Week 10- Exercise Adherence and Safety Measures

final

exercise adherence and older adults

Problems

Needs

Safety cannot be neglected

Some general precautions can be adhered to

barriers to physical activity adherence

Psychological

Environmental

Physiological

psychological barriers

Low self efficacy

Lack of Motivation

Depression

Other mental illness

Fear of falling

Lack of social support from family or friends

Lack of awareness/knowledge of PA benefits

environmental barriers

Geographic proximity to an exercise facility

Physical layout of an exercise facility (accessible?)

Current financial situation

Cost of fitness programs

Lack of transportation

Living in a rural setting

physiological barrier

Poor health

Pain

Side effects from medications

Current or past injury

Low energy

Decreased strength

Decreased mobility

determinants of PA participation

personal characteristics and attributes

environmental factors

mental health and self efficacy

characteristics of PA

personal characteristics and attributes

Need encouragement which can be challenging

Ultimately they must choose to participate (their decision)

Factors include: Age, gender, chronic health issues, time, psychological conditions

personal characteristics and attributes- aging

Increase in sedentary time

Decrease in physical activity
• 90% of Canadian Adults spend 8hrs being sedentary

Gender
• Older women are more sedentary than men
• Some women are the primary family care giver and feel they do not have time for exercise

personal characteristics and attributes- gender

Older women are more sedentary than men

Some women are the primary family care giver and feel they do not have time for exercise, nor do they make the time.

Some feel ADLs are enough to consider themselves not sedentary

Some have never experience hard physical exercise

Exercise instructors need to be aware that older women may have
never participated in a regular fitness program, so find ways to be
engaging, and convenient

Men often do not like group exercise classes

personal characteristics and attributes- chronic medical conditions

Educate older people about what is safe and benefits of exercise
• Prevent/manage chronic diseases
• Maintain independence
• Improve quality of life
• Home programs (online, or a visit from a trainer)
• Exercise can be safely modified to safely meet needs and restrictions at any age

personal characteristics and attributes- personality

• Instructors, families, friends, need the right arguments to persuade participation
• Success depends on the: needs, desires, and abilities of individuals to enjoy
themselves while participating in exercise
• Instructors need knowledge and support an individual to make new exercise
behaviour become habitual (a lifestyle change)

environmental factors

High attrition for seniors (leave exercise)

Location of facility
• In neighbourhood

Accessibility of facility
• (parking, bus route, unsafe)

Physical layout
• Relatively quiet
• Font sizes/colours
• Attractiveness of the site
• Health and Safety at the site

Winnipeg Example

Location of facility: SOGH Wellness Institute

neighborhood: North Perimeter at McPhillips

Accessibility of facility (parking, bus route, unsafe): On a bus route, lots of parking

Physical layout
• Relatively quiet

• Not pumping loud music
• Font sizes/colours

• Very aesthetic
• Health and Safety at the site

• It is at a Hospital

self efficacy

Ones’ belief in their ability to perform a task

Low SE is linked to decreased PA participation

Environment should be socially inclusive and enhance:
• Sense of belonging
• Positivity
• Support and promote positive mental health and well being
• Regular PA can decrease anxiety and depression

strategies to increase adherence

To all positive behaviours

Exercise

Medication use

Strategies include:
• Program Enhancers
• Behaviour Modification
• Behavioural Management Techniques

program enhancers

Group Exercise Class
• Variety
• Fun
• Equipment
• Activity options
• Music
• Keep a program interesting for joy and satisfaction to be high
• Create something people:

• look forward to

• want to regularly attend

Groups with commonalities (ex. Joint replacement)
• Creates a community
• Peer support

behaviour modification

Planning

Identify barriers then identify solutions

Visual demonstration of tasks

Rewards for successful behaviour

Create and deliver a well-planned program in a friendly, pleasing environment can bring about positive change

behaviour management techniques

Behavioural Change to Increasing PA (3 stages)
1. Decision to start exercising (not happen by accident)
2. Early stages of behaviour (adoption
3. Maintenance of new behaviour (adherence)

Different strategies at each stage to reinforce PA

behaviour management techniques - decision to start exercising

Refer to the
• physiological changes of aging
• requirements to remain independent

Consider
• personality
• Exercise background
• Starting simple
• Educating on the benefits of PA and the timeline of changes to the body (one visit does not completely change you)

behaviour management techniques- early stages of behaviour

adoption

Strategies of reminders to exercise
• Leave exercise shoes by the door
• Keep a gym bag in the car
• Start with manageable intervals of time
• Make it social – meet up with a friend to walk dogs together

behaviour management techniques- maintenance of new behaviour

adherence

Leads to results

Increased quality of life

Exercise professionals can send a note to PCP (with consent) that an individual is remaining active

Reinforce:
• personal benefits – clothes fit better, feel more confident
• Health benefits they are enjoying (not winded from simple activities)

safety

Generally safe to participate in group classes.

Instructor must be aware of complex cases

general safety precautions

• Be prepared to deal with emergencies

Be CPR/First Aid certified

Have participants complete a Physical Activity Readiness
Questionairre (PAR-Q)
• Provides health status
• Lets you know if further medical evaluation is needed prior to beginning exercise

recognize signs/symptoms of a problem (when to stop exercise)

signs and symptoms of a problem

when to stop exercise

light headedness/dizziness

confusion

pallor

nausea

extremely increased HR

sharp leg pain

shortness of breath

chest pain

musculoskeletal pain