Map the Apps: a rapid review of digital approaches to support the engagement of older adults in strength and balance exercises

Abstract Background: Exercise interventions, particularly those targeting strength and balance, are effective in preventing falls in older people. Activity levels are generally below recommended levels and reduce with age. There is concern that exercise levels may be further reduced in the context of the COVID-19 pandemic. Digital approaches may offer a means for older people to engage in strength and balance exercises independently in their own homes. The objective of this review was to identify and evaluate existing apps and websites to support independent engagement in strength and balance exercises by older people.Methods: We conducted a rapid review of apps and websites, following PRISMA guidelines. We searched for available apps in the Android and iOS app stores, and performed a database search (MEDLINE and EMBASE) for apps in development. We searched for websites using the Google search engine. Apps and websites were evaluated in terms of existing evidence for effectiveness, use of behaviour change techniques (BCTs), and quality. Results: We evaluated 13 apps and 24 websites on the basis of our selection criteria. Considering the evidence-base, quality and BCT scores, four apps and six websites are recommended for use by older people who wish to engage in exercise independently in their own homes. No apps or websites have been to RCT evaluation at the time of review.Conclusions: Apps and websites have the potential to provide a convenient, cost-effective, and accessible means for many older adults to engage in strength and balance training and reduce falls risk.

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Map the apps: a rapid review of digital approaches to support the engagement of older adults in strength and balance exercises

BMC Geriatrics ◽

10.1186/s12877-020-01880-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lisa McGarrigle ◽

Elisabeth Boulton ◽

Chris Todd

Keyword(s):

Older Adults ◽

Older People ◽

Balance Training ◽

Evidence Base ◽

Rapid Review ◽

Behaviour Change Techniques ◽

Activity Levels ◽

Exercise Interventions ◽

Balance Exercises ◽

Google Search

Abstract Background Exercise interventions, particularly those targeting strength and balance, are effective in preventing falls in older people. Activity levels are generally below recommended levels and reduce with age. There is concern that exercise levels may be further reduced in the context of the COVID-19 pandemic. Digital approaches may offer a means for older people to engage in strength and balance exercises independently in their own homes. The objective of this review was to identify and evaluate existing apps and websites to support independent engagement in strength and balance exercises by older people. Methods We conducted a rapid review of apps and websites, following PRISMA guidelines. We searched for available apps in the Android and iOS app stores, and performed a database search (MEDLINE and EMBASE) for apps in development. We searched for websites using the Google search engine. Apps and websites were evaluated in terms of existing evidence for effectiveness, use of behaviour change techniques (BCTs), and quality. Results We evaluated 13 apps and 24 websites on the basis of our selection criteria. Considering the evidence-base, quality and BCT scores, four apps and six websites are recommended for use by older people who wish to engage in exercise independently in their own homes. No apps or websites have been to RCT evaluation at the time of review. Conclusions Apps and websites have the potential to provide a convenient, cost-effective, and accessible means for many older adults to engage in strength and balance training and reduce falls risk.

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Interpersonal psychotherapy

Oxford Textbook of Old Age Psychiatry ◽

10.1093/med/9780198807292.003.0018 ◽

2020 ◽

pp. 261-264

Author(s):

Philip Wilkinson ◽

Ken Laidlaw

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Older People ◽

Psychological Treatment ◽

Interpersonal Psychotherapy ◽

Evidence Base ◽

Theory And Practice ◽

Role Transitions ◽

Treatment Of Depression

This chapter on interpersonal psychotherapy (IPT) describes the theory and practice of this structured psychological treatment. It discusses the implementation of IPT with older people. Next it reviews the applications of IPT with a main focus on the treatment of depression in older adults and distinguishes between the treatment of depression with and without cognitive impairment. It summarizes the structure of IPT and the use of specific techniques, and it then addresses the main therapeutic foci encountered in treatment (grief, interpersonal role disputes, role transitions, and interpersonal deficits). Finally, it briefly reviews the evidence base for IPT with older people.

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Systematic Balance Exercises Influence Cortical Activation and Serum BDNF Levels in Older Adults

Journal of Clinical Medicine ◽

10.3390/jcm8111910 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1910 ◽

Cited By ~ 3

Author(s):

Kubica ◽

Szymura ◽

Domagalik ◽

Golda ◽

Wiecek ◽

...

Keyword(s):

Older Adults ◽

Motor Imagery ◽

Action Observation ◽

Brain Area ◽

Balance Training ◽

Cortical Activation ◽

Bdnf Expression ◽

Age Related ◽

Balance Exercises ◽

Serum Bdnf

: We sought to investigate whether systematic balance training modulates brain area activity responsible for postural control and influence brain-derived neurotrophic factor (BDNF) mRNA protein expression. Seventy-four older adults were randomly divided into three groups (mean age 65.34 ± 3.79 years, 30 females): Classic balance exercises (CBT), virtual reality balance exercises (VBT), and control (CON). Neuroimaging studies were performed at inclusion and after completion of the training or 12 weeks later (CON). Blood samples were obtained to measure BDNF expression. The study revealed significant interaction of sessions and groups: In the motor imagery (MI) condition for supplementary motor area (SMA) activity (Fat peak = 5.25, p < 0.05); in the action observation (AO) condition for left and right supramarginal gyrus/posterior insula (left: Fat peak = 6.48, p < 0.05; right: Fat peak = 6.92, p < 0.05); in the action observation together with motor imagery (AOMI) condition for the middle occipital gyrus (laterally)/area V5 (left: Fat peak = 6.26, p < 0.05; right: Fat peak = 8.37, p < 0.05), and in the cerebellum–inferior semilunar lobule/tonsil (Fat peak = 5.47, p < 0.05). After the training serum BDNF level has increased in CBT (p < 0.001) and in CBT compared to CON (p < 0.05). Systematic balance training may reverse the age-related cortical over-activations and appear to be a factor mediating neuroplasticity in older adults.

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Exploring the role of volunteers in social care for older adults

Quality in Ageing and Older Adults ◽

10.1108/qaoa-02-2020-0005 ◽

2020 ◽

Vol 21 (2) ◽

pp. 129-139 ◽

Cited By ~ 1

Author(s):

Ailsa Cameron ◽

Eleanor K. Johnson ◽

Paul B. Willis ◽

Liz Lloyd ◽

Randall Smith

Keyword(s):

Older Adults ◽

Older People ◽

Social Care ◽

Evidence Base ◽

Care Staff ◽

Small Scale ◽

The South ◽

Content Type ◽

South West

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided.

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E-Health for Older Adults

Engaging Older Adults with Modern Technology ◽

10.4018/978-1-4666-1966-1.ch012 ◽

2013 ◽

pp. 229-248 ◽

Cited By ~ 1

Author(s):

Shane O’Hanlon ◽

Alan Bourke ◽

Valerie Power

Keyword(s):

Older Adults ◽

Clinical Trials ◽

Older People ◽

Independent Living ◽

Evidence Base ◽

Political Support ◽

International Level ◽

Provision Of Care ◽

Further Development

e-Health has become a major focus for research in healthcare, with significant funding and political support at an international level. Older people stand to benefit more than others, as e-Health aims to facilitate provision of care at a distance and promote independent living for as long as possible. However, barriers remain including an immature evidence-base; questions about risk and safety; and variable rates of uptake in this population. This chapter explores these issues and reviews the literature on e-Health for older adults. Successful clinical trials are identified and the e-CAALYX project is described in detail as a case study. E-Health has presents many exciting opportunities but needs further development and guidance.

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Fall prevention among older adults: Case reports exemplifying the value of incorporating lumbar stabilization training during balance exercises

South African Journal of Physiotherapy ◽

10.4102/sajp.v69i3.30 ◽

2013 ◽

Vol 69 (3) ◽

Author(s):

P. Van Der Merwe ◽

M.A. Wilmarth

Keyword(s):

Older Adults ◽

Gait Speed ◽

Fear Of Falling ◽

Case Reports ◽

Balance Training ◽

Cost Effective ◽

Sit To Stand ◽

Balance Exercise ◽

Balance Exercises ◽

Lumbar Stabilization

Background: Older adults are at risk of fallingeach year. Fall injuries results in many health care expenses anddisabilities, yet non-western countries lack the infra-structure andresources for prevention programs. Balance exercises have beenfound to be a cost effective evidence-based intervention in treatingand preventing falls among older adults in western countries.Purpose: The aim of this report was to show that lumbar stabilizationexercises are not only a beneficial addition to a balanceprogram for the prevention and treatment of falls in older adults,but to demonstrate that these exercise can more rapidly improve thefunctional status of older adults, limiting healthcare costs.Case description: Two high functional older adults with a historyof falls presented with poor balance and fear of falling. Both patientsreceived the same balance exercise regime however lumbar stabilization exercises were added to one of the patient’s exerciseprograms. Gait speed, lower extremity strength and balance were assessed with the Balance Evaluation systems test (BESTest),figure-of-eight, four-step-square (FSST), five-time-sit-to-stand tests (5TSTS) after two weeks and four weeks of treatment.Outcomes. All the outcome measures showed statistically significant improvements. Greater improvements in vertical stabilitylimits (14%), gait speed (9%), stability during gait (20%) and five-time-sit-to-stand test were seen with the addition of lumbarstabilization exercises.Discussion. The addition of lumbar stabilization exercises during balance training is of value to improve gait speed, balancetesting scores in stability in gait and vertical stability limits.

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The performance of balance exercises during daily tooth brushing is not sufficient to improve balance and muscle strength in healthy older adults

BMC Geriatrics ◽

10.1186/s12877-021-02206-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Urs Granacher ◽

Thomas Muehlbauer ◽

Gerd Göstemeyer ◽

Stefanie Gruber ◽

Markus Gruber

Keyword(s):

Physical Activity ◽

Older Adults ◽

Muscle Strength ◽

Balance Training ◽

Tooth Brushing ◽

Healthy Older Adults ◽

Home Based ◽

Balance Exercises ◽

Romberg Test ◽

Steady State Balance

Abstract Background High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics. Objective The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults. Methods Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age: 65.1 ± 1.1 years) or a passive control group (n = 24; age: 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic steady-state balance (i.e., 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (i.e., Timed-Up-and-Go Test [TUG], Functional-Reach-Test [FRT]), and muscle strength (i.e., Chair-Rise-Test [CRT]). Results Irrespective of group, the statistical analysis revealed significant main effects for time (pre vs. post) for dual-task gait speed (p < .001, 1.12 ≤ d ≤ 2.65), TUG (p < .001, d = 1.17), FRT (p = .002, d = 0.92), and CRT (p = .002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group × time interactions were found for any of the investigated variables. Conclusions The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60–72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.

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48 Do Exercise Programmes for Older People with Sarcopenia or Frailty Deliver An Evidence-Based Service? Findings From A UK Survey

Age and Ageing ◽

10.1093/ageing/afab030.09 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

M Chawner ◽

S De Biase ◽

N J Offord ◽

O Todd ◽

A Clegg ◽

...

Keyword(s):

Resistance Training ◽

Older People ◽

Outcome Measures ◽

Online Survey ◽

Balance Training ◽

Target Population ◽

Exercise Programme ◽

Median Number ◽

Evidence Base ◽

Exercise Programmes

Abstract Background Awareness of sarcopenia and frailty is growing and both are known to be potentially reversible with effective resistance training. We aimed to establish whether existing exercise programmes offered to people with sarcopenia or frailty adhere to the known evidence base. Methods We conducted a national on-line survey of practitioners delivering exercise programmes to older people with sarcopenia or frailty. The link to the online survey was distributed through the British Geriatrics Society, Chartered Society of Physiotherapy Special Interest Group for Older People (AGILE), the NHS England Future Collaboration Platform “Supporting People Living with Frailty” forum and social media. Questions covered target population and aims of the exercise programme, type, duration and frequency of exercise, progress assessment and outcome measures. Descriptive analyses were conducted using SPSS v24. Results 136 responses were received from respondents who worked for NHS Trusts, clinical commissioning groups, private practices, and third sector providers. 94% of respondents reported prescribing or delivering exercise programmes to people with sarcopenia or frailty. Most programmes (81/135 [60%]) were primarily designed to prevent or reduce falls. Resistance training was reported as the main focus of the programme in only 11/123 (9%); balance training was the main focus in 61/123 (50%) and functional exercise in 28/123 (23%). Exercise was offered once a week or less by 81/124 (65%) of respondents; the median number of sessions offered was 8.5 (IQR 6 to 12). Outcome measures suitable for assessing the effect of resistance training programmes were reported by fewer than half of respondents (hand grip: 13/119 [11%]; chair stands: 55/119 [46%], short physical performance battery: 4/119 [3%]). Conclusions Current exercise programmes offered to older people with sarcopenia or frailty lack the frequency, duration or specificity of exercise likely to improve outcomes for this group of patients.

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Promotion of Physical Activity in Older People Using mHealth and eHealth Technologies: Rapid Review of Reviews

Journal of Medical Internet Research ◽

10.2196/22201 ◽

2020 ◽

Vol 22 (12) ◽

pp. e22201

Author(s):

Lisa McGarrigle ◽

Chris Todd

Keyword(s):

Physical Activity ◽

Older People ◽

Systematic Reviews ◽

English Language ◽

Rapid Review ◽

Activity Levels ◽

Increased Risk ◽

Reduced Physical Activity ◽

Promotion Of Physical Activity ◽

Review Of Reviews

Background Older people are at increased risk of adverse health events because of reduced physical activity. There is concern that activity levels are further reduced in the context of the COVID-19 pandemic, as many older people are practicing physical and social distancing to minimize transmission. Mobile health (mHealth) and eHealth technologies may offer a means by which older people can engage in physical activity while physically distancing. Objective The objective of this study was to assess the evidence for mHealth or eHealth technology in the promotion of physical activity among older people aged 50 years or older. Methods We conducted a rapid review of reviews using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched for systematic reviews published in the English language in 3 electronic databases: MEDLINE, CINAHL Plus, and Scopus. Two reviewers used predefined inclusion criteria to select relevant reviews and extracted data on review characteristics and intervention effectiveness. Two independent raters assessed review quality using the AMSTAR-2 tool. Results Titles and abstracts (n=472) were screened, and 14 full-text reviews were assessed for eligibility. Initially, we included 5 reviews but excluded 1 from the narrative as it was judged to be of critically low quality. Three reviews concluded that mHealth or eHealth interventions were effective in increasing physical activity. One review found that the evidence was inconclusive. Conclusions There is low to moderate evidence that interventions delivered via mHealth or eHealth approaches may be effective in increasing physical activity in older adults in the short term. Components of successful interventions include self-monitoring, incorporation of theory and behavior change techniques, and social and professional support.

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Rapid review of decision-making for place of care and death in older people: lessons for COVID-19

Age and Ageing ◽

10.1093/ageing/afaa289 ◽

2020 ◽

Author(s):

Emily West ◽

Kirsten Moore ◽

Nuriye Kupeli ◽

Elizabeth L Sampson ◽

Pushpa Nair ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Older People ◽

Data Extraction ◽

Rapid Review ◽

Current Evidence ◽

Key Factors ◽

Full Data ◽

Review Of Reviews ◽

Experience Of Illness

Abstract Introduction The coronavirus pandemic (COVID-19) has affected the functioning and capacity of healthcare systems worldwide. COVID-19 has also disproportionately affected older adults. In the context of COVID-19, decision-making surrounding place of care (PoC) and place of death (PoD) in older adults involves significant new challenges. Aims To explore key factors that influence PoC and PoD decisions in older adults. A secondary aim was to investigate key factors that influence the process and outcome of these decisions in older adults. To apply findings from current evidence to the context of COVID-19. Methods Rapid review of reviews, undertaken using WHO guidance for rapid reviews for the production of actionable evidence. Data extracted was synthesised using narrative synthesis, with thematic analysis and tabulation. Results 10 papers were included for full data extraction. These papers were published between 2005 and 2020. Papers included discussed actual PoD, as well as preferred. Results were divided into papers that explored the process of decision-making, and those that explored decision-making outcomes. Conclusions The process and outcomes of decision-making for older people are affected by many factors—all of which have the potential to influence both patients and caregivers experience of illness and dying. Within the context of COVID-19, such decisions may have to be made rapidly and be reflexive to changing needs of systems and of families and patients.

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