Predictors of Physical Activity Among Older Adults With Peripheral Neuropathy

Purpose

Although the benefits of regular physical activity (PA) participation are well documented, 55% of adults with physical disabilities are completely inactive compared with 37% of adults without disabilities (USDHHS, 2000). The importance of determining PA motivational factors through the use of the transtheoretical model (TTM) among individuals with disabilities has been recognized (Kosma et al., 2006). Therefore the first purpose was to investigate the relations among the stages of change (SOC; PA intention and behavior), the TTM constructs (processes of change, self-efficacy, and perceived pros and cons), and PA. The second purpose was to identify the most important TTM predictors of the SOC and PA.

Methods

In this survey, standardized self-report scales were used to assess the TTM constructs and PA among 71 older adults with peripheral neuropathy (Mean age = 68.1 years, 67.6% females). The behavioral and cognitive processes of change were highly correlated (r = .80) and thus they were combined into one factor for the statistical analyses (Kosma et al., 2006).

Analysis/Results

Based on the MANOVA, the hypothesized relations between the TTM constructs and SOC were supported. Specifically, the processes of change and self-efficacy increased across the SOC. According to the One-Way ANOVA, PA increased across the stages of change. Specifically, people in precontemplation (Mean = 6.1 MET-hrs/day) and contemplation (Mean = 8.3 MET-hrs/day) had lower PA levels than people in preparation (Mean = 17.7 MET-hrs/day) and the active stages (action/maintenance; Mean = 18.4 MET-hrs/day). Based on the direct discriminant function analysis, the most important predictors of the SOC were the processes of change (r = .75) and self-efficacy (r = .60). The most accurately predicted SOC were the action/maintenance (100%), precontemplation (66.7%), and contemplation (50%), whereas preparation had 0% classification accuracy. The overall classification accuracy across the SOC was 67.6%. According to the stepwise multiple regression analysis, the most important TTM-based predictors of PA were the processes of change (R²_change = .20; b = .45) and perceived cons (R²_change = .07; b = .26).

Conclusions

This is the first study to examine the full TTM for PA among older adults with peripheral neuropathy. Health promoters need to implement stage-matched PA motivational programs by using such TTM-based strategies as identification of accessible PA facilities, goal setting, social support, reinforcement of successful activity experiences, and ways to overcome activity barriers. The SOC would also need to be re-conceptualized by assessing intention and behavior within each stage to increase their classification accuracy.