Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.
Background: In March 2020, COVID-19 mandates to restrict face to face exercise and group based gatherings were enacted. These mandates were enforced within most states in the US. Gerofit, a facility-based exercise program for older Veterans in Durham, NC, transitioned to remote virtual exercise instruction to accommodate continuity of care. Objectives: To explore whether remote virtual exercise (RVE) can sustain physical function within individuals previously participating in onsite face to face exercise (OFF). Methods: Physical function assessments performed during OFF were compared with assessments conducted remotely over virtual platform. Assessments included the 30-second arm curl, the 30-second chair stand, time to complete five chair stands, and either 6-minute walk or 2-minute step test. All assessments for RVE were completed via a remote virtual platform. Only participants enrolled in both OFF and home based RVE with functional assessments within 6-months of pre and post COVID-19 transition were compared. Descriptive comparisons, opposed to statistical, were reported due to the limited sample size. Results: Fourteen OFF Gerofit participants were reassessed remotely within the first 6-months of transitioning to RVE (12 male, 2 female, mean age 73.1, mean body mass index 31.5). Functional assessments between OFF versus RVE were arm curls (21.0 vs 20.4 repetitions), chair stands (15.0 vs 17.5 repetitions), and time to 5 chair stands (9.0 vs 8.4 seconds). Cardiovascular function, reported in normalized percentiles (46.4%tile vs 58.9%tile) Conclusion: Among older Veterans engaged in regular structured exercise, physical function was preserved with transition to virtual exercise.
Background Gerofit is a facility-based exercise and health promotion program for older Veterans that transitioned to virtual delivery in March 2020. Little is known about how virtual exercise would promote resilience in the physical function of individuals previously participating in-person. Methods Preliminary data from 1 of 14 sites was gathered 72 Veterans returning to facility-based exercise after COVID mandated shutdowns. 39 individuals chose not to participate virtually, and 33 actively participated virtually for over 1 year. Re-entry data were then compared to the patients’ most recent test. Assessment means were compared within groups. Results Change scores from T1 to T2 were: -1.19 versus +2.4 repetitions for 30-second arm curls; +1.57 repetitions for 30-second chair stands; and -113.87 versus -77.3 yards for six-minute walk distance for non-virtual versus virtual groups. Implications: Participation in virtual exercise interventions may promote resilience and resistance to functional decline in previously active individuals during enforced isolation.
Background. Exercise is a crucial component of maintaining good health in older individuals. The COVID-19 stay-at-home orders forced Veterans actively engaged in facility-based exercise to stop attending in-person group exercise programs like Gerofit. Objective. To compare the characteristics of Veterans who enrolled (E) or declined enrollment (DE) in the transition from a facility-based exercise program, Gerofit, to a virtual Gerofit-to-Home (GTH) program. Methods. Gerofit is a supervised exercise “VA Best Practice” program for older Veterans implemented at 17 VA medical centers around the country. At the time of COVID-19 mandated closures, 1149 Veterans were actively engaged in facility-based programs and invited to attend GTH classes. Comparisons between those enrolling and those declining enrollment were performed by t-tests. Results. Three hundred and eight of 1149 (27%) Veterans made the transition to telehealth delivered classes, with several sites having enrolled participants aged in their mid-nineties. Age was not associated with GTH adoption rates (74.0 vs. 74.7, p=not significant for E vs. NE). Body mass index (31.3 vs. 30.5 kg/m2, p<0.05), gait speed (1.19 vs. 1.12 m/s, p<0.001), arm curls (20.8 vs. 19.5, p<0.001), and chair stands (14.7 vs. 13.2, p<0.05) were higher in individuals actively participating in GTH compared to those that never enrolled. Conclusions. Some older adults can adopt a virtual approach to group-based exercise, demonstrating its feasibility. Further research is needed to improve GTH implementation for lower functioning individuals. Virtual group-based exercise could reduce negative health effects associated with isolation due to lack of in-person exercise.
Rural Veterans often lack access to health care. Veterans Affairs (VA) supports telehealth technologies to provide services remotely that are comparable to onsite in-person care. We piloted VA Video Connect (VVC), to deliver an interactive exercise program for Veterans modeled on the VA Gerofit Program, a successful facility-based exercise program. VVC connects an exercise physiologist directly to the home with smart devices. Invitations to join Gerofit were mailed to 216 rural Veterans. Of 17 respondents, 7 (mean age 68) agreed to VVC tele-exercise 1x week for 12 weeks. Two Veterans were lost to follow-up prior to enrollment. Baseline VVC assessments (N=5) were indicative of high functional impairment in comparison to age-based norms: 2-minute step test (67.2 steps, 5th%tile), 30-second chair stands (12.4 stands, 26th%tile), and 30-second arm curls (15.3 curls, 25th%tile). Feasibility, barriers, and program impact will be discussed. Functional impairment indicates need for telehealth to reach Rural Veterans.
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