Using Inclusive Design to Develop a Tele–Tai Chi Intervention for Older Adults With Long-Term Mobility Disability

Abstract Tele-technologies may be able to increase access to evidence-based exercise interventions for adults aging with long-term mobility disabilities. This population experiences substantial barriers in attending such programs in person, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. It is critical to overcome such barriers to ensure this population has an opportunity to receive the benefits of evidence-based programs. In this study we are translating an in-person evidence-based tai chi intervention, Tai Chi for Arthritis, to an online platform using videoconferencing software for those aging with long-term mobility disabilities. We will describe our approach of including users from the target population and industry representatives (videoconferencing software developer, Tai Chi for Arthritis program developer as well as local master trainer) in the adaptation of the intervention and present the key findings from doing so.

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Delivering a Tai Chi Intervention to Adults Aging with Mobility Disabilities Using Zoom

Innovation in Aging ◽

10.1093/geroni/igab046.1642 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 425-425

Author(s):

Elena Remillard ◽

Kara Cohen ◽

Lelah Cochran ◽

Tracy Mitzner

Keyword(s):

Mental Health ◽

Older Adults ◽

Tai Chi ◽

Lessons Learned ◽

Evidence Based ◽

Physical And Mental Health ◽

Virtual Group ◽

Exercise Classes ◽

Made In

Abstract Many individuals aging with mobility disabilities experience barriers to participating in physical activity, including transportation challenges and the need for specialized instruction. Since the COVID-19 pandemic began, these participation barriers have been amplified due to lockdowns and restrictions. Tele-technologies, including videoconferencing platforms like Zoom, can facilitate access to exercise classes from one’s home. Virtual group exercise classes that incorporate social interaction have particular potential to support the physical and mental health of this population. This session will highlight lessons learned from launching the ‘Tele Tai Chi’ study, in which we are delivering an evidence-based Tai Chi program (Tai Chi for Arthritis) via Zoom to small group classes of older adults with long-term mobility disabilities. We will describe adaptations made in translating the in-person program to an interactive, online class, and provide an overview of a ‘Telewellness’ Tool that provides guidelines for using Zoom to deliver exercise classes to older adults.

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Participation in Two Evidence-Based Falls Prevention Programs by Adults Aging With a Long-Term Disability: Case-Control Study of Reach and Effectiveness

Journal of Aging and Health ◽

10.1177/0898264318808918 ◽

2018 ◽

Vol 31 (10_suppl) ◽

pp. 39S-67S ◽

Cited By ~ 1

Author(s):

Thomas J. Eagen ◽

Salom M. Teshale ◽

Angelica P. Herrera-Venson ◽

Anne Ordway ◽

Joe Caldwell

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Prevention Programs ◽

Preliminary Evidence ◽

Case Control ◽

Falls Prevention ◽

Evidence Based ◽

Activity Restriction ◽

Increased Risk

Objective: Adults aging with a long-term disability (LTD) are at an increased risk for falls. The Older Americans Act Title III-D and Prevention and Public Health Fund (PPHF) support several organizations to deliver falls prevention evidence-based programs designed to reduce risk factors; however, little is understood about the reach and effectiveness of these fall prevention programs for those with LTD compared to those without LTD. This study compared the reach and effectiveness of two evidence-based falls prevention programs between older adults with and without LTD. Method: Using a matched case-control design, 105 LTD older adults enrolled in A Matter of Balance (AMOB) or Stepping On were matched to 315 non-LTD older adults on age, sex, race, and education. Results: On average, LTD older adults attended a higher number of class sessions and were significantly more likely to complete the program compared with the matched-sample of non-LTD older adults. LTD older adults were equally likely as non-LTD older adults to report significant reductions in self-reported fear of falling, falls-related activity restriction, and improvement in falls self-efficacy following completion of the programs. Discussion: These findings provide preliminary evidence for the effectiveness of these evidence-based falls prevention programs for LTD older adults; however, more research is needed to extend these findings.

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Determining the Long-Term Effectiveness of a Group-Based Physical Activity Program

Health Promotion Practice ◽

10.1177/1524839918769590 ◽

2018 ◽

Vol 20 (3) ◽

pp. 401-408

Author(s):

Anamica Batra ◽

Richard C. Palmer ◽

Elena Bastida ◽

H. Virginia McCoy ◽

Hafiz M. R. Khan

Keyword(s):

Physical Activity ◽

Older Adults ◽

Healthy Aging ◽

Population Level ◽

The United States ◽

South Florida ◽

Community Based ◽

Evidence Based Programs ◽

The Impact

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.

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Exercise-Based Interventions to Enhance Long-Term Sustainability of Physical Activity in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16142527 ◽

2019 ◽

Vol 16 (14) ◽

pp. 2527 ◽

Cited By ~ 13

Author(s):

Sansano-Nadal ◽

Giné-Garriga ◽

Brach ◽

Wert ◽

Jerez-Roig ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Active Control ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Community Dwelling ◽

Exercise Interventions ◽

Mean Differences

Exercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.

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UTILIZING TECHNOLOGY NETWORKS TO SUPPORT SOCIAL NETWORKS FOR PEOPLE AGING WITH DISABILITY

Innovation in Aging ◽

10.1093/geroni/igz038.2787 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S758-S759

Author(s):

Elena T Remillard ◽

Wendy Rogers ◽

Sarah Ruiz

Keyword(s):

Older Adults ◽

Successful Aging ◽

Independent Living ◽

Large Scale ◽

Tai Chi ◽

New Technologies ◽

Great Promise ◽

Ongoing Research ◽

Engineering Research

Abstract A growing number of new smart, internet-enabled technologies from smart phone applications, to teleconferencing, to the Internet of Things (IoT), provide great promise and potential to support successful aging-in-place for people with long-term disabilities. This symposium highlights ongoing research at the TechSAge Rehabilitation Engineering Research Center to identify technology needs and develop/adapt new technologies to promote independence, health, and participation of this population. To understand user needs, Harris et al. will present findings from a large-scale interview study with older adults with long-term vision and mobility disabilities (N=120) that explored specific task-based challenges with community activities (e.g., going to entertainment events, volunteering) as well as solutions and strategies to overcome them. Koon et al. will present findings on perceived facilitators and barriers to using digital assistants (e.g., Amazon Alexa) to facilitate a variety of everyday tasks at home, from shopping to communicating with others, among adults aging with mobility disabilities. Levy et al. will discuss findings from research driving the creation of augmented reality tools that can enable individuals to experience how IoT devices, such as smart thermostats and lightbulbs, could be used within the context of one’s own abilities and home. Mitzner et al., will describe the development of a Tele Tai Chi intervention for older adults with long-term mobility disabilities that employs teleconferencing software to translate an in-person, evidence-based class to an online, social experience. TechSAge Program Officer, Sarah Ruiz (National Institute on Disability, Independent Living, and Rehabilitation Research), will serve as the discussant.

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