Background
Method
Participant characteristics
Participant number | Sex | Age | Work status | Region | Ethnicity | Home & work circumstances | History of physical activity | Pre-existing health condition |
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Participant 1 | Male | 55 | Working | Yorkshire | Black/Black British | Lives alone, cares for family member, works full time shift work | Weekly sport – football, squash, martial arts | No |
Participant 2 | Female | 57 | Retired | Yorkshire | Mixed (inc Black/African/ Caribbean) | Has partner & grown up children, retired following redundancy | Regular activity – aerobics, Zumba, Badminton | No |
Participant 3 | Female | 57 | Retired | Yorkshire | Black/Black British | Lives alone, voluntary work | Enjoyed sport at school, regular walking | No |
Participant 4 | Female | 56 | Working | London | Black Caribbean | Lives with partner & grown up children, works in charity sector | Enjoyed sport at school, gym membership, dancing & regular walking | No |
Participant 5 | Male | 55 | Looking for work | South East | Black British | Lives with partner & young child, voluntary football coach | Enjoyed sport at school, gym membership, football and regular running & walking, | No |
Participant 6 | Female | 63 | Working | South East | Mixed (inc Black Caribbean) | Lives alone, grown up children, works in commercial sector | Previous gym membership & personal trainer, enjoyed Zumba & walking | Yes |
Participant 7 | Female | 60 | Looking for work | London | Black Caribbean | Lives with child | Enjoyed tennis, badminton, dancing, has gym membership, regular walking | No |
Participant 8 | Female | 57 | Working | London | Black African | Lives with partner, elderly mother, has grown up children. Works in the social housing sector | Previous gym attendance, regular walker | Yes |
Participant 9 | Female | 55 | Working part-time | South West | Black British | Lives alone, works in the commercial sector | Active childhood, previous regular gym attendance, cycling & regular walking | Yes |
Participant 10 | Female | 55 | Working part-time | South West | Dual Heritage (Italian/Caribbean) | Lives with grown up children, works in the education sector | Previously regular cycling & walking | Yes |
Participant 11 | Male | 55 | Working | South West | Dual Heritage (British/Caribbean) | Lives with partner, works in the commercial sector | Active childhood, regular swimming, cycling, gym | No |
Participant 12 | Female | 58 | Long term sick | East Midlands | British Caribbean | Lives alone, grown up children, previously worked in the care sector | Previous regular attendance at gym, regular walker | No |
Participant 13 | Male | 63 | Working part-time | East Midlands | British Caribbean | Works in local government sector | Previously active – athletics, regular running, swimming and gym sessions | Yes |
Participant 14 | Male | 64 | Working | London | Black African | Lives alone, works in the commercial sector | Active childhood, regular running and walking | No |
Participant 15 | Female | 58 | Working | West Midlands | Black Caribbean | Lives with teenage child, works in the care sector | Active childhood, regular gym and walking | No |
Participant 16 | Male | 55 | Long term sick | West Midlands | Black Caribbean | Has children, previously worked in the commercial sector | Active childhood, regular cycling, gym attendance | Yes |
Participant 17 | Female | 55 | Working part-time | West Midlands | Black Caribbean | Has grown up children, works in the care sector alongside caring role | Active childhood, regular yoga and walking | Yes |
Participant 18 | Female | 58 | Education part-time | West Midlands | Black Caribbean | Lives alone, has grown up children, voluntary work | Active childhood, limited mobility | Yes |
Participant 19 | Female | 63 | Working | East | Black | Active childhood, regular dancing, walking, yoga and Pilates | No | |
Participant 20 | Male | 59 | Working | East | Black | Lives with partner, works in commercial sector | Regular walking and gym attendance | No |
Participant 21 | Female | 64 | Working | West Midlands | Black Caribbean | Lives with grown up child, works in education sector | Active childhood, regular walking | No |
Participant 22 | Female | 56 | Working | North West | Black Caribbean | Lives with partner and teenage children, carer for family members | Active childhood, regular swimming, gym, dancing and walking | Yes |
Participant 23 | Female | 57 | Working | North West | Mixed Black African/Caribbean | Lives with grown up child and teenage foster child, works in care sector | Active childhood, regular walking | Yes |
Participant 24 | Male | 60 | Working | North West | Black British/Caribbean | Has a grown up child, works in education sector | Active childhood, regular gym and badminton | No |
Participant 25 | Female | 65 | Retired | South East | Black British | Lives alone, voluntary work | Active childhood, regular swimming | Yes |
Results
Strength
Understanding of strength
“Why is it important to maintain some strength? Well it keeps my young…Yeah. It keeps me young and it keeps me active... And it helps, it helps me keep away from the hospital and having to actually taking too much tablets or more tablets than what I need to take” Participant 13, Male 63“Well it’s just about keeping movement. Otherwise, if you don’t, your body is going to seize up really…so it’s just about keeping trying to keep active” Participant 17, Female, aged 55 years
“Strength makes a lot of your activities easier doesn’t it? But also, you know, as you’re getting older, muscle wastage, things like that…probably less falls. Sort of many areas I think” Participant 2, Female aged 57 years“Strengthen my legs because I mean you’re carrying your bodyweight on your legs so that’s an area that needs to be strengthened” Participant 6, Female, aged 63 years
“As we get older everything slows down…if you don’t do strength exercises you start to lose your strength as well. Yeah, muscles can get weaker…bones can become more fragile maybe or weaker” Participant 19, Female, aged 63 years
“After the COVID I lost a lot of muscle tissue and, oh, it’s taken me weeks to kind of get my body looking like it was before” Participant 11, Male aged 55 years
Judging their own strength
“I went shopping at Costco and there was a pack of nine coconut waters, and I normally pick them up and stick them in the trolley without even thinking about it.. and I picked it up off the shelf and it landed on my knee. OOH!...I had to shout my son to come and help me” Participant 23, Female, aged 57 years
Sources of information
“Because of the issue that I’ve got when I go to the gym, you know, you have your selected physio person so they will give you the exercises specific for your problem. And then, of course, they will give you exercises to do at home, so it is a continuous thing really. But yes, it’s really, really been helpful” Participant 7, Female, aged 60 years
What did participants say they do to enhance their strength?
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Carrying shopping.
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Gardening.
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Everyday housework.
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Picking up little children.
“I bring my own shopping from the car…or if I’m really, really tired they stay in the car until the next day. Right, okay. I can manage it… if it’s too dark I take out like the things to go in the fridge and I’ll leave the rest in the car until the next day” Participant 18, Female, aged 58 years.
“So I think everyday living, you know, while all your bodily parts are still working, you know, functioning, I think walking up and down the steps, you know, doing everything within your home, that can be exercise in itself” Participant 3, Female, aged 57 years.
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Rolling wheels (a device mainly for abdominal exercises).
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Exercises from YouTube.
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Weights.
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Dumbbells.
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Gym (general term).
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Yoga.
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Pilates.
“I do the weights but obviously not heavy weights because I’m not trying to get muscles, I’m just trying to keep my, you know, strength” Participant 7, Female, aged 60 years
“I think I do most things so, you know, myself, so I think I just keep going. Until I feel I can’t do something, I do it” Participant 2, Female, aged 57 years
“I would do mainly cardio and…I was told that I’ve also got to do a bit of work on the muscles as well...but I would concentrate more on cardio because I was more interested in burning calories and losing weight [interviewer - So building strength wasn’t really a key kind of focus in that respect?] No. No, no. No, it wasn’t my priority, no” Participant 24, Male, aged 60 years
Barriers to doing strength activities.
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I don’t have the motivation.
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I can’t find the time.
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It is too far to the gym.
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I have existing injuries.
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I am in pain (including muscle pain) so can’t do more.
“I didn’t realise until I went to the Osteopath that the effect of pulling a hoover actually is probably one of the worst things you can do for back pain” Participant 8, Female, aged 57 years“I have very weak hands and wrists, and I suffer with nerve damage which gives me a lot of tingling sensations in my hands. So things that I can’t do…I don’t have much strength to pick up and twist things, so I depend a lot on my son who is here every day to help with things like that” Participant 17, Female, aged 55 years
“Some people think oh I’ve tried that, done it and I don’t see any results” Participant 3, Female, aged 57 years
Balance
What is balance?
“I think it’s just for your health. Obviously if you drink, say if you drink and smoke, they say that’s bad for your health, but you can balance it out by doing both. You can drink and smoke and you can still go to the gym and do plenty of exercises. My opinion is you balance it out together” Participant 20, Male, aged 59 years
“Blimey. I think I obviously think, you know, I’m not young but I’m not old. I would seek medical or physical advice if that were the case. I mean, yeah, that would certainly come as a shock if all of a sudden my orientation went and I started to feel unsteady, yeah” Participant 11, Male, aged 55 years“Bending down and picking up things, and reaching cupboards and things, you know, I do all of those, but I guess in my mind I’m not thinking of them as balancing exercises” Participant 4, Female, aged 56 years
“Yeah, I think maybe I need to do some… As you get older things you did without thinking, they don’t just work as they used to. So, yeah, so I think it’s a very good idea” Participant 24, Male, aged 60 years“I think it is very important. I was reading something about it really helps with the muscles, especially in your legs, ones when you’re doing the balance exercise” Participant 22, Female, aged 56 years
“I think I’m sort of aware that you need to kind of keep your body going, so that’s just, I don’t know where that comes from but I just have an awareness of it” Participant 2, Female, aged 57 years“I’ve actually been given, I was given some exercises by a physio. So I do some on my bed, and then some against the wall and then some against the chair. I have a routine” Participant 8, Female, aged 57 years
“I’ve got a leisure centre and studios so it’s not difficult to find them” Participant 19, Female, aged 63 years
The benefits of good balance
“Healthy body, healthy mind they say, don’t they? You know, and obviously your mobility, I’m quite lucky but as you get older your mobility is often impacted quite a lot isn’t it? So if you do a little bit while you can it helps it will probably help you later on” Participant 2, Female, aged 57 years“If you’re not able to balance properly then things will become awkward and, again, you’re going to require help from others. You know, I suppose you can start to feel like you’re losing your independence because if you’re having to constantly rely on others then you’re not as independent as you would like to be” Participant 7, Female, aged 60 years“I just think it’s just a way of keeping yourself as fit as you possibly can. And as they say, the older you get, you know, people tend to fall over due to their balance and things like that, hip problems” Participant 9, Female, aged 55 years
“It’s important that we look after ourselves… If you can walk it’s always better to walk. It’s better to keep the weight off, eat right and exercise right. It’s very, very important. Yeah. I think. Especially when you reach our age. Yeah. I mean my Mum is 96 and she’s still alive and she’s walking. She doesn’t need aids… so it can be done” Participant 18, Female, aged 58 years
“Because I’ve got a friend who does walking. She does her walking daily. She walks for miles and comes back and she is quite fit and active and like, yeah, I think oh maybe if I did that probably I would be the same. But I think I’ve gone too, it’s too late now to try doing things like that because I do get awful tired” Participant 25, Female, aged 65 years
Experiencing balance issues
“I don’t particularly work on it but it’s not something I’ve ever had a problem with” Participant 2, Female, aged 57 years“If, for instance, you were given an exercise to do based solely on your balance, maybe like, even though, you know, I try to be as active as I can, I think that would be something that you would then probably discover maybe you’re not as balanced as you thought you were” Participant 7, Female, aged 60 years
“I don’t think my balance is very good and I think I need to do more to improve it… it sounds funny but I’ve found myself being nervous of walking on uneven surfaces, like cracked pavement slabs or even because I have fallen for no reason quite a few times. And I’m thinking why am I falling like this? Other people just seem to walk quite easily over this… Maybe it’s the high heels, whatever, I don’t know… even when I’m walking in like the right shoes or trainers, or walking shoes, I’m fine but I’m still very conscious, you know, of where I’m placing my feet, where I think when I was younger I wouldn’t care less, I’d just go for it” Participant 4, Female, aged 56 years“I fell over once and I made sure ever since then, I’ve been so paranoid, that I take my time in whatever I’m doing in order not to have an accident or lose my balance… Because if you lose your balance and fall over you could break something and I don’t want any additional problems” Participant 6, Female, aged 63 years“I have to be very particularly careful where I put my steps. Because sometimes you’ll be walking on a smooth bit and you’ll be talking and all of a sudden there’s a little, just a little slight difference and that can put me off-balance a little bit… I think that can happen to anyone but with me I am particularly very careful of that, or things like walking down the stairs. Twice I’ve missed a step down the stairs and I’ve hurt myself” Participant 10, Female, aged 55 years
“I can’t turn round very quickly. Like if somebody comes behind me in the room and they speak to me and whereas one time I would just automatically just turn round, I have to think about it” Participant 13, Male, aged 63 years“As I’ve got older I would say it’s things that you did without thinking about, you have to think about now” Participant 24, Male, aged 60 years
“If I’m having a bad week I’ve got my daughter, I’ve got my sons, my mum as well at the weekends, so they’re there for extra support. But if I’m feeling okay I kind of just take my time around the house and do what I can” Participant 17, Female, aged 55 years“All depending how I feel in the morning when I get up…When I don’t feel like I want to do it… I’m in pain” Participant 13, Male, aged 63 years
Managing and preventing balance issues
“It’s just a flat piece of wood on the floor now but I’m going to try to get it raised a bit… and I just walk along it just to try and I don’t know if it’s going to help me but it’s to improve my balance” Participant 1, Male, aged 55 years“I try to sort of, you know, balance on one leg… like balancing on one leg and sort of like stretch or, you know… you do one leg and you try and bend down… because it’s important I think to try and do these sort of things” Participant 5, Male, aged 55 years“I’ve got some weights at home. They’re only them sort of like dumbbells, but you know, I’ll sit in the chair and I can do those. I’ll stand up and do those. You know, if I’m sitting down I’ll sort of like do, find little exercises to do sat down, where I can sort of like do my leg exercise. You can extend them and bring them back, extend them and bring them back… And that’s something you can do just sat down in the chair, you know, without even standing up. But if I’m stood up obviously you’ve got to have your balance and your stance to be able to operate your dumbbells without falling over. So that helps with your stamina, helps with your strength work, helps with your core as well, and it helps with your posture and being able to balance so you don’t fall over” Participant 3, Female, aged 57 years“I know my balance isn’t that great, that’s why I do my stretching. And I’ve noticed as I’ve grown older, and I’m sure if I wasn’t doing my walking it would be really, really bad, but sometimes I find myself actually sort of tipping slow I don’t know. I can’t even explain it. Not walking straight. I know I’ve got a back problem but sometimes I feel as though I’m tipping to the side. It’s really weird but yeah. So anyway I’m sure that, you know, my stretching and then my walking helps towards hopefully my back, making sure my balance is okay” Participant 8, Female, aged 57 years
“I walk that strong and I try not to make nobody [notices] that I’m going to fall over because I’m losing my balance... I just sit down and just wait for it to come back” Participant 16, Male, aged 55 years“If I’m in a supermarket I balance on the trolley. If I’m on the street, say going from a public car park to maybe a few shops on the high street, my local high street, I will take the stick with me because just in case I lose my balance. I have that extra security to balance on the stick. But indoors I don’t need a stick. Indoors I’m okay” Participant 6, Female, aged 63 years
“We do lots of family challenges like how long can you stand on one leg and different things. But yeah, I need to make it more of a focus, I feel that for myself” Participant 4, Female, aged 56 years“Some exercises they give me is good for the lower back and some that they give me for the back is detrimental to the knee. So it’s like squats, yeah, and they’re telling me about squatting and doing it. I can’t handle the squatting. It then puts me out for about four days after that because I’ve grinded the knee. So you’re in a catch-22. I’ve got a situation where one particular exercise is good for one ailment and then it isn’t for another” Participant 6, Female, aged 63 years
“I’m quite an inpatient person and those types of exercises, just standing there, just going up and down, I just find a little bit boring. It’s not like I don’t know, I know that the net sum effect is going to be good, but it’s just I find, as I say, that a little bit boring” Participant 11, Male, aged 55 years
Discussion
Key findings | Implications |
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Only very general understanding of the importance of maintaining body strength and balance | Consider a communications programme specifically to emphasise the importance of strength and balance as one ages |
Low salience: strength and balance activities were not seen to be an important part of participants’ lives | Perhaps emphasise the negative consequences (e.g. falls and loss of independence) |
Most participants only want to be strong enough to get on with normal life | Specifically emphasise the importance of doing more as one ages (not less) |
Participants aged 50–70 likely to think they were too young to worry about strength and balance | Encourage preparation for older age |
Balance tended to be mentioned only if someone had experienced a problem | Emphasise the importance of good balance |
NHS staff – especially physiotherapists – are a key source of information on the topic | Involve NHS staff in specific broad communications programme, along with the concept of ‘making every contact count’ |