific needs and preferences of the older participant, and do not appear to require gender specific approaches. To increase adherence, intrinsic motivation for exercise may be encouraged by competence enhancing confirmations, energizing spirit lifters, and practical tips for exercise maintenance. The study provides an awareness about women’s and men’s preferences for fall prevention exercises, and this information could be used as guidance in designing inclusive exercise interventions.

scholarly journals Effectiveness of a self-managed digital exercise programme to prevent falls in older community-dwelling adults: study protocol for the Safe Step randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036194 ◽  
Author(s):  
Beatrice Pettersson ◽  
Lillemor Lundin-Olsson ◽  
Dawn A Skelton ◽  
Per Liv ◽  
Magnus Zingmark ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Ethical Review ◽  
Exercise Interventions ◽  
Educational Videos ◽  
Randomised Controlled

IntroductionExercise interventions have a strong evidence base for falls prevention. However, exercise can be challenging to implement and often has limited reach and poor adherence. Digital technology provides opportunities for both increased access to the intervention and support over time. Further knowledge needs to be gained regarding the effectiveness of completely self-managed digital exercise interventions. The main objective of this study is to compare the effectiveness of a self-managed digital exercise programme, Safe Step, in combination with monthly educational videos with educational videos alone, on falls over 1 year in older community-dwelling adults.Methods and analysisA two-arm parallel randomised controlled trial will be conducted with at least 1400 community-living older adults (70+ years) who experience impaired balance. Participants will be recruited throughout Sweden with enrolment through the project website. They will be randomly allocated to either the Safe Step exercise programme with additional monthly educational videos about healthy ageing and fall prevention, or the monthly education videos alone. Participants receiving the exercise intervention will be asked to exercise at home for at least 30 min, 3 times/week with support of the Safe Step application. The primary outcome will be rate of falls (fall per person year). Participants will keep a fall calendar and report falls at the end of each month through a digital questionnaire. Further assessments of secondary outcomes will be made through self-reported questionnaires and a self-test of 30 s chair stand test at baseline and 3, 6, 9 and 12 months after study start. Data will be analysed according to the intention-to-treat principle.Ethics and disseminationEthical approval was obtained by The Regional Ethical Review Board in Umeå (Dnr 2018/433-31). Findings will be disseminated through the project web-site, peer-reviewed journals, national and international conferences and through senior citizen organisations’ newsletters.Trial registration numberNCT03963570.

scholarly journals CORRELATES OF NON-ADHERENCE TO HOME EXERCISE PROGRAMMES IN PATIENTS WITH LOW BACK PAIN

2020 ◽  
Vol 8 (6) ◽  
pp. 280-292
Author(s):  
DO ODEBIYI ◽  
OA FAPOJUWO ◽  
BF OLALEYE ◽  
AS OLANIYAN
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Programme ◽  
Home Exercise ◽  
Daily Routine ◽  
Low Back ◽  
Chi Square ◽  
Home Exercise Programme ◽  
Significant Difference ◽  
Exercise Programmes

Background: Non-adherence to home exercise programmes may lead to delayed progress in recovery and diminished clinical outcomes in patients. Aims of Study: To determine the adherence rate and attributing factors to non-adherence to home exercise programmes in patients with low back pain (LBP). Method: A total of 250 patients with LBP receiving treatment in 5 different out-patient physiotherapy clinics in Lagos State South West, Nigeria participated in this survey. They were required to complete a 27- item questionnaire which collected information on characteristics of participants and home exercise programme, adherence with treatment programme and instructions for carrying out the exercises. Gamma correlation and Chi-square were used to detect the correlation and significant difference of selected variables respectively. The level of significance was set at p< 0.05 Result: Ninety-four (37.6%) respondents performed home exercise programme the recommended number of times daily. There was no significant relationship (p> 0.05) of participants’ characteristics, frequency and duration of exercise per session, total number and manner of recommending the home exercise programme and pain rating respectively with adherence to home exercise programme. Eighty-nine (35.6%) respondents complained of tiredness after the day’s work. Chi-square showed significant association (p<0.05) of the prescribed home exercises programme, the actual exercise carried out at home with their perception to home exercise programme Conclusion: Home exercise programmes may interfere with normal life and daily routine in patients with LBP. It is recommended that home exercise programme be patient centred I.e. fit into individual daily routine to overcome identified barriers.

scholarly journals ‘We got more than we expected.’ Older people’s experiences of falls-prevention exercise interventions and implications for practice; a qualitative study

2019 ◽  
Vol 20 ◽  
Author(s):  
Natasher Lafond ◽  
Asiya Maula ◽  
Steve Iliffe ◽  
Kavita Vedhara ◽  
Sarah Audsley ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Controlled Trial ◽  
Well Being ◽  
Target Population ◽  
Exercise Programme ◽  
Falls Prevention ◽  
Exercise Interventions ◽  
Exercise Programmes ◽  
Randomised Controlled

Abstract Aim: To explore the experiences of older adults participating in strength and balance exercise programmes and understand participants’ rationale for programme uptake and completion. Background: Regular physical activity, specifically strength and balance exercises, has been shown to improve health and well-being and reduce the risk of falling in older adults. With the number of people living into older age increasing, understanding older people’s experiences of strength and balance programmes and what encourages their take-up and completion is extremely important. This paper reports on the qualitative experiences of older adults that previously participated in ProAct65+, a randomised controlled trial of Falls Management Exercise (FaME) programme and Otago Exercise Programme (OEP) versus usual care. Methods: Ten general practices in Nottinghamshire and Derbyshire, England, who participated in the ProAct65+ trial were approached to take part. Using maximum variation sampling (age, gender, falls history, fear of falling and trial arm) we recruited, via the practices, 30 people that had participated in the FaME (n = 15) or OEP (n = 15) trial arms. Participants were interviewed in their own homes. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Findings: We identified five themes: choice of exercise programme; commitment, discipline and motivation; benchmarking, feedback and monitoring; benefits of the exercise programmes and reactions to the end of the programmes. There were four sub-themes within the benefits theme: pleasure and boredom, social interaction and isolation, physical benefits, and knowledge and understanding. This study has outlined the experiences and identified specific barriers and facilitators to uptake and completion of falls-prevention exercises by older adults. The perspective and experiences of these participants is important if programmes are to be designed to meet the needs of the target population. Insights from this study will enable commissioners to develop and provide appropriate falls-prevention exercise programmes that encourage high uptake and programme completion.

scholarly journals Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis

2018 ◽  
Vol 47 (4) ◽  
pp. 512-519 ◽  
Author(s):  
Chiara Naseri ◽  
Terry P Haines ◽  
Christopher Etherton-Beer ◽  
Steven McPhail ◽  
Meg E Morris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Injury Rate ◽  
Community Dwelling ◽  
Nutritional Supplementation ◽  
Falls Prevention ◽  
Home Exercise ◽  
Low Grade ◽  
Exercise Interventions ◽  
Prevention Interventions

Abstract Background older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital. Methods literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager® Results sixteen studies (total sample size N = 3,290, from eight countries, mean age 77) comprising 12 interventions met inclusion criteria. We found home hazard modification interventions delivered to those with a previous falls history (1 study), was effective in reducing the number of falls (RR 0.63, 95%CI 0.43, 0.93, Low GRADE evidence). Home exercise interventions (3 studies) significantly increased the proportion of fallers (OR 1.74, 95%CI 1.17, 2.60, Moderate GRADE evidence), and did not significantly reduce falls rate (RR 1.27, 95%CI 0.99, 1.62, Very Low GRADE evidence) or falls injury rate (RR 1.16, 95%CI, 0.83,1.63, Low GRADE evidence). Nutritional supplementation for malnourished older adults (1 study) significantly reduced the proportion of fallers (HR 0.41, 95% CI 0.19, 0.86, Low GRADE evidence). Conclusion the recommended falls prevention interventions for older adults recently discharged from hospital are to provide home hazard minimisation particularly if they have a recent previous falls history and consider nutritional supplementation if they are malnourished.

scholarly journals Experiences engaging in a group-based physiotherapist-led exercise programme for adults living with HIV and complex multimorbidity: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045158
Author(s):  
Tina S. Homayouni ◽  
Alex Ruth ◽  
Zoe Abbott-Tate ◽  
Helen Burger ◽  
Shaera Rahim ◽  
...  
Keyword(s):  
Exercise Programme ◽  
Community Dwelling ◽  
People Living With Hiv ◽  
Demographic Questionnaire ◽  
Flexible Schedule ◽  
Health Related ◽  
Qualitative Descriptive ◽  
Perceived Impacts ◽  
Exercise Programmes ◽  
Living With Hiv

ObjectiveTo explore experiences participating in a group-based physiotherapist (PT)-led exercise programme among people living with HIV and complex multimorbidity.DesignWe conducted a qualitative descriptive study using semistructured interviews.Recruitment and settingWe recruited community-dwelling adults living with HIV who engaged in a group-based PT-led exercise programme within an HIV-specialty hospital in Toronto, Canada. Interviews were conducted in-person or by telephone.ParticipantsEight men and two women with a median age of 58 years and median of six concurrent conditions in addition to HIV, who had attended ≥2 classes of the exercise programme.Data collectionInterviews explored (1) reasons for engaging in the programme, (2) experiences with exercise prior to and after joining the programme, (3) facilitators and barriers to engagement and (4) perceived impacts of participation on health and disability. We administered the HIV Disability Questionnaire and a demographic questionnaire.ResultsExperiences spanned perspectives prior to, during and after the PT-led exercise programme. Reasons for engaging in the programme included addressing health-related goals. Participants identified accessibility, the flexible schedule, interprofessional staff and the HIV-specific, group-based environment as facilitators to engagement. Participants reported high attendance rates, but identified episodic health challenges and overcrowded space as potential barriers to attending exercise classes. Perceived impacts on health and disability outcomes included improved physical, mental, social and cognitive health, and activities of daily living. Anticipated or actual experiences transitioning to independent exercise included facilitators (supportive programme leaders) and barriers (challenges motivatiing self to exercise alone).ConclusionsFeatures of the programme that facilitated engagement included the interprofessional, group-based environment that offered tailored exercise in an HIV-specific facility, whereby participants perceived benefits in domains of health and disability. However, challenges transitioning to independent exercise remain. Group-based PT-led exercise programmes may facilitate engagement in exercise among adults living with HIV and complex multimorbidity.

scholarly journals Can an online exercise prescription tool improve adherence to home exercise programmes in children with cerebral palsy and other neurodevelopmental disabilities? A randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040108
Author(s):  
Rowan W Johnson ◽  
Sian A Williams ◽  
Daniel F Gucciardi ◽  
Natasha Bear ◽  
Noula Gibson
Keyword(s):  
Exercise Prescription ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Programme ◽  
Home Exercise ◽  
Control Group ◽  
Neurodevelopmental Disabilities ◽  
Home Exercise Programme ◽  
Exercise Programmes ◽  
Randomised Controlled

ObjectiveDetermine the adherence to and effectiveness of an 8-week home exercise programme for children with disabilities delivered using Physitrack, an online exercise prescription tool, compared with traditional paper-based methods.DesignSingle-blinded, parallel-groups, randomised controlled trial (RCT).SettingIntervention took place in participants’ homes in Western Australia.ParticipantsChildren aged 6 to 17 years, with neurodevelopmental disabilities including cerebral palsy (CP), receiving community therapy services.InterventionAll participants completed an individualised home exercise programme, which was delivered to the intervention group using Physitrack and conventional paper-based methods for the control group.Primary outcome measuresAdherence to exercise programme, goal achievement and exercise performance.Secondary outcome measuresEnjoyment, confidence and usability of Physitrack.ResultsFifty-four participants with CP (n=37) or other neurodevelopmental disabilities (n=17) were recruited. Fifty-three were randomised after one early withdrawal. Forty-six completed the 8-week programme, with 24 in the intervention group and 22 in the control group. There was no difference between the two groups for percentage of exercises completed (intervention (n=22): 62.8% (SD 27.7), control (n=22): 55.8% (SD 19.4), between group mean difference −7.0% (95% CI: −21.6 to 7.5, p=0.34)). Both groups showed significant improvement in their self-rated performance of individualised goal activities, however there was no statistically significant difference between groups for goal achievement, quality of exercise performance, enjoyment, confidence or preferred method of delivery. There were no adverse events.ConclusionPhysitrack provides a therapist with a new means of providing an exercise programme with online tools such as exercise videos, but our preliminary findings indicate that it may be no better than a traditional paper-based method for improving exercise adherence or the other outcomes measured. Exercise programmes remain an intervention supported by evidence, but a larger RCT is required to fully evaluate online delivery methods.Trial registration detailsAustralian New Zealand Clinical Trials Registry; ACTRN12616000743460.

scholarly journals EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S854-S854
Author(s):  
Ladda Thiamwong ◽  
Norma E Conner
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Ethnically Diverse ◽  
Role Identity ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Facilitators And Barriers ◽  
And Behaviors

Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.

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