Abstract
BackgroundIt is well recognised that the adoption and longer term adherence to physical activity 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 upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact.Methods'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected.DiscussionThe planned 18 month follow-up post intervention will provide an indication of the effectiveness of the group and home based interventions in terms of adherence to physical activity, health benefits and cost. If the physiotherapy-led home based physical activity program is successful it could provide an alternative option for physical activity program delivery across a number of settings.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000890932
Highlights
It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge
Primary prevention of chronic disease via physical activity programs appears to be under utilised in physiotherapy [12]
The largest and highest quality rating study in this review found that there was a significantly higher adherence rate to physical activity in the home based program compared with the centre based program, especially in the long term [20]
Summary
It is well recognised that the adoption and longer term adherence to physical activity 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 upon. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists prescribe exercise for a wide range of conditions and comorbidities utilising a strong background in disease pathologies and body systems They are well equipped to provide a thorough assessment, individually tailored prescription of exercise and appropriate counselling to achieve an increase in physical activity [10,11]. Further investigation of physical activity promotion and physiotherapy is needed to determine its impact
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