The Impact of an Online Movement Training Program for Community-Based Adults and Older Adults on Balance, Physical Activity, Self-Efficacy and Resilience

Abstract

Objective: To examine the effects of a 30-minute, 3 times per week, 24-session at home online movement exercise program on balance, physical activity, self-efficacy, and resilience in community-based adults and older adults. Background: Balance impairment is a commonly reported consequence of the aging process. It may lead to falls, serious injuries, and physical activity avoidance. Moreover, these sequelae may worsen when balance impairments work in concert with the psychological factors of decreased self-efficacy and resilience. Fortunately, existing evidence supports the use of movement training programs to improve balance in older adults. However, there are no known studies that examine the impact of a dual-task online movement training program on balance, physical activity, self-efficacy, and resilience and associations among these factors in community-based independent living older adults. Several critical relationships have been identified among balance, physical activity, self-efficacy, and resilience, which affect balance and physical activity after motor training that warrant further exploration. Methods: Participants between the ages of 55-80 years of age were recruited from the Washington, D.C. metro area, including senior independent living facilities. Eligible participants were asked to complete a total of 24 30-minute training sessions, 2-3 times per week. Outcome Measures: Participants completed pre- and post-test measures of static balance using the 4-stage balance test, physical activity using the International Physical Activity Questionnaire (IPAQ), self-efficacy using the confidence scale of the OPTIMAL instrument (OPTIMAL) and Activities-Specific Balance Confidence Scale (ABC), and resilience using the Connor-Davidson Resilience Scale (CD-RISC). Data Analysis: Statistical analysis was completed using STATA/BE version 17.0 and Microsoft Excel. Comparison of means pre- and post-training was performed using a paired t-test with a significance level of p≤0.05 to determine if there was significant improvement in balance, physical activity, self-efficacy, and resilience. Wilcoxon signedrank tests were used for comparisons of non-parametric data. Effect sizes were also calculated. Additionally, Pearson’s correlations were used to determine the extent to which self-efficacy and resilience were associated with balance and physical activity before and after training. Results: Significant differences between baseline and final measures were found for tandem stance, single leg stance (SLS), and CD-RISC. Moderate effect sizes were found for both tandem and single leg stance measures. Additionally, moderate correlations were found between baseline SLS and IPAQ measures, final ABC and SLS measures, final OPTIMAL and SLS measures, final CD-RISC and IPAQ measures, and final SLS and IPAQ measures. Strength of correlations increased between baseline and final measures for ABC and SLS, OPTIMAL and tandem stance, OPTIMAL and SLS, OPTIMAL and IPAQ, CD-RISC and tandem, CD-RISC and SLS, and CD-RISC and IPAQ. Conclusion: Based on effect sizes, this study provides preliminary support for the efficacy of an at home online movement training program to make modest improvements in balance and physical activity, and small improvements in self-efficacy and resilience. Correlations among some aspects of balance, physical activity, self-efficacy, and resilience before and after training were also evident.