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Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes: study protocol

Published online by Cambridge University Press:  13 March 2017

Lindsey Brett Open the ORCID record for Lindsey Brett [Opens in a new window] ,
Victoria Traynor ,
Paul Stapley  and
Shahla Meedya
Lindsey Brett*
Affiliation:
Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, NSW 2522, Australia
Victoria Traynor
Affiliation:
Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, NSW 2522, Australia
Paul Stapley
Affiliation:
Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, NSW 2522, Australia
Shahla Meedya
Affiliation:
Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, NSW 2522, Australia
*
Correspondence should be addressed to: Lindsey Brett, c/o Associate Professor Victoria Traynor, Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, NSW 2522, Australia. Phone: +00 61 431 044 713. Email: [email protected].
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Abstract

Background:

Worldwide, there are an estimated 35.6 million individuals living with dementia. It is important that non-pharmacological therapies are utilized to help manage the symptoms of dementia, such as agitation, as they are the recommended first approach in best practice guidelines.

Methods:

This protocol outlines a randomized controlled trial with a qualitative component which evaluated the effects and feasibility of a physical therapist-led physical exercise intervention on agitation of individuals living with dementia in nursing homes. Physical performance levels were considered as a secondary outcome. This evidence-based protocol consisted of a range of adaptable physical exercises that targeted strength, balance, endurance, and flexibility. To help determine the optimum parameters for this population group, the study used two intervention groups: (a) physical exercise intervention for 45 minutes once a week; (b) physical exercise intervention for 15 minutes three times a week (total time also 45 minutes per week). Both intervention groups were compared to a control group, which continued to participate in usual care only (no specific physical exercise intervention), such as basic seated exercise class, carpet bowls, and “armchair” activities.

Conclusions:

The physical therapist-led physical exercise intervention detailed in this protocol could be integrated into dementia care in nursing homes or other similar settings to help reduce agitation and improve physical performance.

Keywords

dementiaexerciseaged careagitationnursing home
Type
Protocol-only paper
Information
International Psychogeriatrics , Volume 29 , Issue 9 , September 2017 , pp. 1565 - 1577
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Aldrich, J. O. and Cunningham, J. B. (2016). Using IBM SPSS Statistics, United States of America: SAGE.Google Scholar
Australian Government. (2014a). Aged Care Funding Instrument (ACFI) User Guide [Online]. Available at: https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-funding/residential-care-subsidy/basic-subsidy-amount-aged-care-funding-instrument/aged-care-funding-instrument-acfi-user-guide; last accessed 18 February 2015.Google Scholar
Australian Government. (2014b). Quality of care principles. In Services, S. (ed.). Canberra, Australia.Google Scholar
Australian Institute of Health and Welfare. (2011). Dementia Among Aged Care Residents: First Information From the Aged Care Funding Instrument. Canberra: Australian Institute of Health and Welfare.Google Scholar
Australian Institute of Health and Welfare. (2012). Dementia in residential aged care. Australian Government.Google Scholar
Bian, H. N. D. SPSS Series 3: Repeated Measures ANOVA and MANOVA. East Carolina, USA: East Carolina University.Google Scholar
Blankevoort, C. G., Van Heuvelen, M. J. G. and Scherder, E. J. A. (2013). Reliability of six physical performance tests in older people with dementia. Physical Therapy, 93, 69–78.CrossRefGoogle ScholarPubMed
Bohannon, R. W. (1995). Sit-to-stand test for measuring performance of lower extremity muscles. Perceptual and Motor Skills, 80, 163–166.Google Scholar
Bonner, S. and Cousins, A. (1996). Exercise and Alzheimer's disease: benefits and barriers. Act Adapt Aging, 20, 21–34.Google Scholar
Bowes, A., Dawson, A., Jepson, R. and Mccabe, L. (2013). Physical activity for people with dementia: a scoping study. BMC Geriatrics, 13, 10.Google Scholar
Brett, L., Traynor, V. and Stapley, P. (2016). Effects of physical exercise on health and well-being of individuals living with a dementia in nursing homes: a systematic review. Journal of American Medical Directors Association, 17, 104–116.Google Scholar
Brett, L., Traynor, V., Stapley, P. and Meedya, S. (in press). Acceptability of the cohen-mansfield agitation inventory in an Australian residential aged care facility. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research.Google Scholar
Brown, D. et al. (2015). Development of an exercise intervention to improve cognition in people with mild to moderate dementia: Dementia And Physical Activity (DAPA) trial, registration ISRCTN32612072. Physiotherapy, 101, 126–134.Google Scholar
Brown, W. J., Moorhead, G. E. and Marshall, A. L. (2008). Choose Health: Be Active, Australia: Commonwealth of Australia.Google Scholar
Buchner, D. M. (2007). Exercise slows functional decline in nursing home residents with Alzheimer's disease. Australian Journal of Physiotherapy, 53, 204–204.Google Scholar
Chenoweth, L. et al. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lances Neurology, 8, 317–325.Google Scholar
Chodzko-Zajko, W. J. et al. (2009). Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41, 1510–1530.Google Scholar
Cohen-Mansfield, J. (1986). Agitated behaviors in the elderly: II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34, 722–727.Google Scholar
Cohen-Mansfield, J. (1991). Instruction Manual for the Cohen-Mansfield Agitation Inventory (CMAI). Rockville, MD: The Research Institute of the Hebrew Home of Greater Washington.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences. NJ: Lawrence Erlbaum Associates Inc.Google Scholar
Conradsson, M., Littbrand, H., Lindelöf, N., Gustafson, Y. and Rosendahl, E. (2010). Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial. Aging and Mental Health, 14, 565–576.Google Scholar
Cyarto, E. V., Brown, W. J. and Marshall, A. L. (2006). Retention, adherence and compliance: important considerations for home- and group-based resistance training programs for older adults. Journal of Science and Medicine in Sport, 9, 402–412.Google Scholar
Dewing, J. (2007). Participatory research: a method for process consent with persons who have dementia. Dementia (14713012), 6, 11–25 15p.Google Scholar
Falls Sa. Functional Reach [Online]. Available at: www.fallssa.com.au/documents/hp/Functional_Reach_Easy_Reference_Sheet.pdf; last accessed 19 April 2015.Google Scholar
Finkel, S. I., Lyons, J. S. and Anderson, R. L. (1992). Reliability and validity of the cohen–mansfield agitation inventory in institutionalized elderly. International Journal of Geriatric Psychiatry, 7, 487–490.Google Scholar
Forbes, D., Thiessen, E. J., Blake, C. M., Forbes, S. C. and Forbes, S. (2013). Exercise programes for people with dementia (review). 4/12/13 ed.: Cochrane Database of Systematic Reviews.Google Scholar
Foster, N. E. et al. (2014). A multicentre, pragmatic, parallel group, randomised controlled trial to compare the clinical and cost-effectiveness of three physiotherapy-led exercise interventions for knee osteoarthritis in older adults: the BEEP trial protocol (ISRCTN: 93634563). BMC Musculoskeletal Disorders, 15, 254–254.Google Scholar
Fox, B., Henwood, T., Neville, C. and Keogh, J. (2014a). Relative and absolute reliability of functional performance measures for adults with dementia living in residential aged care. International Psychogeriatrics, 26, 1659–1667.CrossRefGoogle ScholarPubMed
Fox, B., Hodgkinson, B. and Parker, D. (2014b). The effects of physical exercise on functional performance, quality of life, cognitive impairment and physical activity levels for oldder adults aged 65 years and older with a diagnosis of dementia: a systematic review. JBI Database of Systematic Reviews and Implementation Reports, 12, 158–276.Google Scholar
Garber, C. E. et al. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and Science in Sports and Exercise, 43, 1334–1359 10.1249/MSS.0b013e318213fefb.Google Scholar
Gray, K. F. (2004). Managing agitation and difficult behavior in dementia. Clinics in Geriatric Medicine, 20, 69–82.Google Scholar
Guideline Adaptation Committee (2016). Clinical Practice Guidelines and Principles of Care for People with Dementia. Australia: Guideline Adaptation Committee.Google Scholar
Hoffmann, T. C. et al. (2014). Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ, 348, 1–12. doi:10.1136/bmj.g1687 Google Scholar
Humphreys, G. (2012). The health-care challenges posed by population ageing. Bulletin of the World Health Organisation, 90, 77–156.Google Scholar
International Psychogeriatric Association. (2002). Behavioural and psychological symptoms of dementia educational pack. Available at: http://dbmas.org.au/resources/defining-bpsds; last accessed 9 February 2017.Google Scholar
Katz-Leurer, M., Fisher, I., Neeb, M., Schwartz, I. and Carmeli, E. (2009). Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke. Disability and Rehabilitation, 31, 243–248.Google Scholar
Lewin, S., Glenton, C. and Oxman, A. D. (2009). Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ, 339:b3496. doi:10.1136/bmj.b3496.CrossRefGoogle ScholarPubMed
Lindeman, U. (2011). Commentary on bohannon (2011): “five-repetition sit-to-stand test: usefulness for older patients in a home-care setting”. Perceptual and Motor Skills, 113, 489–490.Google Scholar
Livingston, G. (2014). Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials. The British Journal of Psychiatry, 205, 436–442.CrossRefGoogle ScholarPubMed
Luttenberger, K., Donath, C., Uter, W. and Graessel, E. (2012). Effects of multimodal nondrug therapy on dementia symptoms and need for care in nursing home residents with degenerative dementia: a randomized-controlled study with 6-month follow-up. Journal of the American Geriatric Society, 60, 830–840.Google Scholar
Nøst, T. H., Steinsbekk, A., Bratås, O. and Grønning, K. (2016). Expectations, effect and experiences of an easily accessible self-management intervention for people with chronic pain: study protocol for a randomised controlled trial with embedded qualitative study. Trials, 17, 325–325.Google Scholar
Pitkälä, K., Savikko, N., Poysti, M., Strandberg, T. and Laakkonen, M.-L. (2013). Efficacy of physical exercise intervention on mobility and physical functioning in older people with dementia: a systematic review. Experimental Gerontology, 48, 85–93.Google Scholar
Poldsiadlo, D. and Richardson, S. (1991). The timed “up and go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatric Society, 39, 142–148.Google Scholar
Polit, D. F. and Beck, C. T. (2011). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Philadelphia, PA: Lippincott Williams and Wilkins.Google Scholar
Randomness and Integrity Services Limited. (2015). Random.org Random Number Service [Online]. Available at: www.random.org/; last accessed 15 February 2015.Google Scholar
Richards, L. (1999). Using NVivo in Qualitative Research. London: SAGE Publications.Google Scholar
Ries, J. D., Echternach, J. L., Nof, L. and Blodgett, M. G. (2009). Test-retest reliability and minimal detectable change scores for the timed “up & go” test, the six-minute walk test, and gait speed in people with Alzheimer disease. Physical Therapy, 89, 569–579.Google Scholar
Sung, H.-C., Chang, S.-M., Lee, W.-L. and Lee, M.-S. (2006). The effects of group music with movement intervention on agitated behaviours of institutionalized elders with dementia in Taiwan. Complementary Therapies in Medicine, 14, 113–119.Google Scholar
Suttanon, P., Hill, K. D., Dodd, K. J. and Said, C. M. (2011). Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. International Psychogeriatrics, 23, 1152–1159.Google Scholar
Telenius, E. W., Engedal, K. and Bergland, A. (2015). Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial. PLoS One, 10, 1–18.Google Scholar
Tilson, J. K. (2010). Meaningful gait speed improvement during the first 60 days poststroke. Physical Therapy, 90, 196–208.Google Scholar
Valenzuela, T. (2012). Efficacy of progressive resistance training interventions in older adults in nursing homes: a systematic review. Journal of the American Medical Directors Association, 13, 418–428.CrossRefGoogle ScholarPubMed
Van De Winckel, A., Feys, H., De Weerdt, W. and Dom, R. (2004). Cognitive and behavioural effects of music-based exercises in patients with dementia. Clinical Rehabilitation, 18, 253–60.Google Scholar
White, I. R., Horton, N. J., Carpenter, J. and Pocock, S. J. (2011). Strategy for intention to treat analysis in randomised trials with missing outcome data. BMJ, 342:d40. doi:10.1136/bmj.d40.Google Scholar
World Health Organization. (2016). Dementia Fact Sheet Number 362 [Online]. Available at: www.who.int/mediacentre/factsheets/fs362/en/; last accessed 20 November 2016.Google Scholar
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