Promoting physical activity in geriatric patients with cognitive impairment after discharge from ward-rehabilitation: a
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ORIGINAL INVESTIGATION
Promoting physical activity in geriatric patients with cognitive impairment after discharge from ward‑rehabilitation: a feasibility study Tobias Eckert1 · Martin Bongartz1 · Phoebe Ullrich1 · Bastian Abel1 · Werner Christian1,2 · Rainer Kiss3 · Klaus Hauer1
© Springer Nature B.V. 2020
Abstract The aim of the present study was to examine adherence and acceptance of a home-based program to promote physical activity (PA) in older persons with cognitive impairment (CI) following inpatient rehabilitation. Sixty-three older persons (≥ 65 years) with mild to moderate CI (Mini-Mental State Examination score 17–26), allocated to the intervention group of a randomized, controlled intervention trial underwent a 12-week home-based PA intervention including (1) physical training and outdoor walking to improve functional fitness and (2) motivational strategies (goal-setting, pedometer-based self-monitoring, social support delivered by home visits, phone calls) to promote PA. Training logs were used to assess adherence to physical training, outdoor walking and to motivational strategies (goal-setting, pedometer-based self-monitoring). Acceptance (subjective feasibility and effectiveness) of the program components was assessed by a standardized questionnaire. Mean adherence rates over the intervention period were 63.6% for physical training, 57.9% for outdoor walking, and between 40.1% (achievement of walking goals), and 60.1% (pedometer-based self-monitoring) for motivational strategies. Adherence rates significantly declined from baseline to the end of intervention (T1: 43.4–76.8%, T2: 36.1–51.5%, p values40.5; range 18–72) was used which has been ascertained within a cognitively impaired sample of community-dwelling elderly (Clarke et al. 2007).
Statistical analyses Descriptive data were presented as frequencies and percentages for categorical variables, means (M), and standard deviations (SD) or medians and interquartile ranges (IQR) for continuous variables. Unpaired t tests, Mann–Whitney U-tests, and Chi-square tests were used for baseline comparison between dropouts and completers according to the data distribution. Paired t tests were performed to test for differences regarding mean adherence rates between beginning (week 2) and end of intervention (week 12).
Results Participant characteristics Out of 1981 patients screened for eligibility, 118 individuals were enrolled to the original RCT according to predefined inclusion criteria, of whom 63 participants were allocated to IG (see Fig. 1). The present sample comprised multi-morbid, sedentary, cognitively, and physically impaired older adults with more than the half showing apathetic symptoms (for sample description see Table 1). Fifty-four subjects completed the intervention program and were therefore eligible for analyses of adherence and acceptance of the program. Reasons for dropout were death, fall-related fractures, and other serious medical events unrelated to the intervention program. When dropouts (n = 9) were compared with t
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