A Theory-Based Approach to Adapting a Task-Oriented Community Exercise Programme for Virtual Delivery for People With Balance and Mobility Limitations

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Abstract
Purpose: Despite the health benefits for people with mobility limitations of participating in community-based exercise programmes (CBEPs), accessing and implementing in-person CBEPs can be challenging. We describe a theory-based approach to adapting a group task-oriented, in-person CBEP targeting balance and mobility to a virtual format. Method: We used the Knowledge-to-Action and Medical Research Council frameworks to guide adaptation of an established CBEP for virtual delivery. We undertook consultations with knowledge users (i.e., CBEP providers, health care professionals, managers, policy-makers) and researchers on adapting programme components to optimize the feasibility of virtual delivery and retain benefits of the in-person CBEP. Concurrently, we conducted three feasibility studies involving post-programme participant surveys to evaluate and refine programme components. Results: Programme components, including a pre-programme safety video and use of trained facilitators to stream exercise videos via videoconferencing and facilitate social times, met safety, feasibility, and acceptability benchmarks. In studies 1, 2, and 3, the majority of participants described benefit to physical function (59%, 64%, and 79%, respectively) and emotional well-being (64%, 62%, and 75%, respectively). Conclusions: Theoretical frameworks were useful to guide adaptation of an established in-person CBEP to a virtual format. This theoretical approach may inform virtual programme development for other populations and targeted outcomes.

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