Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID‐19: A randomised controlled trial

Abstract

Aims and ObjectivesQuarantine during the COVID‐19 pandemic resulted in longer‐term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID‐19.BackgroundLockdowns and restrictions during the COVID‐19 pandemic result in longer‐term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle‐strengthening programme for elderly people.DesignA parallel‐group, assessor‐blinded randomised controlled trial was performed according to CONSORT guidelines.MethodsThis study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep‐ and diet‐related health education. The OEP group also received a 12‐week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale‐15 (GDS‐15) and the 12‐Item Short Form Health Survey Mental Component Summary (SF‐12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks.ResultsPhysical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, −2.78; TUGT, −3.73; BBS, 2.17; GDS‐15, −0.72; SF‐12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, −0.10; GDS‐15, 1.07; SF‐12 MCS, −5.95; all p < .001).ConclusionOur findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID‐19 pandemic.Relevance to clinical practiceOtago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer‐term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID‐19 pandemic period.

Prevalence and Risk Factors for Cognitive Frailty in Aging Hypertensive Patients in China

“…The inducing and influencing factors of hypertension include biological, social and psychological aspects [12]. On the basis of drug treatment, experts advocate a healthy lifestyle and correct stress-coping strategies to prevent hypertension [13][14][15][16][17]. Previous studies have shown that hypertension is a common risk factor for physical frailty and cognitive decline [18].…”

Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia

“…Maximizing the challenge did not appear to be a priority in recent published studies, which either do not comment on efforts to individualize the intervention [ 21 , 22 ] or allude to progressing the group as a whole [ 23 ]. Chen et al [ 20 ] mention that physiotherapists “guided” participants to modify their exercise level, but the weights used were consistent at 0.5 kg and nurses “led” the intervention, so it is not clear how often physiotherapists may have guided these changes.…”

“…), and Kovàcs et al delivered the program with two physiotherapists for groups of 2–4 participants [ 19 ]. Recently, a series of studies in nursing home settings has supported the feasibility of group OEP with residents with physical and cognitive frailty [ 20 , 21 , 22 , 23 ]. While the mean MMSE scores of participants represent cognitive impairment (21–22/30) [ 20 , 21 ], a diagnosis of dementia was not in the inclusion criteria of any of these studies.…”

“…Recently, a series of studies in nursing home settings has supported the feasibility of group OEP with residents with physical and cognitive frailty [ 20 , 21 , 22 , 23 ]. While the mean MMSE scores of participants represent cognitive impairment (21–22/30) [ 20 , 21 ], a diagnosis of dementia was not in the inclusion criteria of any of these studies. The strategy for group administration of OEP in two of these studies was to initiate the program in small groups (6 participants to 3 staff [ 21 ] or 4–7 participants to 1 staff [ 22 ]) and after 4 weeks, to combine all small groups into one larger group with 3 staff providing oversight to groups of 18 and 29, respectively.…”

“…The strategy for group administration of OEP in two of these studies was to initiate the program in small groups (6 participants to 3 staff [ 21 ] or 4–7 participants to 1 staff [ 22 ]) and after 4 weeks, to combine all small groups into one larger group with 3 staff providing oversight to groups of 18 and 29, respectively. The mechanics of group OEP administration in the other studies (i.e., size of group and number of staff) was not presented [ 20 , 23 ].…”