Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston 3199, Australia.
National Centre for Healthy Ageing (NCHA), Monash University and Peninsula Health, Frankston 3199, Australia.
Int J Environ Res Public Health. 2023 Feb 18;20(4):3662. doi: 10.3390/ijerph20043662.
Home care clients with dementia/cognitive impairment are typically functionally dependent and physically inactive. We pilot-tested a co-designed physical exercise program for its feasibility, safety, adherence and potential for benefits on physical activity, physical function, healthcare use and falls. Trained community care support workers delivered a 12-week home exercise program to clients with dementia/cognitive impairment, once weekly for 15 min during care shifts, supplemented by carers' supervision of exercises for 30 min, three times weekly. A physiotherapist provided fortnightly phone support to ensure safety and exercise progression. Baseline and Week 12 assessments using validated scales for physical activity, physical function, daily living independence, falls efficacy, quality of life, self-reported healthcare use, falls and sleep quality were undertaken. Differences were examined with regression analyses. Care support workers ( = 26) and client/carer dyads ( = 26 and 80.8% culturally and linguistically diverse) participated. Participants recorded adverse events/falls and exercises in dairies. Fifteen dyads completed the program. No falls/adverse events occurred with the exercises. The adherence rates against targets for exercise time completed and days in which exercise were undertaken for support workers were 137%/79.6%, and for client/carer dyads were 82%/104.8%, respectively. Physical activity participation, physical function and falls efficacy significantly improved at Week 12 compared to baseline. The feasibility, safety and adherence of the co-designed physical exercise program were demonstrated. Strategies to minimise dropouts in future effectiveness studies are required.
家庭护理的痴呆/认知障碍患者通常在身体功能上依赖他人，且身体活动量不足。我们对共同设计的身体锻炼方案进行了试点测试，以评估其可行性、安全性、依从性以及对身体活动、身体功能、医疗保健使用和跌倒的潜在益处。经过培训的社区护理支持人员按照方案，在护理轮班期间，每周为痴呆/认知障碍患者提供 1 次、每次 15 分钟的上门锻炼服务，由护理人员每周监督 3 次、每次 30 分钟的锻炼。物理治疗师每两周通过电话提供支持，以确保安全性和锻炼进展。在基线和第 12 周，使用经过验证的量表评估身体活动、身体功能、日常生活独立性、跌倒效能、生活质量、自我报告的医疗保健使用、跌倒和睡眠质量。采用回归分析比较差异。共有 26 名护理支持人员和 26 对客户/护理人员参与。参与者在日记中记录不良事件/跌倒和锻炼情况。有 15 对客户/护理人员完成了该方案。锻炼过程中没有发生跌倒/不良事件。支持人员完成的锻炼时间和锻炼天数的目标依从率分别为 137%/79.6%，客户/护理人员为 82%/104.8%。与基线相比，第 12 周的身体活动参与度、身体功能和跌倒效能显著提高。共同设计的身体锻炼方案具有可行性、安全性和依从性。需要制定策略以减少未来有效性研究中的脱落率。
