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Jenkins E, Szanton S, Hornstein E, Reiff JS, Seau Q, Huynh G, Gray J, Wright RS, Li Q, Cotter V, Curriero S, Taylor J. The use of photovoice to explore the physical disability experience in older adults with mild cognitive impairment/early dementia. DEMENTIA 2024:14713012241272754. [PMID: 39132879 DOI: 10.1177/14713012241272754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Although co-occurring cognitive impairment and physical disability in older adults is common, there is little understanding of how this group perceives their ability to do their daily activities. This study used photovoice to explore how older adults with MCI/early dementia and physical disability without and with care partners (dyads) perceive challenges with their daily activities. Photovoice is a visual research methodology to capture participants' insight on aspects of their daily lives. No known studies have taken this approach to explore the experiences of older adults with MCI/early dementia and co-occurring physical disability. We used a cross-sectional, exploratory research design to understand participants' (n = 12) experiences in their home environment. Photos and participant thoughts on the photos were categorized based on the Blackfoot Breath of Life Theory and the Hierarchy Model of Needs in Dementia, an adaptation of Maslow's Model. Notable findings included: awareness of physical/cognitive difficulties by older adults, solutions for ADL difficulty in persons with MCI/early dementia, care partners' difficulty recognizing pain without the presence of severe emotional or physical responses, reducing mood severity, and self-esteem needs met with structured, memory-issue adapted, meaningful activities. Older adults with co-occurring physical disability and MCI/early dementia identified both physiological and psychological needs despite challenges impacting their cognition. Photovoice evoked daily situations of these individuals and revealed the importance of developing individualized intervention elements for older adults with dementia and physical disability.
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Affiliation(s)
| | - Sarah Szanton
- School of Nursing, Johns Hopkins University, USA
- Bloomberg School of Public Health, Johns Hopkins University, USA
- Department of Health Policy and Management, Johns Hopkins University, USA
| | | | | | - Quinn Seau
- School of Nursing, Johns Hopkins University, USA
| | - Grace Huynh
- School of Nursing, Johns Hopkins University, USA
| | - Ja'Lynn Gray
- School of Nursing, Johns Hopkins University, USA
| | | | - Qiwei Li
- School of Nursing, Johns Hopkins University, USA
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2
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Andrews M, Cheema BS, Siette J. Barriers and facilitators to implementation of physical activity programs for individuals with dementia living in aged care homes: A systematic review. Arch Gerontol Geriatr 2024; 126:105535. [PMID: 38936317 DOI: 10.1016/j.archger.2024.105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/27/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes. METHODS A search was conducted using the databases Medline, PubMed, PsycINFO, CINAHL, Embase, and ProQuest, and captured articles were assessed for inclusion in the review. Included studies were appraised using the Mixed Methods Appraisal Tool (MMAT). Data extraction was performed for study characteristics, identified barriers and facilitators to physical activity implementation, and synthesised narratively. RESULTS Following full-text screening, 13 articles were included in the review. Reporting quality was high in the majority of studies (69 %). Overall, barriers to implementation of physical activity programs were linked to factors related to the resident or the aged care facility, rather than inherently with the physical activity itself. The most identified barriers were understaffing (62 %), resident fatigue or lack of motivation (46 %), distrust of staff (31 %), and fear of injury (31 %). The most identified facilitators were having a structured physical activity protocol (46 %), opportunities for social interaction (38 %), instructor-led sessions (38 %) and offering an individually tailored program (31 %). CONCLUSIONS Addressing barriers of understaffing and resident fatigue whilst simultaneously offering structured, personalised group physical activity programs led by instructors may help optimise implementation. Future research should focus on developing tailored implementation plans, evaluating their effectiveness and cost-effectiveness, and identifying best practices to support the delivery of physical activity interventions in residential aged care settings. PROSPERO REGISTRATION NUMBER CRD42022372308.
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Affiliation(s)
- Mitchell Andrews
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Birinder S Cheema
- School of Health Sciences, Translational Health Research Institute and the National Institute of Complementary Medicine, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia.
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Hirt J, Vetsch J, Weissenfels I, Heinrich S. Nurse-led physical activity interventions for people with dementia in nursing homes: A systematic review on intervention characteristics and implementation facilitators/barriers. Int J Nurs Stud 2024; 154:104756. [PMID: 38552471 DOI: 10.1016/j.ijnurstu.2024.104756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Physical activities are important to maintain and promote physical functioning and activities of daily living in people with dementia. Nurses are in a key position to deliver physical activity interventions in nursing homes. However, synthesized strategies for sustainable implementation of physical activity interventions in nursing homes for people with dementia are lacking. OBJECTIVE We aimed at synthesizing the evidence on nurse-led physical activity interventions and at identifying facilitators and barriers to sustainable implementation of physical activity interventions for people with dementia. DESIGN Systematic review. REVIEW METHODS We performed a comprehensive literature search combining database searches (MEDLINE, CINAHL, CENTRAL, Web of Science Core Collection; last search: September 27, 2023) and supplementary search methods (citation tracking, web searching, clinical guideline database searching). We considered studies on nurse-led physical activity interventions for people with dementia living in nursing homes for eligibility; published as journal articles and related material in English, French, German language, without restrictions on primary study design and publication year. Independently and in duplicate, we assessed the references' eligibility and the quality of the included studies. We used the Mixed Methods Appraisal Tool to appraise quality of included studies. We piloted and double-checked data extractions, and summarized the results narratively and graphically (harvest plot). We prospectively registered our review (PROSPERO CRD42021271833). RESULTS We identified 24 studies (of which eleven were randomized trials) assessing various interventions that we categorized into physical exercise (n = 8), care-integrated physical activity (n = 6), outdoor or walking activity (n = 5), technology-supported physical exercise (n = 3), and dancing (n = 2). Types of outcomes and length of follow-up varied widely. Effects were inconclusive, except for outdoor or walking activities showing an overall positive impact on physical outcomes. For eight interventions, we identified evidence on implementation barriers (b) and facilitators (f), including staff shortage (b), staff time resources (b), or ease of implementation for staff (f) and adaptability of interventions (f) or refusal to participate of people with dementia (b). CONCLUSIONS The results of our review provide a comprehensive overview on types, characteristics and effects of nurse-led physical activity interventions for people with dementia in nursing homes. Based on evidence from a range of study designs and sources, we came to the conclusion that all stakeholders involved considered physical activity interventions for people with dementia as useful and relevant. Outcome measures varied widely and a clear conclusion on effectiveness remains open.
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Affiliation(s)
- Julian Hirt
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland; Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Janine Vetsch
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
| | - Inga Weissenfels
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
| | - Steffen Heinrich
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
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Gelfo F, Petrosini L, Mandolesi L, Landolfo E, Caruso G, Balsamo F, Bonarota S, Bozzali M, Caltagirone C, Serra L. Land/Water Aerobic Activities: Two Sides of the Same Coin. A Comparative Analysis on the Effects in Cognition of Alzheimer's Disease. J Alzheimers Dis 2024; 98:1181-1197. [PMID: 38552114 DOI: 10.3233/jad-231279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Evidence in the literature indicates that aerobic physical activity may have a protective role in aging pathologies. However, it has not been clarified whether different types of aerobic exercise produce different effects. In particular, these potential differences have not been explored in patients with Alzheimer's disease (AD). The present narrative review has the specific aim of evaluating whether land (walking/running) and water (swimming) aerobic activities exert different effects on cognitive functions and neural correlates in AD patients. In particular, the investigation is carried out by comparing the evidence provided from studies on AD animal models and on patients. On the whole, we ascertained that both human and animal studies documented beneficial effects of land and water aerobic exercise on cognition in AD. Also, the modulation of numerous biological processes is documented in association with structural modifications. Remarkably, we found that aerobic activity appears to improve cognition per se, independently from the specific kind of exercise performed. Aerobic exercise promotes brain functioning through the secretion of molecular factors from skeletal muscles and liver. These molecular factors stimulate neuroplasticity, reduce neuroinflammation, and inhibit neurodegenerative processes leading to amyloid-β accumulation. Additionally, aerobic exercise improves mitochondrial activity, reducing oxidative stress and enhancing ATP production. Aerobic activities protect against AD, but implementing exercise protocols for patients is challenging. We suggest that health policies and specialized institutions should direct increasing attention on aerobic activity as lifestyle modifiable factor for successful aging and age-related conditions.
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Affiliation(s)
- Francesca Gelfo
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | | | - Laura Mandolesi
- Department of Humanities, Federico II University of Naples, Naples, Italy
| | | | | | - Francesca Balsamo
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Sabrina Bonarota
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Marco Bozzali
- Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Turin, Italy
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
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Arrieta H, Rezola-Pardo C, Gil J, Kortajarena M, Zarrazquin I, Echeverria I, Mugica I, Limousin M, Rodriguez-Larrad A, Irazusta J. Effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents: Randomized controlled trial. Geriatr Nurs 2022; 45:77-84. [PMID: 35339954 DOI: 10.1016/j.gerinurse.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 11/04/2022]
Abstract
This study analyzed the effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents. This was a single-blind, multicenter, randomized controlled trial performed in 10 long-term care settings and involved 112 participants. Participants were randomly assigned to a control group or an intervention group. The control group participated in routine activities; the intervention group participated in a six-month individualized and progressive multicomponent exercise program focused on strength, balance, and walking recommendations. The intervention group maintained peak VO2, oxygen saturation, and resting heart rate, while the control group showed a significant decrease in peak VO2 and oxygen saturation and an increase in resting heart rate throughout the six-month period. Individualized and progressive multicomponent exercise programs comprising strength, balance, and walking recommendations appear to be effective in preventing cardiorespiratory fitness decline in older adults living in long-term care settings.
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Affiliation(s)
- Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain..
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| | - Javier Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| | - Maider Kortajarena
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain
| | - Idoia Zarrazquin
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain
| | - Iñaki Echeverria
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain.; Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Portal de Lasarte 71, E-01007 Vitoria-Gasteiz (Araba), Spain
| | - Itxaso Mugica
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain
| | - Marta Limousin
- Uzturre Asistentzia Gunea, San Joan Kalea 4, E-20400 Tolosa (Gipuzkoa), Spain
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
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The Impact of Exercising in the Quality of Life of People with Dementia-Alzheimer's Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1339:309-315. [PMID: 35023118 DOI: 10.1007/978-3-030-78787-5_36] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION In the recent years, the percentage of people with mild mental deterioration or some form of dementia is extremely increasing. Given that until today there has not been found an effective cure for dementia and the side effects of any kind of medicine are immense, the need for alternative non-medicine intervention seems to be obligatory. The target of this research was the activity concerning the mental deterioration of old people and its use with no medicine at all to deal with dementia through a good quality life.Method - Material: Throughout the literature review on which the method of collecting the proper data for the research, numerous published researches were studied from 2010 until 2018 which fulfilled the criteria of accession. The researches were identified in three electronic databases (PubMed, ScienceDirect, Web of Science) and were examined in accordance with the examined population, the draft of the research, the kinds of intervention, and the assessment tools which were used.Results - Conclusions: The majority of researches seem to converge to the aspect that the physical activity offers considerable benefits to the people suffering from the Alzheimer's disease or any other kind of dementia. More specifically, it contributes to the stability and the improvement of mental function as well as to the delay of the appearance of serious neuropsychiatric symptoms such as depression, confusion, and apathy. Moreover, the role of physical activity is significant in the improvement of functional ability of patients suffering from dementia resulting in the enforcement of autonomy in everyday activities and the confinement of the danger of dropping down. Consequently, the researches indicate that physical activity constitutes a well-promising intervention in the prevention and non-medicine treatment as it contributes to the upgrading of good quality life of the patients. However, the results vary depending on the particular characteristics of the body practicing, such as the kind of exercise, the intensity, the frequency, and the duration. Thus, it is extremely important the comprehension and knowledge of specific factors which are responsible for the acquirement of characteristics of therapeutic intervention which will lead to the development of exclusively designed exercise patterns and programs for dementia.
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7
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Feasibility and Effectiveness of a Biography-Based Physical Activity Intervention in Institutionalized People With Dementia: Quantitative and Qualitative Results From a Randomized Controlled Trial. J Aging Phys Act 2021; 30:237-251. [PMID: 34426552 DOI: 10.1123/japa.2020-0343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 03/19/2021] [Accepted: 04/20/2021] [Indexed: 11/18/2022]
Abstract
The objective of this multicenter randomized controlled trial was to evaluate the feasibility and effectiveness of a physical activity intervention for institutionalized people with dementia, individualized by capacity and biography. The intervention group (n = 34; age: mean = 86.09 years; 79.40% female; mean Mini-Mental State Examination value = 18.59) participated in a multicomponent training program, which included daily activities, dancing, gardening, and sports/games, twice weekly for 3 months. The control group (n = 29; age: mean = 86.34 years; 75.90% female; mean Mini-Mental State Examination value = 19.90) received standard care. Feasibility was evaluated by means of focus groups and feedback questionnaires. Functional performance (Short Physical Performance Battery and Timed Up and Go Test), activities of daily living, and gait were outcomes for effectiveness. A high adherence rate (80.46%) and uniformly positive feedback indicate that the piloted training program is feasible. The results show preliminary effectiveness on functional performance (Short Physical Performance Battery mean t0 = 3.15; mean t1 = 4.50; p = .006) and gait (e.g., velocity mean t0 = 46.97; mean t1 = 58.04; p = .007).
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8
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Jenkins E, Koirala B, Rodney T, Lee JW, Cotter VT, Szanton SL, Taylor JL. Home/community-based interventions to improve function in persons with mild cognitive impairment/early dementia. Geriatr Nurs 2021; 42:1109-1124. [PMID: 34280736 DOI: 10.1016/j.gerinurse.2021.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
Persons with mild cognitive impairment/early dementia have a possible 20-year trajectory of disability and dependence with little information on the effectiveness of interventions to improve function. This review investigates the literature of home/community-based interventions for physical and executive function in persons with mild cognitive impairment/early dementia. A 2007-2020 systematic literature search was conducted through PubMed, CINAHL Plus with Full Text and PsycINFO. Of the 1749 articles retrieved, 18 eligible studies were identified and consisted of three types of interventions: cognitive training-only (n = 7), multicomponent (n = 9), and physical activity-only (n = 2). Results showed that the interventions impacting function in persons with cognitive impairment incorporated a visual/written element, technology-based training, caregiver support, and modified duration/increased frequency of interventions. In studies improving function, participants simulated Instrumental Activities of Daily Living. They addressed cognitive function using both objective and subjective cognitive measures. We found gaps in the literature in incorporating race/ethnicity and appropriate socioeconomic status measures.
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Affiliation(s)
- Emerald Jenkins
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA.
| | - Binu Koirala
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Tamar Rodney
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Ji Won Lee
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Valerie T Cotter
- Johns Hopkins University School of Nursing, 929 N Wolfe St. Room 403, Baltimore, MD 21205 USA
| | - Sarah L Szanton
- Health Equity and Social Justice Endowed Professor, Director, Center on Innovative Care in Aging, Johns Hopkins School of Nursing, Joint Appointment with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, 525 North Wolfe Street #424, Baltimore, MD 21205 USA
| | - Janiece L Taylor
- Johns Hopkins University School of Nursing, 525 N. Wolfe St. Room 422, Baltimore, MD 21205 USA
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D'Cunha NM, Isbel S, McKune AJ, Kellett J, Naumovski N. Activities outside of the care setting for people with dementia: a systematic review. BMJ Open 2020; 10:e040753. [PMID: 33028565 PMCID: PMC7539570 DOI: 10.1136/bmjopen-2020-040753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To summarise the evidence from interventions investigating the effects of out of care setting activities on people with dementia living in residential aged care. DESIGN A systematic review. METHODS A systematic search of electronic databases (PubMed, PsycINFO, Scopus, Web of Science and the Cochrane Library) was performed to identify intervention trials published from journal inception to January 2020. Controlled trials, or quasi-experimental trials, which measured pre-intervention, post-intervention or during-intervention outcomes, where the participants were required to leave the care setting to participate in an intervention, were eligible for inclusion. Quality appraisal of the studies was performed following the Cochrane Collaboration's Risk of Bias or Newcastle-Ottawa Scale tools. RESULTS Of the 4155 articles screened, 11 articles met the inclusion criteria from 9 different studies. The number of participants in the studies ranged from 6 to 70 people living with dementia and lasted for 3 weeks up to 5 months. The interventions were aquatic exercise, wheelchair cycling, art gallery discussion groups, an intergenerational mentorship programme, horse riding, walking and outdoor gardening. Overall, the studies indicated preliminary evidence of psychological (n=7), physical (n=4) and physiological (n=1) benefits, and all interventions were feasible to conduct away from the aged care facilities. However, the low number of participants in the included studies (n=177), the absence of a control group in all but three studies, and potential for selection bias, limits the generalisability of the findings. CONCLUSIONS Activities outside of the residential aged care setting have the potential to be effective at providing a range of benefits for people living with dementia. Higher quality studies are required to encourage care providers to implement these type of activities in dementia care settings. PROSPERO REGISTRATION NUMBER CRD42020166518.
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Affiliation(s)
- Nathan Martin D'Cunha
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Stephen Isbel
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Andrew J McKune
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Jane Kellett
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Nenad Naumovski
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Australian Capital Territory, Australia
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10
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Becker BE. Aquatic Therapy in Contemporary Neurorehabilitation: An Update. PM R 2020; 12:1251-1259. [PMID: 32536028 DOI: 10.1002/pmrj.12435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
Aquatic therapy has been used extensively in a number of neurologic diseases and pathologies. This review describes disease-specific rehabilitative applications for this population. Recent research has offered scientific support for use in common neurological diseases that are part of rehabilitative practice, and very recent findings may create even firmer support for its use in these as well as other conditions. Stroke, Parkinsonism, and multiple sclerosis are areas that have recently received a significant number of published studies. Dementia is another area that has been more recently studied and received basic science support. Cerebral palsy has also had recent supportive evidence published. Available literature is reviewed to create a more evidence-based support for the use of aquatic therapy in neurorehabilitation.
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Affiliation(s)
- Bruce E Becker
- Clinical Professor, University of Washington School of Medicine, Seattle, Washington,WA, USA
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11
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Fien S, Henwood T, Climstein M, Rathbone E, Keogh JWL. Gait Speed Characteristics and Their Spatiotemporal Determinants in Nursing Home Residents: A Cross-Sectional Study. J Geriatr Phys Ther 2020; 42:E148-E154. [PMID: 29200084 DOI: 10.1519/jpt.0000000000000160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Low and slowing gait speeds among nursing home residents are linked to a higher risk of disability, cognitive impairment, falls, and mortality. A better understanding of the spatiotemporal parameters of gait that influence declining mobility could lead to effective rehabilitation and preventative intervention. The aims of this study were to objectively quantify the spatiotemporal characteristics of gait in the nursing home setting and define the relationship between these parameters and gait speed. METHODS One hundred nursing home residents were enrolled into the study and completed 3 habitual gait speed trials over a distance of 3.66 m. Trials were performed using an instrumented gait analysis. The manner in which the spatiotemporal parameters predicted gait speed was examined by univariate and multivariable regression modeling. RESULTS The nursing home residents had a habitual mean (SD) gait speed of 0.63 (0.19) m/s, a stride length of 0.83 (0.15) m, a support base of 0.15 (0.06) m, and step time of 0.66 (0.12) seconds. Multivariable linear regression revealed stride length, support base, and step time predicted gait speed (R = 0.89, P < .05). Step time had the greatest influence on gait speed, with each 0.1-second decrease in step time resulting in a 0.09 m/s (95% confidence interval, 0.08-0.10) increase in habitual gait speed. CONCLUSIONS This study revealed step time, stride length, and support base are the strongest predictors of gait speed among nursing home residents. Future research should concentrate on developing and evaluating intervention programs that were specifically designed to focus on the strong predictors of gait speed in nursing home residents. We would also suggest that routine assessments of gait speed, and if possible their spatiotemporal characteristics, be done on all nursing home residents in an attempt to identify residents with low or slowing gait speed.
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Affiliation(s)
- Samantha Fien
- Faculty of Health Science and Medicine, Bond University, Robina, Australia
| | - Timothy Henwood
- Faculty of Health Science and Medicine, Bond University, Robina, Australia.,Southern Cross Care, North Plympton, Australia
| | - Mike Climstein
- Exercise, Health and Performance Faculty Research Group, The University of Sydney, Sydney, Australia.,Water-Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, Australia
| | - Evelyne Rathbone
- Faculty of Health Science and Medicine, Bond University, Robina, Australia
| | - Justin William Leslie Keogh
- Faculty of Health Science and Medicine, Bond University, Robina, Australia.,Human Potential Centre, AUT University, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
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12
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Fien S, Henwood T, Climstein M, Rathbone E, Keogh JWL. Exploring the feasibility, sustainability and the benefits of the GrACE + GAIT exercise programme in the residential aged care setting. PeerJ 2019; 7:e6973. [PMID: 31198633 PMCID: PMC6555397 DOI: 10.7717/peerj.6973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Samantha Fien
- School of Health, Medical and Applied Sciences, CQUniversity, Mackay, Queensland, Australia.,Health Science and Medicine, Bond University, Robina, Queensland, Australia
| | - Tim Henwood
- Southern Cross Care, North Plympton, South Australia, Australia
| | - Mike Climstein
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Queensland, Australia.,Water Based Research Unit, Bond University, Robina, Queensland, Australia.,Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, University of Sydney, Sydney, New South Wales, Australia
| | - Evelyne Rathbone
- Health Science and Medicine, Bond University, Robina, Queensland, Australia
| | - Justin W L Keogh
- Health Science and Medicine, Bond University, Robina, Queensland, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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13
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Henskens M, Nauta IM, van Eekeren MC, Scherder EJ. Effects of Physical Activity in Nursing Home Residents with Dementia: A Randomized Controlled Trial. Dement Geriatr Cogn Disord 2018; 46:60-80. [PMID: 30145595 PMCID: PMC6187838 DOI: 10.1159/000491818] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/AIMS There is no consensus regarding the optimal nonpharmacological intervention to slow down dementia-related decline. We examined whether physical stimulation interventions were effective in reducing cognitive, physical, mood, and behavioral decline in nursing home residents with dementia. METHODS Eighty-seven nursing home residents with dementia were randomly assigned to 3 physical activity interventions: activities of daily living (ADL) training, multicomponent exercise training, or combined multicomponent exercise and ADL training. Outcomes were measured at baseline, and after 3 and 6 months. RESULTS A 6-month ADL training benefitted executive functions, physical endurance, and depression among men. Exercise training benefitted only grip strength of participants with mild-to-moderate cognitive impairment. A combined training benefitted functional mobility compared to ADL training, depressive symptoms and agitation compared to exercise training, and physical endurance compared to no physical stimulation. CONCLUSIONS ADL training appears to be effective for nursing home residents with moderately severe dementia. It remains unclear whether exercise training is an effective type of stimulation.
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Affiliation(s)
- Marinda Henskens
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ilse M. Nauta
- Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | - Erik J.A. Scherder
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Kolanowski A, Fortinsky RH, Calkins M, Devanand DP, Gould E, Heller T, Hodgson NA, Kales HC, Kaye J, Lyketsos C, Resnick B, Schicker M, Zimmerman S. Advancing Research on Care Needs and Supportive Approaches for Persons With Dementia: Recommendations and Rationale. J Am Med Dir Assoc 2018; 19:1047-1053. [PMID: 30145171 DOI: 10.1016/j.jamda.2018.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/03/2018] [Accepted: 07/07/2018] [Indexed: 01/23/2023]
Abstract
The first National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers was held on October 16-17, 2017, at the National Institutes of Health. In this paper, participants from the Summit Session on Research on Care Needs and Supportive Approaches for Persons with Dementia summarize the state of the science, identify gaps in knowledge, and offer recommendations to improve science and practice in long-term care. Recommendations cover 4 areas focused on persons living with dementia: (1) symptoms (behavioral and psychological symptoms of dementia, function, cognition, and sleep); (2) dementia care settings (physical and social environments, home, and residential care); (3) living with dementia (living well with dementia, living alone with dementia, and living with dementia and intellectual and developmental disabilities); and (4) technology as a cross-cutting theme. The participants identify 10 of the most pressing research issues based on the findings from their collective papers. Final Summit recommendations included those presented by session participants and will be used to advise federal agencies and other organizations that fund research.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jeffrey Kaye
- Oregon Health & Science University, Portland, OR
| | | | | | - Melanie Schicker
- Persons Living with Dementia Stakeholder Group, Alzheimer's Association, Chicago, Ill
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15
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Park J, Cohen I. Effects of Exercise Interventions in Older Adults with Various Types of Dementia: Systematic Review. ACTIVITIES, ADAPTATION & AGING 2018. [DOI: 10.1080/01924788.2018.1493897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | - Iris Cohen
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
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16
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Brett L, Stapley P, Meedya S, Traynor V. Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking: an exploration of policy incoherence. Aust N Z J Public Health 2018; 42:427-429. [DOI: 10.1111/1753-6405.12800] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Lindsey Brett
- Centre for Health Systems and Safety ResearchAustralian Institute of Health Innovation, Macquarie University New South Wales
| | - Paul Stapley
- Faculty of Science Medicine and HealthUniversity of Wollongong New South Wales
| | - Shahla Meedya
- Faculty of Science Medicine and HealthUniversity of Wollongong New South Wales
| | - Victoria Traynor
- Faculty of Science Medicine and HealthUniversity of Wollongong New South Wales
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17
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Hobden T, Swallow M, Beer C, Dening T. Swimming for dementia: An exploratory qualitative study: Innovative practice. DEMENTIA 2018; 18:776-784. [DOI: 10.1177/1471301218768372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Swimming is a non-weight bearing form of exercise that can be enjoyable and promote physical fitness. This qualitative study investigated a local group established as part of a national dementia swimming initiative. Semi-structured interviews with people with dementia (N = 4), carers or companions (N = 4) and the organisers and facilitators of the group (N = 6) were analysed using thematic analysis. This revealed four main themes: (1) the pleasure of swimming and its benefits as a form of exercise and for building confidence and empowering participants, (2) the importance of insight and empathy in creating a safe and secure experience, (3) the impact of dementia and (4) how participants valued being part of a group ‘all in the same boat’. ‘Dementia friendly swimming’ appears to be a valuable form of exercise, but it requires considerable preparation and support to make it happen.
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Affiliation(s)
- Tanya Hobden
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
| | - Mary Swallow
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
| | - Charlotte Beer
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
| | - Tom Dening
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
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18
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Aquatic exercise for residential aged care adults with dementia: benefits and barriers to participation. Int Psychogeriatr 2017; 29:1439-1449. [PMID: 28473006 DOI: 10.1017/s104161021700028x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND 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.
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Van Roie E, Martien S, Hurkmans E, Pelssers J, Seghers J, Boen F, Delecluse C. Ergometer-cycling with strict versus minimal contact supervision among the oldest adults: A cluster-randomised controlled trial. Arch Gerontol Geriatr 2017; 70:112-122. [DOI: 10.1016/j.archger.2017.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/12/2017] [Accepted: 01/14/2017] [Indexed: 10/20/2022]
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Fien S, Henwood T, Climstein M, Keogh JWL. Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme. PeerJ 2016; 4:e2018. [PMID: 27231652 PMCID: PMC4878364 DOI: 10.7717/peerj.2018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/17/2016] [Indexed: 11/20/2022] Open
Abstract
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.
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Affiliation(s)
- Samantha Fien
- Health Science and Medicine, Bond University , Robina , Australia
| | - Timothy Henwood
- Health Science and Medicine, Bond University, Robina, Australia; School of Human Movement & Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Mike Climstein
- Exercise, Health and Performance Faculty Research Group, University of Sydney , Sydney, NSW , Australia
| | - Justin William Leslie Keogh
- Health Science and Medicine, Bond University, Robina, Australia; Human Potential Centre, Auckland University of Technology, Auckland, New Zealand; Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Sunshine Coast, Australia
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21
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Hassan BH, Hewitt J, Keogh JWL, Bermeo S, Duque G, Henwood TR. Impact of resistance training on sarcopenia in nursing care facilities: A pilot study. Geriatr Nurs 2015; 37:116-21. [PMID: 26694694 DOI: 10.1016/j.gerinurse.2015.11.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 01/01/2023]
Abstract
The impact of progressive resistance training on sarcopenia among very old institutionalized adults was investigated. Residents of Nursing Care Facilities were included in a controlled trial of twice weekly resistance and balance exercise program for six months (Age: 85.9 ± 7.5 years, Time in care: 707.1 ± 707.5 days, N = 21 per group). Sarcopenia was measured based on the European Working Group on Sarcopenia in Older People criteria. Of the recruited 42 participants, 35.7% had sarcopenia at baseline, with prevalence increasing in the control group post-intervention (42.9%-52.4%). Following training, the exercise group experienced a significant increase in grip strength when compared to controls (p = .02), and a within-group decrease in body mass index and increase in grip strength (p ≤ .007). Resistance and balance exercise has positive benefits for older adults residing in a nursing care facilities which may transfer to reduce disability and sarcopenia transition, but more work is needed to ensure improved program uptake among residents.
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Affiliation(s)
- Bothaina H Hassan
- The University of Queensland, School of Nursing and Midwifery, Brisbane, Australia; Alexandria University, Faculty of Nursing, Alexandria, Egypt
| | - Jennifer Hewitt
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia; Human Potential Centre, AUT University, Auckland, New Zealand; Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia
| | - Sandra Bermeo
- Sydney Medical School Nepean, University of Sydney, Penrith, Australia
| | - Gustavo Duque
- Sydney Medical School Nepean, University of Sydney, Penrith, Australia
| | - Tim R Henwood
- The University of Queensland, School of Nursing and Midwifery, Brisbane, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.
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Benjamin K, Rankin J, Edwards N, Ploeg J, Legault F. The social organization of a sedentary life for residents in long-term care. Nurs Inq 2015; 23:128-37. [PMID: 26314937 DOI: 10.1111/nin.12120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 11/28/2022]
Abstract
Worldwide, the literature reports that many residents in long-term care (LTC) homes are sedentary. In Canada, personal support workers (PSWs) provide most of the direct care in LTC homes and could play a key role in promoting activity for residents. The purpose of this institutional ethnographic study was to uncover the social organization of LTC work and to discover how this organization influenced the physical activity of residents. Data were collected in two LTC homes in Ontario, Canada through participant observations with PSWs and interviews with people within and external to the homes. Findings explicate the links between meals, lifts and transfers, and the LTC standards to reveal that physical activity is considered an add-on program in the purview of physiotherapists. Some of the LTC standards which are intended to product good outcomes for residents actually disrupt the work of PSWs making it difficult for them to respond to the physical activity needs of residents. This descriptive ethnographic account is an important first step in trying to find a solution to optimize real activities of daily living into life in LTC.
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