A Telehealth Home-Based Exercise Program for Community-Dwelling Older People with Dementia in Indonesia: A Feasibility Study

Abstract

(1) Background: This study aimed to evaluate the feasibility of a telehealth home-based exercise program for older people with dementia living in Indonesia with support from their informal carers. (2) Methods: Pre–post intervention single group study with three assessment time-points (baseline, 12 and 18 weeks). Participants with dementia underwent a 12-week physiotherapist-delivered telehealth exercise program, with informal carer supervision between supervised online sessions, and continued the exercises for a further six weeks without physiotherapist online supervision. (3) Results: Thirty dyads of older people with dementia and their informal carers were recruited; four (13.3%) withdrew across the 12-week intervention and one (3.3%) in the 6-week self-maintenance period. Median adherence was 84.1% (IQR [25, 75] = 17.1) during the 12-week intervention, and 66.7% (IQR [25, 75] = 16.7) in the self-maintenance period. No falls/adverse events were reported. Physical activity level, some aspects of function and disability, health-related benefits of exercise, exercise enjoyment and quality of life of older people with dementia improved significantly at 12 and 18 weeks. (4) Conclusions: The telehealth exercise program is feasible and safe and may have benefits for the health outcomes of community-living older people with dementia in Indonesia. Additional strategies are necessary to enhance longer-term adherence to the program.

Experiences of Indonesian people with dementia and carers undertaking an online-delivered exercise program

“…Participants acknowledged benefits of the online-delivered exercise program on physical and psychological health of the people with dementia. The benefits reported in this qualitative study align with objective outcomes from this study ( Sari et al, 2023a ), including improved physical activity levels, improvement in some aspects of function and disability, exercise enjoyment and quality of life. Other studies on online-delivered exercise programs have also reported benefits, including increasing levels of moderate physical activity in both people with dementia and their carers ( Ptomey et al, 2019 ) and improved falls efficacy for the person with dementia ( Taylor et al, 2020 ).…”

“…The flow diagram of participant recruitment, withdrawals, and exclusions is shown in Figure 1 . In our feasibility study from which participants for interviews were recruited ( Sari et al, 2023a ), 30 people with dementia and their 30 family carers, and 10 paid carers were involved. Of these, only 12 of the 30 people with dementia were deemed able to participate in the interview process, while 26 family carers, and 4 paid carers involved in part or all of the 12-week online-delivered exercise program were interviewed.…”

“…A study in China found that 80% of people with dementia are looked after by their families at home ( Xiao et al, 2014 ). In our main feasibility study ( Sari et al, 2023a ) from which the interviewees were recruited, a third of the people with dementia also had a paid carer supporting their care at home, including supporting their participation in the exercise program. Research in China shows that having a paid carer or adding the number of helpers looking after the person with dementia reduces the impact experienced by a sole family carer ( Wang et al, 2022 ).…”

“…Low inference interpretation is an approach used when aiming to reduce the researcher influence on the data interpretation, being strongly focussed on what participants state verbatim ( Goins et al, 2021 ; Sandelowski, 2000 ). This study was part of a larger study with the same study participants that evaluated the feasibility of a home-based online-delivered exercise program for community-dwelling older people with dementia in Indonesia ( Sari et al, 2023a ). The online-delivered exercise program was conducted between January 2021 and July 2022, a period during the COVID-19 pandemic.…”

Technology-based group exercise interventions for people living with dementia or mild cognitive impairment: A scoping review

“…Table 1 outlines the characteristics of 14 eligible studies, with eight originating from the United States [ 16 , 27 – 33 ], two from Australia [ 17 , 34 ], and one each from Germany [ 35 ], Korea [ 36 ], Taiwan [ 37 ], and Brazil [ 38 ]. Among these, nine were quantitative studies (including three RCTs [ 31 , 36 , 37 ], five pre-post intervention studies[ 16 , 27 , 28 , 33 , 34 ], and one cross-sectional design [ 38 ]), three were qualitative studies [ 29 , 32 , 35 ], and two were mixed-method studies, one of which was a pre-post intervention design [ 30 ], and the other a randomized controlled crossover design [ 17 ]. Seven studies were pilot studies [ 16 , 17 , 27 – 30 , 33 ].…”