scholarly journals Exploring the feasibility, sustainability and the benefits of the GrACE + GAIT exercise programme in the residential aged care setting

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6973 ◽  
Author(s):  
Samantha Fien ◽  
Tim Henwood ◽  
Mike Climstein ◽  
Evelyne Rathbone ◽  
Justin W.L. Keogh
Keyword(s):  
Adverse Events ◽  
Gait Speed ◽  
Exercise Intervention ◽  
Weight Bearing ◽  
Exercise Adherence ◽  
Exercise Programme ◽  
Aged Care ◽  
Residential Aged Care ◽  
Control Group ◽  
Sit To Stand

Background The feasibility and benefits of a 24-week targeted progressive supervised resistance and weight-bearing exercise programme (Group Aged Care Exercise + GAIT (GrACE + GAIT)) in the residential aged care (RAC) setting was investigated as very little peer-reviewed research has been conducted in relation to exercise programmes of this duration in this cohort. Methods A quasi-experimental study design consisting of two groups (control and exercise) explored a 24-week targeted progressive supervised resistance and weight-bearing exercise programme (GrACE + GAIT) in two RAC facilities in Northern New South Wales, Australia. A total of 42 adults consented to participate from a total of 68 eligible residents (61.7%). The primary outcome measures were feasibility and sustainability of the exercise programme via intervention uptake, session adherence, attrition, acceptability and adverse events. Secondary measures included gait speed and the spatio-temporal parameters of gait, handgrip muscle strength and sit to stand performance. Results Twenty-three residents participated in the exercise intervention (mean (SD) 85.4 (8.1) years, 15 females) and 19 in the control group (87.4 (6.6) years 13 females). Exercise adherence was 79.3%, with 65% of exercise participants attending ≥70% of the sessions; 100% of those originally enrolled completed the programme and strongly agreed with the programme acceptability. Zero exercise-related adverse events were reported. ANCOVA results indicated that post-intervention gait speed significantly increased (p < 0.001) with an 18.8% increase in gait speed (m/s). Discussion The GrACE + GAIT programme was shown to be feasible and significantly improve adults living in RAC facilities gait speed, handgrip strength and sit to stand performance. These results suggest that the GrACE + GAIT programme is suitable for use in the RAC sector and that it has the potential to reduce disability and improve function and quality of life of the residents.

scholarly journals Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2018 ◽  
Author(s):  
Samantha Fien ◽  
Timothy Henwood ◽  
Mike Climstein ◽  
Justin William Leslie Keogh
Keyword(s):  
Resistance Training ◽  
Adverse Events ◽  
Gait Speed ◽  
Muscle Function ◽  
Handgrip Strength ◽  
Aged Care ◽  
Exercise Group ◽  
Residential Aged Care ◽  
Exercise Session ◽  
Sit To Stand

The objective of the study was to examine the feasibility and benefits of a group resistance training exercise programme for improving muscle function in institutionalised older adults. A feasibility and acceptability study was designed for a residential aged care (RAC) facility, based on the Gold Coast, Australia. Thirty-seven adults, mean age 86.8 ± 6.1 years (30 females) living in a RAC facility. Participants were allocated into an exercise (n = 20) or control (n = 17) group. The exercise group, the Group Aged Care Exercise (GrACE) programme, performed 12 weeks of twice weekly resistance exercises. Feasibility was measured via recruitment rate, measurement (physiological and surveys) completion rate, loss-to-follow-up, exercise session adherence, adverse events, and ratings of burden and acceptability. Muscle function was assessed using gait speed, sit-to-stand and handgrip strength assessments. All intervention participants completed pre- and post-assessments, and the exercise intervention, with 85% (n = 17) of the group attending ≥ 18 of the 24 sessions and 15% (n = 3) attending all sessions. Acceptability was 100% with exercise participants, and staff who had been involved with the programme strongly agreed that the participants “Benefited from the programme.” There were no adverse events reported by any participants during the exercise sessions. When compared to the control group, the exercise group experienced significant improvements in gait speed (F(4.078) = 8.265,p= 0.007), sit to stand performance (F(3.24) = 11.033,p= 0.002) and handgrip strength (F(3.697) = 26.359,p< 0.001). Resistance training via the GrACE programme is feasible, safe and significantly improves gait speed, sit-to-stand performance and handgrip strength in RAC adults.

scholarly journals The effect of a multicomponent exercise protocol (VIVIFRAIL©) on inflammatory profile and physical performance of older adults with different frailty status: study protocol for a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marina Petrella ◽  
Ivan Aprahamian ◽  
Ronei Luciano Mamoni ◽  
Carla Fernanda de Vasconcellos Romanini ◽  
Natália Almeida Lima ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Inflammatory Mediators ◽  
Gait Speed ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Frailty Status ◽  
Anti Inflammatory ◽  
Inflammatory Profile

Abstract Background To investigate whether an exercise intervention using the VIVIFRAIL© protocol has benefits for inflammatory and functional parameters in different frailty status. Methods/design This is a randomized clinical trial in an outpatient geriatrics clinic including older adults ≥60 years. For each frailty state (frail, pre-frail and robust), forty-four volunteers will be randomly allocated to the control group (n = 22) and the intervention group (n = 22) for 12 weeks. In the control group, participants will have meetings of health education while those in the intervention group will be part of a multicomponent exercise program (VIVIFRAIL©) performed five times a week (two times supervised and 3 times of home-based exercises). The primary outcome is a change in the inflammatory profile (a reduction in inflammatory interleukins [IL-6, TNF- α, IL1beta, IL-17, IL-22, CXCL-8, and IL-27] or an increase in anti-inflammatory mediators [IL-10, IL1RA, IL-4]). Secondary outcomes are change in physical performance using the Short Physical Performance Battery, handgrip strength, fatigue, gait speed, dual-task gait speed, depressive symptoms, FRAIL-BR and SARC-F scores, and quality of life at the 12-week period of intervention and after 3 months of follow-up. Discussion We expect a reduction in inflammatory interleukins or an increase in anti-inflammatory mediators in those who performed the VIVIFRAIL© protocol. The results of the study will imply in a better knowledge about the effect of a low-cost intervention that could be easily replicated in outpatient care for the prevention and treatment of frailty, especially regarding the inflammatory and anti-inflammatory pathways involved in its pathophysiology. Trial registration Brazilian Registry of Clinical Trials (RBR-9n5jbw; 01/24/2020). Registred January 2020. http://www.ensaiosclinicos.gov.br/rg/RBR-9n5jbw/.

The role of rehabilitation exercises on weight, functional strength and exercise adherence in knee osteoarthritis patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Muhammad Tariq Rafiq ◽  
Mohamad Shariff Abdul Hamid ◽  
Eliza Hafiz ◽  
Khalid Rashid ◽  
Farid Ahmad Chaudhary
Keyword(s):  
Knee Osteoarthritis ◽  
Weight Bearing ◽  
Exercise Adherence ◽  
Lower Limbs ◽  
Joint Disease ◽  
Control Group ◽  
Post Test ◽  
Rehabilitation Exercises ◽  
Normally Distributed

Introduction: Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients. Materials And Method: The patients were recruited from the Urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for 12 weeks. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for the normally distributed data) and the Wilcoxon Signed Ranked Test (for the data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The analysis of variance 2 × 2 factors and the Mann-Whitney U-test were used to analyze the difference of weight and functional strength respectively between the groups. Results: The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within the group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within the group. The improvement in the scores of functional strength was greater in the patients of RG than the CG (p < 0.001. Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001). Conclusion: The REs could improve weight, functional strength and exercise adherence.

scholarly journals Comparison of difficulty with activities of daily living in elderly adults undergoing hemodialysis and community-dwelling individuals: a cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Toshiki Kutsuna ◽  
Yusuke Isobe ◽  
Takaaki Watanabe ◽  
Yusuke Matsunaga ◽  
Satomi Kusaka ◽  
...  
Keyword(s):  
Physical Function ◽  
Grip Strength ◽  
Gait Speed ◽  
Community Dwelling ◽  
Test Time ◽  
Control Group ◽  
Elderly Adults ◽  
Sit To Stand ◽  
Difficulty Score ◽  
Usual Gait Speed

Abstract Background Elderly adults undergoing hemodialysis (HD) have multiple comorbidities, physical frailty, and functional dependence with activities of daily living (ADL). ADL difficulty is an early predictor of ADL dependency in community-dwelling elderly adults. However, the characteristics of ADL difficulty in patients undergoing HD have not yet been reported. The present study aimed to examine the current status and characteristics of physical function and ADL difficulty in ambulatory elderly patients undergoing HD. Methods In all, 136 elderly outpatients undergoing HD and 40 community-dwelling controls participated in the present study. The characteristics, physical function (SARC-F score, grip strength, five-times sit-to-stand test time, usual gait speed, maximum gait speed, and short physical performance battery score), and scores from the ADL difficulty questionnaires [difficulty related to upper limb (U/L) and lower limb (L/L) functions] were compared between the HD and control groups. Multiple regression analysis was performed to examine whether the characteristics of physical function were able to discriminate ADL difficulty in the HD group. Results The HD group had a significantly greater SARC-F score, lower grip strength, longer five-times sit-to-stand test time, slower usual gait speed, slower maximum gait speed, lower short physical performance battery score, and lower U/L and L/L ADL difficulty scores compared to the control group (all P < 0.001). The distribution of U/L and L/L ADL difficulty scores showed a wider variation in the HD group than in the control group. The U/L ADL difficulty score was independently associated with the SARC-F score (β = −0.52, P < 0.001) and grip strength (β = 0.21, P = 0.02). The L/L ADL difficulty score was independently associated with the SARC-F score (β = −0.56, P < 0.001) and usual gait speed (β = 0.35, P < 0.001). Conclusions The elderly HD group had a poorer physical function and experienced stronger ADL difficulty than the control group. There was an association between ADL difficulty and sarcopenia or poor physical function among patients undergoing HD. These findings provide useful data for effective clinical management to prevent decline of ADL in ambulatory elderly patients undergoing HD.

Aquatic exercise for residential aged care adults with dementia: benefits and barriers to participation

2017 ◽  
Vol 29 (9) ◽  
pp. 1439-1449 ◽  
Author(s):  
Timothy Henwood ◽  
Christine Neville ◽  
Chantelle Baguley ◽  
Elizabeth Beattie
Keyword(s):  
Usual Care ◽  
Exercise Program ◽  
Aged Care ◽  
Aquatic Exercise ◽  
Residential Aged Care ◽  
Control Group ◽  
Advanced Dementia ◽  
Skeletal Muscle Index ◽  
Barriers To Participation ◽  
Exercise Participation

ABSTRACTBackground:Pilot work by our group has demonstrated that aquatic exercise has valuable functional and psychosocial benefits for adults living in the residential aged care setting with dementia. The aim of the currents study was to advance this work by delivering the Watermemories Swimming Club aquatic exercise program to a more representative population of older, institutionalized adults with dementia.Methods:The benefits of 12 weeks of twice weekly participation in the Watermemories Swimming Club aquatic exercise program were assessed among an exercise and usual care control group of residential aged care adults with advanced dementia. A battery of physical and psychosocial measures were collected before and after the intervention period, and program implementation was also investigated.Results:Seven residential aged care facilities of 24 approached, agreed to participate and 56 residents were purposefully allocated to exercise or control. Twenty-three participants per group were included in the final analysis. Both groups experienced decreases in skeletal muscle index and lean mass (p < 0.001), but exercise stifled losses in muscle strength and transition into sarcopenic. Behavioral and psychological symptoms of dementia and activities of daily living approached significance (p = 0.06) with positive trends observed across other psychosocial measures.Conclusions:This study demonstrates the value of exercise participation, and specifically aquatic exercise in comparison to usual care for older, institutionalized adults with advanced dementia. However, it also highlights a number of barriers to participation. To overcome these barriers and ensure opportunity to residents increased provider and sector support is required.

Exercise using a foam bead bag improves balance and lower extremity strength in older adults

2019 ◽  
Vol 26 (6) ◽  
pp. 1-11
Author(s):  
Akkradate Siriphorn ◽  
Siriporn Vongsaiyat Siriphorn ◽  
Kittaphon Sawatthuk ◽  
Kanjana Temvorasub ◽  
Malinee Auttawut
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Lower Extremities ◽  
Exercise Programme ◽  
Control Group ◽  
Timed Up And Go ◽  
Suitable Alternative ◽  
Balance Scale ◽  
Sit To Stand ◽  
Lower Extremity Strength

Background/AimsBalance training using unstable support surfaces is widely used in clinics and research and can reduce the risk of falls in older people. This study aimed to investigate the effect of an exercise programme using a foam bead bag on older adults' ability to balance and the strength of their lower extremities and compare the effect with no exercise and foam pad exercise using the same programme.MethodsA total of 24 older adults were allocated into one of three groups: control (n=8), foam pad exercise (n=8) and foam bead bag exercise (n=8). The foam pad exercise and foam bead bag exercise groups carried out a programme consisting of 30 minutes of exercise performed twice a week for 5 weeks. The control group did not participate in an exercise programme. Participants' balance abilities were measured using the Fullerton Advanced Balance Scale, the Timed Up and Go Test and the Single-Leg Stance Test. The strength of their lower extremities was measured using the 30-second sit-to-stand test.ResultsThe Fullerton Advanced Balance scale and 30-second sit-to-stand scores significantly improved in the foam pad exercise and foam bead bag exercise groups. Both of these groups also demonstrated significant improvements in Timed Up and Go tests. The amount of time that participants were able to stand on one leg while unassisted significantly increased in the foam bead bag group only. No significant differences were found in balance ability or lower extremity strength in the control group.ConclusionsA foam bead bag is a suitable alternative to a foam pad when performing exercises to improve balance and strength of the lower extremities in older adults.

Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors

2014 ◽  
Vol 38 (3) ◽  
pp. 325 ◽  
Author(s):  
Kirsten J. Moore ◽  
Colleen J. Doyle ◽  
Trisha L. Dunning ◽  
Ann T. Hague ◽  
Lucas A. Lloyd ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Cognitive Impairment ◽  
Adverse Events ◽  
Regression Models ◽  
Aged Care ◽  
Residential Aged Care ◽  
Risk Of Falling ◽  
Related Factors ◽  
Health Related

Objective To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors. Methods Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities. Results Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%–11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%–14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%–546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%–11%) reduction in the likelihood of polypharmacy. Conclusions Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events. What is known about the topic? Currently, the VPSRACS report on five QI. Previous research has shown associations between several of these indicators, but not all. What does this paper add? This paper examines associations between the five VPSRAC QI as well as other key demographic and health-related factors. Novel findings from regression analyses included an increased risk of falls associated with recommended body mass index and using gait aids, but no association between pressure ulcers and the Norton score. Regression models for other QI were limited by the small occurrences of the QI. However, significant associations were identified indicating that residents using a gait aid had a lower level of unplanned weight loss and residents with polypharmacy had higher unplanned weight loss. What are the implications for practitioners? This paper reinforces the value of collecting VPSRAC QI data to enable facilities to consider how these variables could impact on care quality and to proactively plan to reduce the risk of adverse events. Although QI data can be used to benchmark with other settings, this paper shows how QI data can be used to inform practice within a facility and help identify patient-related factors that may warrant further investigation.

scholarly journals Antipsychotic polypharmacy in older Australians

2017 ◽  
Vol 30 (4) ◽  
pp. 539-546 ◽  
Author(s):  
Lisa M. Kalisch Ellett ◽  
Nicole L. Pratt ◽  
Mhairi Kerr ◽  
Elizabeth E. Roughead
Keyword(s):  
Adverse Events ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Residential Aged Care ◽  
Administrative Claims ◽  
Elderly Persons ◽  
Department Of Veterans Affairs ◽  
Cross Sectional ◽  
Younger Adults ◽  
Antipsychotic Side Effects

ABSTRACTBackground:Antipsychotics are commonly used, and the rate of use is highest, among those aged 65 years or over, where the risk of adverse events is also high. Up to 20% of younger adults use more than one antipsychotic concurrently; however there are few studies on the prevalence of antipsychotic polypharmacy in older people. We aimed to analyze antipsychotic use in elderly Australians, focusing on the prevalence of antipsychotic polypharmacy and the use of medicines to manage adverse events associated with antipsychotics.Methods:A cross-sectional study was conducted using Australian Department of Veterans’ Affairs (DVA) administrative claims data for the period 1 March 2014 to 30 June 2014. Veterans dispensed at least one antipsychotic medicine during the study period was included. We determined the number of participants dispensed antipsychotic polypharmacy and the number of participants dispensed medicines to manage antipsychotic side effects.Results:There were 7,412 participants with a median age of 86 years. Fifty-one percent (n=3,784) were women and 48% (n=3,569) lived in residential aged-care. Fifty one participants (0.7%) were dispensed anticholinergic medicines indicated for the management of antipsychotic-associated extrapyramidal movement disorders and eight (0.1%) were dispensed medicines for the management of hyperprolactinemia. Five percent of participants (n=365) received dual antipsychotics. Dual antipsychotic users were more likely to be under the care of a psychiatrist or to have had a mental health hospitalization than those using a single antipsychotic.Conclusions:Antipsychotic polypharmacy occurred in one in 20 elderly persons, indicating that there is room for improvement in antipsychotic use in elderly patients.

scholarly journals Re-thinking reablement strategies for older adults in residential aged care: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lucy K. Lewis ◽  
Tim Henwood ◽  
Jo Boylan ◽  
Sarah Hunter ◽  
Belinda Lange ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older Adults ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Physical Function ◽  
Aged Care ◽  
Residential Aged Care ◽  
Controlled Trials

Abstract Background The number of older adults in residential aged care is increasing. Aged care residents have been shown to spend most of the day sedentary and have many co-morbidities. This review aimed to systematically explore the effectiveness of reablement strategies in residential aged care for older adults’ physical function, quality of life and mental health, the features of effective interventions and feasibility (compliance, acceptability, adverse events and cost effectiveness). Method This scoping review was undertaken according to PRISMA guidelines (extension for scoping reviews). Five e-databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL) were searched from 2010 onwards. Randomised controlled trials investigating reablement strategies addressing physical deconditioning for older adults (mean age ≥ 65 yrs) in residential aged care on physical function, quality of life or mental health were included. Feasibility of the interventions (compliance, acceptability, satisfaction, adverse events and cost effectiveness) was explored. Results Five thousand six hundred thirty-one citations were retrieved, and 63 studies included. Sample sizes ranged from 15 to 322 and intervention duration from one to 12 months. Exercise sessions were most often conducted two to three times per week (44 studies) and physiotherapist-led (27 studies). Interventions were predominately multi-component (28 studies, combinations of strength, balance, aerobic, functional exercises). Five interventions used technology. 60% of studies measuring physical function reported significant improvement in the intervention versus control, 40% of studies measuring quality of life reported significant improvements in favour of the intervention, and 26% of studies measuring mental health reported significant intervention benefits. Over half of the studies measured compliance and adverse events, four measured acceptability and none reported cost effectiveness. Conclusions There has been a research surge investigating reablement strategies in residential aged care with wide variability in the types and features of strategies and outcome measures. Few studies have measured acceptability, or cost effectiveness. Exploration of core outcomes, mapping stakeholders and co-designing a scalable intervention is warranted. Trial registration Prospectively registered review protocol (Open Science Framework: DOI 10.17605/OSF.IO/7NX9M).

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