Vseteckova Jitka, Deepak-Gopinath Manik, Borgstrom Erica, Holland Caroline, Draper Jan, Pappas Yannis, McKeown Eamonn, Dadova Klara, Gray Steve
1School of Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Walton Hall, Milton Keynes, MK7 6AA UK.
2Institute for Health Research, University of Bedfordshire, Luton, UK.
Eur Rev Aging Phys Act. 2018 Nov 9;15:11. doi: 10.1186/s11556-018-0200-3. eCollection 2018.
Research suggests targeted exercise is important for people living with dementia, especially those living in residential care. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to group exercise of institutionalized older people living with dementia.
We searched all available electronic databases. Additionally, we searched trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies. We searched for and included papers from January 1990 until September 2017 in any language. We included randomized, non-randomized trials. Studies were not eligible if participants were either healthy older people or people suffering from dementia but not living in an institution. Studies were also excluded if they were not focused on barriers and facilitators to adherence to group exercise.
Using narrative analysis, we identified the following themes for barriers: bio-medical reasons and mental wellbeing and physical ability, relationships dynamics, and socioeconomic reasons. The facilitators were grouped under the following thematic frames: bio-medical benefits and benefits related to physical ability, feelings and emotions and confidence improvements, therapist and group relationships dynamics and activity related reasons.
We conclude that institutionalized older people living with dementia, even those who are physically frail, incontinent and/or have mild dementia can demonstrate certain level of exercise adherence, and therefore can respond positively to exercise programs. Tailored, individually-adjusted and supported physical activity, led by a knowledgeable, engaging and well communicating therapist/facilitator improves the adherence to group exercise interventions of institutionalized older people living with dementia.
研究表明，有针对性的运动对痴呆症患者很重要，尤其是那些住在养老院的患者。本综述的目的是收集并综合关于痴呆症老年住院患者坚持集体运动的已知障碍和促进因素的证据。
我们检索了所有可用的电子数据库。此外，我们在试验注册库（clinicaltrial.gov和世界卫生组织国际临床试验平台）中搜索正在进行的研究。我们检索并纳入了1990年1月至2017年9月以任何语言发表的论文。我们纳入了随机和非随机试验。如果参与者是健康的老年人或患有痴呆症但不住在机构中的人，则这些研究不符合条件。如果研究没有关注坚持集体运动的障碍和促进因素，也将被排除。
通过叙述性分析，我们确定了以下障碍主题：生物医学原因、心理健康和身体能力、人际关系动态以及社会经济原因。促进因素被归为以下主题框架：生物医学益处和与身体能力相关的益处、感觉和情绪以及信心提升、治疗师和团体关系动态以及与活动相关的原因。
我们得出结论，痴呆症老年住院患者，即使是那些身体虚弱、大小便失禁和/或患有轻度痴呆症的患者，也能表现出一定程度的运动坚持性，因此能够对运动计划做出积极反应。由知识渊博、有吸引力且沟通良好的治疗师/促进者主导的量身定制、个性化调整和支持的体育活动，可提高痴呆症老年住院患者对集体运动干预的坚持性。
