Customized exercise programs implemented by physical therapists improve exercise-related self-efficacy and promote behavioral changes in elderly individuals without regular exercise: a randomized controlled trial

BACKGROUND: Specialized, individualized exercise programs that increase self-efficacy (SE) are essential for the development and maintenance of regular exercise. The objective of this study is to examine the effect of customized exercise programs (CEPs) implemented by physical therapists in improving exercise-related SE and promoting behavioral changes among elderly individuals who do not exercise regularly compared with commonly prescribed exercises. METHODS: In this randomized controlled study, the sampling frame consisted of participants in an annual town-sponsored medical check-up. The inclusion criteria were no regular exercise and age of 65–74 years at enrollment. The subjects in the intervention group (CEP group) were instructed to perform individualized exercises prescribed based on an original algorithm. Data collection was performed at baseline and 3, 6, 9, and 12 months after exercise instruction. The primary outcome was SE for exercise at the last time point. Secondary outcomes were SE for exercise, stage of change in exercise behavior, knee pain, and low back pain at each evaluation time point. RESULTS: Fifty subjects (CEP group n = 26; control group n = 24) were randomized. In the CEP group, 25 of 26 subjects were analyzed at 3 months, 26 of 26 subjects were analyzed at 6 and 9 months, and 25 of 26 subjects were analyzed at 12 months. In the control group, 23 of 24 subjects were analyzed at 3, 6, 9, and 12 months. SE for exercise improved 24.0% (CEP group 30.8%; control group 16.7%) compared to baseline. No significant differences were observed in the primary outcome. SE for exercise was significantly lower at 9 and 12 months compared with baseline in the control group. Stage of change for exercise behavior was significantly higher at 3 months compared with baseline in the CEP group and at 6 months in the control group. Knee pain was worse at 3 months compared with baseline in the control group. CONCLUSIONS: This study suggested that exercise instruction with CEPs contributes to the maintenance of SE for exercise and is useful for changing exercise behavior in elderly individuals who do not regularly exercise. TRIAL REGISTRATION: UMIN000027240, registered on 03/05/2017. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-019-7270-7) contains supplementary material, which is available to authorized users.