Abstract
ObjectivesWe developed the Adachi Rehabilitation Programme (ARP), a community rehabilitation program. Under the supervision of professional caregivers, older adults cleaned and planted flowers in the park and they walked and shopped in the community. We examined the effects of ARP on individuals receiving small-group multifunctional at-home care at community facilities.MethodsThis was a multi-centre controlled trial at thirteen small multifunctional at-home care facilities in Adachi, Tokyo. The primary outcomes of the study were daily step counts and timed up & go (TUG). Secondary outcomes included gait speed, step length, Barthel Index for Activities of Daily Living, Functional Independence Measure, Mini-Mental State Examination (MMSE) and EuroQOL 5 Dimension.ResultsNinety-six individuals at thirteen small multifunctional at-home care facilities were recruited for participation in December 2017. They were allocated to intervention (38) and control (40) groups. The average daily step count of the control group decreased from 852 to 727, but it increased by approximately 650 steps, from 990 to 1635, for the intervention group. Average TUG decreased from 16.1 s to 14.0 s and MMSE score increased from 15.9 to 16.3 for the intervention group, but a significant interaction was not found. On non-intervention home days, the daily step counts of the intervention group increased significantly from 908 steps to 1485 steps, while those of the control group decreased from 865 steps to 722 steps.ConclusionsARP may have effectively increased the physical activity of older adults under long-term care by increasing motivation and changing behaviour.
Highlights
Older adults compared to other adults have a higher risk of losing their physical function once they suffer from diseases or disorders [1]
Ninety-six individuals at thirteen small multifunctional at-home care facilities were recruited for participation in December 2017
The average daily step count of the control group decreased from 852 to 727, but it increased by approximately 650 steps, from 990 to 1635, for the intervention group
Summary
Older adults compared to other adults have a higher risk of losing their physical function once they suffer from diseases or disorders [1]. The World Health Organization recommends moderate-intensity exercises of at least 150 minutes per week. Increasing physical activity through behavioural change and other measures may be a more practical approach to better health for older adults under long-term care. The Ministry of Labour, Health and Welfare of Japan, in revising LCTI in 2003, proposed community rehabilitation to enhance activity and participation for older adults with chronic diseases. Several new care services were introduced in 2006, including small multifunctional at-home care (SMAC). These facilities offered community-based service, which was legislated to offer daily care and functional training in a home-like setting and in communication with local residents [10]
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