New Canadian studies on FP exercise programs ask: Is it a Macho Thing? Does it save money? Can frail adults Move Stronger?
Posted July 8, 2022
Three studies have been recently been published from Canadian researchers and health practitioners on fall prevention exercise programs. They pose interesting questions, and show that such programs need to reflect issues for older adults to participate – gender, cost, motivation, capacity and accessibility – beyond Canadian guidelines for movement.
The first one by Saskatchewan researchers “Is it a macho thing? Older adults' perceptions of gender differences in fall prevention class participation.” examines motivating factors and experiences after 12 weeks of fall prevention exercises and education.
- 18 men and 16 women aged 60 years or older participated in focus groups where main themes emerged:
- It might be a macho thing represented an overarching theme of why men might not participate in fall prevention as readily as women.
- Both genders realized the benefits of the program; however, men emphasized the importance of personal outcomes (Being part of something bigger), whereas women highlighted group outcomes (Socialization).
The second one from the Vancouver BC Fall Prevention Clinic is more focused on money and gender, "Comparing the cost-effectiveness of the Otago Exercise Programme among older women and men". Participants: 344 community dwelling older adults over 70 participated in the study with half (172) assigned to Otago Exercise Programme (OEP) and the other half to usual care. The OEP is a 12-month balance and strength retraining program, with PTs visiting homes and prescribed exercises. What is interesting about this study is that OEP program was cost-saving for men but not women. Men were frailer than women at the baseline, and the average healthcare costs for men were higher than women
Encouraging older adults with pre-frailty and frailty to “MoveStrong” through teaching about balance and functional strength training and protein intake to prevent falls and improve mobility. A group of researchers from 6 universities in Ontario and BC published an interesting study in PHAC’s HPCDP Journal on an 8 week pilot RCT to evaluate MoveStrong. They found it may improve grip strength, sit-to-stand functioning and dynamic balance. The program could also improve health-related quality of life and gait speed.
Compare this MoveStrong program to the Stretch, Lift or Tap (SLoT) movement program developed by the Regional Geriatric Program of Toronto (RGP) for older adults with frailty living in the community. It’s described in by Wendy Zeh in the Loop Discussion post on June 23rd on A new movement program for community-dwelling older adults with frailty.
Citations:
Arnold C, Lanovaz J, Banman D. Is it a macho thing? Older adults' perceptions of gender differences in fall prevention class participation. J Appl Gerontol. 2022 May 11:7334648221095623. doi: 10.1177/07334648221095623. PMID: 35543184.
Davis JC, Hsu CL, Barha C, Jehu DA, Chan P, Ghag C, Jacova P, Adjetey C, Dian L, Parmar N, Madden K, Liu-Ambrose T. Comparing the cost-effectiveness of the Otago Exercise Programme among older women and men: A secondary analysis of a randomized controlled trial. PLoS One. 2022 Apr 20;17(4):e0267247. doi: 10.1371/journal.pone.0267247. PMID: 35442974; Full text: PMC9020705.
Rodrigues IB, Wagler JB, Keller H, Thabane L, Weston ZJ, et al. Encouraging older adults with pre-frailty and frailty to “MoveStrong”: an analysis of secondary outcomes for a pilot randomized controlled trial. Health Promot Chronic Dis Prev Can. 2022;42(6):238-251. https://doi.org/10.24095/hpcdp.42.6.02
· The Canadian 24-Hour Movement Guidelines for adults aged 65 years and older recommend muscle-strengthening and balance-challenging activities at least twice a week. But 88% of Canadian adults 65 years and older are not meeting these exercise guidelines, and 50% older adults may have inadequate nutrition and low protein intake contributing to frailty (see Rodrigues et al MoveStrong study).
· Are these exercise programs and movement guidelines meeting the needs and conditions of older adults? Is it time for a rethink?
· What are some of the challenges in similar exercise interventions?