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Farina N, McArdle R, Lowry RG, Banerjee S. Physical Activity Patterns Within Dementia Care Dyads. J Aging Phys Act 2024; 32:480-487. [PMID: 38437844 DOI: 10.1123/japa.2023-0078] [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: 03/14/2023] [Revised: 11/30/2023] [Accepted: 01/12/2024] [Indexed: 03/06/2024]
Abstract
Previous research has explored the physical activity habits of people with dementia and their family carers separately, with little consideration of how physical habits are associated within dyads. In this observational study, we sought to explore the relationship between people with dementia and their carers' physical activity, at a group level and at a dyadic level. Twenty-six participant dyads (persons with dementia and their carer spouses) were asked to wear an accelerometer for 30 days continuously. Comparisons were made at a group level and a dyadic level. People with dementia did not participate in significantly more moderate to vigorous physical activity (M = 15.44 min/day; SD = 14.40) compared with carers (M = 17.95 min/day; SD = 17.01). Within dyads, there were moderately strong associations between daily moderate to vigorous physical activity (r = .48-.54), but not with overall activity levels (r = .24). Despite physical activity habits remaining relatively low within people with dementia and carers, respectively, moderate to vigorous physical activity levels appear to be correlated within dyads. Understanding mutual influence on physical activity levels within dyads is an important pathway to promote an active lifestyle.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, East Sussex, England
- Faculty of Health, University of Plymouth, Plymouth, England
| | - Ríona McArdle
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, England
| | - Ruth G Lowry
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, England
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, England
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Lorito CD, Pollock K, Booth V, Howe L, Goldberg S, Godfrey M, Dunlop M, Harwood RH, Wardt VVD. Social participation in the promoting activity, independence and stability in early dementia (PrAISED), a home-based therapy intervention for people living with dementia: a realist evaluation. BMC Geriatr 2024; 24:615. [PMID: 39026228 PMCID: PMC11264791 DOI: 10.1186/s12877-024-05086-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 05/16/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Interventions promoting social activity may reduce behavioural psychological symptoms and improve quality of life in people living with dementia. This study aimed to identify social benefits for participants living with dementia in the context of Promoting Activity, Independence and Stability in Early Dementia (PrAISED), an exercise intervention programme promoting physical activity and independence in participants living with dementia in England. METHODS This was a multi-method realist evaluation undertaking secondary analysis of data collected during the PrAISED process evaluation, including qualitative interviews with participants with dementia, caregivers and therapists, personal notes of researchers, and video recordings of therapy sessions. The study consisted of four phases: (1) Setting operational definition of social outcomes in PrAISED; (2) Developing Context, Mechanisms, Outcome (CMO) configurations; (3) Testing and refining CMOs; and (4) Synthesising definitive CMOs into a middle range theory. RESULTS Two CMOs were identified. (1) When therapists were able to make therapy sessions engaging and had the caregivers' support, the participants experienced therapy sessions as an opportunity to achieve goals in areas they were interested in. They also found the sessions enjoyable. This all led to the participants being highly engaged in their social interactions with the therapists. (2) When the participants realised that they were gaining benefits and progress through the PrAISED intervention, such as increased balance, this boosted their confidence in physical ability. It might also reduce caregivers' risk-aversion/gatekeeping attitude, which in turn would lead to participants' increased participation in social activities. CONCLUSION The PrAISED intervention supported social participation in participants living with dementia. Under certain circumstances, home-based therapy interventions can be beneficial for social health (regardless of physical health gains). Given the limitations of currently available outcome measures to assess social participation, qualitative methods should be used to explore social health outcomes.
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Affiliation(s)
- Claudio Di Lorito
- Department of Primary Care & Population Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Vicky Booth
- School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Louise Howe
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Sarah Goldberg
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Maureen Godfrey
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Marianne Dunlop
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Rowan H Harwood
- School of Health Sciences, University of Nottingham, Nottingham, UK.
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Feenstra RW, de Bruin LJE, van Heuvelen MJG. Factors Affecting Physical Activity in People with Dementia: A Systematic Review and Narrative Synthesis. Behav Sci (Basel) 2023; 13:913. [PMID: 37998660 PMCID: PMC10669736 DOI: 10.3390/bs13110913] [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: 09/29/2023] [Revised: 10/27/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
Physical activity (PA) has positive effects on the physical and cognitive functioning of people with dementia. Knowledge about what limits and stimulates people with dementia to participate in PA is essential to promote effective PA implementation and enhance PA levels. Previous reviews primarily included opinion-based studies, using data from interviews, focus groups or dyads. By including implementation studies, we aimed to elaborate on previous reviews by identifying new barriers to PA and new facilitators and motivators for PA. We conducted systematic searches in Pubmed, PsychInfo and Web of Science for studies published up to the 21st of September 2021. Search terms were related to the population of people with dementia, PA interventions and implementation outcomes. Studies were included if PA participation was investigated during actual PA implementation. No restrictions were made regarding study design, date of publication, PA type or outcome measures. Studies not implementing PA or not evaluating the implementation were excluded. Based on 13 empirical studies, we identified 35 barriers, 19 facilitators and 12 motivators. Of these, 21 barriers, 11 facilitators and 4 motivators were not identified by previous reviews. New factors are related to the support for people with dementia from informal and formal caregivers, e.g., revealing the importance of a trusting relationship. Furthermore, support for staff from the institution or an external party is needed to overcome doubts about PA, for example, related to safety and effects. New factors also suggested specific recommendations for the content and organization of the PA intervention, for instance, related to how to give instructions. Overall, factors affecting PA identified with opinion-based or implementation studies are complementary. Our extended overview shows the complexity of PA implementation and may help to personalize PA, develop implementation strategies, facilitate actual PA implementation and free up resources needed for effective implementation.
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Affiliation(s)
| | | | - Marieke J. G. van Heuvelen
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
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Manser P, Poikonen H, de Bruin ED. Feasibility, usability, and acceptance of "Brain-IT"-A newly developed exergame-based training concept for the secondary prevention of mild neurocognitive disorder: a pilot randomized controlled trial. Front Aging Neurosci 2023; 15:1163388. [PMID: 37810620 PMCID: PMC10557950 DOI: 10.3389/fnagi.2023.1163388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Background Exergames provide a promising new approach to implement simultaneous motor-cognitive training, which may support preventing the decline in cognitive functioning in older adults who have a mild neurocognitive disorder (mNCD). Objectives To evaluate feasibility, system usability, and acceptance of "Brain-IT", a newly developed training concept combining exergame-based motor-cognitive training and heart rate variability (HRV) guided resonance breathing for the secondary prevention of mNCD. Methods A pilot randomized controlled trial (RCT) with an allocation ratio of 2:1 (i.e., intervention:control) was conducted. The control group proceeded with usual care. The intervention group performed a 12-week training according to the "Brain-IT" training concept implemented with the "Senso Flex" (Dividat AG) exergaming system in addition to usual care. Feasibility and usability outcomes were analyzed using descriptive statistics. User acceptance was analyzed qualitatively and using Friedman analysis of variance (ANOVA), as well as Wilcoxon signed-rank tests. Results Eighteen participants (77.3 ± 9.8 years; 44.4% females) were included. On average, we recruited 2.2 participants per month, and 35.3% of the individuals contacted were included. The intervention group had an attrition rate of 20% and mean adherence and compliance rates of 85.0 and 84.1%, respectively. The mean system usability score, measured with the system usability scale, was 71.7. High levels of exergame enjoyment, an increase in exergame enjoyment, and internalization of training motivation with large effect sizes (p = 0.03, r = 0.75 and p = 0.03, r = 0.74, respectively), as well as acceptable perceived usefulness, were observed. Preliminary data on the effects of the "Brain-IT" training are promising. Conclusion The feasibility and usability of the "Brain-IT" training are acceptable. However, frequent occurrences of technical problems and difficulties in using the exergame training system were identified as barriers to performing the "Brain-IT" training. To optimize feasibility, either improvements or alternative solutions are required in the hardware and software of the exergame used to implement the "Brain-IT" training. The "Brain-IT" training itself was well-accepted by older adults who have mNCD. Therefore, the effectiveness of the "Brain-IT" training concept should be investigated in future studies. Trial registration clinicaltrials.gov/ct2/show/NCT04996654.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Hanna Poikonen
- Learning Sciences and Higher Education, Department of Humanities, Social and Political Sciences, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Harwood RH, Goldberg SE, Brand A, van Der Wardt V, Booth V, Di Lorito C, Hoare Z, Hancox J, Bajwa R, Burgon C, Howe L, Cowley A, Bramley T, Long A, Lock J, Tucker R, Adams EJ, O'Brien R, Kearney F, Kowalewska K, Godfrey M, Dunlop M, Junaid K, Thacker S, Duff C, Welsh T, Haddon-Silver A, Gladman J, Logan P, Pollock K, Vedhara K, Hood V, Das Nair R, Smith H, Tudor-Edwards R, Hartfiel N, Ezeofor V, Vickers R, Orrell M, Masud T. Promoting Activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED): randomised controlled trial. BMJ 2023; 382:e074787. [PMID: 37643788 PMCID: PMC10463053 DOI: 10.1136/bmj-2023-074787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To determine the effectiveness of an exercise and functional activity therapy intervention in adults with early dementia or mild cognitive impairment compared with usual care. DESIGN Randomised controlled trial. SETTING Participants' homes and communities at five sites in the United Kingdom. PARTICIPANTS 365 adults with early dementia or mild cognitive impairment who were living at home, and family members or carers. INTERVENTION The intervention, Promoting activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED), was a specially designed, dementia specific, rehabilitation programme focusing on strength, balance, physical activity, and performance of activities of daily living, which was tailored and progressive and addressed risk and the psychological needs of people with dementia. Up to 50 therapy sessions were provided over 12 months. The control group received usual care plus a falls risk assessment. Procedures were adapted during the covid-19 pandemic. MAIN OUTCOME MEASURES The primary outcome was score on the carer (informant) reported disability assessment for dementia scale 12 months after randomisation. Secondary outcomes were self-reported activities of daily living, physical activity, quality of life, balance, functional mobility, fear of falling, frailty, cognition, mood, carer strain, service use at 12 months, and falls between months 4 and 15. RESULTS 365 patient participants were randomised, 183 to intervention and 182 to control. The median age of participants was 80 years (range 65-95), median Montreal cognitive assessment score was 20 out of 30 (range 13-26), and 58% (n=210) were men. Intervention participants received a median of 31 therapy sessions (interquartile range 22-40) and reported completing a mean 121 minutes of PrAISED exercise each week. Primary outcome data were available for 149 intervention and 141 control participants. Scores on the disability assessment for dementia scale did not differ between groups: adjusted mean difference -1.3, 95% confidence interval -5.2 to 2.6; Cohen's d effect size -0.06, 95% confidence interval -0.26 to 0.15; P=0.51). Upper 95% confidence intervals excluded small to moderate effects on any of the range of outcome measures. Between months 4 and 15 the intervention group experienced 79 falls and the control group 200 falls (adjusted incidence rate ratio 0.78, 95% confidence interval 0.5 to 1.3; P=0.3). CONCLUSION The intensive PrAISED programme of exercise and functional activity training did not improve activities of daily living, physical activity, or quality of life; reduce falls; or improve any other secondary health status outcomes, despite good uptake. Future research should consider alternative approaches to maintaining ability and wellbeing in people with dementia. TRIAL REGISTRATION ISRCTN Registry ISRCTN15320670.
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Affiliation(s)
- Rowan H Harwood
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Andrew Brand
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, Gwynedd, UK
| | - Veronika van Der Wardt
- Department of General, Preventative and Rehabilitation Medicine, Philipps-Universität Marburg 35032 Marburg, Germany
| | - Vicky Booth
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Claudio Di Lorito
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Zoe Hoare
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, Gwynedd, UK
| | - Jennie Hancox
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Rupinder Bajwa
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Clare Burgon
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Louise Howe
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Alison Cowley
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Trevor Bramley
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Gamston, Nottingham, UK
| | - Annabelle Long
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Juliette Lock
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Rachael Tucker
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Emma J Adams
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Rebecca O'Brien
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Fiona Kearney
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Katarzyna Kowalewska
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | | | | | - Kehinde Junaid
- Mental Health Services for Older People, Nottinghamshire Healthcare NHS Foundation Trust, Highbury Hospital, Nottingham, UK
| | - Simon Thacker
- Centre for Research and Development, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Carol Duff
- Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK
| | - Tomas Welsh
- The RICE Centre, Research Institute for the Care of Older People, Royal United Hospital, Bath, UK
| | - Annette Haddon-Silver
- Oxford Health NHS Foundation Trust, Research and Development, Warneford Hospital, Oxford, UK
| | - John Gladman
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Pip Logan
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK
| | - Kavita Vedhara
- Centre for Academic Primary Care, Lifespan and Population Health, University of Nottingham, Nottingham, UK
| | - Victoria Hood
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Gamston, Nottingham, UK
| | - Roshan Das Nair
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
- SINTEF, Torgarden, Trondheim, Norway
| | - Helen Smith
- Nottinghamshire Healthcare NHS Foundation Trust, Lings Bar Hospital, Gamston, Nottingham, UK
| | - Rhiannon Tudor-Edwards
- Centre for Health Economics and Medicines Evaluation, College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
| | - Ned Hartfiel
- Centre for Health Economics and Medicines Evaluation, College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
| | - Victory Ezeofor
- Centre for Health Economics and Medicines Evaluation, College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
| | - Robert Vickers
- School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Martin Orrell
- Mental Health Services for Older People, Nottinghamshire Healthcare NHS Foundation Trust, Highbury Hospital, Nottingham, UK
- Institute for Mental Health, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
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Di Lorito C, van der Wardt V, Pollock K, Howe L, Booth V, Logan P, Gladman J, Masud T, das Nair R, Goldberg S, Vedhara K, O’Brien R, Adams E, Cowley A, Bosco A, Hancox J, Burgon C, Bajwa R, Lock J, Long A, Godfrey M, Dunlop M, Harwood RH. The facilitators and barriers to improving functional activity and wellbeing in people with dementia: a qualitative study from the process evaluation of Promoting Activity, Independence and Stability in Early Dementia (PrAISED). Age Ageing 2023; 52:afad166. [PMID: 37603841 PMCID: PMC10442073 DOI: 10.1093/ageing/afad166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The PRomoting Activity, Independence and Stability in Early Dementia (PrAISED) study delivered an exercise and functional activity programme to participants living with dementia. A Randomised Controlled Trial showed no measurable benefits in activities of daily living, physical activity or quality of life. OBJECTIVE To explore participants' responses to PrAISED and explain why an intervention that might be expected to have produced measurable health gains did not do so. METHODS A process evaluation using qualitative methods, comprising interviews and researcher notes. SETTING Data were collected in participants' homes or remotely by telephone or videoconferencing. SAMPLE A total of 88 interviews were conducted with 44 participants living with dementia (n = 32 intervention group; n = 12 control group) and 39 caregivers. A total of 69 interviews were conducted with 26 therapists. RESULTS Participants valued the intervention as proactively addressing health issues that were of concern to them, and as a source of social contact, interaction, information and advice. Facilitators to achieving positive outcomes included perceiving progress towards desired goals, positive expectations, therapists' skills and rapport with participants, and caregiver support. Barriers included: cognitive impairment, which prevented independent engagement and carry-over between sessions; chronic physical health problems and intercurrent acute illness and injury; 'tapering' (progressively infrequent supervision intended to help develop habits and independent activity); and the COVID-19 pandemic. CONCLUSIONS Self-directed interventions may not be appropriate in the context of dementia, even in the mild stages of the condition. Dementia-specific factors affected outcomes including caregiver support, rapport with therapists, availability of supervision, motivational factors and the limitations of remote delivery. The effects of cognitive impairment, multimorbidity and frailty overwhelmed any positive impact of the intervention. Maintenance of functional ability is valued, but in the face of inevitable progression of disease, other less tangible outcomes become important, challenging how we frame 'health gain' and trial outcomes.
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Affiliation(s)
- Claudio Di Lorito
- Division of Primary Care and Population Health, University College London, UK
| | | | | | - Louise Howe
- School of Medicine, University of Nottingham, UK
| | - Vicky Booth
- School of Medicine, University of Nottingham, UK
- Nottingham University Hospitals NHS Trust, UK
| | - Pip Logan
- School of Medicine, University of Nottingham, UK
| | - John Gladman
- School of Medicine, University of Nottingham, UK
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, UK
| | | | | | | | | | - Emma Adams
- School of Medicine, University of Nottingham, UK
| | - Alison Cowley
- School of Medicine, University of Nottingham, UK
- Nottingham University Hospitals NHS Trust, UK
| | | | - Jennie Hancox
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Clare Burgon
- School of Health Sciences, University of Nottingham, UK
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Manser P, Huber S, Seinsche J, de Bruin ED, Giannouli E. Development and initial validation of the German version of the Exergame Enjoyment Questionnaire (EEQ-G). PLoS One 2023; 18:e0286556. [PMID: 37289701 PMCID: PMC10249825 DOI: 10.1371/journal.pone.0286556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Analyzing and adjusting training programs to increase exercise enjoyment is crucial to achieve long-term adherence and thus also maximize health benefits. The Exergame Enjoyment Questionnaire (EEQ) is the first questionnaire specifically developed to monitor exergame enjoyment. To be used in German speaking countries, the EEQ must be translated, cross-culturally adapted, and tested on its psychometric properties. OBJECTIVES The aim of this study was to develop (i.e., translate and cross-culturally adapt) the German Version of the EEQ (EEQ-G) and investigate its psychometric properties. METHODS Psychometric properties of the EEQ-G were tested using a cross-sectional study design. Each participant performed two consecutive exergame sessions (i.e., 'preferred' and 'unpreferred' condition) in randomized order and rated the EEQ-G as well as reference questionnaires. Internal consistency of the EEQ-G was assessed by calculating Cronbach's α. Construct validity was assessed by calculating Spearman's rank correlation coefficients (rs) between the scores of the EEQ-G and reference questionnaires. Responsiveness was analyzed by performing a Wilcoxon signed-rank test between the median EEQ-G scores of the two conditions. RESULTS Fourty-three healthy older adults (HOA; mean age = 69.4 ± 4.9 years; 53.5% females) were included. Cronbach's α of the EEQ-G was 0.80. The rs values between the EEQ-G and reference questionnaire scores for intrinsic motivation, game enjoyment, physical activity enjoyment, and external motivation were 0.198 (p = 0.101), 0.684 (p < 0.001), 0.277 (p = 0.036), and 0.186 (p = 0.233), respectively. The EEQ-G was rated higher in the 'preferred' than the 'unpreferred' condition (p < 0.001, r = 0.756). CONCLUSION The EEQ-G has high internal consistency and is responsive to changes in exergame enjoyment. The highly skewed data with ceiling effects in some of the reference questionnaires deem the construct validity of the EEQ-G to be inconclusive and thus in need of further evaluation.
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Affiliation(s)
- Patrick Manser
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Simone Huber
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Physiotherapy and Occupational Therapy Research Centre, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
| | - Julia Seinsche
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Health, OST–Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
| | - Eleftheria Giannouli
- Department of Health Sciences and Technology, Motor Control and Learning Group–Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Ramires VV, Dos Santos PC, Barbosa Filho VC, Bandeira ADS, Marinho Tenório MC, de Camargo EM, Ravagnani FCDP, Sandreschi P, de Oliveira VJM, Hallal PC, Silva KS. Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews. J Phys Act Health 2023:1-14. [PMID: 37156540 DOI: 10.1123/jpah.2022-0395] [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: 07/23/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents. METHODS We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary. RESULTS An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted. CONCLUSIONS These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.
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Affiliation(s)
- Virgílio Viana Ramires
- Department of Physical Education, Federal Institute Sul-rio-grandense-IFSUL, Campus Pelotas, Pelotas, Pelotas, RS,Brazil
| | | | | | | | | | - Edina Maria de Camargo
- Department of Physical Education, Federal University of Paraná-UFPR, Curitiba, PR,Brazil
| | - Fabrício Cesar de Paula Ravagnani
- Department of Physical Education, Institute of Education, Science and Technology of Mato Grosso do Sul-Campus Campo Grande, Campo Grande, MS,Brazil
| | - Paula Sandreschi
- Department of Health Promotion, Ministry of Health of Brazil, Brasília, DF,Brazil
| | - Victor José Machado de Oliveira
- Department of Physical Education, Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, AM,Brazil
| | - Pedro Curi Hallal
- Department of Epidemiology, Federal University of Pelotas-UFPEL, Pelotas, RS,Brazil
| | - Kelly Samara Silva
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, SC,Brazil
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Choukou MA, Olatoye F, Urbanowski R, Caon M, Monnin C. Digital Health Technology to Support Health Care Professionals and Family Caregivers Caring for Patients With Cognitive Impairment: Scoping Review. JMIR Ment Health 2023; 10:e40330. [PMID: 36630174 PMCID: PMC9878361 DOI: 10.2196/40330] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/25/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Digital health technology is a promising way of supporting health care providers and family caregivers as they care for patients with cognitive impairment. OBJECTIVE This scoping review aimed to portray the use of digital health technology to assist health care providers and family caregivers in caring for patients with cognitive impairment who live in the community or in a facility. METHODS We conducted a scoping review of peer-reviewed scientific articles available in MEDLINE, PsycINFO, Scopus, and CINAHL with Full Text, as well as gray literature available in preprint servers, theses depositories, and various national and international dementia organizations' websites. The search yielded 975 articles, of which we included 7 (0.7%) in the review. RESULTS Of the 7 interventions included in the retrieved manuscripts, 2 (29%) were digital calendar reminder systems to support activities of daily living and medication management; 2 (29%) were apps on tablet devices to simulate the presence of family before therapy interventions; 1 (14%) was a social robot used in therapeutic sessions to include elements of musicotherapy, reminiscence, cognitive games, and relaxation; 1 (14%) was a commercially available computer system that provides access to various recreational leisure activities; and 1 (14%) was a web-based self-management support system that helps family caregivers to deal with behavior changes in a relative with dementia. Of the 7 articles, only 1 (14%) reported on the use of a behavior change theory, namely a comprehensive process model of engagement coupled with cognitive stimulation therapy. CONCLUSIONS Literature on the topic is scarce, recent, and heterogeneous. There is a clear need for a theoretical framework to conceptualize and govern the use of behavior change models that incorporate technology for patients with cognitive impairment.
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Affiliation(s)
- Mohamed-Amine Choukou
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Centre on Aging, University of Manitoba, Winnipeg, MB, Canada
| | - Funminiyi Olatoye
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Reg Urbanowski
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Maurizio Caon
- School of Management of Fribourg, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
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10
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Zary N, Adcock-Omlin M, de Bruin ED. Design Considerations for an Exergame-Based Training Intervention for Older Adults With Mild Neurocognitive Disorder: Qualitative Study Including Focus Groups With Experts and Health Care Professionals and Individual Semistructured In-depth Patient Interviews. JMIR Serious Games 2023; 11:e37616. [PMID: 36602851 PMCID: PMC9853342 DOI: 10.2196/37616] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/28/2022] [Accepted: 10/10/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Exergames have attracted growing interest in the prevention and treatment of neurocognitive disorders. The most effective exergame and training components (ie, exercise and training variables such as frequency, intensity, duration, or volume of training and type and content of specific exergame scenarios) however remain to be established for older adults with mild neurocognitive disorders (mNCDs). Regarding the design and development of novel exergame-based training concepts, it seems of crucial importance to explicitly include the intended users' perspective by adopting an interactive and participatory design that includes end users throughout different iterative cycles of development. OBJECTIVE This study aimed to determine the capabilities, treatment preferences, and motivators for the training of older adults with mNCD and the perspectives of individuals on training goals and settings and requirements for exergame and training components. METHODS A qualitative study including expert focus groups and individual semistructured in-depth patient interviews was conducted. Data were transcribed to a written format to perform qualitative content analysis using QCAmap software. RESULTS In total, 10 experts and health care professionals (80% females) and 8 older adults with mNCD (38% females; mean age 82.4, SD 6.2 years) were recruited until data saturation was observed. CONCLUSIONS The psychosocial consequences of patients' self-perceived cognitive deterioration might be more burdensome than the cognitive changes themselves. Older adults with mNCD prefer integrative forms of training (such as exergaming) and are primarily motivated by enjoyment or fun in exercising and the effectiveness of the training. Putting the synthesized perspectives of training goals, settings, and requirements for exergames and training components into context, our considerations point to opportunities for improvement in research and rehabilitation, either by adapting existing exergames to patients with mNCDs or by developing novel exergames and exergame-based training concepts specifically tailored to meet patient requirements and needs.
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Affiliation(s)
| | - Manuela Adcock-Omlin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Health, OST - Eastern Swiss University of Applied Sciences, St.Gallen, Switzerland
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11
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Daly L, Byrne G, Keogh B. Health promotion for older people with dementia living in the community. Nurs Stand 2022; 37:55-60. [PMID: 36254555 DOI: 10.7748/ns.2022.e11973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Dementia has physical, psychological, social and economic effects, not only on people with dementia but also on their families, carers and society as a whole. Health promotion interventions for older people with dementia living in the community can support their health and well-being, particularly early in the course of the condition. Nurses have an important role in working collaboratively with patients, family carers and the multidisciplinary team to develop health promotion activities that are tailored to the person and take into account the progressive nature of the condition. This article gives an overview of health promotion as an aspect of post-diagnosis dementia care and considers how nurses can work with older people with dementia living in the community to promote their health.
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Affiliation(s)
- Louise Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Gobnait Byrne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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12
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Manser P, de Bruin ED. Making the Best Out of IT: Design and Development of Exergames for Older Adults With Mild Neurocognitive Disorder - A Methodological Paper. Front Aging Neurosci 2021; 13:734012. [PMID: 34955806 PMCID: PMC8698204 DOI: 10.3389/fnagi.2021.734012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/03/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Utilizing information technology (IT) systems, for example in form of computerized cognitive screening or exergame-based (also called active videogames) training, has gained growing interest for supporting healthy aging and to detect, prevent and treat neurocognitive disorders (NCD). To ameliorate the effectiveness of exergaming, the neurobiological mechanisms as well as the most effective components for exergame-based training remain to be established. At the same time, it is important to account for the end-users' capabilities, preferences, and therapeutic needs during the design and development process to foster the usability and acceptance of the resulting program in clinical practice. This will positively influence adherence to the resulting exergame-based training program, which, in turn, favors more distinct training-related neurobiological effects. Objectives and Methods: This methodological paper describes the design and development process of novel exergame-based training concepts guided by a recently proposed methodological framework: The 'Multidisciplinary Iterative Design of Exergames (MIDE): A Framework for Supporting the Design, Development, and Evaluation of Exergames for Health' (Li et al., 2020). Case Study: A step-by-step application of the MIDE-framework as a specific guidance in an ongoing project aiming to design, develop, and evaluate an exergame-based training concept with the aim to halt and/or reduce cognitive decline and improve quality of life in older adults with mild neurocognitive disorder (mNCD) is illustrated. Discussion and Conclusion: The development of novel exergame-based training concepts is greatly facilitated when it is based on a theoretical framework (e.g., the MIDE-framework). Applying this framework resulted in a structured, iterative, and evidence-based approach that led to the identification of multiple key requirements for the exergame design as well as the training components that otherwise may have been overlooked or neglected. This is expected to foster the usability and acceptance of the resulting exergame intervention in "real life" settings. Therefore, it is strongly recommended to implement a theoretical framework (e.g., the MIDE-framework) for future research projects in line with well-known checklists to improve completeness of reporting and replicability when serious games for motor-cognitive rehabilitation purposes are to be developed.
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Affiliation(s)
- Patrick Manser
- Movement Control and Learning - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D de Bruin
- Movement Control and Learning - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,OST - Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
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13
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Li B, Huang X, Meng C, Wan Q, Sun Y. Physical Activity and its Influencing Factors in Community-Dwelling Older Adults With Dementia: A Path Analysis. Clin Nurs Res 2021; 31:301-309. [PMID: 34293953 DOI: 10.1177/10547738211033928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers' fear of patients' falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers' fear of patients' falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers' concerns about them falling and consequently foster positive participation in PA.
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Affiliation(s)
- Bei Li
- Peking University First Hospital, Beijing, China
| | - Xiuxiu Huang
- Nursing School of Peking University, Beijing, China
| | | | - Qiaoqin Wan
- Nursing School of Peking University, Beijing, China
| | - Yongan Sun
- Peking University First Hospital, Beijing, China
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14
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Di Lorito C, Long A, Byrne A, Harwood RH, Gladman JRF, Schneider S, Logan P, Bosco A, van der Wardt V. Exercise interventions for older adults: A systematic review of meta-analyses. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:29-47. [PMID: 32525097 PMCID: PMC7858023 DOI: 10.1016/j.jshs.2020.06.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/24/2020] [Accepted: 04/26/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND The evidence concerning which physical exercise characteristics are most effective for older adults is fragmented. We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of meta-analyses of exercise interventions in older adults. METHODS We searched the Cochrane Database of Systematic Reviews, PsycInfo, MEDLINE, Embase, CINAHL, AMED, SPORTDiscus, and Web of Science for articles that met the following criteria: (1) meta-analyses that synthesized measures of improvement (e.g., effect sizes) on any outcome identified in studies of exercise interventions; (2) participants in the studies meta-analyzed were adults aged 65+ or had a mean age of 70+; (3) meta-analyses that included studies of any type of exercise, including its duration, frequency, intensity, and mode of delivery; (4) interventions that included multiple components (e.g., exercise and cognitive stimulation), with effect sizes that were computed separately for the exercise component; and (5) meta-analyses that were published in any year or language. The characteristics of the reviews, of the interventions, and of the parameters improved through exercise were reported through narrative synthesis. Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews. The study included 56 meta-analyses that were heterogeneous in relation to population, sample size, settings, outcomes, and intervention characteristics. RESULTS The largest effect sizes for improvement were found for resistance training, meditative movement interventions, and exercise-based active videogames. CONCLUSION The review identified important gaps in research, including a lack of studies investigating the benefits of group interventions, the characteristics of professionals delivering the interventions associated with better outcomes, and the impact of motivational strategies and of significant others (e.g., carers) on intervention delivery and outcomes.
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Affiliation(s)
- Claudio Di Lorito
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK.
| | - Annabelle Long
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Adrian Byrne
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Rowan H Harwood
- Division of Health Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - John R F Gladman
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University, Cologne 50933, Germany
| | - Pip Logan
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Alessandro Bosco
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Veronika van der Wardt
- Center for Methodology and Health Research, Department of General Medicine, Preventive and Rehabilitative Medicine, Philipps-Universität Marburg, Marburg 35032, Germany
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15
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Di Lorito C, Bosco A, Goldberg SE, Nair R, O'Brien R, Howe L, van der Wardt V, Pollock K, Booth V, Logan P, Godfrey M, Dunlop M, Horne J, Harwood RH. Protocol for the process evaluation of the Promoting Activity, Independence and Stability in Early Dementia (PrAISED), following changes required by the COVID-19 pandemic. BMJ Open 2020; 10:e039305. [PMID: 32859666 PMCID: PMC7453764 DOI: 10.1136/bmjopen-2020-039305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION The Promoting Activity, Independence and Stability in Early Dementia (PrAISED) randomised controlled trial (RCT) is evaluating a home-based, face-to-face, individually tailored, activity and exercise programme for people living with dementia. Social distancing requirements following the COVID-19 pandemic necessitated rapid changes to intervention delivery. METHODS AND ANALYSIS A mixed-methods process evaluation will investigate how the changes were implemented and the impact that these have on participants' experience. An implementation study will investigate how the intervention was delivered during the pandemic. A study on the mechanisms of impact and context will investigate how these changes were experienced by the PrAISED participants, their carers and the therapists delivering the intervention. The study will commence in May 2020. ETHICS AND DISSEMINATION The PrAISED RCT and process evaluation have received ethical approval number 18/YH/0059. The PrAISED process evaluation will enable us to understand how distancing and isolation affected participants, their activity and exercise routines and whether the therapy programme could be continued with remote support. This will be valuable both in explaining trial results and also contribute to understanding and designing new ways of delivering home-based services and rehabilitation interventions for people with dementia and their carers. TRIAL REGISTRATION NUMBER ISRCTN15320670; Pre-results.
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Affiliation(s)
- Claudio Di Lorito
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Alessandro Bosco
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roshan Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Rebecca O'Brien
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Louise Howe
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | | | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Vicky Booth
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Pip Logan
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Maureen Godfrey
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Marianne Dunlop
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Jane Horne
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Rowan H Harwood
- School of Health Sciences, University of Nottingham, Nottingham, UK
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16
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Taraldsen K, Boulton E, Helbostad JL, Saltvedt I, Granbo R. Client, caregiver, volunteer, and therapist views on a voluntary supported group exercise programme for older adults with dementia. BMC Geriatr 2020; 20:235. [PMID: 32641000 PMCID: PMC7346355 DOI: 10.1186/s12877-020-01632-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/25/2020] [Indexed: 02/08/2023] Open
Abstract
Background Existing group exercise programmes, or other services offered to maintain physical activity levels, are typically not developed specifically for older adults with dementia. The aim of this study was to gain knowledge about perceptions of a newly developed volunteer supported group exercise programme for older adults with dementia, and any barriers that may have affected participation and compliance. Methods Seven (six face-to-face and one by email) interviews were conducted with (i) older adults and volunteers participating in a pilot 12-week group exercise programme, (ii) caregivers, and (iii) therapists leading the group sessions. Interview transcriptions were systemised by use of NVivo 8 and analysed by use of Systematic Text Condensation method. Results The theme “building relationships” represents the reason why attending this group was important for the participants. The findings suggest that how we organize exercise groups is important, with some sort of extra support, to ensure that persons will begin and continue to participate in new activities outside their homes. Conclusions This study showed that it is possible to involve home-dwelling persons with cognitive decline and dementia in group exercise sessions. The role of building relationships was the major factor for successful participation. Providing support and ensuring motivation for persons attending the group outside their homes was essential, both for them and their caregivers. Service providers should not underestimate the importance of building relationships between persons involved in service offers.
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Affiliation(s)
- Kristin Taraldsen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. .,Clinic of Clinical Service, St Olav University Hospital, Trondheim, Norway.
| | - Elisabeth Boulton
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.,Department of geriatrics, St Olav University Hospital, Trondheim, Norway
| | - Randi Granbo
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
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17
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Di Lorito C, Bosco A, Pollock K, H. Harwood R, das Nair R, Logan P, Goldberg S, Booth V, Vedhara K, Godfrey M, Dunlop M, van der Wardt V. External Validation of the ' PHYT in Dementia', a Theoretical Model Promoting Physical Activity in People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1544. [PMID: 32121040 PMCID: PMC7084200 DOI: 10.3390/ijerph17051544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/12/2020] [Accepted: 02/19/2020] [Indexed: 01/06/2023]
Abstract
Physical activity is beneficial for people with dementia. We previously developed a theoretical model to explain behaviour change in physical activity in dementia (PHYT-in-dementia). This study aimed to externally validate the model. Validation occurred through the process evaluation of a programme promoting activity in people with dementia (PrAISED 2). Twenty participants with dementia and their carers were interviewed to investigate their experience of the programme. The data were analysed through content analysis. The original constructs of the model were used as initial codes and new codes were generated, if elicited from the data. The constructs were also ranked, based on their frequency in the interviews. All of the original model constructs were validated and two novel constructs created: 'personal history' and 'information/knowledge'. Certain constructs (e.g., support) were more frequently mentioned than others (e.g., personal beliefs). We suggested modifications and integrated them into a revised model. The PHYT-in-dementia recognised that dementia has an impact on motivation to initiate and maintain behaviour change over time. The model advocates that interventions adopt a more holistic approach than traditional behaviour change strategies. The suggested revisions require further validation to accurately predict behaviour change in physical activity in people with dementia.
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Affiliation(s)
- Claudio Di Lorito
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (P.L.); (V.B.); (M.G.); (M.D.)
| | - Alessandro Bosco
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham and Institute of Mental Health, Triumph Road, Nottingham NG7 2TU, UK; (A.B.); (R.d.N.)
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (K.P.); (R.H.H.); (S.G.)
| | - Rowan H. Harwood
- School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (K.P.); (R.H.H.); (S.G.)
| | - Roshan das Nair
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham and Institute of Mental Health, Triumph Road, Nottingham NG7 2TU, UK; (A.B.); (R.d.N.)
| | - Pip Logan
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (P.L.); (V.B.); (M.G.); (M.D.)
| | - Sarah Goldberg
- School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (K.P.); (R.H.H.); (S.G.)
| | - Vicky Booth
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (P.L.); (V.B.); (M.G.); (M.D.)
| | - Kavita Vedhara
- Division of Primary Care, School of Medicine, Room 1305 Tower Building, University Park, Nottingham NG7 2RD, UK;
| | - Maureen Godfrey
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (P.L.); (V.B.); (M.G.); (M.D.)
| | - Marianne Dunlop
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (P.L.); (V.B.); (M.G.); (M.D.)
| | - Veronika van der Wardt
- Wissenschaftliche Mitarbeiterin, Zentrum für Methodenwissenschaften und Gesundheitsforschung Abteilung für Allgemeinmedizin, Präventive und Rehabilitative Medizin, Philipps-Universität Marburg Karl-von-Frisch-Straße 4, 35032 Marburg, Germany;
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