Qualitative study identifies themes influencing adherence to foot strengthening in older adults
This qualitative study, embedded within a randomized controlled trial, explored factors influencing adherence to a 12-week supervised foot strengthening program. The analysis included 12 older adults (7 women, 5 men) aged 69-91 years who were assigned to the intervention arm. The study did not report a comparator group, and the specific setting was not detailed.
The main results identified four final themes that influenced adherence in a sequential manner: 'Getting started,' 'Hanging in,' 'Settled into the rhythm,' and 'Perceiving health benefits is the ultimate.' Positive features of the intervention that supported adherence included clear instructions from the trainer, supportive materials, and flexibility in the timing and content of the training program. The analysis noted that adherence was influenced by factors that changed over the course of the intervention, and the final phase where exercises become habitual practice was not reached by every participant. No quantitative adherence rates or clinical outcomes (e.g., fall reduction, strength improvement) were reported.
Safety and tolerability data, including adverse events and discontinuations, were not reported. Key limitations stem from the study's qualitative and exploratory nature; it is based on thematic analysis of interviews with only 12 participants from a single RCT. The findings do not establish causality or measure clinical efficacy. For practice, the identified timeline and influencing factors may offer professionals a conceptual tool to approach individuals appropriately to support adherence in similar exercise programs, but this requires validation in larger, quantitative studies.
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