Strength recommendations have been embedded within the UK’s Chief Medical Officers’ physical activity guidelines since 2011. In 2019, they were given a more prominent position in the accompanying infographic. However, there is limited evidence that these recommendations have been successful in their population-wide dissemination. This study aimed to explore the engagement of community-dwelling older adults with the guidelines to date and to gain a nuanced understanding of the awareness, knowledge, and action that older adults take to fulfil strength recommendations. A total of fifteen older adults living in the UK participated in one online interview. A general inductive approach was used to generate themes from the data. There were four major themes that were found. 1. The strength component of the physical activity guidelines, 2. Barriers, 3. Motivators, and 4. Solutions. No participants were aware of the strength guidelines. When they were asked what activities they used to fulfil the ‘build strength on at least two-days-per-week′ criteria, walking, yoga, and Pilates were the most common responses. Ageism and strength training misconceptions were major barriers to participation in strengthening exercise. Older adults were much less aware of the benefits of building strength and strength training participation when compared to aerobic activities, so motivators to participation were generally not specific to strength training. Finally, there are several ways that practitioners can overcome the barriers to strength training participation. Solutions to improving the uptake and adherence to strength training participation are likely to be more successful when they include opportunities for social interaction, ability-appropriate challenge, and provide both short- and long-term benefits.
Background
In 2019, the UK prominently placed the strength recommendations on their Chief Medical Officers' Physical Activity Guidelines infographic. The purpose of this study was to offer a nuanced description of older adults' awareness, understanding, and participation in activities that meet the strength component, as well as their perceived barriers to strength training participation.
Methods
Older adults living in the UK (n = 15, 70±3.3 years) volunteered to participate in one 30-minute, semi-structured, one-on-one interview on Zoom with the lead author. Advertisements were placed in ageing charity newsletters. People who identified as 65 years old or over and living in the UK were asked to respond via email if interested.
Results
Awareness. None of our participants were aware of the strength recommendations. “I honestly can't say that I ever recall seeing that.”
Understanding and Action. Walking was the most common modality for participants who believed they were meeting the strength guidelines. “I think I'm more than meeting them because … I do masses of walking …”
Suggestions for Improvement. Adding more detail to the guidelines and separating the guidelines based on ability, rather than chronological age, was suggested. “It's a bit subjective as to what counts as building strength.”
Barriers to Strength Training. Barriers included misconceptions about strength training in later life, “You know, you always know, don't overload yourself…I never push it.” and a lack of options for older adults who are not quite ready for classes for the oldest old, “There's a big cohort of us that are what you might call young old and the provision for us who are fit and active is sadly missing…the classes that are on are always for the older old”
Conclusion
Our participants reported an unawareness of the strength guidelines. Adherence reporting to the strength guidelines should be interpreted with abundance of caution, as older adults are largely unaware of what activities fulfill this requirement. Researchers & practitioners can influence the many barriers to strength training participation primarily with dissemination of accurate information and providing age & ability-appropriate strength prescription.
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