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Factors influencing commencement and adherence to a home-based balance exercise program for reducing risk of falls: perceptions of people with Alzheimer's disease and their caregivers

Published online by Cambridge University Press:  23 January 2012

Plaiwan Suttanon ,
Keith D. Hill ,
Catherine M. Said ,
Karin N. Byrne  and
Karen J. Dodd
Plaiwan Suttanon*
Affiliation:
School of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia Preventive and Public Health Division, National Ageing Research Institute, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Keith D. Hill
Affiliation:
Preventive and Public Health Division, National Ageing Research Institute, The Royal Melbourne Hospital, Parkville, Victoria, Australia Musculoskeletal Research Centre, La Trobe University, Bundoora, Victoria, Australia Allied Health Division, Northern Health, Bundoora, Victoria, Australia
Catherine M. Said
Affiliation:
Department of Physiotherapy, School of Health Science, The University of Melbourne, Parkville, Victoria, Australia Department of Physiotherapy, Heidelberg Repatriation Hospital, Heidelberg West, Victoria, Australia
Karin N. Byrne
Affiliation:
Preventive and Public Health Division, National Ageing Research Institute, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Karen J. Dodd
Affiliation:
School of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia Musculoskeletal Research Centre, La Trobe University, Bundoora, Victoria, Australia
*
Correspondence should be addressed to: Plaiwan Suttanon, Royal Melbourne Hospital (Royal Park Campus), PO Box 2127, Victoria 3050, Australia. Phone: +61 3 8387 2383; Fax: +61 3 8387 2153. Email: [email protected]; [email protected].
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Abstract

Background: Balance exercise is an important component of falls-prevention interventions, with growing evidence that it can be beneficial for people with Alzheimer's disease (AD). However, to implement a balance exercise program successfully for people with AD it is important to consider factors that can affect commencement and adherence to the program. This qualitative study explored these factors.

Methods: Ten participants with AD, who had completed a six-month home-based balance exercise program, and their caregivers (n = 9) participated. A phenomenological theoretical framework with semi-structured interviews was used for data collection and analysis.

Results: Factors influencing the decision to commence the program were: possible benefits of the program, recommendations from health professionals, value of research, positive attitude towards exercise, and minimizing caregivers’ burden. Factors influencing adherence to the program were grouped under 11 themes: six themes facilitated completion (program characteristics, physiotherapist, exercise recording sheet, caregivers’ support, sense of commitment, and perceived benefit) and five themes were barriers (pre-existing conditions, dislike of structured exercise, absence from home, caregiver's health or commitment, and bad weather).

Conclusions: A home-based exercise program with regular support from a physiotherapist and caregiver are key elements facilitating continuing program adherence in people with AD.

Keywords

balance exerciseadherencefallsAlzheimer's diseasequalitative studysemi-structured interview
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 7 , July 2012 , pp. 1172 - 1182
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Allen, J., Dodd, K. J., Taylor, N. F., McBurney, H. and Larkin, H. (2004). Strength training can be enjoyable and beneficial for adults with cerebral palsy. Disability & Rehabilitation, 26, 1121–1127.CrossRefGoogle ScholarPubMed
Brewer, B. W. (1998). Adherence to sport injury rehabilitation programs. Journal of Applied Sport Psychology, 10, 70–82.CrossRefGoogle Scholar
Campbell, A. J., Robertson, M. C., Gardner, M. M., Norton, R. N., Tilyard, M. W. and Buchner, D. M. (1997). Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ, 315, 1065–1069.CrossRefGoogle ScholarPubMed
Chao, D., Foy, C. G. and Farmer, D. (2000). Exercise adherence among older adults: challenges and strategies. Controlled Clinical Trials, 21, S212–S217.CrossRefGoogle ScholarPubMed
Chen, C. Y., Neufeld, P. S., Feely, C. A. and Skinner, C. S. (1999). Factors influencing compliance with home exercise programs among patients with upper-extremity impairment. American Journal of Occupational Therapy, 53, 171–180.CrossRefGoogle ScholarPubMed
Courneya, K. et al. (2010). Predictors of adherence to supervised exercise in lymphoma patients participating in a randomized controlled trial. Annals of Behavioral Medicine, 40, 30–39.CrossRefGoogle ScholarPubMed
Creswell, J. (2007). Qualitative Inquiry and Research Design: Choosing Among Five Approaches, 2nd edn. London: Sage.Google Scholar
Dodd, K. J., Taylor, N. F., Denisenko, S. and Prasad, D. (2006). A qualitative analysis of a progressive resistance exercise programme for people with multiple sclerosis. Disability & Rehabilitation, 28, 1127–1134.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Hawley, H. (2009). Older adults’ perspectives on home exercise after falls rehabilitation: understanding the importance of promoting healthy, active ageing. Health Education Journal, 68, 207–218.CrossRefGoogle Scholar
Heller, T., Ying, G.-S., Rimmer, J. H. and Marks, B. A. (2002). Determinants of exercise in adults with cerebral palsy. Public Health Nursing, 19, 223–231.CrossRefGoogle ScholarPubMed
Hill, K., LoGiudice, D., Lautenschlager, N., Said, C., Dodd, K. and Suttanon, P. (2009). Effectiveness of balance training exercise in people with mild to moderate severity Alzheimer's disease: protocol for a randomised trial. BMC Geriatrics, 9, 29.CrossRefGoogle ScholarPubMed
Liamputtong, P. (2009). Qualitative Research Methods, 3rd edn. Sydney: Oxford University Press.Google Scholar
Magsi, H. and Malloy, T. (2005). Underrecognition of cognitive impairment in assisted living facilities. Journal of the American Geriatrics Society, 53, 295–298.CrossRefGoogle ScholarPubMed
Martin, J. E. and Dubbert, P. M. (1985). Adherence to exercise. Exercise and Sport Sciences Reviews, 13, 137–167.CrossRefGoogle ScholarPubMed
O'Brien, M., Dodd, K. J. and Bilney, B. (2008). A qualitative analysis of a progressive resistance exercise programme for people with Parkinson's disease. Disability & Rehabilitation, 30, 1350–1357.CrossRefGoogle ScholarPubMed
O'Shea, S. D., Taylor, N. F. and Paratz, J. D. (2007). Factors affecting adherence to progressive resistance exercise for persons with COPD. Journal of Cardiopulmonary Rehabilitation and Prevention, 27, 166–174.CrossRefGoogle ScholarPubMed
Sherrington, C., Whitney, J. C., Lord, S. R., Herbert, R. D., Cumming, R. G. and Close, J. C. (2008). Effective exercise for the prevention of falls: a systematic review and meta-analysis. Journal of the American Geriatrics Society, 56, 2234–2243.CrossRefGoogle Scholar
Suttanon, P. et al. (submitted). Feasibility, safety and preliminary evidence of the effectiveness of a home-based balance exercise program for older people with Alzheimer's disease.Google Scholar
Taylor, N. F., Dodd, K. J., McBurney, H. and Graham, H. K. (2004). Factors influencing adherence to a home-based strength-training programme for young people with cerebral palsy. Physiotherapy, 90, 57–63.CrossRefGoogle Scholar
Teri, L. et al. (2003). Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA, 250, 2015–2022 (see comment).CrossRefGoogle Scholar
Tilly, J. and Reed, P. (2008). Falls, wandering, and physical restraints: a review of interventions for individuals with dementia in assisted living and nursing homes. Alzheimer's Care Today, 9, 45–50.Google Scholar
Yardley, L. et al. (2006). Older people's views of falls-prevention interventions in six European countries. Gerontologist, 46, 650–660.CrossRefGoogle ScholarPubMed