scholarly journals Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall

JAMA ◽  
2019 ◽  
Vol 321 (21) ◽  
pp. 2092 ◽  
Author(s):  
Teresa Liu-Ambrose ◽  
Jennifer C. Davis ◽  
John R. Best ◽  
Larry Dian ◽  
Kenneth Madden ◽  
...  
2017 ◽  
Vol 59 (2) ◽  
pp. 565-574 ◽  
Author(s):  
Kalpana P. Padala ◽  
Prasad R. Padala ◽  
Shelly Y. Lensing ◽  
Richard A. Dennis ◽  
Melinda M. Bopp ◽  
...  

Author(s):  
Uratcha Sadjapong ◽  
Supachai Yodkeeree ◽  
Somporn Sungkarat ◽  
Penprapa Siviroj

The efficacy of exercise to reverse frailty in the aging population has not been extensively investigated. This study aimed to investigate the effectiveness of a multicomponent exercise program (MCEP) on frailty, physical performance (handgrip strength, Berg Balance Scale (BBS), Timed Up and Go test (TUG), and VO2Max), blood biomarkers (Interleukin-6 (IL-6) and C-reactive protein (CRP)) in frail older adults. A randomized controlled trial using an allocation concealment method, included 64 older adults (77.78 ± 7.24 years), were divided into two parallel groups using block randomization: an MCEP group (n = 32) and a control group (n = 32). The combined center- and home-based MCEP training consisted of chair aerobic, resistance, and balance, which was carried out 3 days per week for 24 weeks. A mixed model repeated measure ANOVA demonstrated significant interaction effects of group x time for BBS, TUG and frailty scores (p < 0.001). Additionally, the post-hoc analysis revealed that the MCEP group showed significantly improved BBS, TUG, and frailty scores (p < 0.01), at both 12- and 24-weeks. When compared with controls at 12-weeks, the MCEP group decreased IL-6 and CRP levels (p < 0.05). The combined center- and home-based MCEP were effective in reversing frailty to pre-frailty and improving physical performance especially balance in the older population.


2020 ◽  
Author(s):  
Robin M Daly ◽  
Jenny Gianoudis ◽  
Travis Hall ◽  
Niamh Mundell ◽  
Ralph Maddison

BACKGROUND Many older adults choose and prefer to exercise at home, but to attain the greatest benefits the correct type and dose should be prescribed and adherence maintained. Advances in digital health technologies now provide the opportunity for exercise professionals to deliver and monitor personalized, evidence-based exercise programs to anyone at anytime. OBJECTIVE To evaluate the feasibility, usability and enjoyment of an online exercise prescription application as a platform for exercise professionals to remotely deliver and monitor an individually-tailored, home-based multi-component exercise program (delivered through tablet computers) to older adults living independently in the community. METHODS This was an 8-week, prospective single-arm pilot study in 20 adults aged ≥65 years living independently in the community [10 who owned a tablet computer (tablet owners) and 10 who did not (tablet non-owners)]. All participants were prescribed a home-based, muscle strengthening, weight-bearing impact and challenging balance/mobility program (3 days/week) using a commercial exercise prescription application (app) on a tablet computer. Study endpoints were feasibility (retention, adherence, adverse events), usability (System Usability Scale), physical activity enjoyment (Physical Activity Enjoyment Scale), changes in lower extremity function [Short Physical Performance Battery (SPPB)], and level of physical activity (questionnaire). Process measures related to participants’ experiences and perceptions of the exercise program and online application were also included. RESULTS A total of 19 participants (mean age 70 years) completed the study (19 of 20, 95%) and mean adherence to the exercise program was 84% (95% CI, 70, 97). There were two minor adverse events in two participants from 401 completed sessions. Mean weekly walking time increased by 78 minutes [(95% CI, 0, 156), P=.049] and moderate-vigorous physical activity time by 41 minutes [(95% CI, -8, 90), P=.09]. For SPPB scores, there was a 0.3 point [(95% CI, -0.1, 0.7), P=.17] modest sized (effect size, d=0.42) improvement after 8 weeks. Mean system usability was high (mean  SD, 86  10 with 100 best imaginable]. There was no change in overall physical activity enjoyment scores after 8 weeks, but participants reported that they enjoyed using the online exercise app and the exercise program (median score 4 on a 5-point Likert scale). For all measures, there were no differences between previous tablet owners and non-owners. CONCLUSIONS This pilot feasibility study indicates that it is safe and feasible for community-dwelling older adults to participate in a home-based, multi-component exercise program targeting musculoskeletal health and function that was delivered and monitored remotely by exercise professionals using a tablet-based exercise prescription app.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 403-403
Author(s):  
Emma Gulley ◽  
Joe Verghese ◽  
Emmeline Ayers ◽  
Tanya Verghese ◽  
Anne Felicia Ambrose

Abstract Exercise is crucial to maintain mobility, reduce falls and delay functional decline in older adults, but effective implementation strategies are lacking. Self-directed home-based exercise therapy is recommended by clinicians to overcome barriers such as cost, travel and availability. However, non-adherence is a major challenge due to lack of motivation, real time feedback or social support. To overcome these barriers, we conducted a feasibility study to evaluate a home-based exercise program with telephone coaching to improve mobility in frail older adults. Four non-demented, frail community-dwelling older adults were taught one of two exercise routines at our research center. The first involved complex exercises with internal and external cueing techniques that have been associated with neuroplasticity in previous studies (N=3). The second was a lesser cognitively demanding control program that included aerobic, balance and strengthening exercises (N=1). One week later, the participants were asked to repeat the exercises in their own home. The research assistant coached the patient over the telephone. A board-certified physiatrist was present during the home session to monitor adherence and fidelity to the protocol as well as address safety. The study produced qualitative findings regarding recruitment strategies, exercise feasibility, and other logistical issues relating to participant understanding, safety, and monitoring. Based on direct observation of participants at home, safety assessment protocols, instructions, and exercises were all refined. Building on this data, we plan to design a clinical trial to evaluate the impact of complex exercises designed to promote neuroplasticity and reduce cognitive and motoric decline in older adults.


Author(s):  
Branko Olij ◽  
Vicki Erasmus ◽  
Lotte Barmentloo ◽  
Alex Burdorf ◽  
Dini Smilde ◽  
...  

We aimed to describe and evaluate the implementation of a home-based exercise program among community-dwelling adults aged ≥65 years. In an observational study, the twelve-week program was implemented in a community setting. The implementation plan consisted of dialogues with healthcare professionals and older adults, development of an implementation protocol, recruitment of participants, program implementation, and implementation evaluation. The dialogues consisted of a Delphi survey among healthcare professionals, and of individual and group meetings among older adults. The implementation of the program was evaluated using the framework model RE-AIM. In the dialogues with healthcare professionals and older adults, it was found that negative consequences of a fall and positive effects of preventing a fall should be emphasized to older adults, in order to get them engaged in fall prevention activities. A total of 450 older adults enrolled in the study, of which 238 started the program. The process evaluation showed that the majority of older adults were recruited by a community nurse. Also, a good collaboration between the research team and the local primary healthcare providers was accomplished, which was important in the recruitment. Future fall prevention studies may use this information in order to translate an intervention in a research project into a community-based program.


Sign in / Sign up

Export Citation Format

Share Document