Acceptability of home-based high-intensity functional strength training (HIFST) for older adults with preclinical mobility limitations after a slip, trip or fall: a qualitative description

To determine the acceptability of 12-weeks of a home-based high-intensity functional strength training (HIFST) intervention to older adult participants (≥ 55 years) with preclinical mobility limitations following a slip, trip, or fall. A qualitative description study was conducted following a pilot randomized controlled trial of HIFST. HIFST was delivered virtually by a physiotherapist and utilized an interval format (alternating periods of “hard” effort of strengthening exercises with “easy” recovery). Participants randomized to the HIFST intervention were invited to participate in semi-structured interviews and an anonymous survey following intervention completion. Eleven participants (of 12 randomized to HIFST) completed interviews and 8 survey responses were received. Our findings were organized into six themes; “overall impression,” “intervention coherence,” “facilitators,” “challenges and future suggestions,” “perceived effectiveness,” and “sustainability.” Participants reported that the program was efficient, met their expectations and “made sense.” Various facilitators to participation were noted including support from the physiotherapist and preference for a shorter interval length. Virtual delivery and intensity were not participation barriers. Participants reported benefits and clear individualized plans for future exercise. A home-based HIFST intervention delivered virtually was acceptable to participants. Participants reported a positive experience and minimal challenges encountered. Older adults experiencing Preclinical Mobility Limitations (PCML) after a slip, trip or fall reported minimal challenges with participating in home-based High-Intensity Functional Strength Training (HIFST).Key facilitators to participation included participation motivation, support and monitoring from the physiotherapist, and the gradual progression of the program.For older adults completing home-based strengthening interval exercise, shorter strength interval lengths (e.g., 30 s on/30 s off) were perceived as more enjoyable and efficient.All participants reported clear, individualized plans for future physical activity; highlighting virtually delivered higher intensity strengthening exercise as a potential health promotion strategy for rehabilitation professionals. Older adults experiencing Preclinical Mobility Limitations (PCML) after a slip, trip or fall reported minimal challenges with participating in home-based High-Intensity Functional Strength Training (HIFST). Key facilitators to participation included participation motivation, support and monitoring from the physiotherapist, and the gradual progression of the program. For older adults completing home-based strengthening interval exercise, shorter strength interval lengths (e.g., 30 s on/30 s off) were perceived as more enjoyable and efficient. All participants reported clear, individualized plans for future physical activity; highlighting virtually delivered higher intensity strengthening exercise as a potential health promotion strategy for rehabilitation professionals.