Abstract
BackgroundSome older people who find standard exercise programmes too strenuous may be encouraged to exercise while remaining seated - chair based exercises (CBE). We previously developed a consensus CBE programme (CCBE) following a modified Delphi process. We firstly needed to test the feasibility and acceptability of this treatment approach and explore how best to evaluate it before undertaking a definitive trial.MethodsA feasibility study with a cluster randomised controlled trial component was undertaken to 1. Examine the acceptability, feasibility and tolerability of the intervention and 2. Assess the feasibility of running a trial across 12 community settings (4 day centres, 4 care homes, 4 community groups). Centres were randomised to either CCBE, group reminiscence or usual care. Outcomes were collected to assess the feasibility of the trial parameters: level of recruitment interest and eligibility, randomisation, adverse events, retention, completion of health outcomes, missing data and delivery of the CCBE. Semi- structured interviews were conducted with participants and care staff following the intervention to explore acceptability.Results48% (89 out of 184 contacted) of eligible centres were interested in participating with 12 recruited purposively. 73% (94) of the 128 older people screened consented to take part with 83 older people then randomised following mobility testing. Recruitment required greater staffing levels and resources due to 49% of participants requiring a consultee declaration. There was a high dropout rate (40%) primarily due to participants no longer attending the centres. The CCBE intervention was delivered once a week in day centres and community groups and twice a week in care homes. Older people and care staff found the CCBE intervention largely acceptable.ConclusionThere was a good level of interest from centres and older people and the CCBE intervention was largely welcomed. The trial design and governance procedures would need to be revised to maximise recruitment and retention. If the motivation for a future trial is physical health then this study has identified that further work to develop the CCBE delivery model is warranted to ensure it can be delivered at a frequency to elicit physiological change. If the motivation for a future trial is psychological outcomes then this study has identified that the current delivery model is feasible.Trial registrationISRCTN27271501. Date registered: 30/01/2018.
Highlights
Some older people who find standard exercise programmes too strenuous may be encouraged to exercise while remaining seated - chair based exercises (CBE)
Semi-structured interviews were conducted with eight older people, twelve care staff and a telephone interview with one consultee
There was a higher proportion of eligible participants who consented to take part in day centres (86%) compared to care homes (n = 70%) and community groups (67%). 88% (83 participants) of the 94 participants that consented for assessment were eligible after completing the mobility scores and this percentage was similar across centre types
Summary
Some older people who find standard exercise programmes too strenuous may be encouraged to exercise while remaining seated - chair based exercises (CBE). Pragmatic approaches have evolved where exercise is performed primarily in the seated position- chair based exercise (CBE) Such CBE programmes are commonly delivered across health and social care to older adults [3] with compromised health and mobility. The experts identified that CBE should be used for older people who are unable to take part in other forms of exercise due to activity limitation which may be acute (e.g. following an operation) or longer term, and should be undertaken at least once a week This consensus chair based exercise (CCBE) is a complex intervention as it involves a number of interacting components, it is delivered across different settings and has multiple outcomes of interest [6]. We firstly needed to test the feasibility and acceptability of this CCBE intervention and explore how best to evaluate it before undertaking a definitive trial
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