Skip to main content
Erschienen in: Zeitschrift für Gerontologie und Geriatrie 1/2019

26.07.2018 | Original Contributions

Feasibility of the lifestyle integrated functional exercise concept in cognitively impaired geriatric rehabilitation patients

verfasst von: Nacera Belala, Michael Schwenk, Anna Kroog, Clemens Becker

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Background and objective

Increasing numbers of cognitively impaired older persons are admitted for inpatient hospital treatment. Therefore, new approaches are needed to prevent a loss of mobility during hospital stays and improve outcomes of this vulnerable patient group. The lifestyle integrated functional exercise (LiFE) concept uses activities of daily living (ADL) situations as opportunities to improve balance and strength. A pilot study was performed to test the feasibility and acceptability of the LiFE exercises in a geriatric rehabilitation setting.

Methods and patients

A sample of 20 moderately cognitively impaired rehabilitation patients (mean age 84.5 years) tested the feasibility and acceptability of the LiFE exercises.

Results

The testing resulted in floor effects for every tested exercise. Of the exercises two were too difficult for over the half of the participants, namely stepping over objects and walking on heels. In contrast, the sit to stand exercise was feasible for 95% of the patients. The frequency of floor effects for the remaining exercises varied between 20% and 40%.

Conclusion

In this group of moderately cognitively impaired rehabilitation patients the exercises were feasible mostly under supervised conditions and frequently included additional physical support. An adjustment of the LiFE exercises in this setting is required before a trial should be performed in the acute care setting.
Literatur
1.
Zurück zum Zitat Angerhausen S (2008) Demenz – eine Nebendiagnose im Akutkrankenhaus oder mehr? Maßnahmen für eine bessere Versorgung demenzkranker Patienten im Krankenhaus. Z Gerontol Geriat 41:460–446CrossRef Angerhausen S (2008) Demenz – eine Nebendiagnose im Akutkrankenhaus oder mehr? Maßnahmen für eine bessere Versorgung demenzkranker Patienten im Krankenhaus. Z Gerontol Geriat 41:460–446CrossRef
2.
Zurück zum Zitat Basler HD, Hüger D, Kunz R et al (2006) Beurteilung von Schmerz bei Demenz (BESD) – Untersuchung zur Validität eines Verfahrens zur Beobachtung des Schmerzverhaltens. Schmerz 20:519–526CrossRefPubMed Basler HD, Hüger D, Kunz R et al (2006) Beurteilung von Schmerz bei Demenz (BESD) – Untersuchung zur Validität eines Verfahrens zur Beobachtung des Schmerzverhaltens. Schmerz 20:519–526CrossRefPubMed
3.
Zurück zum Zitat Bellamy N, Buchanan WW, Goldsmith CH et al (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH et al (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed
5.
Zurück zum Zitat Boyd CM, Landefeld CS, Counsell SR et al (2008) Recovery of activities of daily living in older adults after hospitalization for acute medical illness. J Am Geriatr Soc 56(12):2171–2179CrossRefPubMedPubMedCentral Boyd CM, Landefeld CS, Counsell SR et al (2008) Recovery of activities of daily living in older adults after hospitalization for acute medical illness. J Am Geriatr Soc 56(12):2171–2179CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Brown CJ, Friedkin RJ, Inouye SK (2004) Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc 52(8):1263–1270CrossRefPubMed Brown CJ, Friedkin RJ, Inouye SK (2004) Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc 52(8):1263–1270CrossRefPubMed
8.
Zurück zum Zitat Campbell SE, Seymour DG, Primrose WR (2004) A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing 33(2):110–115CrossRefPubMed Campbell SE, Seymour DG, Primrose WR (2004) A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing 33(2):110–115CrossRefPubMed
9.
Zurück zum Zitat Clemson L, Fiatarone Singh M, Bundy A et al (2012) Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ 345:e4547CrossRefPubMedPubMedCentral Clemson L, Fiatarone Singh M, Bundy A et al (2012) Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ 345:e4547CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Clemson L, Munro J, Singh MAF (2014) Lifestyle integrated functional exercise (LiFE) program to prevent falls: trainer’s manual. Sydney University Press, Sydney Clemson L, Munro J, Singh MAF (2014) Lifestyle integrated functional exercise (LiFE) program to prevent falls: trainer’s manual. Sydney University Press, Sydney
12.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR (1975) “Mini-Mental State”. a practical method for grading the state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRefPubMed Folstein MF, Folstein SE, McHugh PR (1975) “Mini-Mental State”. a practical method for grading the state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRefPubMed
13.
Zurück zum Zitat Grass-Kapanke B, Kunczik T, Gutzmann H (2008) Studie zur Demenzversorgung im ambulanten Sektor – DIAS. Deutsche Gesellschaft für Gerontopsychiatrie und -psychotherapie, Berlin Grass-Kapanke B, Kunczik T, Gutzmann H (2008) Studie zur Demenzversorgung im ambulanten Sektor – DIAS. Deutsche Gesellschaft für Gerontopsychiatrie und -psychotherapie, Berlin
14.
Zurück zum Zitat Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–94CrossRefPubMed Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–94CrossRefPubMed
17.
Zurück zum Zitat Kalbe E, Kessler J, Calabrese P et al (2004) DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 19(2):136–143CrossRefPubMed Kalbe E, Kessler J, Calabrese P et al (2004) DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 19(2):136–143CrossRefPubMed
18.
Zurück zum Zitat Kempen GI, Yardley L, van Haastregt JC et al (2008) The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing 37(1):45–50CrossRefPubMed Kempen GI, Yardley L, van Haastregt JC et al (2008) The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing 37(1):45–50CrossRefPubMed
19.
Zurück zum Zitat Kortebein P, Ferrando A, Lombeida J et al (2007) Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA 297(16):1769–1774CrossRef Kortebein P, Ferrando A, Lombeida J et al (2007) Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA 297(16):1769–1774CrossRef
20.
Zurück zum Zitat Löhr M, Schulz M, Behrens J (2014) Aus der Praxis: Psychosoziale Interventionen. Möglichkeiten und Grenzen. Menschen mit Demenz im Krankenhaus. Psych Pflege 20:189–195CrossRef Löhr M, Schulz M, Behrens J (2014) Aus der Praxis: Psychosoziale Interventionen. Möglichkeiten und Grenzen. Menschen mit Demenz im Krankenhaus. Psych Pflege 20:189–195CrossRef
21.
Zurück zum Zitat Luppa M, Luck T, Brähler E et al (2008) Prediction of institutionalisation in dementia – a systematic review. Dement Geriatr Cogn Disord 26(1):65–78CrossRefPubMed Luppa M, Luck T, Brähler E et al (2008) Prediction of institutionalisation in dementia – a systematic review. Dement Geriatr Cogn Disord 26(1):65–78CrossRefPubMed
22.
Zurück zum Zitat Medical Research Council (2000) A framework for the development and evaluation of RCTs for complex interventions to improve health. MRC, London Medical Research Council (2000) A framework for the development and evaluation of RCTs for complex interventions to improve health. MRC, London
23.
Zurück zum Zitat De Morton NA, Davidson M, Keating JL (2008) The de Morton Mobility Index (DEMMI): an essential health index for an ageing world. Health Qual Life Outcomes 6:63CrossRefPubMedPubMedCentral De Morton NA, Davidson M, Keating JL (2008) The de Morton Mobility Index (DEMMI): an essential health index for an ageing world. Health Qual Life Outcomes 6:63CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Motzek T, Junge M, Marquardt G (2017) Einfluss der Demenz auf Verweildauer und Erlöse im Akutkrankenhaus. Z Gerontol Geriat 50:59–66CrossRef Motzek T, Junge M, Marquardt G (2017) Einfluss der Demenz auf Verweildauer und Erlöse im Akutkrankenhaus. Z Gerontol Geriat 50:59–66CrossRef
25.
Zurück zum Zitat Nikolaus T, Specht-Leible N, Bach M et al (1999) A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients. Age Ageing 28(6):543–550CrossRefPubMed Nikolaus T, Specht-Leible N, Bach M et al (1999) A randomized trial of comprehensive geriatric assessment and home intervention in the care of hospitalized patients. Age Ageing 28(6):543–550CrossRefPubMed
27.
Zurück zum Zitat Taylor ME, Delbaere K, Lord SR et al (2014) Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults. J Gerontol A Biol Sci Med Sci 69(8):987–995CrossRefPubMed Taylor ME, Delbaere K, Lord SR et al (2014) Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults. J Gerontol A Biol Sci Med Sci 69(8):987–995CrossRefPubMed
28.
Zurück zum Zitat Telenius EW, Engedal K, Bergland A (2015) Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial. PLoS ONE 10:1–18CrossRef Telenius EW, Engedal K, Bergland A (2015) Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial. PLoS ONE 10:1–18CrossRef
29.
Zurück zum Zitat Warden V, Hurley AC, Volicer L (2003) Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc 4(1):9–15CrossRefPubMed Warden V, Hurley AC, Volicer L (2003) Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc 4(1):9–15CrossRefPubMed
Metadaten
Titel
Feasibility of the lifestyle integrated functional exercise concept in cognitively impaired geriatric rehabilitation patients
verfasst von
Nacera Belala
Michael Schwenk
Anna Kroog
Clemens Becker
Publikationsdatum
26.07.2018
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 1/2019
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-018-1431-7

Weitere Artikel der Ausgabe 1/2019

Zeitschrift für Gerontologie und Geriatrie 1/2019 Zur Ausgabe

Mitteilungen der DGG

Mitteilungen der DGG

Mitteilungen der DGGG

Mitteilungen der DGGG

Mitteilungen des BV Geriatrie

Mitteilungen des BV Geriatrie