Capitalizing on Virtual Delivery of Community Programs to Support Health and Well-Being of Older Adults

Vincenzo, Jennifer L.; Hergott, Colleen; Schrodt, Lori A.; Rohrer, Beth; Brach, Jennifer S.; Tripken, Jennifer; Shirley, Kathleen; Sidelinker, Jennifer; Shubert, Tiffany E.

doi:10.1093/ptj/pzab001

Cited by 13 publications

(12 citation statements)

References 10 publications

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“…Physical therapist-led telerehabilitation is effective in the context of other conditions including cardiorespiratory rehabilitation, musculoskeletal rehabilitation and neurorehabilitation 9 11. However, many authors9 11–13 focused on the rapid shift away from in-person care during the COVID-19 pandemic rather than specifically studying telerehabilitation in individuals recovering from COVID-19. While others have provided practical recommendations for implementing resistance training after COVID-1914 and recovering function and fitness after severe acute respiratory distress syndrome,15 these recommendations are not based on direct evidence in COVID-19 survivors.…”

Section: Introductionmentioning

confidence: 99%

Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study

et al. 2022

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ObjectivesDetermine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors.DesignPilot randomised feasibility study.SettingIn-home telerehabilitation.Participants44 participants (21 female, mean age 52 years) discharged home following hospitalisation with COVID-19 (with and without intensive care unit (ICU) stay).InterventionsParticipants were block randomised 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, multicomponent telerehabilitation sessions with a licenced physical therapist (n=29) or to a control group (n=15) consisting of education on exercise and COVID-19 recovery trajectory, physical activity and vitals monitoring, and weekly check-ins with study staff. Interventions were 100% remote and occurred over 12 weeks.Primary and secondary outcome measuresThe primary outcome was feasibility, including safety and session adherence. Secondary outcomes included preliminary efficacy outcomes including tests of function and balance; patient-reported outcome measures; a cognitive assessment; and average daily step count. The 30 s chair stand test was the main secondary (efficacy) outcome.ResultsNo adverse events (AEs) occurred during testing or in telerehabilitation sessions; 38% (11/29) of the intervention group compared with 60% (9/15) of the control group experienced an AE (p=0.21), most of which were minor, over the course of the 12-week study. 27 of 29 participants (93%; 95% CI 77% to 99%) receiving the intervention attended ≥75% of sessions. Both groups demonstrated clinically meaningful improvement in secondary outcomes with no statistically significant differences between groups.ConclusionFully remote telerehabilitation was safe, feasible, had high adherence for COVID-19 recovery, and may apply to other medically complex patients including those with barriers to access care. This pilot study was designed to evaluate feasibility; further efficacy evaluation is needed.Trial registration numberNCT04663945.

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Section: Introductionmentioning

confidence: 99%

Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study

et al. 2022

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“…Tele-exercise, including remote delivery of exercise classes through videoconferencing technology, has emerged as a means for community-based programs to resume guided exercise sessions while complying with the physical distancing restrictions during the COVID-19 pandemic [ 14 ]. The Gerofit-to-Home program has demonstrated preliminary evidence that older veterans who transition from facility-based to remotely delivered programs retain their physical function [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Technology Support Challenges and Recommendations for Adapting an Evidence-Based Exercise Program for Remote Delivery to Older Adults: Exploratory Mixed Methods Study

Gell¹,

Hoffman²,

Patel³

2021

JMIR Aging

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Background Tele-exercise has emerged as a means for older adults to participate in group exercise during the COVID-19 pandemic. However, little is known about the technology support needs of older adults for accessing tele-exercise. Objective This study aims to examine the needs of older adults for transition to tele-exercise, identify barriers to and facilitators of tele-exercise uptake and continued participation, and describe technology support challenges and successes encountered by older adults starting tele-exercise. Methods We used an exploratory, sequential mixed methods study design. Participants were older adults with symptomatic knee osteoarthritis (N=44) who started participating in a remotely delivered program called Enhance Fitness. Before the start of the classes, a subsample of the participants (n=10) completed semistructured phone interviews about their technology support needs and the barriers to and facilitators for technology adoption. All of the participants completed the surveys including the Senior Technology Acceptance Model scale and a technology needs assessment. The study team recorded the technology challenges encountered and the attendance rates for 48 sessions delivered over 16 weeks. Results Four themes emerged from the interviews: participants desire features in a tele-exercise program that foster accountability, direct access to helpful people who can troubleshoot and provide guidance with technology is important, opportunities to participate in high-value activities motivate willingness to persevere through the technology concerns, and belief in the ability to learn new things supersedes technology-related frustration. Among the participants in the tele-exercise classes (mean age 74, SD 6.3 years; 38/44, 86% female; mean 2.5, SD 0.9 chronic conditions), 71% (31/44) had a computer with a webcam, but 41% (18/44) had little or no experience with videoconferencing. The initial technology orientation sessions lasted on average 19.3 (SD 10.3) minutes, and 24% (11/44) required a follow-up assistance call. During the first 2 weeks of tele-exercise, 47% of participants (21/44) required technical assistance, which decreased to 12% (5/44) during weeks 3 to 16. The median attendance was 100% for the first 6 sessions and 93% for the subsequent 42 sessions. Conclusions With appropriate support, older adults can successfully participate in tele-exercise. Recommendations include individualized technology orientation sessions, experiential learning, and availability of standby technical assistance, particularly during the first 2 weeks of classes. Continued development of best practices in this area may allow previously hard-to-reach populations of older adults to participate in health-enhancing, evidence-based exercise programs.

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“…This study sought to expand on existing literature in the field of virtual patient education (Press et al, 2020; Rush et al, 2018; Vincenzo et al, 2021) by examining the experience of community participants attending virtual, bilingual, student-led classes on nutrition, cooking and exercise. To our knowledge, this class is one of the first to combine these features.…”

Section: Discussionmentioning

confidence: 99%

“…Along with an increase in one-on-one telemedicine doctor visits, the COVID-19 pandemic prompted more virtual health education classes (Vincenzo et al, 2021). Studies suggest that virtual health education can be as effective as in-person classes at improving certain health outcomes, including controlling blood sugar, lowering cholesterol, improving inhaler use and pulmonary function test results, increasing knowledge of disease, improving overall quality of life and lowering rates of emergency room visits (Press et al, 2020; Rush et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Virtual, bilingual English-Spanish community nutrition and exercise classes: Barriers and opportunities

Edge

Greenberg

Reilly

et al. 2022

Health Education Journal

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Objective: Regular exercise and healthy eating are important contributors to a person’s overall health and well-being. To enhance community health, Keck School of Medicine of the University of Southern California medical students have been leading in-person nutrition, cooking and exercise classes for community members at the Los Angeles County Wellness Center. In September 2020, due to the COVID-19 pandemic, students pivoted to teaching through a virtual platform. In this study, we evaluated community participants’ experiences attending virtual, bilingual nutrition, cooking and exercise classes; the efficacy of virtual classes in providing education; participants’ preference for virtual versus in-person classes; and potential advantages and disadvantages of the virtual versus in-person formats. Design: Cross-sectional study design. Setting: Following 22 virtual classes between September 2020 and April 2021, participants completed an online Qualtrics survey. Methods: Quantitative data were descriptively analysed within Qualtrics using the Sign test. Qualitative free response data were analysed by coding responses for common themes using an inductive approach. Results: There were 326 responses from 130 unique participants. Satisfaction was high for nutrition and exercise classes (99%), and 98% of participants reported they would make healthy nutrition and exercise behaviour changes. Participants preferred online classes compared to in-person classes ( p = .0008). Barriers to attending in-person classes included lack of childcare, transport issues and COVID-19 risk. Conclusion: Virtual classes were well-received and effective. Virtual classes circumvented some of the barriers to in-person class attendance, and many participants preferred virtual classes to in-person classes.

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Capitalizing on Virtual Delivery of Community Programs to Support Health and Well-Being of Older Adults

Cited by 13 publications

References 10 publications

Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study

Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study

Technology Support Challenges and Recommendations for Adapting an Evidence-Based Exercise Program for Remote Delivery to Older Adults: Exploratory Mixed Methods Study

Virtual, bilingual English-Spanish community nutrition and exercise classes: Barriers and opportunities

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