Walking interventions improve health outcomes among older adults. However, few clinical trials evaluate long-term behavior change adherence. The authors explored factors that influence walking adherence in older adults following their participation in a clinical trial. They conducted n = 7 focus groups with n = 23 participants enrolled in the parent study (ClinicalTrials.gov number: NCT03654807). The authors used content analysis to code data according to the social–ecological model. They found that supportive services (exercise classes) in retirement communities have multilevel impacts on adherence to walking activity. Residents from communities offering services continued walking because of increased confidence gained in the parent trial, while residents in communities without services were motivated by their functional improvements. Residents voiced frustration with retirement community physical activity programs that did not address the full spectrum of physical functioning. Findings support the need for retirement communities to account for various motivational factors in tailoring programs to promote increased physical activity for older adults.
Despite the known effectiveness, physical activity (PA) is not currently offered to older adult clients receiving Medicaid Home and Community Based Services (HCBS). To optimize PA implementation within Medicaid HCBS, understanding client preferences for PA programming is needed. Thus, the objective of this exploratory qualitative study was to identify the PA preferences of HCBS clients including mode, duration, implementation strategy, and frequency, as well as barriers and motivators to PA. We recruited participants from the Illinois’ Department on Aging Community Care Program. We conducted semi-structured interviews in participants’ homes which were audio recorded, transcribed, and analyzed using Dedoose (version 7.0.23). We derived semi-structured interview questions from the Health Belief, Social Cognitive, and Health Action Process Approach framework. We used a structured coding approach using conventional content analysis to derive codes from the text, then applied these codes to each interview and examined the frequency to determine themes. The most frequently referenced theme was barriers to PA, primarily co-morbidities. The primary motivator was social support by a peer or instructor. The preferred PA program components were walking 2-3 days per week with duration varying from 20 minutes to 2 hours. Clients also preferred individualized PA instruction versus a passive strategy such as pamphlets or videotapes. Our findings show that individual-level factors most significantly influence PA participation and should be addressed among Medicaid HCBS clients. We recommend Medicaid HCBS consider a personalized approach of PA implementation with their clients.
Knee osteoarthritis (OA) is the leading cause of chronic pain and disability in older adults. It impacts both muscle strength and power, contributing to decreased functional mobility. Exercise interventions such as power training are recommended for persons with knee OA. The aim of this literature review was to investigate outcomes following power training as a rehabilitation approach for knee OA. Power training resulted in improved outcomes for persons with knee OA. Power training may be a safe and useful addition to exercise programs for older adults with knee OA. Additional research is needed to determine optimal exercises, dosage, and intensity.
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