Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: Quasi-experimental comparison

Nicole Freene, Gordon Waddington, Wendy Chesworth, Rachel Davey, Tom Cochrane

ABSTRACT

Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a prag-matic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activ-ity program (n = 65). The primary outcome was physical activity adherence derived from exer-cise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p < 0.05). Thirty-three percent of the group partici-pants attended ≥70% of group exercise ses-sions. Ninety percent of home-based partici-pants received ≥4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of partici-pants achieving self-reported “sufficient” physical activity (p ≤0.001) and significantly decreased waist circumference (p < 0.001) and WHR (p < 0.05). Conclusion: The physiotherapist- led home-based physical activity program, re-quiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program.

Clinical Trial Registration number Australian New Zealand. Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.

Keywords: Physiotherapy; Home-Based; Physical Activity; Adoption; Adherence; Middle-Aged

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