Use it or lose it: a qualitative study of the maintenance of physical activity in older adults

Abstract

BackgroundLack of physical activity (PA) is a recognised global public health problem, which is increasing in prevalence with a detrimental impact on the pattern of disease worldwide. In the UK, older adults comprise the most sedentary group, with only 57% of males and 52% of females aged 65–74 years and 43% of males and 21% of females aged 75–84 years meeting PA recommendations.PA confers multiple health benefits including increased stamina, muscle, bone and joint strength, increased independence and reduced risk of falls in old age. Despite benefits experienced during time-limited PA programmes, increased PA is not always continued. This study aimed to provide a better understanding of PA maintenance behaviours in older people.MethodsFace to face semi-structured interviews were conducted with adults who completed one of two strength and balance exercise programmes as part of the ProAct65+ trial: group (FaME) and home based (OTAGO) exercises. Five GP practices in Nottingham and Derby were recruited and invited people aged 65 years and older who met eligibility criteria. Interviews were conducted in participants’ homes. Interviews explored PA levels pre and post intervention, perceived health benefits, facilitators, barriers and use of technology for PA maintenance. The interviews were transcribed verbatim and analysed using framework analysis and the software NVivo10.ResultsFifteen participants from each intervention group were interviewed. The FaME group consisted of 10 females and 5 males, age range of 70–88 years. The OTAGO group consisted of 12 females and 3 males aged 72–95 years. Important themes identified were physical, social, psychological and environmental facilitators and barriers. These included increased physical autonomy, enjoyment, positive evaluation of the activity and physical benefits, importance of social interaction, positive feedback, development of behaviour considered normal or habitual, motivation and self-efficacy. Some participants used technologies not included in the original interventions, like pedometers and smart phones to motivate themselves.ConclusionsA range of modifiable factors influence continued participation in PA at the end of exercise programmes. The findings from this study will inform the commissioning and quality improvement of future PA programmes and development of an intervention to enhance continuation of PA after exercise interventions in older adults.

Knowledge, skills and attitudes of older people and staff about getting up from the floor following a fall: a qualitative investigation

“…Physical and functional impairments [22] and living alone are associated with ability to get up after a fall [23]; only one staff participant highlighted that time and exercise training may be required to get people to the point of having the physical ability to get up, yet the benefits of maintaining activity for older people is recognised and has similar barriers to those we identified. In common with the recent study by Maula and colleagues (2019) [24], we also found that novel use of technology, in the form of on-line information, was used within our sample, applied in such a way that ongoing knowledge and behaviour was changed after accessing on-line guidance.…”

Associations between physical function and device-based measures of physical activity and sedentary behavior patterns in older adults: moving beyond moderate-to-vigorous intensity physical activity

“…Importantly, though, given the cross-sectional nature of these data, such associations could reflect reverse or bi-directional causation in that more intact physical function is needed for many types of MVPA. In addition, even if such associations reflected causal relationships, differences in activity of that size are likely unrealistic as a basis for potential intervention targets in older adults due to the magnitude of behavior change required (e.g., increasing daily steps from 3000/day to nearly 9000/day or increasing daily MVPA from 15 min/day to at least 90 min/day) and the existing diversity in older adults’ functional exercise capacity and willingness to routinely engage in this much activity [ 5 , 6 ].…”

“…The current literature examining physical activity, sedentary behavior, and health in older adults suggests that higher levels of moderate-to-vigorous intensity physical activity (MVPA) are key to prolonged health and function [ 2 ]. However, among older adults, for whom physical function typically declines with age [ 3 , 4 ], increasing MVPA may not be feasible due to existing limitations in functional exercise capacity [ 5 , 6 ]. Consequently, public health messages and interventions centered on boosting MVPA in this population may not be effective, optimal, or feasible [ 5 , 7 ].…”

Effects of Augmented-Reality-Based Exercise on Muscle Parameters, Physical Performance, and Exercise Self-Efficacy for Older Adults

“…However, as the elderly have trouble continuing exercise because of physical and environmental restraints, it is very important to motivate them to continue to exercise and stay focused with purpose [11]. Therefore, it is necessary to introduce exercise contents in various ways for them to continue to exercise.…”