Attitudes of Older Adults in a Group-Based Exercise Program Toward a Blended Intervention:A Focus-Group Study

Ageing is associated with a decline in daily functioning and mobility. A physically active life and physical exercise can minimize the decline of daily functioning and improve the physical-, psychological- and social functioning of older adults. Despite several advantages of group-based exercise programs, older adults participating in such interventions often do not meet the frequency, intensity or duration of exercises needed to gain health benefits. An exercise program that combines the advantages of group-based exercises led by an instructor with tailored home-based exercises can increase the effectiveness. Technology can assist in delivering a personalized program. The aim of the study was to determine the susceptibility of older adults currently participating in a nationwide group-based exercise program to such a blended exercise program. Eight focus-groups were held with adults of 55 years of age or older. Two researchers coded independently the remarks of the 30 participants that were included in the analysis according to the three key concepts of the Self Determination Theory: autonomy, competence and relatedness. The results show that maintaining self-reliance and keeping in touch with others were the main motives to participate in the weekly group-based exercises. Participants recognized benefits of doing additional home-based exercises, but had concerns regarding guidance, safety and motivation. Furthermore, some participants strongly rejected the idea to use technology to support them in doing exercises at home, but the majority was open to it. Insights are discussed how these findings can help design novel interventions that can increase the wellbeing of older adults and preserve an independent living.

Determinants of physical activity in wheelchair users with spinal cord injury or lower limb amputation:perspectives of rehabilitation professionals and wheelchair users

Purpose: To gain insight into determinants of physical activity in wheelchair users with spinal cord injury or lower limb amputation, from the perspective of both wheelchair users and rehabilitation professionals.  Methods: Seven focus groups were conducted: five with wheelchair users (n = 25) and two with rehabilitation professionals (n = 11). The transcripts were analysed using a sequential coding strategy, in which the reported determinants of physical activity were categorized using the Physical Activity for people with a Disability (PAD) model.  Results: Reported personal determinants of physical activity were age, general health status, stage of life, demotivation due to difficulty burning calories, available time and energy, balance in daily life, attitude, and history of a physically active lifestyle. Reported environmental determinants were professional guidance, inconvenient exercise times, accessibility of facilities, costs, transportation difficulties, equipment difficulties, and social support.  Conclusions: Important, changeable determinants of physical activity that might be influenced in future lifestyle interventions for wheelchair users are: balance in daily life leading to more time and energy to exercise, attitude towards physical activity, professional guidance, accessibility of facilities (providing information on how and where to find accessible facilities), and social support (learning how to get this). Implications for rehabilitation  A physically active lifestyle improves everyday functioning, and decreases disability and the risk of secondary health problems in wheelchair users with spinal cord injury or lower limb amputation. After inpatient rehabilitation, it is difficult for wheelchair users to maintain or further enhance their physical activity, a lifestyle intervention can help them in this. To be effective, lifestyle interventions should address important, changeable determinants of physical activity.  Important, changeable determinants of physical activity reported by wheelchair users and rehabilitation professionals are: balance in daily life leading to more time and energy to exercise, attitude towards physical activity, professional guidance, accessibility of facilities, and social support