Pilot evaluation of the effect of an exercise intervention on quality of life for Australians living in residential aged care

Intervention: the exercise program designed to provide optimal stimulus to the cardiorespiratory and neuromuscular systems while maximising safety, compliance, and retention for older Australians living in residential aged care facilities (RACFs). The exercise program adheres to the recommendations for physical activity for older adults living in RACF released by the International Association of Gerontology and Geriatrics Global Aging Research Network (De Souto Barreto et al 2016). The program involves twice weekly group exercise sessions of 35-45 min duration per session for 12 weeks. The exercise sessions will comprise a combination of aerobic/endurance (bouts of >10min), strength (8-10 exercises, 10-15 repetition), flexibility (10 mins) and balance/coordination activities tailored to each participant’s need and ability. An Accredited Exercise Physiologist will design and run exercise sessions during the study period, monitor fidelity to the program in coordination with an in-house physiotherapist and a research team member. A class session checklist will be used to assess participants' adherence to the program. Our industry partner for this project is PresCare. PresCare provides care services including residential, in-home community care and chaplaincy and pastoral care in metropolitan and regional areas throughout Queensland. This pilot project will be undertaken at Vela – a 154-bed aged care facility located in Carina, Brisbane. Vela provides care to residents across three separate buildings: a 60 bed facility (block A); a 64 bed facility (block B); and, a 30-bed special care unit for those diagnosed with dementia. Residents in block A will be offered the exercise program (i.e., intervention group) while residents in block B will receive usual care (i.e., the control group). The usual care group will receive standard care according to activities designed by the PresCare lifestyle team that include daily walks and Tai Chi. We anticipate recruiting 60 participants to the study – 30 in the intervention group and 30 in the control. The intervention group will be classified according to the functional ability and / or capacity. An estimated 3 subgroups will be established with an average of 10 participants (i.e., 30 in total). Classification according to the functional ability and / or capacity will ensure that each participant’s exercise prescription is designed to provide optimal stimulus to the cardiorespiratory and neuromuscular systems while maximising safety, compliance and retention. Such a strategy will address the acceptability, effectiveness and sustainability of the exercise program. The project will be officially launched in July 2018 (subject to ethics approval), at Vela, with an information session for Pres Care staff, residents and their families. This session will introduce the research team, project aims, roles, responsibilities, risks and research procedure. Interested participants will be provided with an information sheet. At the completion of the pilot project another information session will be held to provide participants and their families with results of the study. At the commencement of the study, specific training will be provided to PresCare staff (exercise physiologist, lifestyle team, facility manager and other staff) on all facets of the exercise program from recruitment through to implementation, potential risks and strategies to mitigate these risks. The half-day training session will take place at Vela and will be conducted by Associate Investigator Associate Professor Prue Cormie who is an Accredited Exercise Physiologist with Exercise and Sport Science Australia. After an initial information session, participants that express an interest in the study will discuss the exercise program with their GP at their next regular scheduled appointment. The GP will be required to determine if interested residents are physically and mentally fit to participate in the program. Residents, who are supported by their GP, will be asked to provide written consent to participate in the program. Prior to commencing the program and following its completion, participants will receive a one-on-one consultation with an accredited exercise physiologist lasting approximately one hour. These consultations will involve screening of health status, initial and progress assessments in order to individualise the exercise prescription to specific needs, physical abilities and personal preferences. Objective measurements of physical function, resting blood pressure, height, weight, waist and hip circumferences occurs for all participants at pre- and post-program time points. Physical function will be assessed using the 400m walk and repeated chair rise tests and lower time taken to complete the tests representing higher functional performance. as a measure of cardiovascular fitness, peak oxygen consumption (VO2peak) will be estimated from the 400m walk test time and heart rate response. A validated oscillometric device or sphgomamometer will be used to record brachial blood pressure. Circumference measured using an anthropometric tape in accordance to standard protocols. These assessments will be performed in triplicate with the exception of the 400m test. Patient demographic and reported outcomes will be collected with a series of surveys with sound psychometric properties.