scholarly journals Effectiveness of an individually tailored home-based exercise rogramme for pre-frail older adults, driven by a tablet application and mobility monitoring: a pilot study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hilde A. E. Geraedts ◽  
Hidde Dijkstra ◽  
Wei Zhang ◽  
Francisco Ibarra ◽  
Iman Khaghani Far ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Pilot Study ◽  
Functional Performance ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Daily Physical Activity ◽  
Frail Older Adults ◽  
Home Based ◽  
Positive Results

Abstract Objectives To gain first insight into the effectiveness of a home-based exercise programme for pre-frail older adults with independent use of novel ICT technology. Methods A pilot study. Forty pre-frail older adults joined a six-month home-based exercise programme using a tablet PC for exercise administration and feedback, and a necklace-worn motion sensor for daily physical activity registration. Participants received weekly telephone supervision during the first 3 months and exercised independently without supervision from a coach during the last 3 months. Functional performance and daily physical activity were assessed at baseline, after three and 6 months. Results Twenty-one participants completed the programme. Overall, functional performance showed positive results varying from (very) small to large effects (Cohen’s d 0.04–0.81), mainly during the supervised part of the intervention. Regarding daily physical activity, a slight improvement with (very) small effects (Cohen’s d 0.07–0.38), was observed for both self-reported and objectively measured physical activity during the supervised period. However, during the unsupervised period this pattern only continued for self-reported physical activity. Conclusion This pilot study showed positive results varying from (very) small to large effects in levels and maintenance of functional performance and daily physical activity, especially during the supervised first 3 months. Remote supervision seems to importantly affect effectiveness of a home-based exercise programme. Effectiveness of the programme and the exact contribution of its components should be further quantified in a randomized controlled trial. Practice implications Home-based exercising using novel technology may be promising for functional performance and physical activity improvement in (pre-frail) older adults. Trial registration Netherlands Trial Register (NTR); trial number NL4049. The study was prospectively registered (registration date 14/11/2013).

scholarly journals The EX-FRAIL CKD trial: a study protocol for a pilot randomised controlled trial of a home-based EXercise programme for pre-frail and FRAIL, older adults with Chronic Kidney Disease

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035344
Author(s):  
Andrew Christopher Nixon ◽  
Theodoros M Bampouras ◽  
Helen J Gooch ◽  
Hannah M L Young ◽  
Kenneth William Finlayson ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Randomised Controlled Trial ◽  
Kidney Disease ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Frailty Status ◽  
Home Based ◽  
Randomised Controlled

IntroductionFrailty is highly prevalent in adults with chronic kidney disease (CKD) and is associated with adverse health outcomes including falls, poorer health-related quality of life (HRQOL), hospitalisation and mortality. Low physical activity and muscle wasting are important contributors to physical frailty in adults with CKD. Exercise training may improve physical function and frailty status leading to associated improvements in health outcomes, including HRQOL. The EX-FRAIL CKD trial aims to inform the design of a definitive randomised controlled trial (RCT) that investigates the effectiveness of a progressive, multicomponent home-based exercise programme in prefrail and frail older adults with CKD.Methods and analysisThe EX-FRAIL CKD trial is a two-arm parallel group pilot RCT. Participants categorised as prefrail or frail, following Frailty Phenotype (FP) assessment, will be randomised to receive exercise or usual care. Participants randomised to the intervention arm will receive a tailored 12-week exercise programme, which includes weekly telephone calls to advise on exercise progression. Primary feasibility outcome measures include rate of recruitment, intervention adherence, outcome measure completion and participant attrition. Semistructured interviews with a purposively selected group of participants will inform the feasibility of the randomisation procedures, outcome measures and intervention. Secondary outcome measures include physical function (walking speed and Short Physical Performance Battery), frailty status (FP), fall concern (Falls Efficacy Scale-International tool), activities of daily living (Barthel Index), symptom burden (Palliative care Outcome Scale-Symptoms RENAL) and HRQOL (Short Form-12v2).Ethics and disseminationEthical approval was granted by a National Health Service (NHS) Regional Ethics Committee and the NHS Health Research Authority. The study team aims to publish findings in a peer-reviewed journal and presents the results at relevant national and international conferences. A summary of findings will be provided to participants, a local kidney patient charity and the funding body.Trial registration numberISRCTN87708989.

The EX-FRAIL CKD trial: A pilot RCT of a home-based Exercise programme for pre-FRAIL and FRAIL, older adults with CKD

Physiotherapy ◽  
2021 ◽  
Vol 113 ◽  
pp. e7-e8
Author(s):  
A.C. Nixon ◽  
T.M. Bampouras ◽  
H.J. Gooch ◽  
H.M. Young ◽  
K.W. Finlayson ◽  
...  
Keyword(s):  
Older Adults ◽  
Exercise Programme ◽  
Frail Older Adults ◽  
Home Based ◽  
Pilot Rct

scholarly journals Effects of Standardized Home Training in Patients with Cognitive Impairment following Geriatric Rehabilitation: A Randomized Controlled Pilot Study

Gerontology ◽  
2017 ◽  
Vol 63 (6) ◽  
pp. 495-506 ◽  
Author(s):  
Klaus Hauer ◽  
Phoebe Ullrich ◽  
Ilona Dutzi ◽  
Rainer Beurskens ◽  
Sylvia Kern ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Pilot Study ◽  
Geriatric Patients ◽  
Functional Performance ◽  
Secondary Outcome ◽  
Geriatric Rehabilitation ◽  
Randomized Controlled ◽  
Home Based ◽  
Home Training

Background: Post-ward geriatric rehabilitation programs have hardly been developed and validated, which leaves a substantial gap in rehabilitative care in older adults and hinders full exploitation of maintained, but often unrecognized rehabilitation potentials. Geriatric rehabilitation patients with cognitive impairment represent a highly vulnerable population which is often affected by a lack of an ongoing support at the intersection between ward-based and post-ward rehabilitation. Objective: To determine the effect of a standardized home-based training program in geriatric patients with cognitive impairment following ward-based rehabilitation. Methods: A randomized controlled, single-blinded intervention trial (RCT) with wait list control design was used. Geriatric patients (n = 34; age: 81.9 ± 5.7 years) with cognitive impairment (MMSE: 18.8 ± 4.7), identified by predefined in- and exclusion criteria, were consecutively recruited from a geriatric rehab ward. Patients in the intervention group (IG, n = 17) performed a 6-week strength and functional home training. The control group (CG, n = 17) started an identical training 6 weeks later with an initial usual care period during the intervention for the IG. Functional performance (Short Physical Performance Battery; SPPB), clinically relevant functional deficits (Performance Oriented Assessment; POMA), and physical activity (Assessment of Physical Activity For Older Persons questionnaire; APAFOP) represented primary outcome measurements complemented by additional secondary outcome parameters. Results: The IG significantly increased functional performances in SPPB (total score: p = 0.012; chair rise: p = 0.007, balance: p = 0.066), reduced gait and balance deficits in POMA (total score: p = 0.006; balance: p = 0.034; gait: p = 0.019), and increased physical activity (APAFOP; p = 0.05) compared to the CG. Effect sizes showed medium to large effects for significant parameters (eta2 = 0.14-0.45). Training benefits and adherence were more pronounced following the immediate onset of post-ward training compared to a delayed start (eta2 = 0.06-0.23). Conclusion: Results of this pilot study show that a feasible and easy to handle, home-based rehabilitation program increased functional performance and physical activity in a vulnerable, multimorbid patient group with cognitive impairment, in particular when the post-ward training onset was not postponed.

scholarly journals Increasing physical activity in older adults using STARFISH, an interactive smartphone application (app); a pilot study

2017 ◽  
Vol 4 ◽  
pp. 205566831769623 ◽  
Author(s):  
Lorna Paul ◽  
Stephen Brewster ◽  
Sally Wyke ◽  
Angus K McFadyen ◽  
Naveed Sattar ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Pilot Study ◽  
Controlled Trial ◽  
Objective Measure ◽  
Smartphone Application ◽  
Behaviour Change Techniques ◽  
Self Monitoring ◽  
Steps Per Day ◽  
Randomised Controlled

Background Increasing physical activity in older adults has preventative and therapeutic health benefits. We have developed STARFISH, a smartphone application, to increase physical activity. This paper describes the features of STARFISH, presents the views of older users on the acceptability and usability of the app and reports the results of a six week pilot study of the STARFISH app in older adults. Methods The operationalisation of the behaviour change techniques (BCTs) within the STARFISH app was mapped against the BCT Taxonomy of Michie et al. Sixteen healthy older adults (eight women and eight men; age 71.1 ± 5.2 years) used the app, in groups of four, for six weeks. Focus groups explored the user experience and objective measure of steps per day recorded. Results Participants were very positive about using the STARFISH app, in particular the embedded BCTs of self-monitoring, feedback and social support (in the form of group rewards). Objective step data, available for eight participants, showed that step counts increased by an average of 14% ( p = 0.077, d = 0.56). Conclusion The STARFISH app was acceptable and straightforward to use for older adults. STARFISH has potential to increase physical activity in older adults; however, a fully powered randomised controlled trial is required.

scholarly journals Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Tsung-Jen Hsieh ◽  
Shin-Chang Su ◽  
Chun-Wei Chen ◽  
Yaw-Wen Kang ◽  
Ming-Hsia Hu ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Physical Performance ◽  
Controlled Trial ◽  
Control Group ◽  
Nutrition Interventions ◽  
Frail Older Adults ◽  
Randomized Controlled ◽  
Home Based ◽  
Frailty Score

Abstract Background Frail older adults are predisposed to multiple comorbidities and adverse events. Recent interventional studies have shown that frailty can be improved and managed. In this study, effective individualized home-based exercise and nutrition interventions were developed for reducing frailty in older adults. Methods This study was a four-arm, single-blind, randomized controlled trial conducted between October 2015 and June 2017 at Miaoli General Hospital in Taiwan. Overall, 319 pre-frail or frail older adults were randomly assigned into one of the four study groups (control, exercise, nutrition, and exercise plus nutrition [combination]) and followed up during a 3-month intervention period and 3-month self-maintenance period. Improvement in frailty scores was the primary outcome. Secondary outcomes included improvements in physical performance and mental health. The measurements were performed at baseline, 1 month, 3 months, and 6 months. Results At the 6-month measurement, the exercise (difference in frailty score change from baseline: − 0.23; 95% confidence interval [CI]: − 0.41, − 0.05; p = 0.012), nutrition (− 0.28; 95% CI: − 0.46, − 0.11; p = 0.002), and combination (− 0.34; 95% CI: − 0.52, − 0.16; p <  0.001) groups exhibited significantly greater improvements in the frailty scores than the control group. Significant improvements were also observed in several physical performance parameters in the exercise, nutrition, and combination groups, as well as in the 12-Item Short Form Health Survey mental component summary score for the nutrition group. Conclusions The designated home-based exercise and nutrition interventions can help pre-frail or frail older adults to improve their frailty score and physical performance. Trial registration Retrospectively registered at ClinicalTrials.gov (identifier: NCT03477097); registration date: March 26, 2018.

Effectiveness of a group functional power training program for frail older adults implemented through neighbourhood senior centres – a randomised controlled study

2020 ◽  
Author(s):  
Nien Xiang Tou ◽  
Shiou-Liang Wee ◽  
Wei Ting Seah ◽  
Daniella Hui Min Ng ◽  
Benedict Wei Jun Pang ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Performance ◽  
Handgrip Strength ◽  
Controlled Trial ◽  
Knee Extensor ◽  
Controlled Study ◽  
Power Training ◽  
Frail Older Adults ◽  
Frailty Status ◽  
Randomised Controlled

Abstract Background Several trials have demonstrated the efficacy of resistance training to reduce frailty and improve function of older adults. To narrow the research-practice gap, we designed and evaluated the implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighbourhoods. Methods Two-arm, multicentre assessor-blind stratified randomised controlled trial at four local senior activity centres. Older adults (n = 61) with low handgrip strength (HGS) were randomised to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipments) delivered by a community provider. The 12-week program comprised 2 × 60 mins sessions/wk. CG continued usual activities at the centres. Functional performance (SPPB and TUG), HGS, knee extensor strength (KES), and frailty status were assessed at baseline and 3-month. Program implementation was evaluated using RE-AIM framework. Results The program was halted due to Coronavirus Disease 2019 related suspension of senior centre activities. Results are reported from four centres (n = 61), which completed the program. IG showed significant improvement of moderate effect sizes in frailty status (0.36 points, 95CI [0.09, 0.64], p = 0.011) and SPPB (0.51 points, 95CI [0.13, 0.89], p = 0.010). IG improvement in TUG (0.57 s, 95CI [-0.07, 1.20], p = 0.080) did not achieve significance and there were no effects for HGS and KES. Only SPPB showed greater improvement in IG than CG (p = 0.047). The community program exhibited good reach, effectiveness, adoption, and implementation. Conclusions FPT is superior to regular activities at local senior centres in improving physical function and can be successfully implemented for frail older adults in their neighbourhoods. Trial registration: ClinicalTrials.gov, NCT04438876. Registered 19 June 2020 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04438876?term=NCT04438876

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