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Exercise Adherence Following Physical Therapy Intervention in Older Adults With Impaired Balance

R Forkan, B Pumper, N Smyth, and H Wirkkala were physical therapist students in the Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, Wash
MA Ciol, PhD, is Research Assistant Professor, Department of Rehabilitation Medicine, University of Washington
A Shumway-Cook, PT, PhD, is Associate Professor, Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington.

(ashumway{at}u.washington.edu) Address all correspondence to Dr Shumway-Cook at Department of Rehabilitation Medicine, University of Washington, 1959 NE Pacific St, Box 356490, Seattle, WA 98195-6490 (USA)

Background and Purpose. This study looked at adherence, and factors affecting adherence, to a prescribed home exercise program (HEP) in older adults with impaired balance following discharge from physical therapy.

Subjects. The subjects were 556 older adults (65 years of age) who were discharged from physical therapy during the period 2000 to 2003.

Methods. A survey was developed to determine participation in a HEP. Univariate logistic regressions identified specific barriers and motivators that were associated with exercise participation following discharge from physical therapy.

Results. Ninety percent of respondents reported receiving a HEP; 37% no longer performed it. Change in health status was the primary reason for poor adherence to a HEP. Eight barriers (no interest, poor health, weather, depression, weakness, fear of falling, shortness of breath, and low outcomes expectation) were associated with a lack of postdischarge participation in exercise.

Discussion and Conclusions. Exercise adherence following discharge from a physical therapy program is poor among older adults. Barriers, not motivators, appear to predict adherence. [Forkan R, Pumper B, Smyth N, et al. Exercise adherence following physical therapy intervention in older adults with impaired balance. Phys Ther. 2006;86:401–410.]

Key Words: Aging • Barriers • Exercise

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