title: Older people's perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature.
abstract: BACKGROUND
  Physical inactivity accounts for 9% of all deaths worldwide and is among the top 10 risk factors for global disease burden. Nearly half of people aged over 60 years are inactive. Efforts to identify which factors influence physical activity behaviour are needed.
  
  
  OBJECTIVE
  To identify and synthesise the range of barriers and facilitators to physical activity participation.
  
  
  METHODS
  Systematic review of qualitative studies on the perspectives of physical activity among people aged 60 years and over. MEDLINE, EMBASE, CINAHL, PsychINFO and AMED were searched. Independent raters assessed comprehensiveness of reporting of included studies. Thematic synthesis was used to analyse the data.
  
  
  RESULTS
  From 132 studies involving 5987 participants, we identified six major themes: social influences (valuing interaction with peers, social awkwardness, encouragement from others, dependence on professional instruction); physical limitations (pain or discomfort, concerns about falling, comorbidities); competing priorities; access difficulties (environmental barriers, affordability); personal benefits of physical activity (strength, balance and flexibility, self-confidence, independence, improved health and mental well-being); and motivation and beliefs (apathy, irrelevance and inefficacy, maintaining habits).
  
  
  CONCLUSIONS
  Some older people still believe that physical activity is unnecessary or even potentially harmful. Others recognise the benefits of physical activity, but report a range of barriers to physical activity participation. Strategies to enhance physical activity participation among older people should include (1) raising awareness of the benefits and minimise the perceived risks of physical activity and (2) improving the environmental and financial access to physical activity opportunities.
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Marcia R
authors.initials: MR
authors.lastname: Franco
authors.affiliation: School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Tong
authors.affiliation: School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Faculty of Health Science, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Ferreira
authors.affiliation: Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, New South Wales, Australia Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, UNESP-Univ Estadual Paulista, Presidente Prudente, São Paulo, Brazil.
authors.forename: Rafael Z
authors.initials: RZ
authors.lastname: Pinto
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Manuela L
authors.initials: ML
authors.lastname: Ferreira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D003365:Costs and Cost Analysis; D004779:Environment Design; D015444:Exercise / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D007899:Leisure Activities / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D053580:Muscle Strength / Q000502:physiology; D057185:Sedentary Behavior; D012649:Self Concept; D016138:Walking / Q000523:psychology
keywords: Aging; Elderly people; Exercise; Physical activity