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The Applicability of a High-Intensity Functional Exercise Program Among Older People With Dementia Living in Nursing Homes.

https://arctichealth.org/en/permalink/ahliterature292035
Source
J Geriatr Phys Ther. 2018 May 25; :
Publication Type
Journal Article
Date
May-25-2018
Author
Anna Sondell
Erik Rosendahl
Yngve Gustafson
Nina Lindelöf
Håkan Littbrand
Author Affiliation
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Source
J Geriatr Phys Ther. 2018 May 25; :
Date
May-25-2018
Language
English
Publication Type
Journal Article
Abstract
Exercise programs for people with dementia need to be optimized. We therefore evaluated the applicability of a high-intensity functional exercise program among people with dementia in nursing homes with regard to attendance, achieved exercise intensity, adverse events, a focus on dementia type, and whether symptoms of dementia or other medical conditions common in this population were associated with program applicability.
The Umeå Dementia and Exercise study, a cluster-randomized controlled trial set in 16 nursing homes in Umeå, Sweden. Ninety-three people with dementia (mean [SD] Mini-Mental State Examination score of 15.4 [3.4]) were randomized to the exercise intervention. Thirty-four participants had Alzheimer's disease (AD) and 59 non-Alzheimer's dementia (non-AD). High-Intensity Functional Exercise (HIFE) program was conducted in groups of 3 to 8 participants. Two physiotherapists led 5 sessions (45 minutes each) per fortnight for 4 months (total 40 sessions).
Median attendance rate was 82.5%. Lower limb strength exercises were performed at high or medium intensity at a median interquartile range of 94.7% (77.8%-100%) of attended sessions. Participants with non-AD performed more sessions with high intensity in strength exercises than participants with AD (median interquartile range, 53.8% [25.7%-80%] vs 34.9% [2.02%-62.9%]; P = .035). Balance exercises were performed at high intensity at a median interquartile range of 75% (33.3%-88.6%). Adverse events (all minor and temporary, mostly musculoskeletal) occurred during the exercise sessions in 16% of attended sessions. Low motivation was the most common barrier for attendance. Buildup period, low motivation, and pain were common barriers for achieving high intensity in balance and strength exercises, and fear was a barrier in balance exercises. Of medical conditions, only behavioral and psychological symptoms of dementia, including apathy, were negatively associated with applicability.
A group-based, supervised, and individualized high-intensity functional exercise program seems to be applicable with regard to attendance, achieved intensity, and adverse events during the exercise sessions, in people with mild to moderate dementia in nursing homes. Effective strategies to enhance motivation to participate in exercise, as well as prevention and treatment of pain and behavioral and psychological symptoms of dementia, are important when promoting exercise participation in this population.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PubMed ID
29851748 View in PubMed
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Motivation to participate in high-intensity functional exercise compared with a social activity in older people with dementia in nursing homes.

https://arctichealth.org/en/permalink/ahliterature295976
Source
PLoS One. 2018; 13(11):e0206899
Publication Type
Journal Article
Date
2018
Author
Anna Sondell
Erik Rosendahl
Johan Nilsson Sommar
Håkan Littbrand
Lillemor Lundin-Olsson
Nina Lindelöf
Author Affiliation
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Source
PLoS One. 2018; 13(11):e0206899
Date
2018
Language
English
Publication Type
Journal Article
Abstract
Motivation to participate in exercise among people with dementia has not been well studied. The symptoms of dementia, including apathy, may lead to low motivation to participate in exercise. The aim of this study was to evaluate the motivation of older people with dementia to participate in a high-intensity exercise program compared with motivation of those participating in a social group activity.
The Umeå Dementia and Exercise Study (UMDEX) was a cluster-randomized controlled intervention trial including 186 people (mean age; 85, 75% female) with dementia in nursing homes. Participants were randomized to participate in the High-Intensity Functional Exercise (HIFE) Program (n = 93) or a seated social group activity (n = 93). The activities were conducted in groups of 3-8 participants for 45 minutes, five times per two-week period, for 4 months (40 sessions in total). Participants' motivation to go to and during activity sessions were assessed by the activity leaders and nursing homes staff using a five-point Likert scale. Data were analyzed using cumulative link mixed models.
Motivation was high or very high during 61.0% of attended sessions in the exercise group and 62.6% in the social activity group. No overall significant difference between groups was observed, but motivation increased over time in the exercise group and decreased in the social activity group (p
PubMed ID
30427894 View in PubMed
Less detail

Motivation to participate in high-intensity functional exercise compared with a social activity in older people with dementia in nursing homes.

https://arctichealth.org/en/permalink/ahliterature299307
Source
PLoS One. 2018; 13(11):e0206899
Publication Type
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
2018
Author
Anna Sondell
Erik Rosendahl
Johan Nilsson Sommar
Håkan Littbrand
Lillemor Lundin-Olsson
Nina Lindelöf
Author Affiliation
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Source
PLoS One. 2018; 13(11):e0206899
Date
2018
Language
English
Publication Type
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Apathy
Dementia - psychology - rehabilitation
Exercise Therapy - psychology
Female
Homes for the Aged - statistics & numerical data
Humans
Male
Motivation
Nursing Homes - statistics & numerical data
Social Participation - psychology
Sweden
Abstract
Motivation to participate in exercise among people with dementia has not been well studied. The symptoms of dementia, including apathy, may lead to low motivation to participate in exercise. The aim of this study was to evaluate the motivation of older people with dementia to participate in a high-intensity exercise program compared with motivation of those participating in a social group activity.
The Umeå Dementia and Exercise Study (UMDEX) was a cluster-randomized controlled intervention trial including 186 people (mean age; 85, 75% female) with dementia in nursing homes. Participants were randomized to participate in the High-Intensity Functional Exercise (HIFE) Program (n = 93) or a seated social group activity (n = 93). The activities were conducted in groups of 3-8 participants for 45 minutes, five times per two-week period, for 4 months (40 sessions in total). Participants' motivation to go to and during activity sessions were assessed by the activity leaders and nursing homes staff using a five-point Likert scale. Data were analyzed using cumulative link mixed models.
Motivation was high or very high during 61.0% of attended sessions in the exercise group and 62.6% in the social activity group. No overall significant difference between groups was observed, but motivation increased over time in the exercise group and decreased in the social activity group (p
PubMed ID
30427894 View in PubMed
Less detail