title: Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation.
abstract: BACKGROUND
  Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation.
  
  
  METHODS
  Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program.
  
  
  RESULTS
  Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years) commenced the community-based exercise training program. Twenty-two (71%) completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers.
  
  
  CONCLUSIONS
  The convenience and accessibility of a community venue for rehabilitation contributed to high levels of satisfaction and a positive experience for people with chronic respiratory and chronic cardiac disease and physiotherapists.
authors.affiliation: Physiotherapy Department; Respiratory and Sleep Medicine Department, Prince of Wales Hospital, Randwick.
authors.forename: Renae J
authors.initials: RJ
authors.lastname: McNamara
authors.affiliation: Discipline of Physiotherapy, The University of Sydney, Lidcombe.
authors.forename: Zoe J
authors.initials: ZJ
authors.lastname: McKeough
authors.affiliation: Discipline of Physiotherapy, The University of Sydney, Lidcombe.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Mo
authors.affiliation: Eastern Sydney Medicare Local, Rosebery, NSW, Australia.
authors.forename: Jamie T
authors.initials: JT
authors.lastname: Dallimore
authors.affiliation: Discipline of Physiotherapy, The University of Sydney, Lidcombe.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Dennis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D000072038:Cardiac Rehabilitation / Q000379:methods*; D003153:Community Health Services; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009517:New South Wales; D010349:Patient Compliance; D017060:Patient Satisfaction; D059825:Physical Therapists / Q000523:psychology; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012138:Respiratory Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: COPD; exercise; pulmonary rehabilitation; qualitative