Community-based Group Exercise Program Research Articles

Experiences and perspectives of integrating nutrition education into an exercise program for people with chronic medical conditions.

Community-based healthy eating and exercise programs are effective interventions to support some people with chronic conditions. This research aimed to explore the experiences and perceptions of participants regarding the integration of nutrition education into a successful group based exercise program for people with chronic medical conditions. Semi-structured interviews were conducted with past participants of a community based group exercise program (Health Moves) with embedded nutrition advice based in a regional area of New South Wales. A total of 60 individuals who had participated in the Health Moves program between 2017 and 2019 were invited to participate and 19 (32%) randomly selected participants consented to be interviewed. Interviews explored participants' experiences, program impacts, and barriers to sustaining changes post program. Similar concepts and patterns were grouped into themes. Four themes were identified that described the experiences with a community-based group exercise intervention with a nutrition component. The major themes evident were that Health Moves facilitated motivation (via access to health professionals, peer support, accountability, affordability); and there were challenges identified to sustaining change (including cost, comorbidities, end of program support, environmental factors); Nutrition advice was valuable for some but not for all (difficulty recalling nutrition components, superficial coverage) Practical and interactive nutrition advice is desired. Participants expressed a high degree of satisfaction with the program but require ongoing support to sustain changes post program. The position and integration of nutrition education within this exercise program was perceived by participants to be suboptimal. Increased access to practical, interactive nutrition education components may improve participant satisfaction and engagement. SO WHAT?: Key findings from this research include a desire for removal of didactic nutrition education sessions and request for increased peer support. Modifications to the program include the integration of interactive self-paced nutrition modules. Peer support partnerships are now encouraged by trainers to support ongoing motivation of participants to keep training together outside the structured exercise program and transition to managing their own exercise routine. Discussions between organisations involved about ongoing pathway/program support or reduced cost 'off peak' gym membership is underway to help with costs incurred by participants.

Determinants of exercise adherence and maintenance for cancer survivors: Implementation of a community-based group exercise program. A qualitative feasibility study.

Despite verified knowledge that physical exercise plays an important part in recovery after cancer treatment, multiple studies have shown that maintaining a physically active lifestyle after cancer is challenging. There is a need for qualitative studies to increase understanding into patient experiences and perspectives, and facilitate the design of more sustainable exercise program. This qualitative descriptive feasibility study explores experiences from the implementation of a novel four-month community-based group exercise program for cancer survivors within municipality health service after completion of rehabilitation in the specialist health care service. Fourteen cancer survivors participated in focus group interviews after completing Rehabilitation: Physical activity and Coping - feasibility study. Data were analyzed using the systematic text condensation method. We identified a main category, Determinants for exercise adherence and maintenance and four subcategories: peer-support, environment, structure and knowledge. A social and supportive exercise environment promotes exercise adherence and maintenance among cancer survivors. This knowledge can be useful for further efforts to implement high quality community-based group exercise programs for cancer survivors. This study adds knowledge of survivors' experience of a novel community-based group exercise program in clinical practice and can promote the implementation of sustainable community-based exercise programs for cancer survivors.

A Web-Delivered, Clinician-Led Group Exercise Intervention for Older Adults With Type 2 Diabetes: Single-Arm Pre-Post Intervention.

BackgroundThe COVID-19 pandemic created unprecedented shifts in the way health programs and services are delivered. A national lockdown to prevent the spread of COVID-19 in Australia was introduced in March 2020. This lockdown included the closure of exercise clinics, fitness centers, and other community spaces, which, before the pandemic, were used to deliver Beat It. Beat It is an 8-week in-person, community-based, and clinician-led group exercise and education program for adults self-managing diabetes. To continue offering Beat It, it was adapted from an in-person program to a fully web-based supervised group exercise program for adults with type 2 diabetes (T2DM).ObjectiveThis study aims to assess whether the Beat It Online program produced comparable health outcomes to the Beat It in-person program in terms of improving physical fitness (muscular strength and power, aerobic endurance, balance, and flexibility) and waist circumference in older adults with T2DM.MethodsAustralians with T2DM who were aged ≥60 years were included. They were enrolled in Beat It Online, a twice-weekly supervised group exercise and education program conducted via videoconference over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. The adaptations to Beat It are reported using the Model for Adaptation, Design, and Impact, including the type of changes (what, where, when, and for whom), the criteria for making those changes (why and how), and the intended and unintended outcomes. The intended outcomes were comparable functional fitness as well as physical and mental health improvements across demographics and socioeconomic status.ResultsA total of 171 adults (mean 71, SD 5.6 years; n=54, 31.6% male) with T2DM were included in the study, with 40.4% (n=69) residing in lower socioeconomic areas. On the completion of the 8-week program, significant improvements in waist circumference, aerobic capacity, muscular strength, flexibility, and balance were observed in both male and female participants (all P<.001). The Model for Adaptation, Design, and Impact reports on 9 clinical, practical, and technical aspects of Beat It that were adapted for web-based delivery.ConclusionsThis study found that Beat It Online was just as effective as the in-person program. This adapted program produced comparable health benefits across demographics and socioeconomic status. This study offers important findings for practitioners and policy makers seeking to maintain independence of older people with T2DM, reversing frailty and maximizing functional and physical fitness, while improving overall quality of life. Beat It Online offers a flexible and inclusive solution with significant physical and mental health benefits to individuals. Further evaluation of Beat It (both in-person and Online) adapted for culturally and linguistically diverse communities will provide greater insights into the efficacy of this promising program.

Using the Integrative Model of Behavioral Prediction to Understand Female Breast Cancer Survivors' Barriers and Facilitators for Adherence to a Community-Based Group-Exercise Program.

To identify facilitators and barriers associated with adherence to the EXPINKT exercise program for breast cancer survivors in a convenience sample of women. Focus groups discussions; The Integrative Model of Behavioral Prediction. Findings suggest that program adherence could be achieved by the establishment, via staff and processes, of a positive and safe exercise environment, which instills a sense of accountability while developing exercise self-efficacy. Further, multiple referral pathways and promotion of exercise benefit during and following treatment by oncology nurses may assist in enrolment in the program. Oncology nurses may play a unique role in informing and stimulating female breast cancer survivors to partake in breast cancer-specific exercise programs. Results of this study show that most women are unaware of the benefits related to exercising in relation to cancer recovery, as well as the existence of breast cancer-specific exercise programs. Therefore, oncology nurses may play an important role in creating this awareness. Furthermore, shaping a route to adherence to such exercise programs is essential for breast cancer survivors to become and stay sufficiently active.

Potential long-term impact of \u201cOn The Move\u201d group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial

BackgroundWellness program participation may reduce the risk of falling, emergency department-use, and hospitalization among older adults. “On the Move” (OTM), a community-based group exercise program focused on the timing and coordination of walking, improved mobility in older adults, but its impact on falls, emergency department-use, and hospitalizations remains unclear. The aim of this preliminary study was to investigate the potential long-term effects that OTM may have on downstream, tertiary outcomes.MethodsWe conducted a secondary analysis of a cluster-randomized, single-blind intervention trial, which compared two community-based, group exercise programs: OTM and a seated exercise program on strength, endurance, and flexibility (i.e. ‘usual-care’). Program classes met for 50 min/session, 2 sessions/week, for 12 weeks. Older adults (≥65 years), with the ability to ambulate independently at ≥0.60 m/s were recruited. Self-reported incidence of falls, emergency department visitation, and hospitalization were assessed using automated monthly phone calls for the year following intervention completion. Participants with ≥1 completed phone call were included in the analyses. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated (reference = usual-care).ResultsParticipants (n = 248) were similar on baseline characteristics and number of monthly phone calls completed. Participants in the seated exercise program attended an average of 2.9 more classes (p = .017). Of note, all results were not statistically significant (i.e. 95% CI overlapped a null value of 1.0). However, point estimates suggest OTM participation resulted in a decreased incidence rate of hospitalization compared to usual-care (IRR = 0.88; 95% CI = 0.59–1.32), and the estimates strengthened when controlling for between-group differences in attendance (adjusted IRR = 0.82; 95% CI = 0.56–1.21). Falls and emergency department visit incidence rates were initially greater for OTM participants, but decreased after controlling for attendance (adjusted IRR = 1.08; 95% CI = 0.72–1.62 and adjusted IRR = 0.96; 95% CI = 0.55–1.66, respectively).ConclusionCompared to a community-based seated group exercise program, participation in OTM may result in a reduced risk of hospitalization. When OTM is adhered to, the risk for falling and hospitalizations are attenuated. However, definitive conclusions cannot be made. Nevertheless, it appears that a larger randomized trial, designed to specifically evaluate the impact of OTM on these downstream health outcomes is warranted.Trial registrationClinical trials.gov (NCT01986647; prospectively registered on November 18, 2013).

Walking People - Aruku-hito, Community-based Group Exercise Program For Older Adults: Expanding The Reach

Walking People - Aruku-hito, Community-based Group Exercise Program For Older Adults: Expanding The Reach

Poster 5: The Effects of Community Based Group Exercise Program in Frail Older Adults: 24 Weeks Prospective Study

Poster 5: The Effects of Community Based Group Exercise Program in Frail Older Adults: 24 Weeks Prospective Study

Physical Functioning After 1, 3, and 5 Years of Exercise Among People With Parkinson's Disease: A Longitudinal Observational Study.

Regular physical activity is thought to be crucial to maintaining optimal physical function in people with Parkinson's disease (PWP), and it may have neuroprotective effects. As with many medical treatments, exercise is most effective when performed consistently over a period of years. The primary aim of this study was to examine multiyear adherence to a community-based group exercise program for PWP. A secondary aim was to document how physical functioning progressed after 1, 3, and 5 years for participants who consistently attended a community-based, group, exercise program. Forty-six individuals with idiopathic Parkinson's disease, who were at modified Hoehn and Yahr stage I, II, or III and were community ambulators, were recruited on a rolling basis between 2008 and 2013. Each provided yearly medical clearance to exercise. Participants engaged in a free, community-based, group exercise program offered 2 days per week, 1 hour per day, for three 10-week sessions per year. The program included supervised floor exercises for balance, coordination, strength, and flexibility along with resistance training on dual-action exercise machines. Participants who attended more than half the classes for 1, 3, or 5 years (n = 27, n = 14, n = 7, respectively) were considered to have completed the fitness program (consistent exercisers) and were included in the longitudinal data analysis; participants who either dropped out or attended less than half the classes (n = 19) were not included. Physical functioning was evaluated at baseline for all participants and yearly thereafter for consistent exercisers. Wilcoxon signed rank tests were used to compare baseline data with data collected after 1, 3, and 5 years of consistent exercise. Over half of the participants initially evaluated completed at least 1 year of the fitness program (27 of the 46 = 59%) and a proportion completed 3 years (14 of the 39 = 39%), and 5 years (7 of the 24 = 29%). At baseline, consistent exercisers were younger than those who dropped out (63.9 vs 69.9 years, P < .05), but had similar modified Hoehn and Yahr medians (2.0 vs 2.3), and similar time since diagnosis (8.0 vs 5.6 years). Consistent exercisers showed small statistically significant improvements in grip strength (8.9% change), Berg Balance scores (5.1% change), and 6-minute walk test (11% change) from baseline to year 1. No significant differences were found in these variables after 3 or 5 years, or for gait speed and timed up and go after 1, 3, or 5 years. Despite the progressive nature of Parkinson's disease, many PWP can sustain a regular program of varied modes of community-based, group exercise over a period of years. Participants who did so maintained initial performance levels on key measures of physical functioning. By working with an interprofessional team in a supportive community-based exercise program, physical therapists can help many PWP engage in consistent and sustained exercise activity over multiyear periods.

Effects of a tailor-made exercise program on exercise adherence and health outcomes in patients with knee osteoarthritis: a mixed-methods pilot study.

IntroductionPrevious studies showed that exercise intervention was effective in symptoms control of knee osteoarthritis (OA) but poor intervention adherence reduced the exercise effect. It has been suspected that the design of exercise intervention mainly from the health care professionals’ perspective could not address the patients’ barriers to exercise. Therefore, a tailor-made exercise program which incorporated the patient’s perspective in the design was developed and ready for evaluation.ObjectivesThis pilot study estimated the effects of a tailor-made exercise program on exercise adherence and health outcomes, and explored the participants’ perception and experience of the program.MethodsThe intervention of this study was a 4-week community-based group exercise program, which required the participants to attend a 1-hour session each week. Thirty-four older people with knee OA were recruited to the program. Mixed-methods study design was used to estimate the effects of this program and explore the participants’ perception and experience of the program. Exercise adherence and performance in return-demonstration of the exercise were assessed at 12 weeks after the program. Disease-specific health status (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (12-item Short Form of the Medical Outcome Study Questionnaire), knee range of motion, muscle strength, and endurance of the lower extremities (Timed-Stands Test) were measured at the beginning of the program and 12 weeks after. Six participants were interviewed individually on the 12th week.ResultsThirty-three participants (75.0±7.3 years) completed the one-group pretest and post-test study. The participants’ exercise adherence was 91.4%±14.54%, and their correct performance in return-demonstration was 76.7%±21.75%. Most of the participants’ health outcomes significantly improved at posttests except the 12-item Short Form of the Medical Outcome Study Questionnaire physical health summary score. The qualitative findings provided rich information to explain and support the quantitative results.ConclusionThe results of this study showed that a tailor-made exercise program could improve exercise adherence and health outcomes in older people with knee OA.

Evaluating the Factors Associated With the Completion of a Community-Based Group Exercise Program Among Older Women.

Despite the well-known benefits of exercise, only 50% of U.S. women met recommended physical activity levels in 2014. To combat this issue, the Healthy Aging Regional Collaborative of South Florida has been offering the EnhanceFitness (EF) program in community-based settings since 2008. In the current study, we examined the factors associated with the program completion among older women (≥ 60 years). During the first 4 years, 3,829 older women attended EF sessions. Of these, 924 (24.2%) attended the recommended 32 sessions within first 4 months. Results revealed that women who lived in Miami-Dade County, were ≥ 80 years, and did not report depression and/or risk factors for chronic conditions were more likely to complete EF. Black women were less likely to complete the program. Recognition of these factors might help identify at-risk individuals. More efforts are needed to improve completion rates. Theory-based interventions would allow comprehensive understanding of all factors and, therefore, should be explored in the future.

Preliminary Results of a Community-Based Education and Group Exercise Program for Type 2 Diabetics

Preliminary Results of a Community-Based Education and Group Exercise Program for Type 2 Diabetics

Can a single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise acutely reduce blood pressure?

This study aimed to analyze the acute effects of a single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise on blood pressure in healthy young adult women. Twenty-three healthy young adult women (aged 31.57 ± 7.87 years) participated in two experimental sessions (exercise and control) in a crossover study design. Blood pressure was monitored before, immediately after and at 10, 20 and 30 min of recovery. The exercise session consisted of four phases: 1) a warm-up (5 min of dance aerobics); 2) aerobic exercise training (30 min of step aerobics); 3) resistance exercise training (six sets of 12 repetitions of three bodyweight exercises in a circuit mode, 10 min); and 4) a cool-down (5 min of breathing and flexibility exercises); totaling 50 min of duration. Systolic blood pressure after exercise was significantly lower compared to control at the 10th min (−10.83 ± 2.13 vs. −2.6 ± 2.13 mmHg; p = 0.009), 20th min (−11.26 ± 2.13 vs. −3.04 ± 2.13 mmHg; p = 0.009) and 30th min of recovery (−10.87 ± 2.39 vs. −0.48 ± 2.39 mmHg; p = 0.004). A single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise was effective in inducing significant post-exercise hypotension in healthy young adult women. This type of low-cost exercise interventions may have an important role in the prevention of cardiovascular diseases and in community health promotion.

Prognosis of chronic low back pain in patients presenting to a private community-based group exercise program

To examine the prognosis and prognostic factors for patients with chronic low back pain presenting to a private, community-based, group exercise program. A total of 118 consecutive patients with chronic LBP were recruited. Baseline assessments included socio-demographic characteristics, back pain history and clinical examination findings. Primary outcome measures were pain intensity and disability at 3, 6 and 12months. Potential prognostic factors to predict pain intensity and disability at 12months were assessed using a multivariate regression model. 112 (95%) participants were followed up at 12months. The majority of participants were female (73%), had high educational levels (82%) and resided in suburbs with a high socio-economic status (99%). Pain intensity improved markedly during the first 6months (35%) with further minimal reductions up to 12months (39%). Interestingly, disability improved to a greater degree than pain (48% improvement at 6months) and continued to improve throughout the 12months (60%). Baseline pain intensity accounted for 10% of the variance in the 1year pain outcomes. Duration of current episode, baseline disability and educational level accounted for 15% of the variation in disability at 12months. During a period of 12months, patients with chronic LBP presenting to a private, community-based, group exercise program improved markedly, with greater improvements in disability than pain. The predictors investigated accounted for only 10 and 15% of pain and disability outcomes, respectively.

DIABETES EM MOVIMENTO® - COMMUNITY-BASED EXERCISE PROGRAM FOR PATIENTS WITH TYPE 2 DIABETES

BackgroundExercise is widely recommended as a nonpharmacological therapeutic strategy essential to control of type 2 diabetes and cardiovascular related risk. This study aims to present Diabetes em Movimento® a community-based...

Adherence to a Community-based Exercise Program Is a Strong Predictor of Improved Back Pain Status in Older Adults

To identify factors that were predictive of improved pain status among older adults with chronic back pain participating in the Adaptive Physical Activity (APA) program and to identify factors that were predictive of adherence to APA. An observational cohort study of 392 older adults (ages 50 to 88) with chronic back pain participating in APA for 12 months. APA was a community-based group exercise program given for 1-hour, twice weekly, in local gyms. Primary outcome measures were improved pain based on a global rating of change evaluation and adherence to the APA program (defined as participation in >75% of exercise sessions). Potential predictor variables were entered into multivariate logistic regression models to determine the most accurate set of variables for predicting improved pain and adherence. Presence of depressive symptoms, poor self-rated health and adherence to APA were the best predictors of improved pain status, with adherence being the strongest predictor [odds ratio: 13.88 (95% confidence interval: 8.17, 23.59)]. Better physical function, longer pain duration, and positive rating of the trainer were all positively associated with adherence to APA; whereas poor self-rated health and further distance from the gym were inversely associated. Given that adherence to APA is the key predictor of improved back pain, future efforts should focus on strategies to improve adherence. Our data suggest that enhanced training of exercise trainers, development of separate classes for people with different functional levels, and use of psychosocial interventions to reduce health pessimism and depression may be potential targets for improving adherence.

Long-term Group Exercise for People With Parkinson's Disease

Aerobic and strengthening exercises have been shown to benefit people with Parkinson's disease (PD) on the basis of highly structured, short-term, clinical protocols. This study extended previous research by investigating feasibility of an ongoing, community-based, group exercise program for people with PD on the basis of short-term (10 weeks) and long-term (14 months) data. Twenty people with PD (Hoehn and Yahr stages I to III) participated in at least one of four 10-week sessions. Classes were held twice weekly for 1 hour and included strength, flexibility, and balance and walking exercises. Evaluations were done 1.5 hours after medication intake 1 week before and 1 week after each session. Gait speed, 6-Minute Walk test (6MWT), "Timed Up and Go" test, and grip strength were used to assess physical function. Analysis of short-term results were based on 18 participants (2 dropped out prior to posttest), and long-term results were based on 8 participants who started in the first session continued through the 14-month period. Attendance rates were moderate to high (73% overall). No injuries were reported. Wilcoxon signed ranks tests based on each participant's first 10-week session demonstrated significant improvements in 6MWT, and grip strength. Long-term participants showed significant improvements in grip strength, and a trend toward improved 6MWT. Gait speed and Timed Up and Go test did not change significantly in the short or long terms. Our community-based group exercise program was safe, feasible, and appears to be effective. While some measures showed no improvement, there was no evidence of decline. This is an important outcome for persons with progressive neurological disorders, and suggests community-based group exercise is a promising option for people with PD.

地域在住高齢者が運営する運動グループへの参加が自覚的身体機能に及ぼす効果の検証

The objective of this study was to evaluate the effect of a community-based group exercise program on physical functioning among elderly people. This prospective observational study enrolled 494 persons aged 70-84 years who volunteered for the study and completed a baseline measurement in 2006 and were re-evaluated 1 year later in 2007. The exercise regimen consisted of resistance training and recreational exercise for 1.5 hours conducted twice a month. Physical functioning was evaluated by a self-administered questionnaire consisting of the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and Motor Fitness Scale (MFS). Decline in physical functioning was defined as a reduction in either TMIG-IC or MFS scores of more than 2 points deviation from the median change of each score. TMIG-IC and MFS results were obtained from 494 and 392 eligible subjects, respectively. After 1 year, 68 subjects (TMIG-IC) and 88 subjects (MFS) reported a decline in physical functioning. After adjustment for confounding factors, the odds ratio of reduced physical functioning, as assessed by the TMIG-IC among the subjects who did not participate in the exercise group and those who did, were 1.00 (control) and 0.15 (95% confidence interval, 0.01-0.75). Similar results were obtained when assessed on the MFS. These results suggest that participation in a community-based exercise group of elderly people was effective in maintaining self-reported physical function.

The Effects of a Community-Based Exercise Program on Function and Health in Older Adults: The EnhanceFitness Program

This study examined the effectiveness of participation in EnhanceFitness (EF) (formerly the Lifetime Fitness Program), an established community-based group exercise program for older adults. EF incorporated performance and health status measure testing in year 2000. Initial performance was compared to age and gender-based norms to classify participants as within or at or above normal limits (WNL) or below (BNL). In 2,889 participants who participated in outcomes testing, improvements were observed at 4 and 8 months on performance tests for both subgroups. Participants’ self-rating of health improved at 8 months. All participants improved on performance tests. Implementation of performance-based measures in community studies is possible. Challenges included selecting measures, staff training, collecting performance measures, and deciding on time points for data collection. Older adults can maintain and/or improve physical function through participation in EnhanceFitness.

A Community-Based Upper-Extremity Group Exercise Program Improves Motor Function and Performance of Functional Activities in Chronic Stroke: A Randomized Controlled Trial

Pang MY, Harris JE, Eng JJ. A community-based upper-extremity group exercise program improves motor function and performance of functional activities in chronic stroke: a randomized controlled trial. Objective To assess the effects of a community-based exercise program on motor recovery and functional abilities of the paretic upper extremity in persons with chronic stroke. Design Randomized controlled trial. Setting Rehabilitation research laboratory and a community hall. Participants A sample of 63 people (≥50y) with chronic deficits resulting from stroke (onset ≥1y). Interventions The arm group underwent an exercise program designed to improve upper-extremity function (1h/session, 3 sessions/wk for 19wk). The leg group underwent a lower-extremity exercise program. Main Outcome Measures The Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (FMA), hand-held dynamometry (grip strength), and the Motor Activity Log. Results Multivariate analysis showed a significant group by time interaction (Wilks λ=.726, P=.017), indicating that overall, the arm group had significantly more improvement than the leg group. Post hoc analysis demonstrated that gains in WMFT (functional ability) ( P=.001) and FMA ( P=.001) scores were significantly higher in the arm group. The amount of improvement was comparable to other novel treatment approaches such as constraint-induced movement therapy or robot-aided exercise training previously reported in chronic stroke. Participants with moderate arm impairment benefited more from the program. Conclusions The pilot study showed that a community-based exercise program can improve upper-extremity function in persons with chronic stroke. This outcome justifies a larger clinical trial to further assess efficacy and cost effectiveness.

A Community‐Based Fitness and Mobility Exercise Program for Older Adults with Chronic Stroke: A Randomized, Controlled Trial

To examine the effects of a community-based group exercise program for older individuals with chronic stroke. Prospective, single-blind, randomized, controlled intervention trial. Intervention was community-based. Data collection was performed in a research laboratory located in a rehabilitation hospital. Sixty-three older individuals (aged > or = 50) with chronic stroke (poststroke duration > or = 1 year) who were living in the community. Participants were randomized into intervention group (n=32) or control group (n=31). The intervention group underwent a fitness and mobility exercise (FAME) program designed to improve cardiorespiratory fitness, mobility, leg muscle strength, balance, and hip bone mineral density (BMD) (1-hour sessions, three sessions/week, for 19 weeks). The control group underwent a seated upper extremity program. Cardiorespiratory fitness (maximal oxygen consumption), mobility (6-minute walk test), leg muscle strength (isometric knee extension), balance (Berg Balance Scale), activity and participation (Physical Activity Scale for Individuals with Physical Disabilities), and femoral neck BMD (using dual-energy x-ray absorptiometry). The intervention group had significantly more gains in cardiorespiratory fitness, mobility, and paretic leg muscle strength than controls. Femoral neck BMD of the paretic leg was maintained in the intervention group, whereas a significant decline of the same occurred in controls. There was no significant time-by-group interaction for balance, activity and participation, nonparetic leg muscle strength, or nonparetic femoral neck BMD. The FAME program is feasible and beneficial for improving some of the secondary complications resulting from physical inactivity in older adults living with stroke. It may serve as a good model of a community-based fitness program for preventing secondary diseases in older adults living with chronic conditions.