Fitness coordinators’ and fitness instructors’ perspectives on implementing a task-oriented community exercise program within a healthcare-recreation partnership for people with balance and mobility limitations: a qualitative study

Abstract

Background: Healthcare organizations are partnering with recreation organizations to support the delivery of community-based exercise programs for people with balance and mobility limitations. The value and impact of support strategies provided by healthcare organizations, however, have not been examined.

Objective: Study objectives were to explore fitness coordinators’ and fitness instructors’ experiences with implementing a task-oriented community-based exercise program for people with balance and mobility limitations within the context of a healthcare-recreation partnership.

Methods: A qualitative descriptive study was conducted. Fitness coordinators and instructors involved with delivering a licensed, group, task-oriented community-based exercise program for people with balance and mobility limitations supported by a healthcare-recreation partnership were interviewed by telephone. Interviews were audio-recorded and transcribed verbatim. A thematic analysis was performed.

Results: Eight fitness coordinators and 8 fitness instructors from 14 recreation centres were interviewed. Findings showed that healthcare-recreation partnerships help to optimize exercise program quality and safety through multiple strategies. Fitness coordinators and instructors still face challenges with program implementation at start-up and over time. Recommendations to address these challenges included increased training content related to adjusting exercises to accommodate participant abilities, 1–2 visits from a healthcare professional each program after initial program implementation, suggestions to increase exercise variety, and ongoing education.

Conclusions: Findings clarify the role of healthcare organizations, ongoing challenges, and directions for improvement in this program delivery model.

Implications for rehabilitation

• Community recreation centres can provide task-oriented exercise programs to help people with balance and mobility limitations safely engage in regular exercise

• Healthcare organizations should provide specific supports to help increase the safety and quality of task-oriented exercise programs in recreation centres

• Supports include providing clear exercise guidelines, and a healthcare professional who trains fitness instructors, visits the program, answers questions between visits, promotes collaboration and information exchange between recreation centres, and provides ongoing education

Keywords:

• Task-oriented exercise
• community
• balance
• mobility
• physical therapy
• qualitative research

Disclosure statement

Authors NMS and JH are affiliated with the Toronto Rehabilitation Institute-University Health Network which licenses recreation providers to deliver the Together in Movement and Exercise (TIME™) program. Author JH developed the TIME™ program and the TIME™ toolkit. Authors AT and JM facilitate TIME™ program implementation and serve as healthcare partners. None of the authors derives financial gain from the TIME™ program. NMS was supported by a Canadian Institutes of Health Research New Investigator Award while conducting this research.