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Evaluation of the Otago Exercise Programme with or without motivational interviewing: Feasibility, experiences, effects and adherence among older community-dwelling people
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Falls and injuries related to falls are one of the most common health problems among older people and are becoming increasingly more frequent. Regular exercise has been identified as one of the most effective fall-prevention activities for older people; however, awareness of the impact of exercise programmes and adherence to recommended exercise among the elderly population is generally low. Research examining how an exercise programme is administered to and experienced by elderly community-dwelling people is needed.

The overall aim of this thesis was to investigate the feasibility, experiences and effects of and adherence to the fall-preventive Otago Exercise Programme (OEP) with or without motivational interviewing (MI) among community-dwelling people aged 75 years or older.

Four studies were performed from October 2012 to May 2016 in a sample of 175 people. Both quantitative and qualitative research methods were used. The methods included the feasibility for conducting a randomized controlled trial (RCT) (I), individual face-to-face interviews (II), an RCT (III) and a prospective cohort study (IV). The intervention was given to two groups. The participants who received OEP with or without MI were compared with a control group that received standard care.

The feasibility of performing an exercise intervention with or without MI was acceptable from the perspective of the participating physiotherapists. From the perspective of the older participants performing the exercise with behavioural change support, the inclusion of monitored exercises in everyday life and daily routines was important. The participants also expressed experiencing more strength, improved physical functioning and greater hope for an extended active life during old age.

From the short-term perspective, there were significant improvements within the OEP combined with MI group in terms of physical performance, fall self-efficacy, activity level, and handgrip strength. Improved physical performance and fall self-efficacy were also found within the control group; however, corresponding differences did not occur in the OEP group without MI. There were no significant differences between the study groups after 12 weeks of regular exercise. Adherence to the exercises in the pooled exercise group was 81% at the 12-week follow-up.

At the 52-week follow-up, the behavioural factors being physically active and obtaining behavioural support in terms of MI had a significant association with adherence to the exercise programme.

These studies provide some support for the combination of OEP with MI as the addition of MI was valuable for achieving adherence to the exercise programme over time in older community-dwelling people.

 

Place, publisher, year, edition, pages
Västerås: Mälardalen University , 2017.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 225
Keyword [en]
Community-dwelling, older adults, feasibility, falls, exercise, behaviour, self-efficacy, physical activity, exercise, motivational interviewing, Ota-go Exercise Programme, randomized controlled trial
National Category
Physiotherapy
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-35208ISBN: 978-91-7485-321-6 (print)OAI: oai:DiVA.org:mdh-35208DiVA: diva2:1089636
Public defence
2017-06-09, Beta, Västerås, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2017-07-10Bibliographically approved
List of papers
1. A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing
Open this publication in new window or tab >>A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing
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2015 (English)In: Preventive Medicine Reports, ISSN 2211-3355, Vol. 2, 134-140 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this investigation was to study the feasibility of a randomised controlled trial (RCT) based on a multicentre fall prevention intervention including exercise with or without motivational interviewing compared to standard care in community-living people 75. years and older. Method: The feasibility of a three-armed, randomised controlled trial was evaluated according to the following: process, resources, management by questionnaire, and treatment outcomes. The outcome measures were fall frequency, physical performance and falls self-efficacy evaluated after three months. Twelve physiotherapists conducted the measurements and treatments and responded to the questionnaire. The first 45 participants recruited to the ongoing RCT were included: 16 individuals in the Otago Exercise Program group (OEP), 16 individuals in the OEP combined with motivational interviewing group (MI), and 13 individuals in the control group. The study was conducted from November 2012 to December 2013. Results: The feasibility of the study process, resources and management reached the set goals in most aspects; however, the set goal regarding the MI guide and planned exercise for the participating older people was not completely reached. No significant differences were found between the groups regarding the outcome measures. Conclusion: This study confirmed the acceptable feasibility for the study protocol in the ongoing RCT.

Keyword
Community-living, Exercise, Feasibility study, Motivational interviewing, Older adults
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-27610 (URN)10.1016/j.pmedr.2015.01.007 (DOI)2-s2.0-84923087120 (Scopus ID)
Available from: 2015-02-26 Created: 2015-02-26 Last updated: 2017-04-20Bibliographically approved
2. Older persons’ experiences of a home-based exercise programme with behavioural change support
Open this publication in new window or tab >>Older persons’ experiences of a home-based exercise programme with behavioural change support
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(English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed) Accepted
Abstract [en]

Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and wellbeing in older persons.

Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise programme with support for behavioural change.

Methods: Semi-structured interviews were conducted with twelve older persons aged 75 years or older, and a qualitative content analysis was performed.

Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

Conclusion: With support from physiotherapists, home-based exercise can be adapted to individual circumstances in a meaningful way. By including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning and give hope for an extended active life in old age.

National Category
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-35203 (URN)
Available from: 2017-04-19 Created: 2017-04-19 Last updated: 2017-05-03Bibliographically approved
3. Fall Preventive Exercise with or without behavior change support for community-dwelling older adults: A Randomized Controlled Trial With Short-Term Follow-up.
Open this publication in new window or tab >>Fall Preventive Exercise with or without behavior change support for community-dwelling older adults: A Randomized Controlled Trial With Short-Term Follow-up.
(English)In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895Article in journal (Refereed) Epub ahead of print
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-34994 (URN)10.1519/JPT.0000000000000129 (DOI)
Available from: 2017-03-03 Created: 2017-03-03 Last updated: 2017-04-20Bibliographically approved
4. One- year adherence to the Otago Exercise Programme with or without motivational interviewing in older people
Open this publication in new window or tab >>One- year adherence to the Otago Exercise Programme with or without motivational interviewing in older people
(English)Manuscript (preprint) (Other academic)
Keyword
older adults, physical activity, motivational interviewing
National Category
Physiotherapy
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-35207 (URN)
Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2017-05-03Bibliographically approved

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