Share this Article
Justine M, Azizan A, Hassan V, Salleh Z, Manaf H
Correspondence: Dr Maria Justine, mar_physio@yahoo.com
ABSTRACT
INTRODUCTION Although the benefits of physical activity and exercise are widely acknowledged, many middleaged and elderly individuals remain sedentary. This cross-sectional study aimed to identify the external and internal barriers to physical activity and exercise participation among middle-aged and elderly individuals, as well as identify any differences in these barriers between the two groups.
METHODS Recruited individuals were categorised into either the middle-aged (age 45–59 years, n = 60) or elderly (age ≥ 60 years, n = 60) group. Data on demographics, anthropometry, as well as external and internal barriers to participation in physical activity and exercise were collected.
RESULTS Analysis showed no significant differences in the total scores of all internal barriers between the two groups (p > 0.05). The total scores for most external barriers between the two groups also showed no significant differences (p > 0.05); only ‘cost’ (p = 0.045) and ‘exercise interferes with social/family activities’ (p = 0.011) showed significant differences. The most common external barriers among the middle-aged and elderly respondents were ‘not enough time’ (46.7% vs. 48.4%), ‘no one to exercise with’ (40.0% vs. 28.3%) and ‘lack of facilities’ (33.4% vs. 35.0%). The most common internal barriers for middle-aged respondents were ‘too tired’ (48.3%), ‘already active enough’ (38.3%), ‘do not know how to do it’ (36.7%) and ‘too lazy’ (36.7%), while those for elderly respondents were ‘too tired’ (51.7%), ‘lack of motivation’ (38.4%) and ‘already active enough’ (38.4%).
CONCLUSION Middle-aged and elderly respondents presented with similar external and internal barriers to physical activity and exercise participation. These factors should be taken into account when healthcare policies are being designed and when interventions such as the provision of facilities to promote physical activity and exercise among older people are being considered.
Keywords: barrier, elderly, exercise, middle-aged, physical activity
Singapore Med J 2013; 54(10): 581-586; http://dx.doi.org/10.11622/smedj.2013203
REFERENCES
| 1. King KA, Krista M, Bernard AL, Vidourek RA. Does involvement in healthy eating among university students differ based on exercise status and reasons for exercise? Californian J Health Promot 2007; 5:106-19. | ||||
| 2. Lim K, Taylor L. Factors associated with physical activity among older people-a population-based study. Prev Med 2005; 40:33-40. http://dx.doi.org/10.1016/j.ypmed.2004.04.046 | ||||
| 3. Forkan R, Pumper B, Smyth N, et al. Exercise adherence following physical therapy intervention in older adults with impaired balance. Phys Ther 2006; 86:401-10. | ||||
| 4. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39:1435-45. http://dx.doi.org/10.1249/mss.0b013e3180616aa2 | ||||
| 5. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273:402-7. http://dx.doi.org/10.1001/jama.1995.03520290054029 | ||||
| 6. U.S. Department of Health and Human Services. Physical activity and health; A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion 1996 [online]. Available at: www.cdc.gov/nccdphp/sgr/pdf/chap5.pdf. Accessed March 12, 2010. | ||||
| 7. Lam TH, Ho SY, Hedley AJ, Mak KH, Leung GM. Leisure time physical activity and mortality in Hong Kong: case-control study of all adult deaths in 1998. Ann Epidemiol 2004; 14:391-8. http://dx.doi.org/10.1016/j.annepidem.2003.09.005 | ||||
| 8. Stutts WC. Physical activity determinants in adults. Perceived benefits, barriers, and self-efficacy. AAOHN J 2002; 50:499-507. | ||||
| 9. Kamwendo K, Askendom M, Wahlgren C. Physical activity in the life of the patient with rheumatoid arthritis. Physiother Res Int 1999; 4:278-92. http://dx.doi.org/10.1002/pri.174 | ||||
| 10. Larkin JM. Psychosocial determinants of exercise in people 65 and older: Recruitment and population campaign strategies. Dissertation Abstracts International Section A: Human and Social Science 2005; 65:3712. | ||||
| 11. Netz Y, Wu MJ, Becker BJ, Tenenbaum G. Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol Aging 2005; 20:272-84. http://dx.doi.org/10.1037/0882-7974.20.2.272 | ||||
| 12. Korkiakangas EE, Alahuhta AA, Laitinen JH. Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: a systematic review. Health Promot Int 2009; 24:416-27. http://dx.doi.org/10.1093/heapro/dap031 | ||||
| 13. Hanson JA, Benedict JA. Use of the Health Belief Model to examine older adults' food-handling behaviors. J Nutr Educ Behav 2002; 34 Suppl 1:S25-30. http://dx.doi.org/10.1016/S1499-4046(06)60308-4 | ||||
| 14. van de Mortel TF. Development of a questionnaire to assess health care students' hand hygiene knowledge, beliefs and practices. Aust J Adv Nurs 2009; 26:9-16. | ||||
| 15. Ziebland S, Thorogood M, Yudkin P, Jones L, Coulter A. Lack of willpower or lack of wherewithal? "Internal" and "external" barriers to changing diet and exercise in a three year follow-up of participants in a health check. Soc Sci Med 1998; 46:461-5. http://dx.doi.org/10.1016/S0277-9536(97)00190-1 | ||||
| 16. Cohen-Mansfield J, Marx MS, Biddison JR, Guralnik JM. Socio-environmental exercise preferences among older adults. Prev Med 2004; 38:804-11. http://dx.doi.org/10.1016/j.ypmed.2004.01.007 | ||||
| 17. Sit CHP, Kerr JH, Wong ITF. Motives for and barriers to physical activity participation in middle-aged Chinese women. Psychol Sport Exerc 2008; 9:266-83. http://dx.doi.org/10.1016/j.psychsport.2007.04.006 | ||||
| 18. Schuler PB, Roy JLP, Vinci D, Philipp SF, Cohen SJ. Barriers and motivations to exercise in older African American and European American women. Californian J Health Promot 2006; 4:128-34. | ||||
| 19. Pham KL, Harrison GG, Kagawa-Singer M. Perceptions of diet and physical activity among California Hmong adults and youths. Prev Chronic Dis 2007; 4:A93. | ||||
| 20. Dutton GR, Johnson J, Whitehead D, Bodenlos JS, Brantley PJ. Barriers to physical activity among predominantly low-income African-American patients with type 2 diabetes. Diabetes Care 2005; 28:1209-10. http://dx.doi.org/10.2337/diacare.28.5.1209 | ||||
| 21. Reichert FF, Barros AJD, Domingues MR, Hallal PC. The role of perceived personal barriers to engagement in leisure-time physical activity. Am J Public Health 2007; 97:515-19. http://dx.doi.org/10.2105/AJPH.2005.070144 | ||||
| 22. Conn VS, Burks KJ, Pomeroy SH, Ulbrich SL, Cochran JE. Older women and exercise: explanatory concepts. Womens Health Issues 2003; 13:158-66. http://dx.doi.org/10.1016/S1049-3867(03)00037-9 | ||||
| 23. Rabieyah M, Hajar T. Socio-economic characteristics of the elderly in Malaysia. In: 21st Population Census Conference 19-21 November 2003 Kyoto, Japan. Analysis of the 2000 round of censuses [online]. Available at: http://www.ancsdaap.org/cencon2003/Papers/Malaysia/Malaysia.pdf. Accessed March 14, 2010. | ||||
| 24. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A Practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189-98. http://dx.doi.org/10.1016/0022-3956(75)90026-6 | ||||
| 25. Karimlou M, Zayeri F, Salehi M. Psychometric properties of the Persian version of the World Health Organization's quality of life questionnaire (WHOQOL-100). Arch Iran Med 2011; 14:281-7. | ||||
| 26. Setbon M, Raude J. Factors in vaccination intention against the pandemic influenza A/H1N1. Eur J Public Health 2010; 20:490-4. http://dx.doi.org/10.1093/eurpub/ckq054 | ||||
| 27. Mehta KK. The impact of religious beliefs and practices on aging: A cross-cultural comparison. J Aging Stud 1997; 11:101-14. 28. Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Prev Med 2004; 39:1056-61. | ||||
| 29. Buman MP, Yasova D, Giacobbi PR. Descriptive and narrative reports of barriers and motivators to physical activity in sedentary older adults. Psychol Sport Exerc 2010; 11:223-30. http://dx.doi.org/10.1016/j.psychsport.2010.02.002 | ||||
| 30. Sallinen J, Leinonen R, Hirvensalo M, et al. Perceived constraints on physical exercise among obese and non-obese older people. Prev Med 2009; 49:506-10. http://dx.doi.org/10.1016/j.ypmed.2009.10.001 | ||||
| 31. Cooper KM, Bilbrew D, Dubbert PM, Kerr K, Kirchner K. Health barriers to walking for exercise in elderly primary care. Geriatr Nurs 2001; 22:258-62. http://dx.doi.org/10.1067/mgn.2001.119470 | ||||
| 32. Chao D, Foy CG, Farmer D. Exercise adherence among older adults: challenges and strategies. Control Clin Trials 2000; 21 Suppl 5:212S-17S. http://dx.doi.org/10.1016/S0197-2456(00)00081-7 | ||||
| 33. Andajani-Sutjahjo S, Ball K, Warren N, Inglis V, Crawford D. Perceived personal, social and environmental barriers to weight maintenance among young women: A community survey. Int J Behav Nutr Phys Act 2004; 1:15. http://dx.doi.org/10.1186/1479-5868-1-15 | ||||
| 34. Daskapan A, Tuzun EH, Eker L. Perceived barriers to physical activity in university students. J Sports Sci Med 2006; 5:615-20. | ||||