Effectiveness of a low-threshold physical activity intervention in residential aged care--results of a randomized controlled trial

Martin Cichocki, Viktoria Quehenberger, Michael Zeiler, Tanja Adamcik, Matthias Manousek, Tanja Stamm, Karl Krajic, Martin Cichocki, Viktoria Quehenberger, Michael Zeiler, Tanja Adamcik, Matthias Manousek, Tanja Stamm, Karl Krajic

Abstract

Purpose: Research on effectiveness of low-threshold mobility interventions that are viable for users of residential aged care is scarce. Low-threshold is defined as keeping demands on organizations (staff skills, costs) and participants (health status, discipline) rather low. The study explored the effectiveness of a multi-faceted, low-threshold physical activity program in three residential aged-care facilities in Austria. Main goals were enhancement of mobility by conducting a multi-faceted training program to foster occupational performance and thus improve different aspects of health-related quality of life (QoL).

Participants and methods: The program consisted of a weekly session of 60 minutes over a period of 20 weeks. A standardized assessment of mobility status and health-related QoL was applied before and after the intervention. A total of 222 of 276 participants completed the randomized controlled trial study (intervention group n=104, control group n=118; average age 84 years, 88% female).

Results: Subjective health status (EuroQoL-5 dimensions: P=0.001, d=0.36) improved significantly in the intervention group, and there were also positive trends in occupational performance (Canadian Occupational Performance Measure). No clear effects were found concerning the functional and cognitive measures applied.

Conclusion: Thus, the low-threshold approach turned out to be effective primarily on subjective health-related QoL. This outcome could be a useful asset for organizations offering low-threshold physical activity interventions.

Keywords: aged; effectiveness; intervention; physical activity; residential aged care.

Figures

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Figure 1
Recruitment process and enrollment of participants.

References

    1. Horn A, Brause M, Schäffer D. Bewegungsförderung in der (stationären) Langzeitversorgung [Enhancement of physical activity in (residential) long-term care] In: Geuter G, Hollederer A, editors. Handbuch Bewegungsförderung und Gesundheit. Bern: Hans Huber; 2012. pp. 305–318. German.
    1. Chin A, Paw MJ, van Uffelen JG, Riphagen I, van Mechelen W. The functional effects of physical exercise training in frail older people: a systematic review. Sports Med. 2008;38(9):781–793.
    1. Stathi A, Simey P. Quality of life in the Fourth Age: exercise experiences of nursing home residents. J Aging Phys Act. 2007;15(3):272–286.
    1. Weening-Dijksterhuis E, de Greef MH, Scherder EJ, Slaets JP, van der Schans CP. Frail institutionalized older persons: A comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Phys Med Rehabil. 2011;90(2):156–168.
    1. Forster A, Lambley R, Young JB. Is physical rehabilitation for older people in long-term care effective? Findings from a systematic review. Age Ageing. 2010;39(2):169–175.
    1. Chin A, Paw MJ, van Poppel MN, Twisk JW, van Mechelen W. Once a week not enough, twice a week not feasible? A randomised controlled exercise trial in long-term care facilities [ISRCTN87177281] Patient Educ Couns. 2006;63(1–2):205–214.
    1. Rydwik E, Frandin K, Akner G. Physical training in institutionalized elderly people with multiple diagnoses – a controlled pilot study. Arch Gerontol Geriatr. 2005;40(1):29–44.
    1. Lazowski DA, Ecclestone NA, Myers AM, et al. A randomized outcome evaluation of group exercise programs in long-term care institutions. J Gerontol A Biol Sci Med Sci. 1999;54(12):M621–M628.
    1. Baert V, Gorus E, Mets T, Geerts C, Bautmans I. Motivators and barriers for physical activity in the oldest old: a systematic review. Ageing Res Rev. 2011;10(4):464–474.
    1. Ferrucci L. The Baltimore Longitudinal Study of Aging (BLSA): a 50-year-long journey and plans for the future. J Gerontol A Biol Sci Med Sci. 2008;63(12):1416–1419.
    1. Krajic K, Cichocki M, Quehenberger V. Health-promoting residential aged care: a pilot project in Austria. Health Promot Int. 2014 Mar 28; Epub.
    1. Stamm T, Diermayr G. Curriculum Für die interdisziplinäre Intervention „Bewegtes Leben“ im Projekt „. Gesundheit hat kein Alter [ Curriculum for the interdisciplinary intervention “Moving Life” as part of the project “Health has no age”] 2011. [Accessed March 25, 2015]. Available from: . German.
    1. CEBMnet [homepage on the Internet] University of Oxford: Centre for Evidence Based Medicine; Levels of Evidence; 2009. [Accessed December 12, 2014]. Available from: .
    1. EuroQol Group EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.
    1. Scott J, Huskisson EC. Graphic representation of pain. Pain. 1976;2(2):175–184.
    1. Law M, Baptiste S, Carswell A, et al. In: Canadian Occupational Performance Measure: Vierte Auflage. Dehnhardt B, George S, Harth A, translators. Idstein: Schulz-Kirchner; 2009. Lizenzierte deutsche Ausgabe.
    1. Bohannon RW. Reference Values for the Timed Up and Go Test. A Descriptive Meta-Analysis. J Geriatr Phys Ther. 2006;29(2):64–68.
    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. Rydwik E, Bergland A, Forsen L, et al. Psychometric Properties of Timed Up and Go in Elderly People. A Systematic Review. Phys Occup Ther Geriatr. 2011;29(2):102–125.
    1. Jones CJ, Rikli RE. Measuring functional fitness of older adults. The Journal on Active Aging. 2002:24–30.
    1. Niethard FU, Pfeil J, Biberthaler P. Orthopädie und Unfallchirurgie [Orthopedics and Traumatology] Stuttgart: Georg Thieme Verlag KG; 2009. German.
    1. Haubois G, Annweiler C, Launay C, et al. Derivation and validation of a Short Form of the Mini-Mental State Examination for the screening of dementia in older adults with a memory complaint. Eur J Neurol. 2013;20(3):588–590.
    1. Gusi N, Prieto J, Olivares PR, et al. Normative fitness performance scores of community-dwelling older adults in Spain. J Aging Phys Act. 2012;20(1):106–126.
    1. Kirk RE. Practical significance: A concept whose time has come. Educ Psychol Meas. 1996;56(5):746–759.
    1. Quehenberger V, Cichocki M, Krajic K. Sustainable effects of a low-threshold mobility enhancement intervention on health-related quality of life in residential aged care. Clin Interv Aging. 2014;9:1853–1864.
    1. Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.
    1. Zubritsky C, Abbott KM, Hirschman KB, et al. Health-related quality of life: expanding a conceptual framework to include older adults who receive long-term services and supports. Gerontologist. 2013;53(2):205–210.
    1. Grossman MD, Stewart AL. “You aren’t going to get better by just sitting around”: physical activity perceptions, motivations, and barriers in adults 75 years of age or older. Am J Geriatr Cardiol. 2003;12(1):33–37.
    1. Brenner I, Marsella A.Factors influencing exercise participation by clients in long-term care Perspectives 2008. –20093245–11.
    1. Lim K, Taylor L. Factors associated with physical activity among older people – a population-based study. Prev Med. 2005;40(1):33–40.
    1. Costello E, Kafchinski M, Vrazel J, Sullivan P. Motivators, barriers, and beliefs regarding physical activity in an older adult population. J Geriatr Phys Ther. 2011;34(3):138–147.
    1. Boehm J, Franklin RC, Newitt R, et al. Barriers and motivators to exercise for older adults: A focus on those living in rural and remote areas of Australia. Aust J Rural Health. 2013;21(3):141–149.
    1. Bibas L, Levi M, Bendayan M, et al. Therapeutic interventions for frail elderly patients: part I. Published randomized trials. Prog Cardiovasc Dis. 2014;57(2):134–143.
    1. Bendayan M, Bibas L, Levi M, et al. Therapeutic interventions for frail elderly patients: part II. Ongoing and unpublished randomized trials. Prog Cardiovasc Dis. 2014;57(2):144–151.

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