Physical activity at home : long-term effectiveness of a community group exercise versus physiotherapist-led home-based physical activity program in middle-aged adults

Student thesis: Doctoral Thesis

Abstract

Background It is well recognised that the adoption and longer-term adherence to physical activity (PA) by adults to reduce the risk of chronic disease is a challenge. Interventions,such as group and home-based physical activity programs,have been widely reported. However,few studies have directly compared these interventions to determine their effectiveness,in terms of health benefits,long-term physical activity adherence,and cost. Some evidence suggests that homebased physical activity programs are preferred by the majority of middle-aged adults,and provide better long-term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence,but research on their impact is limited. Methods Using a pragmatic,mixed methods,quasi-experimental design,sedentary,communitydwelling, healthy 50-65 year olds were recruited to a non-randomized 6-month community group exercise program (G,n=93),or a physiotherapist-led home-based physical activity program (HB,n=65),targeting those not interested in,or unable to attend,a group exercise program. An 18-month no-intervention follow-up period was included,with outcome measures collected at baseline,6,12,18 and 24-months. Outcomes measures comprised of ‘sufficient’ physical activity (Active Australia Survey (AAS)),minutes of moderate-vigorous physical activity (MVPA,ActiGraph GT1M),physical activity adherence (PA diaries), aerobic capacity (2-minute step-test),quality of life (SF-12v2),blood pressure,waist circumference,waist-to-hip ratio (WHR),and body mass index. Qualitative data was collected via focus groups with sub-groups of participants (group attendees (n=14),group non-attendees (n=9),and home-based (n=14)),and exit telephone calls (n=37) at the end of the intervention period. A validation of subjective physical activity measures was conducted over 7-days,with 76 participants (HB,n=39; G,n=37) wearing an ActiGraph GT1M accelerometer,completing the AAS and a daily PA diary,towards the end of the intervention period. A cost analysis (cost and effect (benefit)) was carried out,collecting direct costs of delivering the interventions prospectively. Mean differences in costs and effects between interventions were calculated at 6 and 24-months. Results Home-based participants were more likely to be younger,working full-time and not in a relationship (p
Date of Award1 Jan 2014
Original languageEnglish
Awarding Institution
  • University of Canberra

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Physical activity at home : long-term effectiveness of a community group exercise versus physiotherapist-led home-based physical activity program in middle-aged adults
Freene, N. (Author). 1 Jan 2014

Student thesis: Doctoral Thesis