Improving Mobility in Residential Aged Care

Bond University

Status: Completed

Conditions: Geriatric Disorder

Treatments: Other: GrACE program; Other: GrACE + gait

Study type: Interventional

Funder types: Other

Identifiers

NCT02766738

RO1823

Details and patient eligibility

About

This study aims to test which of three exercise programs, previously demonstrated valuable for residential aged care adults, has the greatest benefit for walking speed and the spatiotemporal parameters that define it. The programs to be included are:

1. The GrACE program and
2. The GrACE plus Gait specific training.

Full description

This study will employ a non-randomised controlled design in which three different 24-week exercise programs and a non-exercising control group will be compared in the residential aged care (RAC) setting. The three programs are the GrACE and the GrACE plus a gait specific training program.

Data Collection

~40 participants from two RAC facilities will be recruited into the study. This number of participants will provide 80% statistical power to identify moderate effect size between group differences on the primary outcome measures. The control group will be drawn from each of the RAC facility approached receiving exercise treatment. Participation will be informed by a discussion with the facilities Service Manager about the eligibility of participants and a medical history screen undertaken. All participants will provide informed written consent prior to participation.

Participants in the exercise group will perform twice weekly training for 24 weeks. Data will be collected at 0 weeks, 12 weeks and 24 weeks in the control and exercise groups.

Enrollment: 84 patients

Sex: All

Ages: 65 to 100 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• aged over 65 years
• residing in a RAC facility
• able to walk with a walker and/or walking stick or can self-ambulate for the test (including those who have had knee and hip replacements)
• can provide informed consent (Self- or by proxy).

Exclusion criteria

• end-stage terminal and/or life expectancy <6-months (ethical reasons)
• two person transfer or unable to self-ambulate (increased falls risk)
• unable to communicate or follow instructions (personal needs beyond the scope of this project)
• dangerous behaviours (endanger the client or research staff).

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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84 participants in 3 patient groups

Control

No Intervention group

Description:

All participants assigned to the control group will be given the option to engage in other activities that were offered by the facility during the 24-week intervention period. However, no specific resistance exercises were offered in these activities.

GrACE program

Experimental group

Description:

Participants in the exercise group will perform twice weekly training for 24 weeks. In brief, the program will include weight-bearing exercises and a range of seated, non-resisted upper- and lower-body dynamic and reaching movements. The following-weight bearing and resistance exercises: chair stands, chair dips, calf raises and hip flexor/abdominal lifts, trunk twists, and bicep curl and shoulder press. In total the sessions will be 45 minutes twice weekly.

Treatment:

Other: GrACE program

GrACE + gait program

Experimental group

Description:

GrACE program as mentioned above plus focus on gait specific training will be one-hour training sessions for 24 weeks. Gait exercises will be a combination of exercises: heel and toe raises, stepping in different directions, single leg stand¬ing, step-ups, and task-specific balance work (e.g. reaching outward from the base of support while standing, sitting, and standing and turning). Gait exercises will be upgraded by: 1) reducing hand support and/or 2) narrowing the base of support, and/or 3) introducing a cognitive challenge (e.g. counting backwards while performing exercise) or perform¬ing exercise with the eyes closed.

Treatment:

Other: GrACE + gait