Abstract
BackgroundPhysical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted.MethodsThe study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs.ConclusionA new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme.Trial registrationCurrent Controlled Trials ISRCTN58562962.
Highlights
Physical activity programmes can help to prevent functional decline in the elderly
An randomised controlled trial (RCT) should examine the effects of the programme
Approaching seniors at home and via general practitioners Until now, activity programmes used to target on healthy, community-dwelling seniors or on elderly living in special residences or care institutions [[29], for an example]
Summary
Study overview: settings, targets, design and registration The trial targets on community-dwelling patients, aged 70 years or above, who visit their GP's surgery. The following items of the protocol are based on a structured dialogue between the therapist and the participant: general well-being of the participant, activity log use (problems, documentation of exercises and steps, inactivity), pedometer use (problems, usage, frequency and duration of use), walking for exercise (problems, frequency, intensity, duration), home-exercises (problems, chosen exercises, frequency, intensity, duration), medical consultations (reason, specialisation of the consultant) or hospital admissions (reason, hospital department). At the end of the consultation, the patient gets an adapted exercise programme (duration and intensity of walks, selection of home exercises), that is documented in the consultation protocol and in the participant's activity log. Appraisal by participant (week 13) Participants who completed the intervention will be asked to rate the utility of the following programme actions and devices The protocol has been approved by the Ruhr-University of Bochum (Germany) Ethics Committee on 10 February 2009 (Reg.-No 3054-07)
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