Physical Activity Levels and Barriers to Exercise in Individuals with Low Bone Mineral Density

Abstract

Background: Fractures are a major health concern for older adults, especially for those with osteoporosis or low bone mineral density (BMD). Physical activity and exercise can be important self-management strategies for older adults with osteoporosis or low BMD to prevent fractures. Objectives: This study examined the physical activity and exercise levels of older adults with low BMD and determined the proportion of individuals meeting the Canadian Physical Activity Guidelines. As well, this study characterized perceived individuals’ barriers to exercise and their willingness to pay for different methods of delivering exercise information. Secondary goals of this study were to investigate correlates of aerobic exercise and factors associated with meeting moderate- to vigorous-intensity aerobic physical activity guidelines. Methods: Individuals aged 50 years or older with a self-reported diagnosis of low BMD were recruited from the Canadian Osteoporosis Patient Network (COPN) and an osteoporosis public education event. Questionnaires were distributed online and through mail to individuals interested in participating. Participants were asked about the amount of time they spent doing moderate- and vigorous-intensity physical activity (MVPA) and the frequency at which they did strength and balance training per week. Also, participants were asked about potential barriers to exercise that they perceive, the strength at which they perceived those barriers at, and their interest in and willingness to pay (WTP) for different methods of delivering exercise information. Information about different factors affecting exercise behaviour such as risk perception, intention to exercise, and exercise self-efficacy were collected as well. Results: The total number of participants included in this study was 130 (mean [SD] age 66.32 [8.81] years). The mean (SD) time spent doing MVPA per week reported by participants was 831.35 (1065.43) minutes. The mean (SD) days per week that participants reported doing strength and balance training were 1.90 (1.66) and 1.36 (1.84), respectively. Sixteen individuals (12.3%) did not meet the guideline of engaging in at least 150 minutes of MVPA per week. Forty-one participants (31.5%) did not report doing any strength training and sixty-five individuals (50%) did not report doing any balance training. The most prevalent barriers to exercise that were reported was having no enjoyment for exercise (51.2%) , having no company to exercise with (47.2%), and health-related problems (37.5%). Although a majority of participants expressed interest in all methods of delivering exercise information, the mean WTP for a group exercise class and for training one-on-one with a certified personal trainer was lower than the suggested amounts that they would normally cost. Factors associated with meeting MVPA recommendations were intention to exercise (p = 0.03), exercise self-efficacy (p = 0.03), and strength of perceived barriers (p = 0.02). Conclusion: Many older adults with low bone mineral density are not meeting established physical activity guidelines. Greater measures need to be taken in promoting strength and balance training among these individuals. Addressing barriers to exercise may be an effective strategy to encourage individuals with low bone mineral density to become more active.