Barriers and motivators to exercise for older adults: A focus on those living in rural and remote areas of Australia

Abstract

To identify the barriers and facilitators for exercise in older adults (50 years or over) specific to those living in rural and remote areas in Australia and to identify how this relates to falls prevention exercise programs in these areas. Literature review. Search of the databases of Medline, Scopus and Social Sciences Citation Index. Rural and remote areas. Searching identified 56 articles relating to barriers or facilitators to exercise in older adults in general, of which 25 are discussed in the article. Five of these articles specifically related to rural and remote areas, of which all were from studies in the United States. No literature specifically relating to rural and remote Australia was identified. Therefore, articles included in the final review were from three different domains - world literature (excluding those specific to rural and remote areas of Australia), rural and remote literature (note not Australian), and Australian literature to enable a comparison between the different populations to occur. There are similarities and differences between the barriers and facilitators in various populations, and no one factor alone will enable exercise in older adults. Research needs to be conducted on the barriers and facilitators to exercise in older adults living in rural and remote areas in Australia. Falls prevention exercise programs need to be tailored to suit the unique needs of the rural and remote older population.

Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context

“…For question (3) on barriers and facilitators to PA, nine qualitative systematic reviews met the inclusion criteria with a median of 10 (range = 4–132) primary studies and 22,413 participants [48–57]. Of these, five reviewed purely qualitative studies [48, 49, 51, 54, 56], while the rest included a mixture of studies [50, 52, 53, 57]. …”

“…Three reviews [49–51] investigated barriers and facilitators (B&F) to the uptake of falls prevention exercise programmes, one review focused on recreational PA [48], one explored sports activities [53], while the final two explored PA in general [52, 54]. Two reviews explored the perceptions of older adults towards PA participation and the acceptability of PA interventions [56, 57].…”

“…The review of PA uptake among older adults after retirement identified health status, previous PA habits, and new personal challenges as predisposing factors for PA uptake. Reviews of PA with the objective of preventing falls [49–51] identified predisposing factors including health, motivation, feelings, fatalism, stigma and fear of falling. The predisposing factors identified in the review of PA uptake among South Asian community dwelling older adults included language, overprotective family, dependency on social support and group norms, cultural sensitivity and collectivist attitudes [54].…”

“…Therefore it is not surprising that the reviews identified few need factors to promote the uptake of PA. However, two reviews [49, 50] identified referral or recommendation by a health professional / doctor as a facilitator of PA uptake. Referral by a health professional to a PA programme would normally indicate that there is a need for a patient to participate, either for preventative, or rehabilitative management.…”

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

“…We found very little evidence that people thought exercise in older age was inappropriate or unachievable (Boehm et al ., 2013) and little reference to previous exercise experiences and how this influence exercise self-efficacy (Bunn et al ., 2008). …”