Eckert Tobias, Bongartz Martin, Ullrich Phoebe, Abel Bastian, Christian Werner, Kiss Rainer, Hauer Klaus
AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany.
Centre of Geriatric Medicine, University of Heidelberg, 69117 Heidelberg, Germany.
Eur J Ageing. 2020 Feb 13;17(3):309-320. doi: 10.1007/s10433-020-00555-w. eCollection 2020 Sep.
The aim of the present study was to examine adherence and acceptance of a home-based program to promote physical activity (PA) in older persons with cognitive impairment (CI) following inpatient rehabilitation. Sixty-three older persons (≥ 65 years) with mild to moderate CI (Mini-Mental State Examination score 17-26), allocated to the intervention group of a randomized, controlled intervention trial underwent a 12-week home-based PA intervention including (1) physical training and outdoor walking to improve functional fitness and (2) motivational strategies (goal-setting, pedometer-based self-monitoring, social support delivered by home visits, phone calls) to promote PA. Training logs were used to assess adherence to physical training, outdoor walking and to motivational strategies (goal-setting, pedometer-based self-monitoring). Acceptance (subjective feasibility and effectiveness) of the program components was assessed by a standardized questionnaire. Mean adherence rates over the intervention period were 63.6% for physical training, 57.9% for outdoor walking, and between 40.1% (achievement of walking goals), and 60.1% (pedometer-based self-monitoring) for motivational strategies. Adherence rates significantly declined from baseline to the end of intervention (T1: 43.4-76.8%, T2: 36.1-51.5%, <.019). Most participants rated physical training, outdoor walking, goal-setting, and pedometer self-monitoring as feasible (68.2-83.0%) and effective (63.5-78.3%). Highest ratings of self-perceived effectiveness were found for home visits (90.6%) and phone calls (79.2%). The moderate to high adherence to self-performed physical training and motivational strategies proved the feasibility of the home-based PA program in older persons with CI following inpatient rehabilitation.
本研究的目的是检验一项以家庭为基础的计划在住院康复后的认知障碍（CI）老年人中促进身体活动（PA）的依从性和接受度。63名年龄≥65岁、患有轻度至中度CI（简易精神状态检查表得分17 - 26）的老年人被分配到一项随机对照干预试验的干预组，接受为期12周的以家庭为基础的PA干预，包括（1）体育锻炼和户外散步以改善身体功能适应性，以及（2）激励策略（目标设定、基于计步器的自我监测、家访和电话提供的社会支持）以促进PA。训练日志用于评估体育锻炼、户外散步以及激励策略（目标设定、基于计步器的自我监测）的依从性。通过标准化问卷评估计划组成部分的接受度（主观可行性和有效性）。干预期间体育锻炼的平均依从率为63.6%，户外散步为57.9%，激励策略的依从率在40.1%（步行目标达成情况）至60.1%（基于计步器的自我监测）之间。从基线到干预结束，依从率显著下降（T1：43.4 - 76.8%，T2：36.1 - 51.5%，<.019）。大多数参与者将体育锻炼、户外散步、目标设定和计步器自我监测评为可行（68.2 - 83.0%）且有效（63.5 - 78.3%）。自我感知有效性评分最高的是家访（90.6%）和电话（79.2%）。对自行进行的体育锻炼和激励策略的中度至高依从性证明了以家庭为基础的PA计划在住院康复后的CI老年人中的可行性。
