"We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD

Laura Desveaux; Samantha Harrison; Annemarie Lee; Sunita Mathur; Roger Goldstein; Dina Brooks

doi:10.1016/j.hrtlng.2017.04.008

"We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD

Heart Lung. 2017 Jul-Aug;46(4):308-312. doi: 10.1016/j.hrtlng.2017.04.008. Epub 2017 May 17.

Authors

Laura Desveaux¹, Samantha Harrison², Annemarie Lee², Sunita Mathur³, Roger Goldstein⁴, Dina Brooks⁵

Affiliations

¹ Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada.
² Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada.
³ Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada.
⁴ Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada.
⁵ Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada. Electronic address: dina.brooks@utoronto.ca.

PMID: 28527832
DOI: 10.1016/j.hrtlng.2017.04.008

Abstract

Background: Despite well-established improvements following rehabilitation, functional gains often diminish following discharge.

Objective: To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance.

Methods: Semi-structured interviews were conducted with 11 individuals with HF or COPD.

Results: Deductive thematic analysis uncovered three themes: 1) transitioning to community exercise is challenging, highlighting participants' struggle with unstructured maintenance and a lack of appropriate programs; 2) a structured, group-based program tailored to functional ability facilitates adherence, describing participants views on the importance of routine, and accountability; and 3) "We are all there for the same purpose" - participant support for integrated exercise, including the benefit of multiple perspectives and sustainability.

Conclusions: A motivating program leader and access to appropriate facilities are key features to support adherence to prescribed activity. Tailored programs can be delivered consecutively to older adults with HF and COPD.

Keywords: Barriers; COPD; Exercise; Heart failure; Program design; Qualitative; Rehabilitation.

MeSH terms

Adult
Aged
Community Health Centers*
Cross-Sectional Studies
Exercise / physiology*
Exercise Therapy / methods*
Female
Health Promotion
Heart Failure / physiopathology
Heart Failure / rehabilitation*
Humans
Male
Middle Aged
Motivation
Patient Discharge
Program Evaluation*
Pulmonary Disease, Chronic Obstructive / physiopathology
Pulmonary Disease, Chronic Obstructive / rehabilitation*