Frail older adults’ perceptions of an in-hospital structured exercise intervention

O’Hare, Louise; Savage, Eileen; McCullagh, Ruth; White, Eleanor Bantry; Fitzgerald, Éilís; Timmons, Suzanne

doi:10.1016/j.physio.2017.04.002

Cited by 11 publications

(18 citation statements)

References 21 publications

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“…New evidence on how to increase the participation and adherence rate of the APEP intervention has recently been reported by O’Hare et al [86], who explored how frail older inpatients perceived the effects of the APEP intervention. The authors concluded that “education tailored to the participants, and setting restorative goals, may improve outcome expectations and future intention to exercise” [86]. Especially the participants’ perceived relationship with the interventionist seems highly influential.…”

Section: Discussionmentioning

confidence: 99%

“…Especially the participants’ perceived relationship with the interventionist seems highly influential. It affects crucial aspects such as participation rate, perceived value of the APEP and outcome expectations [86]. We did not address and evaluate these aspects in our study, but it should be considered in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Future studies should examine the cost-effectiveness of the APEP intervention, to enable health care providers to make informed decisions about resource allocation. Qualitative research can be conducted to further examine older adults’ perceptions of an in-hospital APEP intervention [86]. In large sample studies, sub-group or correlation analyses might be used to assess the association between the effect of the APEP intervention on the primary outcome and LOS, as well as age, baseline mobility, primary diagnosis, multimorbidity, or frailty [35].…”

Section: Discussionmentioning

confidence: 99%

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An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial

et al. 2019

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Background There is inconclusive evidence for the effectiveness of additional exercise in older hospital patients. The aims of this study were (1) to assess the feasibility of an augmented prescribed exercise program (APEP) in older acute medical patients and (2) to measure the potential effects of APEP on mobility capacity in order to assess the feasibility of a large full-scale study. Methods We conducted a single-center, prospective, parallel-group, single-blinded, randomized (1:1) controlled pilot and feasibility trial. Participants were recruited from acute geriatric wards of a general hospital. Key inclusion criteria were: age ≥ 65 years and walking ability. Key exclusion criteria were severe cognitive impairment and medical restriction for physical exercise interventions. Both groups received usual care, including physiotherapy. Intervention group participants were scheduled for additional exercise sessions (20–30 min, 4-5x/week). Feasibility of the trial design was assessed along pre-defined criteria for process, resources and management. Feasibility of the APEP intervention was analyzed by means of adherence, compliance and safety. Outcomes were measured at baseline and prior to hospital discharge. The primary outcome was mobility capacity (de Morton Mobility Index; DEMMI). Secondary outcomes were walking ability, physical endurance, fear of falling, frailty and length of stay. Results Thirty-five participants were recruited (recruitment rate 20.3%). We lost 7 participants to follow-up (retention rate: 80%). Intervention group participants (n = 17) each participated in 5.3 ± 2.2 additional exercise sessions (mean duration: 23.2 ± 4.0 min; mean adherence rate 78% ± 26%). No severe adverse events occurred during study assessments or APEP sessions. There were no statistically significant differences in mean change scores in any outcome measure. A sample of 124 participants would be required to detect a difference of 4 DEMMI points (ES = 0.45) with a power of 80%. Conclusions This small feasibility RCT indicates that an APEP intervention may be safe and feasible in older acute medical patients. APEP may possibly induce small to moderate effects on mobility, but the clinical relevance of these effects may be limited. These results inform the planning of a larger-scale phase III study. Trial registration German Clinical Trials Register ( DRKS00011262 ). Registered 27 October 2016. Electronic supplementary material The online version of this article (10.1186/s12877-019-1246-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial

et al. 2019

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“…The qualitative analysis of the semi-structured interviews identified the need for flexibility in terms of the time and dose of exercise. This need for flexibility was not explicitly identified in three qualitative studies evaluating in-hospital exercise interventions [24][25][26] , though it does mirror the varied expectations of participants in Cattanach, Sheedy 27 with regard to physical activity in hospital. In this study, nine participants felt that they should rest in bed until well, 13 thought they should do light activity until well and two to keep active.…”

Section: Acceptability Of the Exercise Programmementioning

confidence: 99%

A mixed-methods feasibility study of a sit-to-stand based exercise programme to maintain knee-extension muscle strength for older patients during hospitalisation

Hartley¹,

Romero-Ortuño²,

Deaton³

2021

JFSF

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with an average amount of physically 'active' time less than 3% 11 , earlier intervention may be beneficial.Before addressing the efficacy of exercise interventions during hospitalisation, the present study aimed to determine the acceptability of the exercise programme and to identify Abstract Objectives: To determine the acceptability of an exercise programme and to identify barriers and facilitators to compliance with the programme from the participants' perspective. Methods: Patients aged 75 years or older were recruited within the first 36 hours of hospital admission. Participants were randomised to complete two strengthening-based (intervention arm) or stretching-based (control arm) exercise sessions per-day. At hospital discharge, participants were asked to take part in interviews with a member of the research team exploring the barriers and facilitators to adherence to the intervention. Results: 15 participants (7 intervention arm, 8 control arm) were recruited before the trial was stopped due to COVID-19. Both groups showed reductions in knee-extension strength, and improvements in functional mobility at discharge from hospital. A total of 23/60 intervention sessions were classed as 'complete', 12/60 as partially complete, and 25/60 were missed entirely. Eight participants took part in interviews. Intrinsic factors that impacted participation in the research, related to current health, health beliefs, and experience of multi-morbidity or functional decline. Staff had both a positive and negative effect on participant adherence to the intervention. Conclusions: The exercise intervention was well received, with most participants describing health benefits, though intervention fidelity was lower than expected.

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“…manter a motivação e frequência dos exercícios(O'HARE et al, 2017) e pela viabilidade de implementar as propostas nesse ambiente(BROWN et al, 2006).Em2006Brown et al, (2006 relataram que um programa de exercícios não parecia ser viável durante cuidados agudos hospitalizados, em função das barreiras de recrutamento que incluíam a gravidade da doença, as curtas internações e a recusa do paciente. Porém, recentemente, em uma revisão sistemática(VALENZUELA et al, 2020), os autores chegaram a conclusão que exercícios realizados no ambiente hospitalar eram seguros e eficazes para melhorar e até de atenuar o declínio da independência funcional e desempenho físicos de idosos hospitalizados.…”

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O Consultório Na Rua Como Linha De Frente No Enfrentamento À Covid-19: Experiência Da Residência Multiprofissional Em Saúde Da Família

Alves¹,

Jorge²,

Belo³

et al. 2021

Residências Em Saúde: Experiências, Pesquisa E Produção Do Conhecimento Para O SUS

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Frail older adults’ perceptions of an in-hospital structured exercise intervention

Cited by 11 publications

References 21 publications

An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial

An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial

A mixed-methods feasibility study of a sit-to-stand based exercise programme to maintain knee-extension muscle strength for older patients during hospitalisation

O Consultório Na Rua Como Linha De Frente No Enfrentamento À Covid-19: Experiência Da Residência Multiprofissional Em Saúde Da Família

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