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, community dwelling, 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 Award2014
    Original languageEnglish
    SupervisorGordon Waddington (Supervisor), Wendy Chesworth (Supervisor) & Rachel Davey (Supervisor)

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