Effects of the Intervention “Reflective STRENGTH-Giving Dialogues” for Older Adults Living with Long-Term Pain: A Pilot Study

Background. Long-term musculoskeletal pain is a major, often undertreated, disabling health problem among an increasing number of older adults. Reflective STRENGTH-giving dialogues (STRENGTH) may be a tool to support older adults living with long-term pain. The main aim of this pilot study was to investigate the immediate and longitudinal effect of the intervention STRENGTH on levels of pain, wellbeing, occurrence of depression symptoms, and sense of coherence (SOC) among community-dwelling older adults suffering from musculoskeletal pain compared to a control group. Methods. The study was semiexperimental with an intervention group and a control group. The effect of a single STRENGTH intervention was reported on the Numeric Rating Scale (NRS) regarding pain and wellbeing. To evaluate the longitudinal effect of STRENGTH, using the Brief Pain Inventory-Short Form (BPI-SF), the Geriatric Depression Scale-20 (GDS-20), SOC-13 at baseline (T1), and six months after the intervention/no intervention (T2), a total of 30 older adults, aged 72 to 97 years (Mdn 86 years), were included consecutively and fulfilled the intervention series (n = 18) or untreated controls (n = 12). Results. The intervention with STRENGTH decreases pain (NRS 6 Mdn versus NRS 4 Mdn, p<0.001) and increases wellbeing (NRS 7 Mdn versus NRS 8 Mdn, p<0.001). After a six-month study period with STRENGTH, no longitudinal effect difference was found compared to baseline. Compared to the control group, there was an increasing trend between decreased pain level and increased SOC level for STRENGTH intervention. Conclusions. This pilot study supports STRENGTH’s effect as a pain-alleviating model that provides a decrease in pain levels and an increase of wellbeing in older adults with long-term pain. STRENGTH dialogues could be a useful intervention to provide individually holistic care in older adults living with long-term pain.

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Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

10.21203/rs.2.15840/v2 ◽

2019 ◽

Author(s):

Lynne Taylor ◽

John Parsons ◽

Denise Taylor ◽

Elizabeth Binns ◽

Sue Lord ◽

...

Keyword(s):

Older Adults ◽

Cost Effectiveness ◽

Long Term Care ◽

Controlled Trial ◽

Intervention Group ◽

Exercise Program ◽

Community Dwelling ◽

Control Group ◽

Term Care

Abstract Background Falls are two to four times more frequent amongst long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesized that a progressive exercise program targeting balance and strength will reduce falls rates when compared to a seated exercise program and do so cost effectively. Methods/Design This is a single blind, parallel-group, randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥65 years) will be recruited from LTC facilities in New Zealand. Participants (n= 528 total; with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia, (intervention group) or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 hour twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period. Secondary outcomes will be risk of falling (the proportion of fallers per group), falls rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline, 6 and 12 months. Cost effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 31 November 2018. Discussion This study evaluates the efficacy and cost effectiveness of a progressive strength and balance exercise program for aged-care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programs for this vulnerable population.

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“Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189514 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9514

Author(s):

Shefaly Shorey ◽

Ee Heok Kua ◽

Wilson Tam ◽

Valerie Chan ◽

Yong Shian Goh ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Pilot Study ◽

Intervention Group ◽

Well Being ◽

Small Sample ◽

Community Dwelling ◽

Control Group ◽

Community Dwelling Older Adults

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.

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eSeniorCare: Technology for Promoting Well-Being of Older Adults in Independent Living Facilities (Preprint)

10.2196/preprints.26686 ◽

2020 ◽

Author(s):

Dipanwita Dasgupta ◽

Beenish Chaudhry ◽

Kimberly Greeves ◽

Joyce Long ◽

Mayra Duarte ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Mobile Technology ◽

Successful Aging ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Health Goals

BACKGROUND Successful Aging is a multidimensional concept that encompasses mental and physical health, chronic disease management and social engagement of older adults. A number of mobile health interventions have been designed to promote Successful Aging, but the majority focus on only one dimension. Moreover, there is a dearth of research studies that explore the feasibility and long-term acceptance of these interventions in community-dwelling older adults from lower socioeconomic strata (SES), who can derive the greatest health and economic benefits from such interventions. OBJECTIVE To study the long-term feasibility of an integrated intervention, which combined mobile technology with social relationships, in improving perceptions of Successful Aging in community-dwelling low-SES older adults. METHODS The intervention combined mobile technology with social relationships. The mobile technology component of the intervention consisted of a tablet-based application, eSeniorCare, that allowed older adults to track their medications and health activities and play proprietary gaming apps from the online app store. Whereas the social component consisted of weekly technology workshops and meetups. Study Design. We used a pre-test post-test experimental design approach with two groups (intervention and control). 25 older adults were recruited in each group. Each participant in the intervention group received a tablet PC pre-installed with the eSeniorCare app and various gaming apps. The control group received usual care. Participants completed self-reported outcomes consisting of SF12v2 and Older Person Quality of Life (OPQOL) questionnaires both at the beginning and at the end of the study. The study lasted for 42 weeks during which the intervention group used the eSeniorCare app to track their medications and health activities, and they also played the installed gaming apps. In addition, they received technology training via weekly workshops, where they interacted with participants in the intervention group and the study staff. RESULTS The results indicate that the integrated intervention significantly improved participants’ perceptions of their mental health and health-related quality of life. Specifically, they found that the eSeniorCare app improved their adherence to medication regimen and motivated them to pursue their health goals. They also thought that playing tablet games was men- tally stimulating and it improved their overall cognitive health. By the end of the study, the intervention group preferred technology over paper for managing their medications and health goals, while no one in the control group wanted to preferred technology over paper. CONCLUSIONS An integrated mobile health intervention is feasible for long-term use by community-dwelling older adults from lower SES and community-based caregivers. It improved perceptions of mental health and health related quality of life among the study participants.

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Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-021-00251-x ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Niklas Sörlén ◽

Andreas Hult ◽

Peter Nordström ◽

Anna Nordström ◽

Jonas Johansson

Keyword(s):

Older Adults ◽

Postural Sway ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Positive Effects ◽

Randomized Controlled ◽

Eyes Closed ◽

Balance Exercise

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.

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The effect of group exercises on balance, mobility, and depressive symptoms in older adults with mild cognitive impairment: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215518815218 ◽

2018 ◽

Vol 33 (3) ◽

pp. 439-449 ◽

Cited By ~ 4

Author(s):

Chandra da Silveira Langoni ◽

Thais de Lima Resende ◽

Andressa Bombardi Barcellos ◽

Betina Cecchele ◽

Juliana Nunes da Rosa ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Mild Cognitive Impairment ◽

Intervention Group ◽

Depression Scale ◽

Community Dwelling ◽

Effect Sizes ◽

Control Group ◽

Community Dwelling Older Adults

Objective: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment. Design: Single blinded, randomized, matched pairs clinical trial. Setting: Four primary healthcare units. Subjects: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke’s Cognitive Examination Revised score), tested, and then randomized into an intervention group ( n = 26) and a control group ( n = 26). Intervention: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities’ public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine. Main measures: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention. Results: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement ( P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8–6); after: 2.5 (1–4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2–7.3); after: 4 (2–5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group’s mobility and balance. Large effect sizes were observed the intervention group’s mobility and balance. Conclusion: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.

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Efficacy of an antigravity treadmill on functional outcome in non-operatively treated pelvic fractures: a prospective pilot study

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2018.0057 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1-9

Author(s):

Ralf Henkelmann ◽

Michael Schäfer ◽

Andreas Höch ◽

Christian Leps ◽

Martin Busse ◽

...

Keyword(s):

Pilot Study ◽

Gait Analysis ◽

Rating Scale ◽

Intervention Group ◽

Training Session ◽

Pelvic Fractures ◽

Control Group ◽

Gait Patterns ◽

Prospective Pilot Study ◽

Normal Gait

Background/Aims Treating pelvic fractures non-operatively is possible. The immobilisation stage of recovery requires different adjustment processes compared to those used in operative treatment. The aim of the present study was to prove the additional benefit an antigravity treadmill can have on patients with non-operatively treated pelvic fractures. Methods A prospective pilot study, including patients with non-operatively treated pelvic fractures as the intervention group and healthy volunteers as a control group, was undertaken. Patients of the intervention group participated in a training session with an antigravity treadmill every 3 days for a total of 40 days, in addition to physiotherapy, lymph drainage massage and manual therapy. Patients were evaluated using a dynamic gait index, and a numeric rating scale on three successive dates, to assess their pain. A standardised gait analysis was also carried out. Results The intervention group comprised 9 patients, while 33 patients made up the control group. All patients completed the protocols and experienced a significant decrease in pain and increase of mobility. Gait analysis showed that by the 40-day follow-up, patients in the intervention group had regained almost normal gait patterns when compared to the control group. At each time point, a significant improvement in patients' gait patterns could be seen. Conclusions The results concurred with previous studies, suggesting that the antigravity treadmill is safe and that recovery to almost normal gait patterns is possible, while the comparison to a healthy group strengthened the data. The present prospective study thus showed promising results regarding the efficacy of the antigravity treadmill, despite study limitations.

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86 Developing the Adapted Lifestyle - Integrated Functional Exercise Programme in Thai Context (TLIFE) to Prevent Falls among Older Adults in Thailand: A Mixed Methods Study

Age and Ageing ◽

10.1093/ageing/afz164.86 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Sasiporn Ounjaichon ◽

Chris Todd ◽

Emma Stanmore ◽

Elisabeth Boulton

Keyword(s):

Older Adults ◽

Randomised Controlled Trial ◽

Retention Rate ◽

Controlled Trial ◽

Intervention Group ◽

Exercise Programme ◽

Community Dwelling ◽

Control Group ◽

Functional Exercise ◽

Randomised Controlled

Abstract Introduction Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in Thai context (TLiFE) among older Thai adults. Methods Based on the findings of a prior qualitative study, a feasibility randomised controlled trial (RCT) of TLiFE was conducted among community-dwelling older adults, comparing the TLiFE intervention group with a usual care control group. Outcome measures were analysed at baseline, 3 months, and after 6 months of the intervention. Results We recruited a total of 72 older adults into the RCT, randomised to TLiFE (n=36) and control (n=36). The retention rate at 6 months was 91.7%. Attendance in the intervention group (3 home visits and 4 follow-up calls) was 82.9%. There were no differences in fall incidence between the groups. The acceptability survey reveals TLiFE is easy to perform in daily life, safe, and useful. No adverse events were reported. Conclusion The TLiFE programme appears to be acceptable and feasible to deliver to community-dwelling older Thai adults. This feasibility study was not powered to detect a difference between groups. A further fully powered definitive randomised controlled trial of TLiFE is needed to evaluate long-term outcomes and cost-effectiveness before it is integrated within the healthcare system in Thailand.

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AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.603 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S169-S169

Author(s):

Junxin Li ◽

Sarah Szanton ◽

Minhui Liu ◽

Nada Lukkahatai ◽

Junxin Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Quality ◽

Behavioral Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Tnf Α ◽

Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

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Evaluating the Efficacy of Therapeutic Programs on Improving Cognitive Function and Depression among Older Adults Living with Dementia in Korea

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093218 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3218

Author(s):

Jaeeon Yoo ◽

Sunhee Lee

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Effect Size ◽

Group Activity ◽

Control Group ◽

Depression Symptoms ◽

Effective Interventions ◽

Meta Regression Analysis ◽

Comprehensive Curriculum

The purpose of this study was to evaluate the effect size of programs for enhancing cognition and alleviating depression in older adults with dementia. This study selected 45 cognition and 37 depression programs, which conducted pre- and post-tests and had a treatment group and a control group comprising older adults living in Korea. This study conducted a meta-regression analysis to examine the moderating effect of the program location, number of sessions, intervals, group activities, and curriculum on cognition and depression. Most programs improved cognitive function and lowered depression symptoms. The heterogeneity of the effect size was large. The effect size of the number of sessions on a cognitive function significantly increased with an increasing number of sessions. The effect size of the group activity program on cognitive function was higher. The effect of healthcare institutions on depression was lower compared to other locations. To make more effective interventions for cognition and depression, long-term and group activity programs following a comprehensive curriculum will be required. The programs of healthcare institutions are encouraged to accept the advantages of other institutions and apply them to improve the effects of the programs on depression. Future studies shall focus on establishing concrete measures to enable healthcare institutions to connect older adults with dementia with various other institutions that offer long-term group programs.

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Effectiveness of a Treadmill Training Programme in Improving the Postural Balance on Institutionalized Older Adults

Journal of Aging Research ◽

10.1155/2020/4980618 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Natalia Moya Pereira ◽

Marcel Jean Pierre Massè Araya ◽

Marcos Eduardo Scheicher

Keyword(s):

Older Adults ◽

Gait Speed ◽

Postural Balance ◽

Intervention Group ◽

Community Dwelling ◽

Treadmill Walking ◽

Control Group ◽

Timed Up And Go ◽

Positive Effects ◽

Before And After

Background. Institutionalized older adults have increased gait and balance impairment compared with community-dwelling older adults. The use of the treadmill for the rehabilitation process has been studied in different groups, but not in the institutionalized elderly. Objectives. The objective of this study was to assess the effects of a treadmill walking workout program on the postural balance of institutionalized older adults. Methods. Postural balance was assessed by the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), gait speed, and Timed Up and Go Test (TUG) on 37 institutionalized older adults (23 in the intervention group and 14 in the control group). Training consisted of a 20-minute treadmill walking workout carried out twice a week for 10 weeks. Measurements were obtained before and after 10 weeks and with 1 month of follow-up for the intervention group. For the control group, the data were obtained before and after the training period. Results. Significant improvement occurred in all motor function parameters (BBS: p<0.01; gait speed: p<0.001; SPPB: p<0.001; and TUG: p<0.001). Conclusions. The present results permit us to conclude that a treadmill walking program had positive effects on the postural balance of institutionalized older adults.

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