# A retrospective, observational study on the effectiveness of an individualized community-based fitness program for people who are living with disability.

## Description

Introduction: The aim of this retrospective study is to investigate the effectiveness of an individualised, and interdisciplinary approach to develop self-efficacy in people with disability in enhancing participation in physical activity. The program in this study utilizes available resources in the community to facilitate an environment that can empower participants to develop self-management skills, and to become independent in their own physical activity program. Method: Data of 32 participants who participated in Rocky Bay Fitness Program from October 2014 to December 2017 was retrieved from client management software system. The retrieved data included baseline and re-assessment values of the primary and secondary outcome measures. The outcome measures used in the program have indicated the participants’ level of physical activity and function. Results: Data analysis showed significant increase in physical activity level from initial assessment (≥3<6 months, mean increase of 358 ±178(t(9)=6.34, p=0.000, ≥6<12 months, mean increase of 363± 262 t(6)=6.34, p=0.011, ≥12<24 months, mean increase of 577± 565 t(13)=3.80, p=0.002). The result also indicated significant improvement in functional mobility and lower limb strength, with suggestion that physical activity level is positively correlated with improvement in 6-Minute-Walk-Test (r = 0.674, n = 12, p = 0.016). Conclusion: An individualised program in the community may be effective in promoting sustainable long-term physical activity level in people with disability, and may also improve their functional mobility.

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Any participant without any follow-up assessment will have their follow up measures replaced by their baseline value. Thus, allowing for an intention-to-treat analysis. The mean value of initial outcome measure is used to compare with the mean value of subsequent reassessments between ≥ 3 <6 months, ≥ 6<12 months, and ≥12<24 months if data was available. Paired-T test is used to reflect if there are any significant difference in the outcome measure values between the initial and re-assessments.Paired-sample T-test indicated statistical insignificant changes in FRSTS between initial and during follow up periods. (≥3<6 months (t(1)=1.426, p=0.389, ≥6<12 months t(1)=1.361, p=0.403 and ≥12<24 months t(3)=2.359, p=0.099). Statistical changes were found in m30sCST during initial and during follow up periods. The mean improvement from ≥3<6 months was +2.87 additional stands (t(14)=6.013, p=0.000), +3.23 additional stands from ≥6<12 months (t(12)=3.914, p=0.002), and +4.75 additional stands from ≥12<24 months (t(11)=4.513, p=0.001). Statistical significant changes were also found in 6MWT between initial and during follow up periods. The mean improvement from initial to ≥3<6 months was +35.2 metres (t(8)=3.477, p=0.008), +28 metres from ≥6<12 months (t(7)=3.246, p=0.012), and +65 metres from ≥12<24 months (t(7)=5.575, p=0.001). In TUGT, there changes between initial and during ≥3<6 and ≥6<12 were insignificant (t(8)=1.7, p=0.127 and t(9)=2.18, p=0.057). However, the changes between initial and ≥12<24 months was significant (t(7)=2.845, p=0.025) with mean improvement of -5.51 seconds. For higher level mobility, paired-sample T-test indicated statistical insignificant changes in plank test between initial and during follow up periods. From ≥3<6 months (t(3)=1.485, p=0.234), ≥6<12 months (t(4)=2.072, p=0.107), and ≥12<24 months (t(4)=1.472, p=0.215). Most of the changes in SLBT from initial to other periods on both legs were also insignificant (Left leg ≥3<6 months (t(6)=-0.014, p=0.990), ≥6<12 months (t(6)=0.583, p=0.107), ≥12<24 months (t(9)=1.853, p=0.097, Right leg ≥3<6 months (t(7)=-1.588, p=0.156), ≥6<12 months (t(6)=1.292, p=0.244). However, the changes between initial and ≥12<24 months period on right SLBT was significant with a mean improvement of 7.09 seconds (t(9)=3.4, p=0.008) The difference (in percentage of initial value) between initial and the last re-assessment will also be plotted against change in exercise intensity (IPAQ value), and hours spent by the FO in developing the program with the individual. This is achieved with Pearson Correlation. As services and funding are likely to reduce overtime (FO <3 months and CLPG <12 months), this study will also explore some qualitative outcome of ongoing participation in PA when services are weaned off. It will investigate if participants are continuing with gym or home-based PA after the intensive phase of FO service, as well as when as CLPG expired.