• Kristina Åhlund, Birgitta Öberg, Niklas Ekerstad, and Maria Bäck.
• Department of Physiotherapy, NU Hospital Group, Trollhättan, Sweden. kristina.ahlund@vgregion.se.
• BMC Geriatr. 2020 Nov 23; 20 (1): 490.

BackgroundThere is growing evidence of the benefits of physical activity and exercise for frail elderly patients with comorbidity. In order to improve participation in physical activity and exercise interventions, there is a need to increase our understanding of the patient's perspective.AimThe aim of this study is to explore the perceptions of physical activity and exercise among frail elderly patients with a severe comorbidity burden.MethodFace-to-face, in-depth interviews were conducted with eighteen frail elderly patients with a severe comorbidity burden, median age 85.5 years (min-max 75-94). The interviews were transcribed verbatim and analyzed according to content analysis inspired by Krippendorf.ResultsAn overall theme, defined as "Meaningfulness and risk of harm in an aging body" was identified, followed by three main categories, labeled physical activity in daily life, goals of physical activity and exercise and prerequisites for physical activity and exercise, and eight sub-categories.ConclusionThis study suggests that, in frail elderly patients with severe multimorbidity, physical activity and exercise is a balance between what is perceived as meaningful and the risk of harm. Patients perceived aging as an inevitable process that they needed to accept and gradually adapt their physical activities in daily life to match. As patients said they were unclear about the benefits and risks of exercise and referred to their previous life and experiences when describing physical activity and exercise, it is likely that the communication relating to this within the healthcare system needs to be further developed To promote physical activity and exercise to maintain or improve physical fitness in this frail population, healthcare providers need to use extended, personalized information to tailor the type of physical activities, goals and prerequisites for each patient.

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