Motivating Older Adults to Participate in Physical Activity
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Jenna Mammenga, SPT, Deandra Woebke, SPT, Kyler Bergeson, SPT, Drew Keuck, SPT
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Jenna Mammenga, SPT, Deandra Woebke, SPT, Kyler Bergeson, SPT, Drew Keuck, SPT
USD PT Research 
What suggestions do you have for therapists to facilitate social accountability in relation to exercise outside of rehab?
Have the authors suggested if there is a difference in accountability based on specific activities i.e. competition team activities vs general group exercise? Thanks!
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Those are great questions! One of the ways I think that we, as therapists, can facilitate accountability outside of rehab is recommending group fitness classes or support groups. When individuals work with the same individuals over time, they are more likely to hold each other accountable. As therapists, we can look into our patient’s interests and desires and create / find like minded groups for our patients to work with. We did not look into the difference of specific activities, but that would be a good additional study. Thanks!
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What an interesting topic to research! I feel as if the general population does not typically think about individuals 65+ needing to exercise, but your introduction shows the importance of exercise even as an aging individual.
Growing up in a rural area, do you have any suggestions for motivating the more ‘stubborn’ older population from rural areas? ie. farmers? (not to be stereotypical, just relating to clinical experience and individuals from my hometown)
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Great Job, I enjoyed reading the poster!
1) The majority of the research was focused on “motivating” the older adult to exercise. Did any of the motivational strategies utilize explaining the health benefits of physical activity compared to the risks of a sedentary lifestyle?
2) What advice would you give a therapist on educating/motivating an older adult who does not have access to a gym or group exercise classes? (e.g. small rural community)
Thanks!
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Hey JP, those are great questions! In regards to your first question, I know that education about the benefits of living an active lifestyle were discussed with the patients in a few of the studies that we looked at, but that was not the main motivational strategy used. I definitely think that it would be interesting to use that a sole motivational strategy and see what the results are in future research. For the second question, the intrinsic motivation study also found that if you get them started on an exercise program they are more likely to continue with the routine. My advice to someone in a small rural community would be to get the patients started on a routine and make sure that they are completing all the exercises correctly then follow up with them at 2 or 4 weeks and see how things are going. Thanks for the questions!
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Thanks for the information! It is clear that physical activity is beneficial and has huge effects on the health of the aging population. My question to you is, how do you think clinicians can take this information and use it to advocate for developing physical activity programs in group living settings such as NH or ALF? What role do you think that PTs can have as advocates for physical activity in their community?
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Hi Justine! These are great questions. To answer your first question, we feel that clinicians can take our findings to build and promote a well structured group fitness class in a nursing home or assisted living facility. To dig further into your question, the physical therapist must develop a fitness class schedule ideal to the resident’s routine and maintain its longevity. For example, scheduling a fitness class Monday, Wednesday, and Friday each week at 2:00pm is more beneficial that picking random days and times every week. Next, promoting physical activity to older adults is imperative within these settings. Physical therapists can not only promote fitness to the residents but also the staff and family members as well. This can be through various handouts, advertisements, and/or communication. We feel the answer to your first question aligns well with your second question regardless of the setting. As for promoting physical activity in the community, a physical therapist can also promote a regular exercise routine to community members by setting up seminars at recreation/community centers. Physical therapists can challenge the community to complete the exercise program with partners or develop it into a group fitness class. Again, the class/routine must be structured. Thanks for the questions!
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Nice poster, you guys! It’s evident that PT’s play a major role in advocating and motivating older adults to live an active lifestyle. After reading your poster, I was wondering if you could further explain or give some examples of what the interpersonal motivation or social aspects specifically refer to. I’d imagine group therapy or finding others in the community to exercise with would be motivating for older adults, but I was curious to what this is specifically referencing to. I’m currently working at a clinic that implements group therapy and they thoroughly enjoy aquatic therapy, so I was interested to see if you had any articles that touched base on that too. Nice job again!
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Hey Christian, there were 5 interpersonal strategies used in the study. The first was a discussion of social support for fall reducing physical activity with important people in the participants’ lives. The second was identifying one’s self as a role model. The third strategy involved problem-solving social and environmental barriers to physical activity, which seems to me like an effective way to counter excuses people may have as to why they cannot/do not exercise. The fourth strategy is to work with participants to integrate physical activity into their social routines and help identify community resources. The last strategy was using friendly, non-competitive social comparisons of physical activity using activity tracking monitors. The last strategy is very similar to the premise used by companies like Fitbit or Garmin with their step challenges. Thanks for the question! Hopefully there is something in these strategies that can be of some use to you!
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Your poster was very helpful in understanding ways older adults can be motivated to exercise, good work! I have one question about how a therapist may or may not utilize external motivators as they seem to be an effective way to begin short term exercise adherence. Are there any scenarios where building an exercise routine and social accountability wouldn’t be the first choice when attempting to create a behavior change? Can external motivators be used in conjunction with the more proven long term adherence interventions?
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Hi Zachary! These are some excellent questions. Although our research did not pertain to other scenarios since our findings found the long-term benefit in only routine and social accountability, we feel that external motivators would be beneficial in the long-term especially in conjunction with a structured exercise routine with social accountability. Unfortunately, our remaining articles involving external motivators were only researched in the short term. It would be interesting to see if there are long term effects associated with external motivators. Thanks!
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Wow what an amazing poster guys, I personally think its a very important and interesting topic that does not get talked about enough. In your professional experiences what motivation technique works best in clinic?
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Good question Paul. I have seen a lot of success with routine building, home exercise programs, for patients in the clinics that I have been in. I think that explaining the routine to the patients and having them demonstrate the exercises is super important to make sure that they know what the exercises are for as well as how to properly perform them to get the benefits with less risk of injury. I also think that knowing what group therapy opportunities are available in your area and promoting them to patients would be super beneficial, however I have not been in a clinic with much access to group therapy. Thanks for the question!
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This poster was very well put together by your team! What an interesting topic, especially considering how many of us as PT students have individuals who fall into this category so close to us in our personal lives.
Based on the research you researched, were the certain types of exercise interventions utilized mentioned at all? I’m sure they kept it light, and similar to the chart you provided, but I was just wondering if they touched on the specifics. I loved the little image you provided as well!
I only ask because I know that could also alter how a person feels motivated to do something; for example if you ask me to do 100 jumping jacks I will be fine and dandy, but if you asked me to do 100 burpees, I would probably feel very unmotivated from and not even want to begin.
Great work you guys!
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Good question Alysa! I completely see your point in that different forms of exercise motivate different individuals. Each article focused on their own type of exercises. One article used walked and step counts as a form of exercise, so participants were motivated in another way to walk more. Another article used traditional strength training such as the leg press machine. Since the participants knew the type of exercise when signing up for the study, I would assume they were already willing and motivating to attempt that form of exercise.
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This was a very nice poster! I think motivating older adults is a topic that is beneficial for all future PT’s as it is a growing population. I know your group specifically focused on motivating older adults (over the age of 65), but do you believe these motivational strategies differ from ones that work with younger populations as well? Overall, very nice job!
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Thanks for the question, Maia! I feel there would likely be similarities in motivating different age groups. Building routines is probably the most broadly applicable category of motivation with the research we examined, as consistency is key with exercise. Social accountability is also likely to be successful with younger populations just based on the success of group fitness classes as well as products and services geared toward working out in a social environment (like Peloton, Fitbit, Strava, etc.). External sources of motivation, such as the financial incentives or biofeedback games from the studies we reviewed, also are likely to carry over to younger populations, but may need to be modified to better fit the age group. For example, younger populations might need biofeedback technology to be something newer than a Nintendo Wii from 2006 to captivate them.
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Nice job on the poster! It was easy to read and understand. Was anything mentioned on how the Transtheoretical Model of Behavior Change (Stages of Change Model) could be implemented for possible long term adherence to exercise?
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Hi Ashley! Thanks for the question. That is not something that any of the articles that we studied looked directly at. I would be interested to see if there are articles relating to the stages of change model in relation to motivating older adults. My assumption would be most of our participates would begin in the preparation phase or action phase since they are already intending to take action within 30 days of signing up for the study or they have recently started to change the behavior by being involved in the research study.
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Great job with your poster! This was a very interesting topic! Did your article about interpersonal/intrapersonal motivation explain why the interpersonal groups had the greatest outcome? I was slightly surprised that the intrapersonal group didn’t have the greatest result. As with most things, I’m sure that one form of motivation does not work for each patient. Based on your results, how do you suggest finding which strategy works best for our patients?
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Thanks for the question, Whitney! The authors of the article did not give their own explanation of why the interpersonal groups had greater outcomes, but did point to other research that suggests older adults seek social connections that enhance personal well-being and counter age-related declines. So if the social connections promote exercise, like with the interpersonal groups, then that improves both well-being and limits age-related declines and makes the older adults more likely to continue exercising. The authors did call for additional research to delve deeper into how this works specifically. As for finding which strategy works for each patient, the patients themselves are a good resource. Asking questions like if they have or want social support/people to keep them accountable, what their goals are, and what keeps them from exercising now will help you identify what methods the patient will most likely respond to. No one strategy is best and no one strategy works for everyone, so you may need to do some trial and error to find one that works.
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Hi everyone! I really enjoyed this poster, and I thought you did a great job explaining your findings and relating this topic with our roles as PTs. A couple of questions already touched on this, but I was curious if any of the studies elaborated on specific examples that have seemed promising for motivating older adults? For instance, were they using a specific type group exercise to influence interpersonal motivation that would appeal to older adults?
Thank you!
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Hi Andy! Thank you for the questions! In regards to your first question, most of the research that we found supported a structured routine as well as a social aspect to help motivate older adults to partake in physical activity. In the article about intrapersonal vs interpersonal motivation, all the participants were involved in the Otago exercise program. The Otago exercise program is a structured routine of strength and balance exercises that helps to reduce the fall risk present in older adults. Within the interpersonal group, there were 5 different strategies used which are discussed more in-depth above. Thank you again for the questions!
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Nice work crew! My question kind of goes hand in hand with Whitney’s question. I also find it very interesting that interpersonal motivation had a far greater outcome than intrapersonal. You guys concluded that there was no significant change for groups without interpersonal motivation. Does this mean we always have to include social aspects to see results with this group? This may be hard in a rural general setting for some older adults. For instance, if an older person lives out in the country and isn’t willing to really leave the house. What would be your guys’ approach for a patient such as this one?
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Hi Bailey! These are very good questions. To answer your first question, and we all love this answer, it depends. All patients are different, and although we found more prominent positive outcomes and more accountability within social settings, not everyone is this population may enjoy being surrounded by other individuals when completing exercise/activity. With that being said, older individuals who may not want to leave the house could enjoy an at-home exercise program tailored to what the patient is capable of doing in that setting. Also, individuals not willing to leave the home could participate through forms of video contact such as Zoom or Facetime during activity at a certain time each day with other community members to maintain accountability. This was not researched within this group, but family members could potentially be invited to face to face or virtually for once in a while to keep the older adult accountable as well. On the other hand, and it is a tough pill to swallow, there may be some individuals unwilling to participate no matter the motivation presented. Everyone is different. Overall, open communication with participants is vital to understand the best way to keep him or her motivated. I hope this helps! Thank you for the questions!
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Great job! The topic presented in this poster is so relevant to society with a constantly aging population. As PT’s, these strategies are so important to implement with the older populations, as well as younger. Knowing exercise has proven to be beneficial in older adults, has there been any research regarding whether group training is preferred by older adults over individual training? From a personal perspective, it always seemed the older patients in my summer clinical seemed to maintain their retention of exercise long term in the group training rather than by themselves. Did research support one over the other?
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Hi Dayton! Overall, the research that we found did support group training over individual training for motivating older adults. Both the intrinsic motivation and interpersonal/intrapersonal motivation articles mention how a social component of exercise can be beneficial to the older adult population. In the intrinsic motivation article, the participants completed the resistance training in groups of 8-10 to help improve accountability in exercise adherence. In the interpersonal/intrapersonal motivation article, participants in the interpersonal group increased their physical activity by around 180 minutes per week which was a significant increase when compared to those in the intrapersonal group. Thank you for the great questions!
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Well done on the poster! I think this is an incredibly important topic in community health right now. For research like this, my thoughts initially go to my own grandparents and what I might be able to do to motivate them to stay active. Do you know if there was any research regarding the relationships between the client and the exercise professional/PT? For example, would grandparents be more responsive to friends/family members encouraging them to stay active, or strangers like health professionals/athletic trainers? Would it be beneficial if their trainer was one of their grandchildren? Or an exercise professional they just met?
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Thanks for the question, Jessica. Our research did not directly address relationships between the client and physical therapist. I would be interested to know if there is research on that topic. From listening to experiences from other PTs on this topic, I believe treating a family member can be hard. It may be difficulty to develop a professional relationship with an individual you have a familial relation to in regard to structure around an exercise plan. I have seen it done before, but I would personally rather refer my family member to a trusted PT I know that specializes in their ailment. I hope that answers your question! Let me know if you find any articles relating directly to your question.
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