Dr. Lawrence R. Brawley
Canada Research Chair in Physical Activity in Health Promotion and Disease Prevention
For older adults, the path to better health and an improved quality of life through physical activity is often fraught with obstacles – unfamiliarity, a lack of confidence, even pain. Developing interventions that help overcome those roadblocks is at the centre of Dr. Lawrence Brawley’s work as Canada Research Chair in Physical Activity in Health Promotion and Disease Prevention at the University of Saskatchewan’s College of Kinesiology.
“Many older adults have never included regular physical activity in their lives,” explains Dr. Brawley. “Today, physical activity is recommended to improve health and prevent disease. Many individuals, however, are unable to manage both the exercise suitable to their age and condition, and also to reorganize their lives to include that exercise. It’s about managing a lifestyle change.”
Dr. Brawley is investigating interventions that help older adults develop exercise regimes as well as change their behavior so they remain physically active. In cardiac rehabilitation programs for example, adherence to a selfmanaged regime drops by 50 per cent in the first six months once participants leave the structured environment. “This suggests we’re not equipping people to manage on their own. Our goal is to move the process from being reliant on the health care provider to one that is self-managed.”
The first step is teaching people to monitor themselves, he said. By understanding how much of a target behaviour like eating or physical activity they do, they can come to grips with their risk for disease, their current health and their physical limitations. With this understanding comes the ability to set realistic goals for improvement. Other intervention techniques include corrective feedback, teaching older adults how to manage their activity schedule in order to cope with unforeseen events, and helping people to be active while still managing symptoms like arthritic pain, he said.
“Another key to self-management is convincing older adults they have the physical function they seem to doubt. For some, that could mean altering the timid and fearful approach they have been using to walk so they can then walk confidently without fear of falling.”
The core elements of Dr. Brawley’s interventions are applicable to many chronic diseases and illnesses and his goal is to find ways of transferring those interventions to the community with leadership provided by qualified exercise and peer leaders. Clinic or centre-based programs will still provide initial training but “we’re interested in determining if peer-led or communityled programs can be part of the long-term solution to adherence by providing older adults with the support they need to maintain the behaviour change they initially accomplished”.
Improved health, independent living, quality of life – these are all known benefits of increased levels of physical activity for individuals but, as Dr. Brawley explains, the ramifications are much more far-reaching: “A small change in the lifestyles of many people can have a significant impact on population health and therefore on health care spending. My research is just one part of the larger puzzle of how we accomplish this in Canadian society.”
The University of Saskatchewan gratefully acknowledges the Saskatoon Cardiac Rehabilitation Program offered by the Saskatoon Health Region in providing the background for Dr. Brawley’s CRC photograph.