Prescribing tailored home exercise program to older adults in the community using a tailored self-modeled video: A pre-post study

Abstract

BackgroundCommunity rehabilitation for older people after hospital discharge is necessary to regain functional ability and independence. However, poor adherence to exercise programs continues to hinder achieving positive health outcomes in older people. This study aimed to evaluate the effectiveness of prescribing a tailored video self-modeled DVD-HEP for 6 weeks, on functional mobility, physical activity, exercise self-efficacy, and health-related quality of life, in a sample of frail older adults.Materials and methodsA pre- and post-test intervention study design was conducted, with each participant acting as their own control. A convergent, parallel, mixed-methods approach involving quantitative, and qualitative data collection was used. Participants received an individualized assessment at baseline and subsequently were provided with a 30-min tailored 6-week self-modeled DVD-HEP that showed the physiotherapist instructing the participant. The physiotherapist phoned participants fortnightly to encourage engagement in the program and explore responses to it. Outcomes evaluated included functional mobility, balance, gait speed, and exercise self-efficacy.ResultsParticipants (n = 15) showed clinically meaningful improvements at follow-up compared to baseline in functional mobility (TUGMCID = 3.4–3.5 s, 3-MWTMCID = 0.1–0.2 m/s) and gait speed (3-MWTMCID = 0.1–0.2 m/s). There were also significant improvements in balance and self-efficacy for exercise and a 2.5- and a 1.3-fold increase in moderate and light physical activity participation at follow-up compared to baseline. The deductive themes were: (i) Enjoyment, self-efficacy, and wellbeing; (ii) Achieving life goals; (iii) Background music as a motivator to adherence; and (iv) Enhanced motor performance and learning: Task goal mastery, multimodal feedback, autonomy to self-regulate learning. The new inductive theme was (v) Preference for in-person support for exercise.ConclusionFuture studies are warranted to compare a tailored self-modeled video HEP to face-to-face programs and other digital health modalities to evaluate older adults' adherence levels and functional improvement.

Physical activity and fiber intake beneficial for muscle mass and strength preservation during aging: A Comprehensive Cross-Sectional Study in the UK Biobank cohort

“…Our results therefore underscore that older individuals might need tailored exercise and dietary regimens to counteract these age-related changes and maintain or enhance their muscle mass and strength. 26,27 The positive association of higher fiber intake with muscle mass across genders and age groups may be explained by the gut-muscle axis hypothesis, which posits that dietary fiber intake enhances gut microbiota diversity. [31][32][33] A diverse gut microbiota promotes the production of short-chain fatty acids, which are known to influence muscle metabolism.…”

“…Our results therefore underscore that older individuals might need tailored exercise and dietary regimens to counteract these age-related changes and maintain or enhance their muscle mass and strength. 26,27…”

The Effectiveness of Home-Based Exergames Training on Cognition and Balance in Older Adults: A Comparative Quasi-Randomized Study of Two Exergame Interventions

“…The improvement on the TUG test in CIT might be due to the fact that both visual processing speed and visual-spatial working memory were more improved, allowing individuals to quickly perceive and interpret obstacles or cues during the TUG test, enabling faster reaction times and smoother navigation through the task, leading to better overall performance ( Mirelman et al, 2014 ). In addition, this improvement is not clinically meaningful as the minimal clinically important difference (MCID) for the TUG test is considered to be 3.4–3.5 s, as reported by Vaz et al (2022) , although the MCID may vary depending on factors such as population, age, and other demographics. As expected, physical-intensive exergame training improved balance more than cognitive-intensive exergame training and balance was the only outcome that did not improve in the cognitive-intensive exergame training group based on ITT analysis.…”