OJPM  Vol.3 No.2 , April 2013
Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: Quasi-experimental comparison
ABSTRACT

Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a pragmatic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activity program (n = 65). The primary outcome was physical activity adherence derived from exercise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p < 0.05). Thirty-three percent of the group participants attended ≥ 70% of group exercise sessions. Ninety percent of home-based participants received ≥ 4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of participants achieving self-reported “sufficient” physical activity (p ≤ 0.001) and significantly decreased waist circumference (p < 0.001) and

WHR (p < 0.05). Conclusion: The physiotherapist- led home-based physical activity program, requiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program. Clinical Trial Registration number Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.


Cite this paper
Freene, N. , Waddington, G. , Chesworth, W. , Davey, R. and Cochrane, T. (2013) Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: Quasi-experimental comparison. Open Journal of Preventive Medicine, 3, 229-237. doi: 10.4236/ojpm.2013.32031.
References
[1]   Warburton, D.E.R., Nicol, C.W. and Bredin, S.S.D. (2006) Health benefits of physical activity: The evidence. CMAJ: Canadian Medical Association Journal, 174, 801-809. doi:10.1503/cmaj.051351

[2]   Booth, F.W., Gordon, S.E., Carlson, C.J. and Hamilton, M.T. (2000) Waging war on modern chronic diseases: Primary prevention through exercise biology. Journal of Applied Physiology, 88, 774-787.

[3]   World Health Organization (2004) Global strategy on diet, physical activity and health. World Health Organization, Geneva.

[4]   Muller-Riemenschneider, F., Reinhold, T., Nocon, M. and Willich, S.N. (2008) Long-term effectiveness of interventions promoting physical activity: A systematic review. Preventive Medicine, 47, 354-368. doi:10.1016/j.ypmed.2008.07.006

[5]   Hillsdon, M., Foster, C. and Thorogood, M. (2005) Interventions for promoting physical activity. Cochrane Database of Systematic Reviews (Online), 1, Article ID: CD003180.

[6]   Ashworth, N.L., Chad, K.E., Harrison, E.L., Reeder, B.A. and Marshall, S.C. (2005) Home versus center based physical activity programs in older adults. Cochrane Database of Systematic Reviews (Online), 1, Article ID: CD004017.

[7]   Van der Bij, A.K., Laurant, M.G. and Wensing, M. (2002) Effectiveness of physical activity interventions for older adults: A review. American Journal of Preventive Medicine, 22, 120-133. doi:10.1016/S0749-3797(01)00413-5

[8]   Shirley, D., Van der Ploeg, H.P. and Bauman, A.E. (2010) Physical activity promotion in the physical therapy setting: Perspectives from practitioners and students. Physical Therapy, 90, 1311-1322. doi:10.2522/ptj.20090383

[9]   Booth, M.L., Bauman, A. Owen, N. and Gore, C.J. (1997) Physical activity preferences, preferred sources of assistance, and perceived barriers to increased activity among physically inactive Australians. Preventive Medicine, 26, 131-137. doi:10.1006/pmed.1996.9982

[10]   Wilcox, S., King, A.C., Brassington, G.S. and Ahn, D.K. (1999) Physical activity preferences of middle-aged and older adults: A community analysis. Journal of Aging & Physical Activity, 7, 386-399.

[11]   Yardley, L., Kirby, S. Ben-Shlomo, Y., et al. (2008) How likely are older people to take up different falls prevention activities? Preventive Medicine, 47, 554-558. doi:10.1016/j.ypmed.2008.09.001

[12]   Sheedy, J., Smith, B., Bauman, A., et al. (2000) A controlled trial of behavioural education to promote exercise among physiotherapy outpatients. Australian Journal of Physiotherapy, 46, 281-289.

[13]   Australian Physiotherapy Association (2009) Position Statement: Chronic disease and physiotherapy. http://www.physiotherapy.asn.au/policy-and-communications/position-statements

[14]   O’Donoghue, G. and Dean, E. (2010) The physiotherapist’s role in contemporary health care in Ireland: Responding to 21st century indicators and priorities. Physiotherapy Ireland, 31, 4-9.

[15]   Freene, N., Waddington, G., Chesworth, W., Davey, R. and Goss, J. (2011) “Physical Activity at Home (PAAH)”, evaluation of a group versus home based physical activity program in community dwelling middle aged adults: Rationale and study design. BMC Public Health, 11, 883. doi:10.1186/1471-2458-11-883

[16]   Wilbur, J., McDevitt, J.H., Wang, E., et al. (2008) Outcomes of a home-based walking program for AfricanAmerican women. American Journal of Health Promotion, 22, 307-317. doi:10.4278/ajhp.22.5.307

[17]   Department of Health and Aging, Australia Government (2005) Sports Medicine Australia (SMA) Pre-exercise screening system 2005. http://sma.org.au/wp-content/uploads/2009/05/new_pre_screening.pdf

[18]   Thompson, D.R., Chair, S.Y., Chan, S.W., et al. (2011) Motivational interviewing: A useful approach to improving cardiovascular health? Journal of Clinical Nursing, 20, 1236-1244. doi:10.1111/j.1365-2702.2010.03558.x

[19]   Duncan, K.A. and Pozehl, B. (2002) Staying on course: The effects of an adherence facilitation intervention on home exercise participation. Progress in Cardiovascular Nursing, 17, 59. doi:10.1111/j.0889-7204.2002.01229.x

[20]   Borg, G.A.V. (1982) Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise, 14, 377-381. doi:10.1249/00005768-198205000-00012

[21]   King, A.C., Haskell, W.L., Young, D.R., Oka, R.K. and Stefanick, M.L. (1995) Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Circulation, 91, 2596-2604. doi:10.1161/01.CIR.91.10.2596

[22]   Norton, K., Norton, L. and Sadgrove, D. (2010) Position statement on physical activity and exercise intensity terminology. Journal of Science and Medicine in Sport, 13, 469-502.

[23]   Brown, W.J., Trost, S.G., Bauman, A., Mummery, K. and Owen, N. (2004) Test-retest reliability of four physical activity measures used in population surveys. Journal of Science and Medicine in Sport, 7, 205-215. doi:10.1016/S1440-2440(04)80010-0

[24]   Brown, W.J., Burton, N.W., Marshall, A.L. and Miller, Y.D. (2008) Reliability and validity of a modified selfadministered version of the Active Australia physical activity survey in a sample of mid-age women. Australian and New Zealand Journal of Public Health, 32, 535-541. doi:10.1111/j.1753-6405.2008.00305.x

[25]   Ware Jr., J., Kosinski, M. and Keller, S.D. (1996) A 12item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220-233. doi:10.1097/00005650-199603000-00003

[26]   Rikli, R.E. and Jones, C.J. (1999) Development and validation of a functional fitness test for community-residing older adults. Journal of Aging & Physical Activity, 7, 129-161.

[27]   Dalal, H.M., Evans, P.H., Campbell, J.L., et al. (2007) Home-based versus hospital-based rehabilitation after myocardial infarction: A randomized trial with preference arms—Cornwall Heart Attack Rehabilitation Management Study (CHARMS). International Journal of Cardiology, 119, 202-211. doi:10.1016/j.ijcard.2006.11.018

[28]   Jancey, J., Lee, A., Howat, P., et al. (2007) Reducing attrition in physical activity programs for older adults. Journal of Aging & Physical Activity, 15, 152-165.

[29]   Hong, S.Y., Hughes, S. and Prohaska, T. (2008) Factors affecting exercise attendance and completion in sedentary older adults: A meta-analytic approach. Journal of Physical Activity & Health, 5, 385-397.

[30]   National Health & Medical Research Council (2004) Clinical practice guidelines for the management of overweight and obesity in adults 2004. Department of Health and Ageing, Australian Government, Canberra, 48.

[31]   World Health Organization (2008) Waist circumference and waist-hip ratio. Report of a WHO expert consultation. World Health Organization, Geneva.

[32]   Jancey, J., Howat, P., Lee, A., et al. (2006) Effective recruitment and retention of older adults in physical activity research: PALS study. Perth Active Living Seniors Project (PALS). American Journal of Health Behavior, 30, 626-635. doi:10.5993/AJHB.30.6.9

[33]   Office of the Chief Health Officer (2010) Australian Capital Territory Chief Health Officer’s Report 2010. ACT Health, Communications and Marketing Unit, Canberra.

[34]   Australian Bureau of Statistics (2006) Physical activity in Australia: A snapshot, 2004-05. Australian Bureau of Statistics, Canberra.

[35]   Australian Bureau of Statistics (2008) Census of population and housing: Socio-Economic Indexes for Areas (SEIFA), Australia—Data only 2006 (cat. no. 2033.0.55.001). Australian Bureau of Statistics, Canberra.

 
 
Top