For older adults, exercise that challenges the muscular system, commonly referred to as resistance training, has significant physical, psychometrical and functional benefits. While well recognised by the scientific community, the translation of these benefits into practice has received little attention. Particularly neglected is an understanding of the personal experiences, motivation towards and adherence to resistance training recommendations among older adults. This paper investigated the benefits older individuals attribute to resistance training and the motivational tactics they employed to undertake it. Data were drawn from three focus groups where participants (o65 years ; presently, previously or wanting to become involved in a resistance training intervention) were encouraged to openly discuss resistance training, physical activity and exercise. Findings revealed that participants were aware of the benefits of training on general and functional health, and that these benefits were employed in the motivation to train. In addition, presently or previously trained individuals stress the importance of environment and programme structure as a training motivator. The benefits to mental and social health, effect on ageing and body image were also raised. However, participants discussed these in a broad context. While it could be said that public knowledge reflects current evidence, it is also clear that individuals are still unaware of a number of specific benefits.
Intervening parties should be aware of the 'cultural color,' and not ignore the unique difficulties this population faces. Policy-makers should acknowledge the patterns of non-formal services used in this community.
Background
Current approaches to falls prevention mostly rely on secondary and tertiary prevention and target individuals at high risk of falls. An alternative is primary prevention, in which all seniors are screened, referred as appropriate, and educated regarding falls risk. Little information is available on research designs that allow investigation of this approach in the setting of aging services delivery, where randomization may not be possible.
Methods
Healthy Steps for Older Adults, a statewide program of the Pennsylvania (PA) Department of Aging, involves a combination of education about falls and screening for balance problems, with referral to personal physicians and home safety assessments. We developed a nonrandomized statewide trial, Falls Free PA, to assess its effectiveness in reducing falls incidence over 12 months. We recruited 814 seniors who completed the program (503 first time participants, 311 people repeating the program) and 1020 who did not participate in the program, from the same sites. We assessed the quality of this nonrandomized design by examining recruitment, follow-up across study groups, and comparability at baseline.
Results
Of older adults approached in senior centers, 90.5% (n=2219) signed informed consent, and 1834 (82.4%) completed baseline assessments and were eligible for follow-up. Attrition in the three groups over 12 months was low and non-differential (<10% for withdrawal and <2% for other loss to follow-up). Median follow-up, which involved standardized monthly assessment of falls, was 10 months in all study groups. At baseline the groups did not differ in measures of health or falls risk factors.
Conclusions
Comparable status at baseline, recruitment from common sites, and similar experience with retention suggest that the nonrandomized design will be effective for assessment of this approach to primary prevention of falls.
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