Effects of Group Exercise on Sleep, Balance, and Fear of Falling in Older Adults: A Convergent Mixed-Methods Analysis

ABSTRACT Introduction This 8-wk prospective mixed-methods study aimed to evaluate the effects of group exercise interventions on sleep quality, functional balance, and fear of falling in older adults to provide a comprehensive understanding of both objective outcomes and subjective experiences. Methods Forty-five older adults (60–81 yr) were randomized to resistance training ( n = 15), walking ( n = 16), or control ( n = 14) groups. Pre- and post-intervention changes in sleep, functional performance, and fear of falling were analyzed using analyses of variance. Post-intervention interviews were conducted with five participants per group to explore participants’ experiences. Quantitative and qualitative findings were integrated using joint displays to identify convergences and divergences. Results Participants in the resistance training group showed greater improvements in sleep compared to the control group ( P = 0.01) and better functional performance and flexibility than the walking group ( P ≤ 0.04). Qualitative interviews revealed that most participants in the resistance training and walking groups perceived either improvements or no changes in sleep and fear of falling. However, converged findings highlighted varied experiences; for example, some participants reported improved balance but unchanged fear of falling or inconsistent sleep outcomes across survey and interview data. Conclusions This mixed-methods study revealed that community-based exercise interventions can improve sleep, physical function, and motivation among older adults, although subjective experiences did not always align with standardized measures. Discrepancies in reported outcomes underscore the importance of integrating qualitative feedback with quantitative assessments to fully capture program impact. Enhancing self-efficacy, addressing persistent fear of falling, and tailoring education on sleep and functional health may improve long-term adherence and intervention effectiveness in this population.