Effects of an exercise programme for chronically ill and mobility-restricted elderly with structured support by the general practitioner's practice (HOMEfit) - study protocol of a randomised controlled trial

Timo Hinrichs, Anna Moschny, Michael Brach, Stefan Wilm, Renate Klaaßen-Mielke, Matthias Trampisch, Petra Platen, Timo Hinrichs, Anna Moschny, Michael Brach, Stefan Wilm, Renate Klaaßen-Mielke, Matthias Trampisch, Petra Platen

Abstract

Background: Exercise programmes can be administered successfully as therapeutic agents to patients with a number of chronic diseases and help to improve physical functioning in older adults. Usually, such programmes target either healthy and mobile community-dwelling seniors or elderly individuals living in nursing institutions or special residences. Chronically ill or mobility-restricted individuals, however, are difficult to reach when they live in their own homes.A pilot study has shown good feasibility of a home-based exercise programme that is delivered to this target group through cooperation between general practitioners and exercise therapists. A logical next step involves evaluation of the effects of the programme.

Methods/design: The study is designed as a randomised controlled trial. We plan to recruit 210 patients (≥ 70 years) in about 15 general practices.The experimental intervention (duration 12 weeks)-a multidimensional home-based exercise programme-is delivered to the participant by an exercise therapist in counselling sessions at the general practitioner's practice and on the telephone. It is based on methods and strategies for facilitating behaviour change according to the Health Action Process Approach (HAPA). The control intervention-baseline physical activities-differs from the experimental intervention with regard to content of the counselling sessions as well as to content and frequency of the promoted activities.Primary outcome is functional lower body strength measured by the "chair-rise" test. Secondary outcomes are: physical function (battery of motor tests), physical activity (step count), health-related quality of life (SF-8), fall-related self-efficacy (FES-I), and exercise self-efficacy (SSA-Scale).The hypothesis that there will be differences between the two groups (experimental/control) with respect to post-interventional chair-rise time will be tested using an ANCOVA with chair-rise time at baseline, treatment group, and study centre effects as explanatory variables. Analysis of the data will be undertaken using the principle of intention-to-treat.

Trial registration: Current Controlled Trials ISRCTN17727272.

Figures

Figure 1
Figure 1
Flow chart of the study, referring to the participant level.
Figure 2
Figure 2
Time schedule of the intervention.

References

    1. Wurm S, Tesch-Römer C. In: Altwerden in Deutschland [Aging in Germany] Tesch-Römer C, Engstler H, Wurm S, editor. Wiesbaden: VS Verlag für Sozialwissenschaften; 2006. Gesundheit, Hilfebedarf und Versorgung [Health, medical requirements and medical care] pp. 329–383.
    1. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–228. doi: 10.1370/afm.272.
    1. van den Akker M, Buntinx F, Metsemakers JFM, Roos S, Knottnerus JA. Multimorbidity in general practice: Prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998;51(5):367–375. doi: 10.1016/S0895-4356(97)00306-5.
    1. Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162(20):2269–2276. doi: 10.1001/archinte.162.20.2269.
    1. Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. Can Med Assoc J. 2006;174(6):801–809. doi: 10.1503/cmaj.051351.
    1. Fries J. Physical activity, the compression of morbidity, and the health of the elderly. J R Soc Med. 1996;89(2):64–68.
    1. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094–1105.
    1. Hurley BF. Age, gender and muscular strength. J Gerontol A Biol Sci Med Sci. 1995;50:41–44.
    1. Jette AM, Branch LG. The Framingham Disability Study. 2. Physical disability among the aging. Am J Public Health. 1981;71(11):1211–1216. doi: 10.2105/AJPH.71.11.1211.
    1. Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, Lakatta EG. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112(5):674–682. doi: 10.1161/CIRCULATIONAHA.105.545459.
    1. Era P, Sainio P, Koskinen S, Haavisto P, Vaara M, Aromaa A. Postural balance in a random sample of 7,979 subjects aged 30 years and over. Gerontology. 2006;52(4):204–213. doi: 10.1159/000093652.
    1. Granacher U, Zahner L, Gollhofer A. Strength, power, and postural control in seniors: Considerations for functional adaptations and for fall prevention. Europ J Sport Sci. 2008;8(6):325–340. doi: 10.1080/17461390802478066.
    1. Geraldes AAR, Albuquerque RB, Soares RM, Carvalho J, Farinatti PTV. Association between flexibility of the glenohumeral and coxofemoral joints and functional performance in active elderly women. Rev Bras Fisioter. 2008;12(4):274–282.
    1. Lee JH, Chun MH, Jang DH, Ahn JS, Yoo JY. A comparison of young and old using three-dimensional motion analyses of gait, sit-to-stand and upper extremity performance. Aging Clin Exp Res. 2007;19(6):451–456.
    1. Thibaud M, Bloch F, Tournoux-Facon C, Brèque C, Rigaud AS, Dugué B, Kemoun G. Impact of physical activity and sedentary behaviour on fall risks in older people: a systematic review and meta-analysis of observational studies. Eur Rev Aging Phys Act. 2011. in press .
    1. Peel C, Baker PS, Roth DL, Brown CJ, Bodner EV, Allman RM. Assessing mobility in older adults: The UAB Study of Aging Life-Space Assessment. Phys Ther. 2005;85(10):1008–1019.
    1. Shephard RJ. What is the optimal type of physical activity to enhance health? Br J Sports Med. 1997;31(4):277–284. doi: 10.1136/bjsm.31.4.277.
    1. Doherty TJ. Aging and sarcopenia. J Appl Physiol. 2003;95(4):1717–1727.
    1. Lacroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S. Maintaining mobility in late-life. 2. Smoking, alcohol-consumption, physical activity, and body mass index. Am J Epidemiol. 1993;137(8):858–869.
    1. Hara T, Shimada T. Effects of exercise on the improvement of the physical functions of the elderly. J Phys Ther Sci. 2007;19(1):15–26. doi: 10.1589/jpts.19.15.
    1. Chodzko-Zajko WJ, Proctor DN, Singh MAF, Minson CT, Nigg CR, Salem GJ, Skinner JS. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510–1530. doi: 10.1249/MSS.0b013e3181a0c95c.
    1. Kruger J, Carlson SA, Buchner D. How active are older Americans? Prev Chronic Dis. 2007;4(3):A53.
    1. Moschny A, Platen P, Klaaßen-Mielke R, Trampisch U, Hinrichs T. Physical activity patterns in German elderly men and women: a cross-sectional study. BMC Public Health. 2011;11:559. doi: 10.1186/1471-2458-11-559.
    1. Painter P. Exercise for patients with chronic disease: physician responsibility. Curr Sports Med Rep. 2003;2(3):173–180.
    1. Kaplan MS, Newsom JT, McFarland BH, Lu LN. Demographic and psychosocial correlates of physical activity in late life. Am J Prev Med. 2001;21(4):306–312. doi: 10.1016/S0749-3797(01)00364-6.
    1. Sandland CJ, Singh SJ, Curcio A, Jones PM, Morgan MDL. A profile of daily activity in chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2005;25(3):181–183. doi: 10.1097/00008483-200505000-00011.
    1. Hinrichs T, Trampisch U, Burghaus I, Endres H, Klaaßen-Mielke R, Moschny A, Platen P. Correlates of sport participation among community-dwelling elderly people in Germany: a cross-sectional study. Eur Rev Aging Phys Act. 2010;7:105–115. doi: 10.1007/s11556-010-0063-8.
    1. Dapp U, Anders J, Meier-Baumgartner HP, von Renteln-Kruse W. Geriatric health promotion and prevention for independently living senior citizens: Programmes and target groups. Z Gerontol Geriatr. 2007;40(4):226–240. doi: 10.1007/s00391-007-0469-8.
    1. Hildebrand M, Neufeld P. Recruiting older adults into a physical activity promotion program: Active Living Every Day offered in a naturally occurring retirement community. Gerontologist. 2009;49(5):702–710. doi: 10.1093/geront/gnp072.
    1. Brach M, Nieder F, Nieder U, Mechling H. Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels. BMC Geriatrics. 2009;9:51. doi: 10.1186/1471-2318-9-51.
    1. Lindesay J, Thompson C. Housebound elderly people-definition, prevalence and characteristics. Int J Geriatr Psychiatry. 1993;8(3):231–237. doi: 10.1002/gps.930080306.
    1. Rasinaho M, Hirvensalo M, Leinonen R, Lintunen T, Rantanen T. Motives for and barriers to physical activity among older adults with mobility limitations. J Aging Phys Act. 2007;15(1):90–102.
    1. Cohen-Mansfield J, Marx MS, Guralnik JM. Motivators and barriers to exercise in an older community-dwelling population. J Aging Phys Act. 2003;11(2):242–253.
    1. Moschny A, Platen P, Klaaßen-Mielke R, Trampisch U, Hinrichs T. Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act. 2011;8:121. doi: 10.1186/1479-5868-8-121.
    1. Tudor-Locke C, Myers AM, Jacob CS, Jones G, Lazowski DA, Ecclestone NA. Development and formative evaluation of the Centre for Activity and Ageing's Home Support Exercise Program for frail older adults. J Aging Phys Act. 2000;8(1):59–75.
    1. McMurdo MET, Johnstone R. A randomized controlled trial of a home exercise program for elderly people with poor mobility. Age Ageing. 1995;24(5):425–428. doi: 10.1093/ageing/24.5.425.
    1. Saß AC, Wurm S, Ziese T. In: Beiträge zur Gesundheitsberichterstattung des Bundes: Gesundheit und Krankheit im Alter. Böhm K, Tesch-Römer C, Ziese T, editor. Berlin: Robert Koch-Institut; 2009. Inanspruchnahmeverhalten [Health care utilisation] pp. 134–159. [Contributions to federal health monitoring: health and morbidity in old age]
    1. Falvo D, Woehlke P, Deichmann J. Relationship of physician behaviour to patient compliance. Patient Couns Health Educ. 1980;2(4):185–188. doi: 10.1016/S0738-3991(80)80101-7.
    1. Booth ML, Bauman A, Owen N, Gore CJ. Physical activity preferences, preferred sources of assistance, and perceived barriers to increased activity among physically inactive Australians. Prev Med. 1997;26(1):131–137. doi: 10.1006/pmed.1996.9982.
    1. Schofield G, Croteau K, McLean G. Trust levels of physical activity information sources: a population study. Health Promot J Austr. 2005;16(3):221–224.
    1. Craig P, Dieppe P, Macintyre S, Mitchie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. Br Med J. 2008;337(7676):5.
    1. Hinrichs T, Brach M. The general practitioner's role in promoting physical activity to older adults: a review based on program theory. Curr Aging Sci. 2012;5(1):41–50. doi: 10.2174/1874609811205010041.
    1. Hinrichs T, Moschny A, Klaaßen-Mielke R, Trampisch U, Thiem U, Platen P. General practitioner advice on physical activity: Analyses in a cohort of older primary health care patients (getABI) BMC Fam Pract. 2011;12:26. doi: 10.1186/1471-2296-12-26.
    1. Glasgow RE, Eakin EG, Fisher EB, Bacak SJ, Brownson RC. Physician advice and support for physical activity-Results from a national survey. Am J Prev Med. 2001;21(3):189–196. doi: 10.1016/S0749-3797(01)00350-6.
    1. Wee CC, McCarthy EP, Davis RB, Phillips RS. Physician counseling about exercise. JAMA-J Am Med Assoc. 1999;282(16):1583–1588. doi: 10.1001/jama.282.16.1583.
    1. Stange KC, Flocke SA, Goodwin MA, Kelly RB, Zyzanski SJ. Direct observation of rates of preventive service delivery in community family practice. Prev Med. 2000;31(2):167–176. doi: 10.1006/pmed.2000.0700.
    1. Eakin E, Brown W, Schofield G, Mummery K, Reeves M. General practitioner advice on physical activity-Who gets it? Am J Health Promot. 2007;21(4):225–228. doi: 10.4278/0890-1171-21.4.225.
    1. Damush TM, Stewart AL, Mills KM, King AC, Ritter PL. Prevalence and correlates of physician recommendations to exercise among older adults. J Gerontol Ser A-Biol Sci Med Sci. 1999;54(8):M423–M427. doi: 10.1093/gerona/54.8.M423.
    1. Balde A, Figueras J, Hawking DA, Miller JR. Physician advice to the elderly about physical activity. J Aging Phys Act. 2003;11(1):90–97.
    1. Goldstein MG, Whitlock EP, DePue J. Multiple behavioral risk factor interventions in primary care summary of research evidence. Am J Prev Med. 2004;27(2):61–79. doi: 10.1016/j.amepre.2004.04.023.
    1. Stange KC, Fedirko T, Zyzanski SJ, Jaen CR. How do family physicians prioritize delivery of multiple preventive services? J Fam Pract. 1994;38(3):231–237.
    1. Bull FCL, Schipper ECC, Jamrozik K, Blanksby BA. Beliefs and behavior of general practitioners regarding promotion of physical activity. Aust J Public Health. 1995;19(3):300–304.
    1. Hinrichs T, Bucchi C, Brach M, Wilm S, Endres H, Burghaus I, Trampisch HJ, Platen P. Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962] BMC Geriatrics. 2009;9:37. doi: 10.1186/1471-2318-9-37.
    1. Schwarzer R. Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Appl Psychol-Int Rev. 2008;57(1):1–29. doi: 10.1111/j.1464-0597.2007.00325.x.
    1. Hinrichs T, Bucchi C, Moschny A, Brach M, Volke J, Trampisch U, Wilm S, Platen P. Cooperation between general practitioners and exercise therapists to deliver a home-based exercise programme to elderly patients [abstract] Eur Rev Aging Phys Act. 2010;7:87.
    1. Rollnick S, Miller WR, Butler CC, editor. Motivational interviewing in health care. Helping patients change behaviour. New York: The Guilford Press; 2008.
    1. U.S. Department of Health and Human Services. Physical activity guidelines for Americans. Be active, healthy, and happy. Washington, D.C: HHS. 2008.
    1. Hinrichs T, Bucchi C, Brach M, Moschny A, Volke J, Trampisch U, Wilm S, Platen P. In: Book of Abstracts of the 16th Annual Congress of the European College of Sport Science-6-9 July 2011. Cable T, George, K, editor. Liverpool/UK: ECSS; 2011. Correctness of home exercise performance in older adults; pp. 493–494.
    1. Lippke S, Ziegelmann J, Schwarzer R. Behavioral intentions and action plans to promote physical exercise: A longitudinal study with orthopedic rehabilitation patients. J Sport Exerc Psychol. 2003;13:470–483.
    1. Sniehotta FF, Nagy G, Scholz U, Schwarzer R. The role of action control in implementing intentions during the first weeks of behaviour change. Br J Soc Psychol. 2006;45(1):87–106. doi: 10.1348/014466605X62460.
    1. Booth ML, Owen N, Bauman A, Clavisi O, Leslie E. Social-cognitive and perceived environment influences associated with physical activity in older Australians. Prev Med. 2000;31(1):15–22. doi: 10.1006/pmed.2000.0661.
    1. Brassington GS, Atienza AA, Perczck RE, DiLorenzo TN, King AC. Intervention-related cognitive versus social mediators of exercise adherence in the elderly. Am J Prev Med. 2002;23(2):80–86. doi: 10.1016/S0749-3797(02)00477-4.
    1. Conn VS, Tripp-Reimer T, Maas ML. Older women and exercise: Theory of planned behavior beliefs. Public Health Nurs. 2003;20(2):153–163. doi: 10.1046/j.1525-1446.2003.20209.x.
    1. Lee LL, Arthur A, Avis M. Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: A discussion paper. Int J Nurs Stud. 2008;45(11):1690–1699. doi: 10.1016/j.ijnurstu.2008.02.012.
    1. Litt MD, Kleppinger A, Judge JO. Initiation and maintenance of exercise behavior in older women: Predictors from the social learning model. J Behav Med. 2002;25(1):83–97. doi: 10.1023/A:1013593819121.
    1. McAuley E, Jerome GJ, Elavsky S, Marquez DX, Ramsey SN. Predicting long-term maintenance of physical activity in older adults. Prev Med. 2003;37(2):110–118. doi: 10.1016/S0091-7435(03)00089-6.
    1. Perkins JM, Multhaup KS, Perkins HW, Barton C. Self-efficacy and participation in physical and social activity among older adults in Spain and the United States. Gerontologist. 2008;48(1):51–58. doi: 10.1093/geront/48.1.51.
    1. Resnick B. Testing a model of exercise behavior in older adults. Res Nurs Health. 2001;24(2):83–92. doi: 10.1002/nur.1011.
    1. Rhodes RE, Martin AD, Taunton JE, Rhodes EC, Donnelly M, Elliot J. Factors associated with exercise adherence among older adults. An individual perspective. Sports Med. 1999;28(6):397–411. doi: 10.2165/00007256-199928060-00003.
    1. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143–164. doi: 10.1177/1090198104263660.
    1. Lee LL, Arthur A, Avis M. Evaluating a community-based walking intervention for hypertensive older people in Taiwan: a randomized controlled trial. Prev Med. 2007;44(2):160–166. doi: 10.1016/j.ypmed.2006.09.001.
    1. Lee LL, Avis M, Arthur A. The role of self-efficacy in older people's decisions to initiate and maintain regular walking as exercise-Findings from a qualitative study. Prev Med. 2007;45(1):62–65. doi: 10.1016/j.ypmed.2007.04.011.
    1. Williams DM, Anderson ES, Winett RA. A review of the outcome expectancy construct in physical activity research. Ann Behav Med. 2005;29(1):70–79. doi: 10.1207/s15324796abm2901_10.
    1. Kelley K, Abraham C. RCT of a theory-based intervention promoting healthy eating and physical activity amongst out-patients older than 65 years. Soc Sci Med. 2004;59(4):787–797. doi: 10.1016/j.socscimed.2003.11.036.
    1. Scholz U, Schuz B, Ziegelmann JR, Lippke S, Schwarzer R. Beyond behavioural intentions: Planning mediates between intentions and physical activity. Brit J Health Psych. 2008;13:479–494. doi: 10.1348/135910707X216062.
    1. Scholz U, Sniehotta FF, Burkert S, Schwarzer R. Increasing physical exercise levels-Age-specific benefits of planning. J Aging Health. 2007;19(5):851–866. doi: 10.1177/0898264307305207.
    1. Sniehotta FF, Scholz U, Schwarzer R. Bridging the intention-behaviour gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health. 2005;20(2):143–160. doi: 10.1080/08870440512331317670.
    1. Sniehotta FF, Scholz U, Schwarzer R. Action plans and coping plans for physical exercise: A longitudinal intervention study in cardiac rehabilitation. Br J Health Psychol. 2006;11(1):23–37. doi: 10.1348/135910705X43804.
    1. Ziegelmann JP, Lippke S, Schwarzer R. Adoption and maintenance of physical activity: Planning interventions in young, middle-aged, and older adults. Psychol Health. 2006;21(2):145–163. doi: 10.1080/1476832050018891.
    1. Gollwitzer PM. Implementation intentions-Strong effects of simple plans. Am Psychol. 1999;54(7):493–503.
    1. van Stralen MM, De Vries H, Mudde A, Bolman C, Lechner L. Determinants of initiation and maintenance of physical activity among older adults: a literature review. Health Psychol Rev. 2009;3(2):147–207. doi: 10.1080/17437190903229462.
    1. Jöckel K-H, Babitsch B, Bellach B-M, Bloomfield K, Hoffmeyer-Zlotnik JHP, Winkler J, Wolf C. In: Messung soziodemographischer Merkmale in der Epidemiologie. Ahrens W, Bellach B-M, Jöckel K-H, editor. München: MMV Medizin Verlag; 1998. Messung und Quantifizierung soziographischer Merkmale in epidemiologischen Studien, RKI-Schriften 1/1998; pp. 7–38.
    1. Trampisch U, Platen P, Burghaus I, Moschny A, Wilm S, Thiem U, Hinrichs T. Reliabilität des PRISCUS-PAQ-Fragebogen zur Erfassung körperlicher Aktivität von Personen im Alter von 70 Jahren und älter [Reliability of the PRISCUS-PAQ-a questionnaire to assess physical activity of persons aged 70 years and older] Z Gerontol Geriatr. 2010;43:399–406. doi: 10.1007/s00391-010-0118-5.
    1. Trampisch U, Platen P, Burghaus I, Moschny A, Wilm S, Thiem U, Hinrichs T. Messung körperlicher Aktivität bei älteren Erwachsenen: Übereinstimmung zwischen PRISCUS-PAQ und Akzelerometrie [Measurement of physical activity in older adults: Association between the PRISCUS-PAQ and accelerometry] Z Gerontol Geriatr. in press .
    1. Trampisch US, Platen P, Moschny A, Hinrichs T. Über die Eignung von Fragebögen zur Erfassung der körperlichen Aktivität älterer Erwachsener für den Einsatz in einer epidemiologischen Studie [Suitability of existing questionnaires to assess physical activity of older adults for the application in epidemiological research] Dtsch Z Sportmed. 2011;62(10):329–333.
    1. Lamb SE, Jorstad-Stein EC, Hauer K, Becker C. Development of a common outcome data set for fall injury prevention trials: The prevention of falls network Europe consensus. J Am Geriatr Soc. 2005;53(9):1618–1622. doi: 10.1111/j.1532-5415.2005.53455.x.
    1. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332(9):556–561. doi: 10.1056/NEJM199503023320902.
    1. Penninx B, Ferrucci L, Leveille SG, Rantanen T, Pahor M, Guralnik JM. Lower extremity performance in nondisabled older persons as a predictor of subsequent hospitalization. J Gerontol Ser A-Biol Sci Med Sci. 2000;55(11):M691–M697. doi: 10.1093/gerona/55.11.M691.
    1. Gill TM, Williams CS, Tinetti ME. Assessing risk for the onset of functional dependence among older adults-the role of physical performance. J Am Geriatr Soc. 1995;43(6):603–609.
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower-extremity function-association with self-reported disability and prediction of mortality and nursing-home admission. J Gerontol. 1994;49(2):M85–M94.
    1. Seeman TE, Charpentier PA, Berkman LF, Tinetti ME, Guralnik JM, Albert M, Blazer D, Rowe JW. Predicting changes in physical performance in a high-functioning elderly cohort-MacArthur studies of successful aging. J Gerontol. 1994;49(3):M97–M108.
    1. Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills. 1995;80(1):163–166. doi: 10.2466/pms.1995.80.1.163.
    1. Bohannon RW, Shove ME, Barreca SR, Masters LM, Sigouin CS. Five-repetition sit-to-stand test performance by community-dwelling adults: A preliminary investigation of times, determinants, and relationship with self-reported physical performance. Isokinetics Exerc Sci. 2007;15(2):77–81.
    1. Schenkman M, Hughes MA, Samsa G, Studenski S. The relative importance of strength and balance in chair rise by functionally impaired older individuals. J Am Geriatr Soc. 1996;44(12):1441–1446.
    1. Alexander NB, Galecki AT, Nyquist LV, Hofmeyer MR, Grunawalt JC, Grenier ML, Medell JL. Chair and bed rise performance in ADL-impaired congregate housing residents. J Am Geriatr Soc. 2000;48(5):526–533.
    1. Alexander NB, Schultz AB, Warwick DN. Rising from a chair-effects of age and functional ability on performance biomechanics. J Gerontol. 1991;46(3):M91–M98.
    1. Eriksrud O, Bohannon RW. Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. Phys Ther. 2003;83(6):544–551.
    1. Suzuki T, Bean JF, Fielding RA. Muscle power of the ankle flexors predicts functional performance in community-dwelling older women. J Am Geriatr Soc. 2001;49(9):1161–1167. doi: 10.1046/j.1532-5415.2001.49232.x.
    1. Bean JF, Kiely DK, Herman S, Leveille SG, Mizer K, Frontera WR, Fielding RA. The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc. 2002;50(3):461–467. doi: 10.1046/j.1532-5415.2002.50111.x.
    1. Ikezoe T, Asakawa Y, Hazaki H, Kuroki H, Morinaga T, Kawano I, Kanzaki H, Aoki N. Muscle strength and muscle endurance required for independent walking and in the elderly. J Phys Ther Sci. 1997;9(1):19–22. doi: 10.1589/jpts.9.19.
    1. Severson MA, Smith GE, Tangalos EG, Petersen RC, Kokmen E, Ivnik RJ, Atkinson EJ, Kurland LT. Patterns and predictors of institutionalization in community-based dementia patients. J Am Geriatr Soc. 1994;42(2):181–185.
    1. Manton KG. A longitudinal study of functional change and mortality in the United States. J Gerontol. 1988;43(5):S153–S161.
    1. Podsiadlo D, Richardson S. The timed up and go-a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–148.
    1. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896–903.
    1. Rikli RE, Jones CJ. Development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act. 1999;7(2):129–161.
    1. Desrosiers J, Bravo G, Hebert R, Dutil E. Normative data for grip strength of elderly men and women. Am J Occup Ther. 1995;49(7):637–644.
    1. Winograd CH, Lemsky CM, Nevitt MC, Nordstrom TM, Stewart AL, Miller CJ, Bloch DA. Development of a physical performance and mobility examination. J Am Geriatr Soc. 1994;42(7):743–749.
    1. Jones CJ, Rikli RE, Max J, Noffal G. The reliability and validity of a chair sit-and-reach test as a measure of hamstring flexibility in older adults. Res Q Exerc Sport. 1998;69(4):338–343.
    1. Ware JE, Kosinski M, Dewey JE, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey. Lincoln, RI: Quality Metric Inc.; 2001.
    1. Dias N, Kempen G, Todd CJ, Beyer N, Freiberger E, Piot-Ziegler C, Yardley L, Hauer K. The German version of the falls Efficacy Scale-International Version (FES-I) Z Gerontol Geriatr. 2006;39(4):297–300. doi: 10.1007/s00391-006-0400-8.
    1. Fuchs R, Schwarzer R. Selbstwirksamkeit zur sportlichen Aktivität: Reliabilität und Validität eines neuen Meßinstruments [Self-efficacy towards physical exercise: Reliability and validity of a new instrument] Z D D P. 1994;15(3):141–154.
    1. International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use-Harmonised Tripartite Guideline-Clinical safety data management: Definitions and standards for expedited reporting E2A-Current Step 4 version.
    1. Schulz KF, Altman DG, Moher D. for the CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8:18. doi: 10.1186/1741-7015-8-18.
    1. Wade DT, Smeets R, Verbunt JA. Research in rehabilitation medicine: Methodological challenges. J Clin Epidemiol. 2010;63(7):699–704. doi: 10.1016/j.jclinepi.2009.07.010.
    1. Verordnung über die Anwendung der Guten Klinischen Praxis bei der Durchführung von klinischen Prüfungen mit Arzneimitteln zur Anwendung am Menschen (GCP-Verordnung-GCP-V)
    1. Hoffmann W, Latza U, Terschuren C. Guidelines and recommendations for ensuring good epidemiological practice (GEP)-Revised version after evaluation. Gesundheitswesen. 2005;67(3):217–225. doi: 10.1055/s-2004-813850.
    1. Nagi S. A study in the evaluation of disability and rehabilitation potential: Concepts, methods, and procedures. Am J Public Health. 1964;54:1568–1579. doi: 10.2105/AJPH.54.9.1568.
    1. DiPietro L. The epidemiology of physical activity and physical function in older people. Med Sci Sports Exerc. 1996;28(5):596–600.
    1. Rikli RE, Jones CJ. Assessing physical performance in independent older adults: Issues and guidelines. J Aging Phys Act. 1997;5(3):244–261.
    1. World Health Organization. International classification of impairments, disabilities and handicaps: a manual of classification relating to the consequences of disease. Geneva: WHO; 1980.
    1. World Health Organisation. International Classification of Functioning, Disability and Health: ICF. Geneva: WHO; 2001.
    1. World Health Organization. World report on disability. Geneva: WHO & The World Bank; 2011.
    1. Stucki G, Cieza A, Melvin J. The international classification of functioning, disability and health: A unifying model for the conceptual description of the rehabilitation strategy. J Rehabil Med. 2007;39(4):279–285. doi: 10.2340/16501977-0041.
    1. Uhlig T, Finset A, Kvien TK. Effectiveness and cost-effectiveness of comprehensive rehabilitation programs. Curr Opin Rheumatol. 2003;15(2):134–140. doi: 10.1097/00002281-200303000-00009.
    1. Cimera RE, Rumrill PD. Economic analyses of rehabilitation services as research methodologies. Work. 2008;31(4):483–487.
    1. Kücükdeveci AA, Tennant A, Grimby G, Franchignoni F. Strategies for assessment and outcome measurement in Physical and Rehabilitation Medicine: An educational review. J Rehabil Med. 2011;43(8):661–672. doi: 10.2340/16501977-0844.
    1. Stevens W, Hillsdon M, Thorogood M, McArdle D. Cost-effectiveness of a primary care based physical activity intervention in 45-74 year old men and women: a randomised controlled trial. Br J Sports Med. 1998;32(3):236–241. doi: 10.1136/bjsm.32.3.236.
    1. Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB, Walston JD. Interventions Frailty Working G. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: A consensus report. J Am Geriatr Soc. 2004;52(4):625–634. doi: 10.1111/j.1532-5415.2004.52174.x.
    1. Thiem U, Theile G, Junius-Walker U, Holt S, Thürmann P, Hinrichs T, Platen P, Diederichs C, Berger K, Hodek JM. et al.Prerequisites for a new health care model for elderly people with multimorbidity-the PRISCUS research consortium. Z Gerontol Geriatr. 2011;44(2):115–120. doi: 10.1007/s00391-010-0156-z.

Source: PubMed

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