Investigating the effectiveness of a structured low-impact activity program on mobility, nutrition and quality of life in aged care residents: A Pragmatic, Non-Randomised Controlled Pilot Trial

Abstract

Background: Australia’s growing ageing population presents several challenges for the government, economy and health and aged care sectors to cater to their increasing needs. Age-associated changes in mobility, which can lead to impaired nutrition status and lower quality of life (QoL) for older adults, also contributes to this burden. Physical activity is recommended to manage the age-associated changes in older adults. The aim of the current study was to evaluate the feasibility of conducting a pragmatic study to assess the effects of an established, structured activity program on QoL, mobility and nutrition in aged care residents. Methods: A pragmatic, non-randomised, controlled pilot trial was conducted with a mixed methods analysis design. A total of 24 participants were included in the study with 12 participants each in the structured activity group and control group. Participants in the activity group consisted of residents who were active participants of the established program, while the control group were residents who did not participate in any structured activity program. The primary outcome was a predefined criterion assessing trial feasibility. Secondary outcomes included changes in QoL, mobility and nutrition between and within the groups over time. Assessment of Quality of Life-6 Dimensions (AQoL-6D), Mini Nutritional Assessment (MNA) and Physiotherapy Mobility Assessment (PMA) tools were employed to assess QoL, nutrition and mobility, respectively, at baseline and follow-up (i.e., after six months). Interviews were conducted at the end of the study to obtain feedback on the structured activity program from staff and participants. Five participants (three from activity group and two from control group) and three staff were interviewed. Thematic analysis was used with the emerging themes in the interviews developed into major categories. Results: The average age of participants was slightly higher in the control group (83.67 years) than in the structured activity group (79.33 years). Most participants in the study were female (66.67%). The feasibility criterion of a minimum 80 per cent recruitment rate was met. Retention and completion fell slightly short of this 80 per cent criteria. However, the feasibility of proceeding to a full trial can be considered by employing strategies to increase retention and completion. No statistically significant differences (p > 0.05) were found between the activity and control group for AQoL-6D total score, MNA and PMA score at baseline or follow-up. Emerging themes identified from the interview data include reluctance to participate in group activities for the control group participants, satisfaction with the program and experience of effects with participation for activity group participants as well as promoting choice and dignity and social interactions for the staff. Conclusion: Key criteria for progression of the trial to a larger multi-centre study was met with conditions. Recruitment of a larger sample size with power to detect changes in the outcome measures is important, as under-powered studies limit the ability to conclude the effects of the activity program on the outcome measures.