Abstract
Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a pragmatic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activity program (n = 65). The primary outcome was physical activity adherence derived from exercise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p Thirty-three percent of the group participants attended ≥ 70% of group exercise sessions. Ninety percent of home-based participants received ≥ 4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of participants achieving self-reported “sufficient” physical activity (p ≤ 0.001) and significantly decreased waist circumference (p WHR (p 0.05). Conclusion: The physiotherapist- led home-based physical activity program, requiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program. Clinical Trial Registration number Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.
Highlights
The benefits of physical activity are well documented [1,2,3]
The initial mail out inviting 2105 participants to take part in a group exercise program resulted in 422 replies, a 20% (95% confidence interval (CI): 18
Adherence to the physical activity program requirements is an important factor for physical activity adoption
Summary
The benefits of physical activity are well documented [1,2,3]. A number of health promotion strategies have been employed to increase the population’s physical activity levels, including group and home-based physical activity programs [4,5]. Few studies have directly compared group and home-based physical activity interventions, over the longer term [6,7]. Fewer studies have investigated the role the physiotherapist plays in physical activity promotion [8] and no studies appear to directly target individuals not interested in group exercise. There is some evidence that middle-aged adults prefer not to attend group programs. Large surveys in Australia, the USA and the UK report that between 41% - 73% of middle-aged adults (50 - 65 years old) prefer not to at-
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