Patients’ experiences of exercise-based falls prevention: The building of autonomy, competence, and relatedness

Introduction: Satisfaction of basic psychological needs is proposed to underpin the internalization of motivation for physical activity (Self Determination Theory: Deci & Ryan, 2000). This may be salient in an older population who can experience age related need thwarting. Physical activity interventions can increase need satisfaction, however, the mechanisms by which this occurs are not fully understood. In-depth longitudinal case studies may help to clarify how need satisfaction occurs in older participants throughout an exercise programme. This work presents case studies of individuals’ experiences during a 32 week Postural Stability Instruction programme. Method: Six programme participants (78-89 years, FRAT scores from 1-3) were interviewed at programme commencement, weeks 10-11, 20-22, 30-32, and post programme. In interviews they discussed exercise, attitudes towards the class and physical activity, perceptions of need satisfaction, and their physical identity. Results: Participants’ narratives highlighted a range of sources of need satisfaction (e.g., relatedness – instructor support; autonomy – becoming uninhibited by their physical self and able to grow, develop, and contribute; and competence – being able to do daily activities/tasks lost to them previously). Participants emphasised the personal salience of changes in different needs, however, it was notable that competence appeared important for all patients. Discussion: Sources of need satisfaction were generally consistent with previous literature. Taken as a whole, the narratives support need satisfaction as one mechanism through which development of a physically active identity is facilitated. PSTI programmes may satisfy different needs for different individuals by supplementing needs thwarted in other areas of participants’ daily lives.