Group or individual lifestyle-integrated functional exercise (LiFE)? A qualitative analysis of acceptability

Abstract

Background The Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes. A recently developed group-based LiFE (gLiFE) could enhance large-scale implementability and decrease resource intensity. The aim of this qualitative focus group study is to compare participants’ experiences regarding acceptability of gLiFE vs LiFE. Methods Programs were delivered in seven group sessions (gLiFE) or seven individual home visits (LiFE) within a multi-center, randomized non-inferiority trial. Four structured focus group discussions (90–100 min duration; one per format and study site) on content, structure, and subjective effects of gLiFE and LiFE were conducted. Qualitative content analysis using the method of inductive category formation by Mayring was applied for data analysis. Coding was managed using NVivo. Results In both formats, participants (N = 30, 22 women, ngLiFE = 15, nLiFE = 15, mean age 78.8 ± 6.6 years) were positive about content, structure, and support received by trainers. Participants reflected on advantages of both formats: the social aspects of learning the program in a peer group (gLiFE), and benefits of learning the program at home (LiFE). In gLiFE, some difficulties with the implementation of activities were reported. In both formats, the majority of participants reported positive outcomes and successful implementation of new movement habits. Conclusion This is the first study to examine participants’ views on and experiences with gLiFE and LiFE, revealing strengths and limitations of both formats that can be used for program refinement. Both formats were highly acceptable to participants, suggesting that gLiFE may have similar potential to be adopted by adults aged 70 years and older compared to LiFE. Trial registration ClinicalTrials.gov, NCT03462654. Registered on March 12, 2018.

Group-Based and Individually Delivered LiFE: Content Evaluation and Predictors of Training Response – A Dose-Response Analysis

“…Moreover, the participants of both LiFE formats graded the LiFE program as “good”, indicating that both formats were highly accepted by participants. Thus, the statement of the participants of two previous pilot studies, who would recommend the LiFE program to a friend 23 and the positive attitude towards both LiFE formats 48 can be confirmed.…”

“…Consequently, participants might not have exploited the potential of the LiFE program fully due to a too low training stimulus. This assumption is also supported by a focus group analysis of a previous pilot study 48 in which participants stated that the intensity “was slightly too low” and that the strength activities could be “a bit more challenging”.…”

“…One leg stand and tandem stand are static balance activities, which were reported by the participants of two pilot studies as “easy to incorporate into everyday life”. 23 , 48 Activities that can be easily incorporated into everyday life were perceived as most beneficial 48 and were therefore probably selected most frequently in this study. For the strength component, stair climbing and sit to stand were performed most often in both groups.…”

Construction and validation of a rehabilitation nursing program for fragile elderly

“…To that end, it is essential to train movement patterns similar to self-care, hygiene, clothing, feeding, toilet use, walking (with or without walking aid) on regular, irregular floors, with obstacles, in incline or slope, going up and down the stairs as people need in their daily life. According to experts, in line with the literature (37)(38) , this training will favor independence and social participation for a successful aging.…”

“…Recent studies highlight the preference of the elderly for lifestyle activities such as cleaning or gardening rather than performing specific exercises (42) . Exercise training focused on DLAs promotes behavioral change and greater long-term adherence compared to community sports programs (37) . As pointed out by one of the experts during the discussion, an international study highlights motivation as an incredibly relevant key mechanism for change and developing and maintaining new behaviors (43) .…”