Factors influencing adherence to home-based strength and balance exercises among older adults with mild cognitive impairment and early dementia: Promoting Activity, Independence and Stability in Early Dementia (PrAISED).
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
05
07
2018
accepted:
10
05
2019
entrez:
24
5
2019
pubmed:
24
5
2019
medline:
30
1
2020
Statut:
epublish
Résumé
Older adults with dementia are at a high risk of losing abilities and of accidental falls. Promoting Activity, Independence and Stability in Early Dementia (PrAISED) is a 12-month person-centred exercise and activity programme which aims to increase activity and independence whilst reducing falls in people with early dementia. In this patient group, as well as many others, poor adherence to exercise interventions can undermine treatment effectiveness. We aimed to explore patterns of barriers and facilitators influencing PrAISED participants' adherence to home-based strength and balance exercises. Participants were a subsample of 20 individuals with mild cognitive impairment or early dementia and their carer(s) taking part in the PrAISED programme. Participants (with the support of a carer where necessary) kept a daily exercise diary. Participants' adherence were categorised based upon reported number of times a week they undertook the PrAISED strength and balance exercises over a 4 month period (<3 times a week = low adherence, 3-4 = meeting adherence expectations, >5 = exceeding adherence expectations). Semi-structured interviews were conducted in month 4 of the PrAISED programme to explore barriers and facilitators to adherence. A mixture of deductive and inductive thematic analysis was employed with themes categorised using the Theoretical Domains Framework. Participants completed on average 98 minutes of home-based strength and balance exercises per week, 3.8 sessions per week, for an average of 24 minutes per session. Five participants were categorised as exceeding adherence expectations, 7 as meeting adherence expectations, and 8 as low adherers. Analysis of interview data based on self-reported adherence revealed six interacting themes: 1) routine, 2) practical and emotional support, 3) memory support, 4) purpose, 5) past experiences of sport and exercise, and 6) belief in and experience of benefits. Identifiable cognitive, psychological, and practical factors influence adherence to exercise, and should be addressed in future development of interventions with this population.
Sections du résumé
BACKGROUND
Older adults with dementia are at a high risk of losing abilities and of accidental falls. Promoting Activity, Independence and Stability in Early Dementia (PrAISED) is a 12-month person-centred exercise and activity programme which aims to increase activity and independence whilst reducing falls in people with early dementia. In this patient group, as well as many others, poor adherence to exercise interventions can undermine treatment effectiveness. We aimed to explore patterns of barriers and facilitators influencing PrAISED participants' adherence to home-based strength and balance exercises.
METHODS
Participants were a subsample of 20 individuals with mild cognitive impairment or early dementia and their carer(s) taking part in the PrAISED programme. Participants (with the support of a carer where necessary) kept a daily exercise diary. Participants' adherence were categorised based upon reported number of times a week they undertook the PrAISED strength and balance exercises over a 4 month period (<3 times a week = low adherence, 3-4 = meeting adherence expectations, >5 = exceeding adherence expectations). Semi-structured interviews were conducted in month 4 of the PrAISED programme to explore barriers and facilitators to adherence. A mixture of deductive and inductive thematic analysis was employed with themes categorised using the Theoretical Domains Framework.
FINDINGS
Participants completed on average 98 minutes of home-based strength and balance exercises per week, 3.8 sessions per week, for an average of 24 minutes per session. Five participants were categorised as exceeding adherence expectations, 7 as meeting adherence expectations, and 8 as low adherers. Analysis of interview data based on self-reported adherence revealed six interacting themes: 1) routine, 2) practical and emotional support, 3) memory support, 4) purpose, 5) past experiences of sport and exercise, and 6) belief in and experience of benefits.
CONCLUSIONS
Identifiable cognitive, psychological, and practical factors influence adherence to exercise, and should be addressed in future development of interventions with this population.
Identifiants
pubmed: 31120953
doi: 10.1371/journal.pone.0217387
pii: PONE-D-18-19992
pmc: PMC6532965
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0217387Subventions
Organisme : Department of Health
ID : RP-PG-0614-20007
Pays : United Kingdom
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Ageing Res Rev. 2015 Nov;24(Pt B):274-85
pubmed: 26369357
JAMA. 2003 Oct 15;290(15):2015-22
pubmed: 14559955
J Am Geriatr Soc. 2008 Oct;56(10):1821-30
pubmed: 18795987
Int Psychogeriatr. 2017 Jan;29(1):81-91
pubmed: 27692024
J Intern Med. 2014 Mar;275(3):214-28
pubmed: 24605806
Br J Sports Med. 2017 Dec;51(24):1750-1758
pubmed: 27707740
Int Psychogeriatr. 2012 Jul;24(7):1172-82
pubmed: 22265269
Physiotherapy. 2014 Jun;100(2):169-75
pubmed: 24530168
Implement Sci. 2012 Apr 24;7:37
pubmed: 22530986
Arch Gerontol Geriatr. 2016 Sep-Oct;66:109-18
pubmed: 27295140
Can Fam Physician. 2001 Oct;47:2018-23
pubmed: 11723596
Clin Interv Aging. 2015 Feb 09;10:421-34
pubmed: 25709416
Ann Behav Med. 2011 Oct;42(2):174-87
pubmed: 21626256
BMC Geriatr. 2018 Jan 25;18(1):27
pubmed: 29370756
BMC Med Res Methodol. 2013 Sep 18;13:117
pubmed: 24047204
Maturitas. 2019 Apr;122:8-21
pubmed: 30797535
J Aging Phys Act. 2015 Oct;23(4):659-68
pubmed: 25414947
Med Sci Sports Exerc. 2003 Aug;35(8):1381-95
pubmed: 12900694
BMJ. 2017 Jun 22;357:j2709
pubmed: 28642251
Implement Sci. 2017 Jun 21;12(1):77
pubmed: 28637486
Implement Sci. 2012 Apr 24;7:38
pubmed: 22531013
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Aging Ment Health. 2015;19(8):679-88
pubmed: 25265932
BMJ. 2006 Dec 9;333(7580):1196
pubmed: 17114212
Public Health Rep. 1985 Mar-Apr;100(2):126-31
pubmed: 3920711
BMJ Open. 2014 Jun 27;4(6):e005044
pubmed: 24972606
JAMA Intern Med. 2013 May 27;173(10):894-901
pubmed: 23589097
Cochrane Database Syst Rev. 2015 Apr 15;(4):CD006489
pubmed: 25874613
Prev Med Rep. 2017 May 18;7:38-45
pubmed: 28593121
BMJ. 2012 Aug 07;345:e4547
pubmed: 22872695
Pilot Feasibility Stud. 2018 Feb 17;4:49
pubmed: 29468084
Rev Med Suisse. 2011 Jun 15;7(299):1305-8, 1310
pubmed: 21793420