Health promotion among elderly - experiences from senior exercise groups

Health Promotion Research – An International Forum

6th - 9th August 2012

Randi Granbo, 9. 8.2012 St. Olavs University Hospita Randi.granbo@stolav.nol

Definitions Physical activity (PA) – any bodily movements prodused by sceletal muscles that increases energy expenditure. (Pate m.fl 1995) Exercise - a subcategory of PA that is – planned, structured and repetitive and purposive in the sence that the improvement or maintenance of one or more components of physical fitness is the objective. (Caspersen m.fl. 2005)

Physical activity-level in Norway

Physical Activity among Adults and Elders in Norway (2008-2009) Norwegian Directorate of Health

0

50

100

150

200

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350

Physical Activity-level counts/min

20-64 65-69 70-74 75-79 > 80

Male Female

Assosiation between Physical Activity and Health

An active lifestile helps to increase quality of life of older adults by preserving functional ability and independence across the lifespan Schutzer et al (2004)

Participation and maintainance of regular physical activity is one of the most important health behaviors in preventing the onset or reducing the severity of many chronic diseases US. Department of Health and Human Services. Physical activity and health, 1996

Unique challenges are assosiated with initiating and maintaining physical activity in

the elderly

Schutzer et al., 2004

A model for translating research based knowledge into practice

Helbostad, Granbo, Vaskinn, 2005

Project: Preventing dysfunction and falls among older people (2005-2006).

Aim: To develop locally driven exercise groups for seniors in the municipality. The target group: People > 65 years (with gait instability, difficulties with outdoors mobility or who had experienced a fall the last year).

- A collaborative project between research and practice

Results from the pilot – project (2006)

Participants´ characteristics: •average age: 78.2 years

•80 % females •38 % had suffered a fall within the past year before entering the exercise group. •90 % reported good health •84 % reported fear of falling.

No improvements in SF-36, or Senior Fitness Test, but a reduction in fear of falling Taraldsen et al 2010

Status Summer 2012 - 6 year follow –up

- 12 exercise groups - 150 – 170 senior participants - 7 instructors

Evaluation of the exercise groups

for seniors in Trondheim

Questionnaire (135 respondants) Focus groups (3) (17 senior informants) Focus group (1) (5 instructors)

Who are they? 135 respondants: 120 (89 %) females og 15 (11 %) males and the average age was 77, 8 år

Age Total

< 70 70 - 79 80 - 89 => 90 missing Gender Male 1 2 12 0 15

(11 %)

Female 18 47 52 1 2 120 (89 %)

Total 19 49 64 1 2 135

Only 17 (12,6 %) of the seniors received any form of health services - safety alarm (12)

- personal or practical support (5)

How do they transport themselves to the exercise group ?

104 (77 %) take part in an exercice group near by their homes. 81 % of them report that they usually walk to the group. 16 (15 %) of the seniors live near by and transport themselves by car or go by car together with one of the other seniors in the group

0

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40

60

80

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120

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160

Exellent Verygood

Good Fairlygood

Poorly Missing Total

Seniors NSeniors %

How they perceive their own state of health

Falls and fear of falling

30 % reported 1 or more falls during the last year (34 % of the seniors > 80 years)

%

not at all concerned

a little concerned

rather conserned

very concerned

missing

17 %

59 %

15 %

6 % 3 %

Durability of participation in exercise group

Almost 90 % of the these seniors have been exercising in the same group for more than 1 and 50 % for more than 3 years.

0

20

40

60

80

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120

140

< 1 year 1 - 3 years 3 - 5 years > 5 years missing total

n

%

Motivation for partaking in an exercise group

Knowing someone already participating in an exercise group I had a friend who participated in this group – and I noticed the advertisement in the newspaper, it was the invitation from my friend …. (female 83)

Support from family and friends In the beginning I was ashamed not to manage the exercises, but then I thought …this is a social setting and perhaps I can try it out a few times …and you (NN) encouraged me – of course you can, you said – it is so easy…. (female 80)

Identifying with the advertisement in the newspaper / poster

The advertisement spoke to me – do you worry about the winter – that was me! (female 78)

Motivation for weekly exercising

Physical health and managing activities of daily living

Mental health

Social well-being

Physical health/activity of daily living

and physical functioning

Getting older is a motivation in itself – as exercising can help us manage on our own longer …and for the balance and the strength in our legs. (female 88) First of all it´s a nice thing to meet, and I struggle with my balance. I can´t say it has improved that much, but perhaps this helps in not making it any worse. (female 83) The thing is, I feel much better. I can do so many more things, and my breathing has improved – something I experience walking up and down the stairs… I also appreciate the company it brings with it, and it is a really nice setting. (female 80)

Mental health

…before I used to trip all the time, and I suppose that had do with my balance. Now I´m happier, and it´s made me become more active. (female 83) Meeting the group and exercising together makes you really happy. Participation in this group saves my day. Our mood improves and we shape up at the same time. (female 84) It also enlightens your mood. … Now the group has grown by three men, and that certainly adds a little something to the meetings (female 83).

Social well-being

We started out just exercising together, then we all got to know each other better, so the social bit of the session improved after some time female 83

… in addition participating in an exercise group lead to new acquaintances and in this way the group also have a social value…. male 67

Barriers for exercising?

They tackle different weather conditions by carrying walking sticks and put special covers on their shoes in the winter time.

The seniors explain how there ought to be big barriers for them NOT TO PARTAKE in the exercise sessions.

Exercising in a group – a reminder of the importance of PA?

I could have done all of this (exercise program) at home, but I

end up never doing it … This exercise session (weekly) is a reminder of the possibility to activate oneself half an hour beyond this … male 87

Important Messages to Health Professionals

Recruit seniors to exercise groups o Improve the information about health benifits o make sure to let people know of possibilities in the municipality, and highlight the quality of the existing exercise groups Provide support in the beginning o by the organizers of the exercise groups o within the exercise group o by the instructors Organizers have to make improvements in their advertising

An Important Strategy is to Inform Seniors about the Health Benefits of Physical Activity and Exercising

AND

to offer activities for seniors in the local communities!

Thank you for the attention!