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Measuring the Implementation of Lifestyle-Integrated Functional Exercise in Primary Care for Older Adults: Results of a Feasibility Study

  • Jenna C. Gibbs (a1) (a2), Caitlin McArthur (a1) (a3) (a4), James Milligan (a5) (a6), Lindy Clemson (a7), Linda Lee (a5) (a6) (a8), Veronique M. Boscart (a8) (a9), George Heckman (a8) (a10), Paul Stolee (a8) (a10) and Lora M. Giangregorio (a1) (a8) (a11)...

Abstract

Our pilot study evaluated the feasibility, effectiveness, and implementation of a group-based lifestyle-integrated functional exercise (Mi-LiFE) program for older adults in an interprofessional primary care practice. A physical therapist taught participants how to integrate strength and balance activities into daily routines during one individual and four group sessions, and two follow-up phone calls. Feasibility outcomes were recruitment, adherence, and retention over 6 months. Physical activity (PA) (accelerometer, International Physical Activity Questionnaire [IPAQ]), Short Physical Performance Battery (SPPB), and health-related quality of life (EuroQol Five-Dimensional Questionnaire with 3 Levels [EQ5D-3L]) were evaluated at baseline and 6 months. Of the 123 eligible individuals, 39 per cent participated and 61 per cent were not interested or unreachable. Forty-eight participants (mean ± standard deviation [SD] age = 81 ± 5 years; body mass index [BMI] = 28 ± 5 kg/m2; 60% women; moderate-to-vigorous PA = 49 ± 87 minutes/week) enrolled. Four participants withdrew prior to intervention. Thirty-two participants (67%) were retained at follow-up. Daily diary-documented adherence was 50 per cent at 6 months, and 77 per cent attended more than four sessions. No statistically significant changes in moderate-to-vigorous PA and SPPB outcomes were observed; yet self-reported strength and balance PA and quality of life significantly improved at follow-up. The Mi-LiFE program is feasible with acceptable recruitment and attendance rates alongside modifications to address retention and adherence challenges. These findings inform the feasibility of future pragmatic exercise programs in primary care for older adults.

Notre étude pilote a évalué la faisabilité, l’efficacité et la mise en œuvre du programme d’exercices fonctionnels en groupe intégrés au mode de vie (Lifestyle-integrated Functional Exercise; Mi-LiFE) créé pour des personnes âgées, dans le cadre d’une pratique interprofessionnelle en soins de première ligne. Un physiothérapeute a enseigné aux participants comment intégrer des exercices de force et d’équilibre dans la routine quotidienne au cours d’une séance individuelle et de quatre séances de groupe, suivis de deux rendez-vous téléphoniques. Les résultats concernant la faisabilité incluaient le recrutement, l’adhésion et la rétention sur une période de six mois. L’activité physique (AP) (accéléromètre, IPAQ), une version courte de la batterie de tests de performance physique (SPPB) et la qualité de vie liée à la santé (EQ5D-3L) ont été évaluées au début de l’intervention et 6 mois plus tard. Des 123 personnes admissibles, 39 % ont participé à l’intervention et 61 % n’étaient pas intéressées ou non joignables. Quarante-huit participants (âge moyen ± ÉT = 81 ± 5 ans ; IMC = 28 ± 5 kg/m2 ; 60 % de femmes ; AP modérée à vigoureuse = 49 ± 87 minutes par semaine) ont pris part à cette étude. Quatre participants se sont retirés avant le début de l’intervention. Trente-deux participants (67 %) étaient présents au suivi. Le taux d’adhésion quotidien documenté dans le journal de bord était de 50 % à 6 mois, et 77 % des participants ont assisté à au moins 4 séances. Aucun changement statistiquement significatif n’a été observé dans les résultats de l’AP modérée à forte et de la SPPB. Cependant, les participants ont déclaré lors du suivi que leur force et leur équilibre dans l’AP se sont améliorés, tout comme leur qualité de vie. Le programme Mi-LiFE présente une bonne faisabilité, avec des taux de recrutement et d’assiduité acceptables. Des modifications pourraient être apportées pour améliorer la rétention et l’adhésion à l’intervention. Ces résultats renseignent sur la faisabilité de programames d’exercices pragmatiques qui pourraient être développés pour être offerts aux personnes âgées se présentant pour des soins de première ligne.

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Corresponding author

La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Jenna C. Gibbs, Ph.D. Department of Kinesiology & Physical Education McGill University 475 Pine Avenue West Montreal, QC, H2W 1S4 Canada (jenna.gibbs@mcgill.ca)

Footnotes

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We thank the participants for their time and efforts in this study, and appreciate the contributions of the physicians and staff at the Centre for Family Medicine. We also thank Joanne Munro for her valuable guidance on the LiFE program, and acknowledge the Bone Health and Exercise Science laboratory team, especially Rebecca Clark and Valerie Boyes, for their contributions to data management and analysis. We are grateful for the contributions of Dr. Carlos Rojas-Fernandez and Dr. Heather Keller to the study protocol. The University of Waterloo Propel Centre Chronic Disease Prevention Initiative seed grant funded this study. Dr. Gibbs holds a CIHR Fellowship Award and received funding from the CIHR-Institute of Aging. Dr. Giangregorio received funding from the Ontario Ministry of Health Research and Innovation-Early Researcher Award, CIHR New Investigator Award, and Canadian Foundation for Innovation. The funding sources had no role in study design and execution, analyses, and interpretation of the data, or decision to submit results.

Dr. Clemson published the LiFE program with the Sydney University Press. The authors declare that they have no other conflicts of interests.

Footnotes

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