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Osteoporosis International

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Open Access 01-03-2016 | Original Article

An exploration of barriers and facilitators to older adults’ participation in higher impact physical activity and bone health: a qualitative study

Authors: B. A. J. Simmonds, K. J. Hannam, K. R. Fox, J. H. Tobias

Published in: Osteoporosis International | Issue 3/2016

Abstract

Summary

This qualitative study explored the acceptability of high-impact physical activity for increasing bone strength in later life. Thematic analysis established the barriers and facilitators to this physical activity. They prioritised joint over skeletal health, of which they had little concept. Interventions need to clearly communicate the rationale and benefits.

Introduction

The aim of this study was to explore the acceptability of doing high-impact physical activity in later life.

Methods

This qualitative study was embedded within a large-scale observational study and was designed to address specific objectives and feed into a subsequent intervention. Five focus groups with physically active men and women (over 50 years) were used to develop an interview topic guide to explore the acceptability of high-impact physical activity in older men and women (over 65 years) in South West England. A total of 28 semi-structured interviews with 31 participants were then conducted and transcripts analysed thematically.

Results

Three main barriers emerged: conceptualising bone, damage to joints and falling/safety concerns. Two main facilitators were also identified: the need to understand clear tangible benefits and incorporation of activity into everyday habits. Older adults were interested how high-impact physical activity would help to maintain their mobility, independence or social relationships. Some participants wanted tangible feedback from accelerometers, health care professionals and/or bone scans in order to develop a more intimate knowledge of their bone health.

Conclusions

Interventions incorporating high-impact physical activity for older adults need to communicate how this activity can impact more broadly on health and lives; that physical activity will be safe, beneficial and not damaging to their joints will need to be clearly conveyed. Ways in which high-impact physical activity can be habitualised into everyday activities, be fun and interactive may help facilitate longer term adoption.

Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 34:691–697CrossRef

Panula J, Pihlajamaki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P, Kivela S-L (2011) Mortality and cause of death in hip fracture patients aged 65 or older—a population based study. BMC Musculoskelet Disord 12:105CrossRefPubMedPubMedCentral

Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL, Jones MP, Rodenthal GE, Wolinsky FD (2009) The aftermath of hip fracture: discharge placement, functional status change and mortality. Am J Epidemiol 170(10):1290–1299CrossRefPubMedPubMedCentral

Gutierrez L, Roskell N, Castellsague J, Beard S, Rycroft C, Abeysinghe S, Shannon P, Robbins S, Gitlin M (2011) Study of the incremental cost and clinical burden of hip fractures in postmenopausal women in the United Kingdom. J Med Econ 14(1):99–107CrossRefPubMed

Holroyd C, Cooper C, Dennison E (2008) Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab 22(5):671–685CrossRefPubMed

Simmonds BAJ (2011) Experiences of physical activity in later life: making sense of embodiment, negotiating practicalities, and the construction of identities in rural spaces. Thesis. University of Southampton

Simmonds BAJ, Fox KR, Davis M, Gray S, Hillsdon M, Po-Wen K, Sharpe D, Stathi A, Thompson JT, Coulson JC, Trayers T (2014) Objectively assessed physical activity and function and subsequent health service use of UK adults aged 70 and over: a four-year follow up study. PLoS One. doi:10.1371/journal.pone.0097676

Department of Health and Human Services (2008) Physical activity guidelines for Americans. Department of Health and Human Services, Washington

Department of Health (2011) Start active, stay active: a report on physical activity for health from the four home countries’ chief medical officers. Department of Health, London

10.

Kohrt WM, Bloomfield SA, Little KD, Nelson ME, Yingling VR (2004) Physical activity and bone health. Med Sci Sports. doi:10.1249/01.MSS.0000142662.21767.58

11.

Allison SJ, Folland JP, Winston JR, Summers GD, Brooke-Wavell K (2013) High impact exercise increased femoral neck bone mineral density in older men: a randomised unilateral intervention. Bone 53:321–328CrossRefPubMed

12.

Bailey CA, Brooke-Wavell K (2010) Optimum frequency of exercise for bone health: randomised controlled trial of high-impact unilateral intervention. Bone 46:1043–1049CrossRefPubMed

13.

Bremben DA, Bemben MG (2011) Dose-response effect of 40 weeks of resistance training on bone mineral density in older adults. Osteoporos Int 22:179–186CrossRef

14.

Hamilton CJ, Swan VJD, Jamal SA (2010) The effects of exercise and physical activity participation on bone mass and geometry in postmenopausal women: a systematic review of pQCT studies. Osteoporos Int 21:11–23CrossRefPubMed

15.

James MM, Carroll S (2009) A meta-analysis of impact exercise on postmenopausal bone loss: the case for mixed loading exercise programmes. Br J Sports Med 43:898–908CrossRef

16.

James MM, Carroll S (2010) Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis. J Bone Miner Metab 28:251–267CrossRef

17.

Marques EA, Wanderley F, Machado L, Sousa F, Viana JL, Moreira-Goncalves D, Moreira P, Mota J, Carvalho J (2011) Effects of resistance and aerobic exercise on physical function, bone mineral density, OPG and RANKL in older women. Exp Gerontol 46:524–532CrossRefPubMed

18.

Zhao R, Zhao M, Zhang L (2014) Efficiency of jumping exercise in improving bone mineral density among premenopausal women: a meta-analysis. Sports Med 44:1393–1402CrossRefPubMed

19.

Lamothe JM, Zernicke RF (2004) Rest insertion combined with high-frequency loading enhances osteogenesis. J Appl Physol 96:1788–1793

20.

Srinivasan S, Weimer DA, Agans SC, Bain SD, Gross TS (2002) Low-magnitude loading becomes oestrogenic when rest is inserted between each load cycle. J Bone Miner Res 17(9):1613–1619CrossRefPubMedPubMedCentral

21.

Sanders C, Donovan J, Dieppe P (2002) The significance and consequences of having painful and disabled joints in older age: co-existing accounts of normal and disrupted biographies. Sociol Health Illn 24(2):227–253CrossRef

22.

Gignac MAM, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin PR, Badley EM (2006) “What do you expect? You’re just getting older”: a comparison of perceived osteoarthritis-related and aging-related health experiences in middle- and older-age adults. Arthritis Rheum 55(6):905–912CrossRefPubMed

23.

Sale JEM, Gignac MA, Frankel L, Hawker G, Beaton D, Elliot-Gibson V, Bogoch E (2012) Patients reject the concept of fragility fracture—a new understanding based on fracture patients’ communication. Osteoporos Int 23:2829–2834CrossRefPubMed

24.

Dalsgaard RS (2007) Perceived risk and osteoporosis: restricted physical activities? Scand J Prim Health 25:160–165CrossRef

25.

Hughes K, van Beurden E, Eakin EG, Barnett LM, Patterson E, Backhouse J, Jones S, Hauser D, Beard JR, Newman B (2008) Older persons’ perception of risk and falling: implications for fall-prevention campaigns. Am J Public Health 98(2):351–357CrossRefPubMedPubMedCentral

26.

Ballinger C, Payne C (2002) The construction of the risk of falling among and by older people. Ageing Soc 22(3):305–324CrossRef

27.

Seidman I (2013) Interviewing as qualitative research: a guide for researchers in education. Teachers College Press, New York

28.

Silverman RM, Patterson KL (2015) Qualitative research methods for community development. Routledge, Abingdon

29.

Attride-Stirling J (2001) Thematic networks: an analytic tool for qualitative research. Qual Res 1:385–405CrossRef

30.

Patton MQ (1999) Enhancing the quality and credibility of qualitative analysis. BMC Health Serv Res 34(5):1189–1208

31.

Blaikie N (2000) Designing social research. Polity Press, Cambridge

32.

Hurd CL, Lui-Ambrose T, Zyla J-A, McKay H, Khan K (2008) Being able to do the thing that I want to do. Act Adapt Aging 29(4):41–59

33.

Bury MR (1982) Chronic illness as biographical disruption. Sociol Health Illn 4(2):167–82CrossRefPubMed

34.

Giangregorio L, Dolovich L, Cranney A, Adili A, de Beer J, Papaioannou A, Thabane L, Adachi JD (2009) Osteoporosis risk perceptions among patients who have sustained a fragility fracture. Patient Educ Couns 74:213–220CrossRefPubMed

35.

Sale JEM, Beaton DE, Bogoch ER, Elliot-Gibson V, Frankel L (2010) The BMD muddle: the disconnect between bone densitometry results and perception of bone health. J Clin Densitom 13(4):370–378CrossRefPubMed

36.

Siris ES, Gehlbach S, Adachi JD, Boonen S, Chapurlat RD, Compston JE, Cooper C, Delmas P, Diez-Perez A, Hooven FH, LaCroix AZ, Netelenbos JC, Pfeilschifter J, Rossini M, Roux C, Saag KG, Sambrook P, Silverman S, Watts NB, Wyman A, Greenspan SL (2001) Failure to perceive the increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporos Int 22:27–35CrossRef

37.

Allison SJ, Poole KES, Treece GM, Gee AH, Tonkin C, Rennie WJ, Folland JP, Summers GD, Brooke-Wavell K (2015) The influence of high impact exercise on cortical and trabecular bone mineral content and 3D distribution across the proximal femur in older men: a randomised controlled unilateral intervention. J Bone Miner Res. doi:10.1002/jbmr.2499 PubMed

38.

Stathi A, Fox KR, McKenna J (2002) Physical activity and dimensions of subjective well-being in older adults. J Aging Phys Act 10:76–92CrossRef

Title: An exploration of barriers and facilitators to older adults’ participation in higher impact physical activity and bone health: a qualitative study
Authors: B. A. J. Simmonds
K. J. Hannam
K. R. Fox
J. H. Tobias
Publication date: 01-03-2016
Publisher: Springer London
Published in: Osteoporosis International / Issue 3/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-015-3376-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

An exploration of barriers and facilitators to older adults’ participation in higher impact physical activity and bone health: a qualitative study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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