‘Managing pieces of a personal puzzle’ — older people’s experiences of self-management falls prevention exercise guided by a digital program or a booklet

Background: Exercise is effective in order to prevent falls in community-dwelling older people. Self-management programs have the potential to increase access and reduce costs related to exercise-based fall prevention. However, information regarding older people's views of participating in such programs is needed to support implementation. The aim of this study was to explore older people's experiences of a self-management fall prevention exercise routine guided either by a digital program (web-based or mobile) or a paper booklet. Methods: This qualitative study was part of a feasibility study exploring two completely self-managed exercise interventions in which the participants tailored their own program, guided either by a digital program or a paper booklet. Individual face-to-face semi-structured interviews were conducted with a purposeful sample of 28 participants (18 women), mean age 76yrs. Qualitative content analysis was used to analyse the data. Results: Self-managing and self-tailoring these exercise programs was experienced as Managing pieces of a personal puzzle'. To independently being able to create a program and manage exercise was described in the categories Finding my own level' and Programming it into my life'. The participants experienced the flexibility and independence provided by completely self-managed exercise as positive and constructive although it required discipline. Furthermore, different needs and preferences when managing their exercise were described, as well as varying sources of motivation for doing the exercise, as highlighted in the category Defining my source of motivation'. The category Evolving my acquired knowledge' captures the participants' views of building their competence and strategies for maintenance of the exercise. It describes a combined process of learning the program and developing reflection, which was more clearly articulated by participants using the digital program. Conclusions: This study provides new knowledge regarding experiences, preferences and motivations of older people to engage in home-based self-managed fall prevention exercise. They expressed both a capability and willingness to independently manage their exercise. A digital program seems to have strengthened the feeling of support while creating their own exercise program and tailoring it to their preferences and circumstances, which might therefore create better opportunities for adoption and adherence in the long term

Fit Into College: A Program to Improve Physical Activity and Dietary Intake Lifestyles Among College Students

The purpose of this study was to determine whether a 10-week program could improve physical activity, physical fitness, body weight, dietary intake, and perceptions of exercise and diet among college 30 healthy college freshmen. Outcomes were measured at baseline, and following the 10-week program. The weekly sessions incorporated constructs of the Transtheoretical Model of Health Behavior Change and were administered by fitness interns who were junior or senior college students enrolled in health-related majors. The participants presented with low physical activity, physical fitness, and poor dietary intake, and 50% were overweight/obese (BMI \u3e 25). Participants demonstrated gains in their physical fitness and their perceived benefits to engaging in exercise and decreased their perceived barriers to engaging in exercise and a healthy diet. College freshmen presented with low levels of physical activity, poor dietary intake, and excess body weight. A peer-administered program can improve these measures and favorably change perceptions of exercise and diet

Can a Home-based Cardiac Physical Activity Program Improve the Physical Function Quality of Life in Children with Fontan Circulation?

Objective Patients after Fontan operation for complex congenital heart disease (CHD) have decreased exercise capacity and report reduced health-related quality of life (HRQOL). Studies suggest hospital-based cardiac physical activity programs can improve HRQOL and exercise capacity in patients with CHD; however, these programs have variable adherence rates. The impact of a home-based cardiac physical activity program in Fontan survivors is unclear. This pilot study evaluated the safety, feasibility, and benefits of an innovative home-based physical activity program on HRQOL in Fontan patients. Methods A total of 14 children, 8–12 years, with Fontan circulation enrolled in a 12-week moderate/high intensity home-based cardiac physical activity program, which included a home exercise routine and 3 formalized in-person exercise sessions at 0, 6, and 12 weeks. Subjects and parents completed validated questionnaires to assess HRQOL. The Shuttle Test Run was used to measure exercise capacity. A Fitbit Flex Activity Monitor was used to assess adherence to the home activity program. Results Of the 14 patients, 57% were male and 36% had a dominant left ventricle. Overall, 93% completed the program. There were no adverse events. Parents reported significant improvement in their child\u27s overall HRQOL (P \u3c .01), physical function (P \u3c .01), school function (P = .01), and psychosocial function (P  \u3c .01). Patients reported no improvement in HRQOL. Exercise capacity, measured by total shuttles and exercise time in the Shuttle Test Run and calculated VO2max, improved progressively from baseline to the 6 and 12 week follow up sessions. Monthly Fitbit data suggested adherence to the program. Conclusion This 12-week home-based cardiac physical activity program is safe and feasible in preteen Fontan patients. Parent proxy-reported HRQOL and objective measures of exercise capacity significantly improved. A 6-month follow up session is scheduled to assess sustainability. A larger study is needed to determine the applicability and reproducibility of these findings in other age groups and forms of complex CHD

The Effect of Dietary and Exercise Self-Management Support Program on Dietary Behavior Exercise Behavior and Clinical Outcomes in Muslim Patients with Poorly Controlled Type 2 DM in a Community Setting in Indonesia

Purpose: The objective of this study was to examine the effect of dietary and exercise self-management support program on the dietary behavior, exercise behavior, and clinical outcomes of Muslim patients with poorly controlled type 2 DM in Indonesia. Methods: This study was a quasi-experimental, two group, pre-test and post-test design. The experimental group received the dietary and exercise self-management support program and usual care, whereas the control group only received the usual nursing care.Result: 35 subjects in the experimental group and 35 subjects in the control group completed the program, respectively. The findings indicated that there are significantly differences in dietary behavior (p=.00), exercise behavior (p=.00) and clinical outcomes: fasting blood glucose (FBG) (p=.00), cholesterol total level (p=.01) and systolic blood pressure (p=.00) between the experimental group and control group. However, for the BMI status (p=.84) and diastolic blood pressure (BP) (p=.32) were no significant differences between two groups. Conclusion: The dietary and exercise self-management support program was effective for improving the dietary behavior, exercise behavior, FBG, and total cholesterol level for individuals with poorly controlled type 2 diabetes mellitus. Further studies should be replicated using larger groups over a longer time frame

Promoting Team-Based Exercise Among African American Breast Cancer Survivors

Physical activity benefits the health and well-being of breast cancer survivors (BCS). Yet, many African American survivors do not routinely exercise and have increased risk of poor outcomes. The purpose of this mixed-method study was to identify motivational factors compelling African American BCS to participate in a 14-week team walking program and to intend to continue exercise after the intervention concluded. Focus groups were held with participants (n = 12) before and after training. Content analysis discovered themes before the intervention: Not wanting to go at it alone, exercise not a life or treatment priority, cancer treatment affected activity, advocates to exercise, and can exercise really help? Four themes postintervention themes included: In the same boat, changed mind-set, improved weight and activity, and overcoming barriers. Physical data verified improvements. Results suggest that a team-based exercise training program may assist in overcoming a sedentary behavior tendency and subsequently improve health among survivors

Improvement of heart rate recovery after exercise training in older people.

Twenty-four subjects aged 70 and older were retrospectively selected from our archives and screened for symptoms of cardiovascular disease. Baseline exercise test was negative for myocardial ischemia in all subjects. All subjects had completed an 8-week program, performed for a variety of indications and consisting of an aerobic physical training program including 30 minutes of cycling three times per week at 65% to 75% of maximum heart rate achieved at peak exercise test performed at enrollment, an educational intervention, dietary advice, and psychological support. All subjects underwent a cardiopulmonary exercise test (CPX) before and at the end of exercise training. At the end of each CPX, peak oxygen uptake (VO2peak), the rate of increase of ventilation per unit of increase of carbon dioxide production (VE/VCO2slope), and HRR were recorded. Twenty-five healthy subjects younger than 60 with no evidence of exercise-induced myocardial ischemia and not enrolled in any exercise training program were also retrospectively selected from our archives and used as a control group for analyzing HRR. These patients performed two exercise tests several weeks apart. Several studies have shown that changes in vagal tone can be used as an outcome tool that helps identify patients or subjects with or without cardiovascular disease at risk for a cardiovascular event, although the evidence of a prognostic value of HRR in older subjects without cardiovascular disease is rather poor. In this study, exercise training resulted in HRR improvement in healthy elderly subjects, suggesting that exercise training improves vagal/sympathetic balance in older subjects without cardiovascular disease as well. Whether the observed improvement in HRR may have long-term beneficial prognostic effects was not the aim of the study, although a beneficial effect might be postulated, in light of the Framingham dat

Summary and recommendations for initial exercise prescription

The recommendations summarized herein constitute a basis on which an initial exercise prescription can be formulated. It is noteworthy that any exercise program designed currently would be an approximation. Examination of the existing space-flight data reveals a scarcity of in-flight data on which to rigorously design an exercise program. The relevant experience within the U.S. space program (with regard to long-duration space flight) is limited to the Skylab Program. Lessons learned from Skylab are relevant to the design of a Space Station exercise program, especially with regard to the total length of exercise time required, cardiovascular (CV) deconditioning/reconditioning, and bone loss. Certain observations of the U.S.S.R. exercise activities can also contribute to the formulation of an exercise prescription of Space Station. Reportedly, the U.S.S.R. uses both a bicycle ergometer and a treadmill device on long-duration missions with some degree of success. Using the third crew of Salyut 6, which was a 175-day stay, as a representative mission, the typical time dedicated to exercise varies from 2 to 3 hours per day. In addition, the cosmonauts wear an elasticized suit, called a penquin suit, for time periods ranging from 12 to 16 hours per day. This device provides a load across the axial skeleton against which the wearer must exert himself. Despite these extensive countermeasures, the effects of adaptation are not totally prevented

Motivation Contagion When Instructing Obese Individuals: A Test in Exercise Settings

We examined motivation contagion in a hypothetical exercise setting. Exercise science students (n = 164) were provided with quotes of hypothetical male and female obese exercisers displaying different quality of motivation to start an exercise program. We used a 3 (exerciser motivation) × 2 (exerciser gender) × 2 (student gender) between-subjects experimental design to examine students’ (a) motivation to instruct, (b) interpersonal style, (c) perception of barrier efficacy of the exerciser, and (d) effort to identify factors that could maximize the effectiveness of an exercise program for the exerciser. Results showed that students displayed less controlled motivation and rated the exerciser as more capable of overcoming barriers to exercise when they perceived the exerciser to be autonomously motivated. However, students, particularly females, reported more autonomy support and invested more effort toward female exercisers with controlled motivation. Our findings indicate that motivation contagion effects are plausible in exercise settings and may affect interactions between fitness instructors and obese clients

Exercise Preferences Among Young Adults: Do Men and Women Want Different Things?

Background Young adult men are difficult to recruit and retain in lifestyle interventions. This may be in part to gender differences in exercise goals observed in men, but little is known about exercise preferences for young adults, specifically. The purpose of this study is to compare the exercise preferences of young men and women to inform future interventions in this area. We hypothesize that men will prefer strength training at higher rates than women, and that women will prefer supervised guidance at higher rates than men. Methods The sample included 288 young adults aged 18-25 (mean age=21.85, SD=2.2). Majority were women and within a normal BMI range (M=25.91, SD=5.3). An anonymous online survey study was completed. Participants were asked their preferred type of exercise (moderate intensity cardio, strength training, intense strength training, or a combination of cardio and strength training), and if they preferred to exercise at a clinic-based facility with supervised guidance or to exercise alone with guidance.Chi-square tests were conducted to determine if there are gender differences in preferences for exercise type and mode of delivery, accounting for BMI. Results Over two-third of young adults preferred a combination of moderate intensity cardio and strength training. Women and men differed significantly in their exercise preferences (p=\u3c .001). Less than 1% of women preferred intense strength training compared to the 15.3% of men. Women (17.4%) preferred moderate intensity cardio at higher rates than men (12.2%). However, when examining outcomes by BMI category, these results were only significantly different among individuals within a normal BMI (p=.000). Majority of young adults (67.7%) prefer exercising with their own with guidance from a program. Men and women did not differ in their preference to exercise with guidance or in a clinic-based program with supervision (p=.115). Conclusion Findings suggest that young adults overall prefer a combination of strength training and cardio, conducted on their own with guidance from a program. However, young men were more likely to prefer intense strength training; this was particularly true among men in a normal BMI range. These findings may be used to inform the tailoring of recruitment messaging and lifestyle interventions targeting this high-risk population.https://scholarscompass.vcu.edu/gradposters/1033/thumbnail.jp

A Pilot Study: The Effects of Group Exercise On Fatigue and Quality of Life During Cancer Treatment

Fatigue affects 60-100% of all cancer patients, is difficult to manage, and can have a profound impact on everyday functioning and quality of life. Though seemingly counterintuitive, exercise has emerged as a promising intervention for the management of cancer related fatigue (CRF). Current research predominantly involves individual, home-based exercise programs with few studies exploring other modes of exercise delivery. The purpose of this pilot study was to determine if participation in a structured group exercise program (SGEP) was a feasible intervention for adult oncology patients receiving cancer treatment and to test the impact of a SGEP on reducing CRF and improving quality of life (QOL). This unique study integrated the known benefits of exercise with the powerful effects of group dynamics in a group of adult oncology patients with mixed cancers, at various stages of treatment. Using a pretest and posttest one-group design, findings showed a significant decrease in bodily pain (p=0.0118); subscale scores for physical role, vitality, and social function increased, but did not yield statistical significance. No difference was found in reported fatigue. A post-program questionnaire identified themes of support, learning from shared information, and usefulness of having an exercise program serve concurrently as an informal support group. The findings of this pilot study provide encouraging data that suggests a SGEP is feasible, safe, and well tolerated by adult oncology patients receiving cancer treatment, and may have positive effects on CRF and QOL