Factors influencing commencement and adherence to a home-based balance exercise program for reducing risk of falls: perceptions of people with Alzheimer's disease and their caregivers

Int Psychogeriatr. 2012 Jul;24(7):1172-82. doi: 10.1017/S1041610211002729. Epub 2012 Jan 23.

Abstract

Background: Balance exercise is an important component of falls-prevention interventions, with growing evidence that it can be beneficial for people with Alzheimer's disease (AD). However, to implement a balance exercise program successfully for people with AD it is important to consider factors that can affect commencement and adherence to the program. This qualitative study explored these factors.

Methods: Ten participants with AD, who had completed a six-month home-based balance exercise program, and their caregivers (n = 9) participated. A phenomenological theoretical framework with semi-structured interviews was used for data collection and analysis.

Results: Factors influencing the decision to commence the program were: possible benefits of the program, recommendations from health professionals, value of research, positive attitude towards exercise, and minimizing caregivers' burden. Factors influencing adherence to the program were grouped under 11 themes: six themes facilitated completion (program characteristics, physiotherapist, exercise recording sheet, caregivers' support, sense of commitment, and perceived benefit) and five themes were barriers (pre-existing conditions, dislike of structured exercise, absence from home, caregiver's health or commitment, and bad weather).

Conclusions: A home-based exercise program with regular support from a physiotherapist and caregiver are key elements facilitating continuing program adherence in people with AD.

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / psychology*
  • Attitude to Health
  • Caregivers / psychology*
  • Exercise Therapy* / statistics & numerical data
  • Female
  • Home Care Services
  • Humans
  • Interviews as Topic
  • Male
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Physical Therapists / psychology
  • Postural Balance*