scholarly journals Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19

2020 ◽  
Vol 6 ◽  
pp. 233372142098031
Author(s):  
Stephen C. Jennings ◽  
Kenneth M. Manning ◽  
Janet Prvu Bettger ◽  
Katherine M. Hall ◽  
Megan Pearson ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Exercise Program ◽  
Performance Testing ◽  
Group Exercise ◽  
Health Maintenance ◽  
Functional Assessments ◽  
Wide Scale ◽  
Rapid Transition ◽  
Exercise Classes

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.

scholarly journals The ‘new normal’ includes online prenatal exercise: Exploring pregnant women’s experiences during the pandemic and the role of virtual group fitness on maternal mental health

2021 ◽  
Author(s):  
Cristina Silva-Jose ◽  
Taniya S Nagpal ◽  
Javier Coterón ◽  
Ruben Barakat ◽  
Michelle F Mottola
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Pregnant Women ◽  
Maternal Mental Health ◽  
Exercise Program ◽  
Well Being ◽  
Group Exercise ◽  
Exercise Classes ◽  
Prenatal Exercise ◽  
Online Group

Abstract Background: Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic. Furthermore, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs.Methods: Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women’s experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory (STAI) and these data supplemented qualitative findings. Results: Twenty-four women were interviewed, and the average STAI score was 32.23 ± 9.31, ranging from low to moderate anxiety. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional.Conclusion: Pregnant women are receptive to online group exercise classes and expressed that these are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health.

Technology support challenges and recommendations for adapting an evidence-based exercise program for virtual delivery to older adults: Mixed-methods study (Preprint)

2021 ◽  
Author(s):  
Nancy Gell ◽  
Elise Hoffman ◽  
Kushang Patel
Keyword(s):  
Older Adults ◽  
Technical Assistance ◽  
Exercise Program ◽  
Barriers And Facilitators ◽  
Support Needs ◽  
Evidence Based ◽  
Technology Support ◽  
Symptomatic Knee Osteoarthritis ◽  
Technology Orientation ◽  
Exercise Classes

BACKGROUND Tele-exercise has emerged as a way for older adults to participate in group exercise during the COVID-19 pandemic. Yet, little is known about the technology support needs of older adults for accessing tele-exercise. OBJECTIVE Examine the interests and needs of older adults for transition to tele-exercise, 2) Identify barriers and facilitators of tele-exercise uptake and continued participation, and 3) Describe technology support challenges and successes encountered among older adults beginning tele-exercise. METHODS We used an exploratory sequential mixed method study design. Participants were older adults with symptomatic knee osteoarthritis (n=44) who started participating in remotely delivered Enhance Fitness. Prior to the start of classes, a subsample of participants (n=10) completed semi-structured phone interviews about technology support needs and barriers and facilitators for technology adoption. All participants completed surveys including the PROMIS-57, the Senior Technology Acceptance Model scale, and a technology needs assessment. The study team recorded technology challenges encountered when participants engaged in tele-exercise classes and attendance rates. RESULTS Four themes emerged from the interviews: Participants desire features in a tele-exercise program that foster accountability; importance of direct access to helpful people who can troubleshoot and provide guidance with technology; opportunities to participate in high value activities motivates willingness to persevere through technology concerns; and belief in the ability to learn new things supersedes technology-related anxiety. Among participants in the tele-exercise classes (mean age 74.0 years ± 6.3; 86.4% female; mean of 2.5 ± 0.9 chronic conditions), 70.5% had a computer with a webcam, but 40.9% had little or no experience with videoconferencing. Initial technology orientation sessions lasted, on average, 19.3 (±10.3) minutes and 23.9% required a follow-up assistance call. During the first two weeks of tele-exercise, 47.6% required technical assistance which decreased to 11.9% for weeks 3-16. Median attendance was 100% for the first six sessions and 93% for the subsequent 42 sessions. CONCLUSIONS With appropriate support, older adults can successfully participate in tele-exercise. Recommendations include individualized technology orientation sessions, experiential learning, and availability of stand-by technical assistance, particularly during the first two weeks of classes. Continued development of best practices in this area may allow previously hard-to reach populations of older adults to participate in health-enhancing, evidence-based exercise programs. CLINICALTRIAL NCT04099394

scholarly journals Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants

2016 ◽  
Vol 37 (1) ◽  
pp. 79-98 ◽  
Author(s):  
Tiffany E. Shubert ◽  
Matthew Lee Smith ◽  
Luohua Jiang ◽  
Marcia G. Ory
Keyword(s):  
United States ◽  
Older Adults ◽  
Physical Performance ◽  
Functional Performance ◽  
Exercise Program ◽  
The United States ◽  
Functional Mobility ◽  
Self Report ◽  
Timed Up And Go ◽  
Logistic Regression Models

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program. Baseline and 8-week functional and self-report data were collected on 210 older adults from 2013 to 2015. Linear mixed models and general estimating equations logistic regression models adjusted for socio-demographic factors were performed to assess changes. At 8 weeks, scores dramatically improved on self-report and physical performance tests: Timed Up-and-Go ( p < .001), 30-Second Chair Rise ( p < .001), and Four-Stage Balance ( p < .001). Findings support that participation in the U.S. OEP as part of a plan of care can result in significant improvements in objective functional mobility, balance measures, and self-reported ability.

Effects of a Group Exercise Program on Risk Factors for Falls in Frail Older Adults

1994 ◽  
Vol 2 (1) ◽  
pp. 25-37 ◽  
Author(s):  
Ellen F. Binder ◽  
Marybeth Brown ◽  
Suzanne Craft ◽  
Kenneth B. Schechtman ◽  
Stanley J. Birge
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Exercise Program ◽  
Knee Extensor ◽  
Community Dwelling ◽  
Moderate Intensity ◽  
Group Exercise ◽  
Frail Older Adults ◽  
The Mean ◽  
Risk Factors For Falls

Fifteen community dwelling older adults, ages 66 to 97 years, with at least one risk factor for recurrent falls, attended a thrice weekly group exercise class for 8 weeks. In post- versus preexercise comparisons, knee extensor torque at 0°/sec increased by 16.5% (p= 0.055); time to perform the stand-up test once, and five times consecutively, improved by 29.4 and 27.4%, respectively (p= 0.05,p= 0.01); gait speed for 24 feet increased by 16.5% (p< 0.001); and performance of the progressive Romberg test of balance improved with a mean increase of 1.1 ± 0.9 positions (p= 0.001). Participants reported a significant increase in the mean number of times per week that they went out of their apartment/home independent of exercising, and a significant increase in the mean number of city blocks they could walk. Performance data for nine exercise participants at 1-yr postintervention are presented. A low- to moderate-intensity groups exercise program can effect improvements in lower extremity strength, gait speed, balance, and self-reported mobility function in frail older adults.

scholarly journals Cachexia and Sarcopenia in Older Adults with Cancer: A Comprehensive Review

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1861 ◽  
Author(s):  
Richard F. Dunne ◽  
Kah Poh Loh ◽  
Grant R. Williams ◽  
Aminah Jatoi ◽  
Karen M. Mustian ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Cancer Cachexia ◽  
Assessment Tool ◽  
Treatment Guidelines ◽  
Geriatric Oncology ◽  
Performance Testing ◽  
Older Patient ◽  
Consensus Definition ◽  
Patient Reported

Cancer cachexia is a syndrome characterized by weight loss with accompanying loss of muscle and/or fat mass and leads to impaired patient function and physical performance and is associated with a poor prognosis. It is prevalent in older adults with cancer; age-associated physiologic muscle wasting and weakness, also known as sarcopenia, can compound deficits associated with cancer cachexia in older adults and makes studying this condition more complex in this population. Multiple measurement options are available to assess the older patient with cancer and cachexia and/or sarcopenia including anthropometric measures, imaging modalities such as Dual X-ray absorptiometry (DEXA) and Computed Tomography (CT), muscular strength and physical performance testing, and patient-reported outcomes (PROs). A geriatric assessment (GA) is a useful tool when studying the older patient with cachexia given its comprehensive ability to capture aging-sensitive PROs. Interventions focused on nutrition and increasing physical activity may improve outcomes in older adults with cachexia. Efforts to develop targeted pharmacologic therapies with cachexia have not been successful thus far. Formal treatment guidelines, an updated consensus definition for cancer cachexia and the development of a widely adapted assessment tool, much like the GA utilized in geriatric oncology, could help advance the field of cancer cachexia over the next decade.

scholarly journals 257 Participants’ Experience of a Novel Group Exercise Program: Results from the DEFRAIL (Diet and Exercise for Frailty) Study Pilot

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Pádraig Bambrick ◽  
Niamh Phelan ◽  
Thomas Byrne ◽  
Clare McMahon ◽  
George Pope ◽  
...  
Keyword(s):  
Older Adults ◽  
Pilot Trial ◽  
Exercise Program ◽  
Protein Supplementation ◽  
Group Exercise ◽  
Joint Injury ◽  
Frail Older Adults ◽  
Translational Study ◽  
Diet And Exercise ◽  
Additional Feedback

Abstract Background DEFRAIL (Diet and Exercise for Frailty) is a translational study examining the effect of an eight-week multicomponent group exercise program and protein supplementation on frailty in older adults. As part of the development of this novel intervention, a four-week pilot was carried out to assess participants’ experience of the program, with a view to optimising the final format. Methods Inclusion in the DEFRAIL study requires a candidate to be deemed frail as per the Fried criteria. During the initial stages of recruitment for DEFRAIL, any individual who was identified as pre-frail was offered the opportunity to participate in the pilot trial (11 x 1-hour group sessions at a local sporting facility). Following its conclusion, a telephone interview using a standardised questionnaire was conducted on all participants to assess various aspects of their experience. Results Of 9 participants recruited for the pilot, 7 completed the four-week program (One participant failed to attend any sessions due to difficulties with transport and one participant withdrew after the first week, reporting excessive fatigue as the main issue). Amongst these 7 individuals, attendance was 90.9%. The only other adverse events recorded were delayed-onset muscle soreness (DOMS) in 4 out of 7 and aggravation of a pre-existing joint injury in one individual (neither of which prevented participation in subsequent classes). All attendees reporting enjoying the program with additional feedback obtained via the questionnaire regarding the timing, duration, frequency and intensity of classes, in addition to identifying potential barriers or enablers to participation. Conclusion This pilot of a novel exercise program for older adults was enjoyed and well-tolerated by pre-frail older adults. Participant feedback, both during the pilot and through a standardised questionnaire following completion, has had a meaningful impact on the final version of the exercise program that will be used for frail older adults in the DEFRAIL intervention.

scholarly journals Implementation of an Evidence-Based Exercise Program for Older Adults in South Florida

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Richard C. Palmer ◽  
Anamica Batra ◽  
Chelsie Anderson ◽  
Timothy Page ◽  
Edgar Vieira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Exercise Program ◽  
South Florida ◽  
Community Dwelling ◽  
Evidence Based ◽  
Functional Fitness ◽  
Body Strength ◽  
High Satisfaction ◽  
Wide Scale

Introduction. This study aimed to examine how well an evidence-based physical activity program could be translated for wide scale dissemination and adoption to increase physical activity among community-dwelling older adults.Methods. Between October 2009 and December 2012, reach, fidelity, dosage, ease of implementation, and barriers to translation of EnhanceFitness (EF) were assessed. To assess effectiveness, a pretest-posttest design was used to measure increases in functional fitness (chair stands, arm curls, and the up-and-go test).Results. Fourteen community-based agencies offered 126 EF classes in 83 different locations and reached 4,490 older adults. Most participants were female (72%). Thirty-eight percent of participants did not complete the initial 16-week EF program. The 25% who received the recommended dose experienced an increase in upper and lower body strength and mobility. Further, participants reported high satisfaction with the program.Conclusion. EF was successfully implemented in a variety of settings throughout South Florida and reached a large number of older adults. However, challenges were encountered in ensuring that those who participated received a program dose that would lead to beneficial gains in functional fitness.

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