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推陈出新:一项体力活动干预措施扩大了养老院居民的传感器评估生活空间。

Pushing the Boundaries: A Physical Activity Intervention Extends Sensor-Assessed Life-Space in Nursing Home Residents.

机构信息

Department of Psychological Aging Research, Institute of Psychology, Heidelberg University, Germany.

Department of Geriatric Research, Agaplesion Bethanien Hospital, Geriatric Center at Heidelberg University, Germany.

出版信息

Gerontologist. 2018 Sep 14;58(5):979-988. doi: 10.1093/geront/gnx136.

Abstract

BACKGROUND AND OBJECTIVES

To determine whether a multicomponent, individually tailored intervention to promote physical activity (PA) enhances life-space (LS) utilization in nursing home (NH) residents and whether intervention effects can be sustained at follow-up after continuation of the program as part of institutional daily routines.

RESEARCH DESIGN AND METHODS

Pre-post-assessed controlled trial in two highly similar NHs with a 3month follow-up in 143 NH residents (intervention group: n = 78; control group: n = 65) and LS as primary outcome. The PA promoting intervention consisted of several components (group sessions; individual exercise; serious games training; competence training for staff) tailored to residents' individual functional capacity. LS was innovatively assessed via an indoor wireless sensor network including three assessment-specific LS parameters: overall LS score (LSSc), time spent away from the private room (TAFR), and the maximally distal zone from private room visited (MaxZ). To exploit the available intervention-control comparative data in the best way possible, a generalized linear mixed model approach was applied.

RESULTS

At post-test, intervention participants had a significantly higher overall LSSc, spent more TAFR, and had extended their MaxZ as compared to controls. At follow-up, a significant group difference remained for MaxZ.

DISCUSSION AND IMPLICATIONS

A PA intervention in the NH setting impacts on LS utilization as measured using sensor-based assessment. The program has proven its practical sustainability when being handed over to NH personnel for continuation in daily practice. Further research is needed to determine whether an increase in LS utilization also impacts on social participation and quality of life.

摘要

背景与目的

确定多组分、个体化的促进身体活动(PA)干预措施是否能提高养老院(NH)居民的生活空间(LS)利用率,以及在该计划继续作为机构日常例行活动的一部分时,干预效果是否能在后续随访中持续。

研究设计与方法

在两个高度相似的 NH 中进行了预-后评估对照试验,对 143 名 NH 居民进行了 3 个月的随访(干预组:n = 78;对照组:n = 65),以 LS 为主要结局。促进 PA 的干预措施包括几个组件(小组会议;个体运动;严肃游戏训练;员工能力培训),根据居民的个体功能能力进行个体化定制。LS 通过室内无线传感器网络进行创新评估,包括三个特定 LS 参数:整体 LS 得分(LSSc)、离开私人房间的时间(TAFR)和访问的最远私人房间区域(MaxZ)。为了尽可能充分地利用可用的干预-对照比较数据,应用了广义线性混合模型方法。

结果

在测试后,干预组的整体 LSSc 更高,TAFR 时间更长,MaxZ 访问的最远私人房间区域更大,与对照组相比有显著差异。在随访时,MaxZ 仍存在显著的组间差异。

讨论与意义

NH 环境中的 PA 干预措施对使用基于传感器的评估方法测量的 LS 利用率有影响。该计划在移交给 NH 人员继续日常实践时,已经证明了其实用的可持续性。需要进一步研究以确定 LS 利用率的增加是否也会影响社会参与和生活质量。

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