We all know exercise is good for us, but following through on a new routine can be tough. For older adults, sticking with a foot-strengthening program meant navigating four distinct phases, according to a small, in-depth study. Researchers interviewed 12 people aged 69 to 91 who were part of a larger trial. They described the journey from 'Getting started' and 'Hanging in' to 'Settled into the rhythm' and, finally, 'Perceiving health benefits is the ultimate.' Not everyone reached that final stage where exercise felt like a habit. What helped them along the way? Clear instructions from a trainer, helpful materials, and having some flexibility in when and how they did the exercises. The study didn't track whether anyone got hurt or stopped the program, and it's important to remember this was a small group sharing their personal experiences. These findings don't prove the exercises made anyone stronger or prevented falls—they simply map out the mental and practical journey of sticking with a plan. For physical therapists or trainers, this timeline offers a useful way to understand where someone might be struggling and how to support them better.
Qualitative study identifies themes influencing adherence to foot strengthening in older adultsWhat helps older adults stick with foot-strengthening exercises?
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Key Takeaway
Consider qualitative themes on adherence phases when designing supervised exercise programs for 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.
What this means for you:
For older adults, sticking with foot exercises is a journey through four phases, helped by clear instructions and flexibility. More on Postoperative Pain
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View Original Abstract ↓
INTRODUCTION: Falls among older adults are an increasing concern. Foot exercise programs may reduce fall risk, but adherence is low to moderate. This study aimed to acquire an in-depth insight into how adherence to a foot strengthening program is influenced.
METHODS: Twelve older adults (7 women, 5 men, aged 69-91 years) assigned to a 12-week supervised foot strengthening program, as part of a randomized controlled trial, were interviewed to explore their perspectives on and experiences with the program. Reflexive thematic analysis was used with an experiential and inductive orientation to collect and approach the data. The semi-structured interviews were guided by open-ended questions based on behavior change theory. Coding was done iteratively and driven by the data. Themes were developed as the analytic output.
RESULTS: The final themes were: "Getting started," "Hanging in," "Settled into the rhythm" and "Perceiving health benefits is the ultimate." These central themes were additional to the positive evaluation of intervention features: clear instructions from the trainer, supportive materials, and flexibility in timing and content of the training program.
CONCLUSION: Adherence to a foot strengthening program is influenced by factors that change over the course of the intervention. These factors are linked to typical phases encountered consecutively by the participants. The last phase involves the exercises becoming habitual practice, which is, like the second-to-last phase, not reached by every participant. This timeline and the influencing factors offer professionals a tool to approach individuals appropriately to maximize adherence to a foot strengthening program. It also guides the development of similar interventions.
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