exercise; nursing home; elderly; ambulatory; physical activity; autonomy; game
Résumé :
[en] Purpose: This study examined the effects of a giant (4×3 m) exercising board game intervention on ambulatory physical activity (PA) and a broader array of physical and psychological outcomes among nursing home residents.
Materials and methods: A quasi-experimental longitudinal study was carried out in two comparable nursing homes. Ten participants (aged 82.5±6.3 and comprising 6 women) meeting the inclusion criteria took part in the 1-month intervention in one nursing home, whereas 11 participants (aged 89.9±3.1 with 8 women) were assigned to the control group in the other nursing home. The giant exercising board game required participants to perform strength, flexibility, balance and endurance activities. The assistance provided by an exercising specialist decreased gradually during the intervention in an autonomy-oriented approach based on the self-determination theory. The following were assessed at baseline, after the intervention and after a follow-up period of 3 months: PA (steps/day and energy
expenditure/day with ActiGraph), cognitive status (mini mental state examination), quality of life (EuroQol 5-dimensions), motivation for PA (Behavioral Regulation in Exercise Questionnaire-2), gait and balance (Tinetti and Short Physical Performance Battery), functional mobility (timed up and go), and the muscular isometric strength of the lower limb muscles.
Results and conclusion: In the intervention group, PA increased from 2,921 steps/day at baseline to 3,358 steps/day after the intervention (+14.9%, P=0.04) and 4,083 steps/day (+39.8%, P=0.03) after 3 months. Energy expenditure/day also increased after the intervention (+110 kcal/day, +6.3%, P=0.01) and after 3 months (+219 kcal/day, +12.3%, P=0.02). Quality of life (P,0.05), balance and gait (P,0.05), and strength of the ankle (P,0.05) were also improved after 3 months. Such improvements were not observed in the control group. The preliminary results are promising but further investigation is required to confirm and evaluate the long-term effectiveness of PA interventions in nursing homes.
Paterson DH, Warburton DE. Physical activity and functional limitations in older adults: a systematic review related to Canada’s Physical Activity Guidelines. Int J Behav Nutr Phys Act. 2010;7:38.
Tudor-Locke C, Craig CL, Aoyagi Y, et al. How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011;8:80-80.
Buckinx F, Mouton A, Reginster JY, et al. Relationship between ambulatory physical activity assessed by activity trackers and physical frailty among nursing home residents. Gait Posture. 2017;54:56-61.
den Ouden M, Bleijlevens MH, Meijers JM, et al. Daily (In)activities of nursing home residents in their wards: an observation study. J Am Med Dir Assoc. 2015;16(11):963-968.
Hallal P, Andersen L, Bull F, Guthold R, Haskell W, Ekelund U; Lancet Physical Activity Series Working Group. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247-257.
Sun F, Norman I, While A. Physical activity in older people: a systematic review. BMC Public Health. 2013;13(1):449.
Weening-Dijksterhuis E, de Greef MH, Scherder EJ, Slaets JP, van der Schans CP. Frail institutionalized older persons: a comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Phys Med Rehabil. 2011;90(2):156-168.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752-762.
Brown WJ, McLaughlin D, Leung J, et al. Physical activity and all-cause mortality in older women and men. Br J Sports Med. 2012;46(9):664-668.
Samitz G, Egger M, Zwahlen M. Domains of physical activity and all-cause mortality: systematic review and dose-response meta-analysis of cohort studies. Int J Epidemiol. 2011;40(5):1382-1400.
Hupin D, Roche F, Gremeaux V, et al. Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged $60 years: a systematic review and meta-analysis. Br J Sports Med. 2015;49(19):1262-1267.
Hamer M, Lavoie KL, Bacon SL. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med. 2014;48(3):239-243.
MacRae PG, Asplund LA, Schnelle JF, Ouslander JG, Abrahamse A, Morris C. A walking program for nursing home residents: effects on walk endurance, physical activity, mobility, and quality of life. J Am Geriatr Soc. 1996;44(2):175-180.
Buckinx F, Reginster JY, Petermans J, et al. Relationship between frailty, physical performance and quality of life among nursing home residents: the SENIOR cohort. Aging Clin Exp Res. 2016;28(6):1149-1157.
Jansen CP, Claßen K, Wahl HW, Hauer K. Effects of interventions on physical activity in nursing home residents. Eur J Ageing. 2015;12(3):261-271.
Teixeira PJ, Carraça EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Act. 2012;9:78-78.
Deci EL, Ryan RM. The “What” and “Why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inquiry. 2000;11(4):227-268.
Chen YM, Li YP. Motivators for physical activity among ambulatory nursing home older residents. ScientificWorldJournal. 2014;2014:329397.
Dartigues JF, Foubert-Samier A, Le Goff M, et al. Playing board games, cognitive decline and dementia: a French population-based cohort study. BMJ Open. 2013;3(8):e002998.
Bleakley CM, Charles D, Porter-Armstrong A, McNeill MDJ, McDonough SM, McCormack B. Gaming for health: asystematic review of the physical and cognitive effects of interactive computer games in older adults. J Appl Gerontol. 2015;34(3):NP166-NP189.
Bieryla KA, Dold NM. Feasibility of Wii Fit training to improve clinical measures of balance in older adults. Clin Interv Aging. 2013;8:775-781.
Molina KI, Ricci NA, de Moraes SA, Perracini MR. Virtual reality using games for improving physical functioning in older adults: a systematic review. J Neuroeng Rehabil. 2014;11(1):1-20.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. JPsychiatrRes. 1975;12(3):189-198.
Korpan SM, Schafer JL, Wilson KC, Webber SC. Effect of actiGraph GT3X+ position and algorithm choice on step count accuracy in older adults. J Aging Phys Act. 2015;23(3):377-382.
O’Neil ME, Fragala-Pinkham MA, Forman JL, Trost SG. Measuring reliability and validity of the ActiGraph GT3X accelerometer for children with cerebral palsy: a feasibility study. J Pediatr Rehabil Med. 2014;7(3):233-240.
Pulakka A, Cheung YB, Ashorn U, et al. Feasibility and validity of the ActiGraph GT3X accelerometer in measuring physical activity of Malawian toddlers. Acta paediatr. 2013;102(12):1192-1198.
Aadland E, Ylvisaker E. Reliability of the actigraph GT3X+ accelerometer in adults under free-living conditions. PLoS One. 2015;10(8):e0134606.
Troiano RP. Large-scale applications of accelerometers: new frontiers and new questions. Med Sci Sports Exerc. 2007;39(9):1501.
Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30(5):777-781.
Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922-935.
Dolan P. Modeling valuations for EuroQol health states. MedCare. 1997;35(11):1095-1108.
Markland D, Tobin V. A modification to the behavioural regulation in exercise questionnaire to include an assessment of a motivation. J Sport Exercise Psychol. 2004;26(2):191-196.
Verloigne M, De Bourdeaudhuij I, Tanghe A, et al. Self-determined motivation towards physical activity in adolescents treated for obesity: an observational study. Int J Behav Nutr Phys Act. 2011;8:97.
Perell KL, Nelson A, Goldman RL, Luther SL, Prieto-Lewis N, Rubenstein LZ. Fall risk assessment measures: an analytic review. J Gerontol A Biol Sci Med Sci. 2001;56(12):M761-M766.
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34(2):119-126.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-423.
Schoppen T, Boonstra A, Groothoff JW, de Vries J, Goeken LN, Eisma WH. The Timed “up and go” test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehabil. 1999;80(7):825-828.
Buckinx F, Croisier JL, Reginster JY, Petermans J, Goffart E, Bruyere O. Relationship between isometric strength of six lower limb muscle groups and motor skills among nursing home residents. J Frailty Aging. 2015;4(4):184-187.
Buckinx F, Croisier JL, Reginster JY, et al. Reliability of muscle strength measures obtained with a hand-held dynamometer in an elderly population. Clin Physiol Funct Imaging. Epub 2015 Oct 30.
Tucker P, Gilliland J. The effect of season and weather on physical activity: a systematic review. Public Health. 2007;121(12):909-922.
Simmons SF, Schnelle JF. Effects of an exercise and scheduled-toileting intervention on appetite and constipation in nursing home residents. J Nutr Health Aging. 2004;8(2):116-121.
Schnelle JF, Leung FW, Rao SS, et al. A controlled trial of an intervention to improve urinary and fecal incontinence and constipation. J Am Geriatr Soc. 2010;58(8):1504-1511.
Friederichs SAH, Bolman C, Oenema A, Lechner L. Profiling physical activity motivation based on self-determination theory: a cluster analysis approach. BMC Psychology. 2015;3(1):1.
McAuley E, Jerome GJ, Elavsky S, Marquez DX, Ramsey SN. Predicting long-term maintenance of physical activity in older adults. Prev Med. 2003;37(2):110-118.
Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Prev Med. 2004;39(5):1056-1061.
Theou O, Stathokostas L, Roland KP, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res. 2011;2011:569194.
de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev. 2012;11(1):136-149.
Brunet J, Sabiston CM. Exploring motivation for physical activity across the adult lifespan. Psychol Sport Exerc. 2011;12(2):99-105.
Finch H, Health Education A. Physical Activity “at Our Age”: Qualitative Research Among People Over the Age of 50. London, UK: Health Education Authority; 1997.
Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. N S W Public Health Bull. 2011;22(3-4):78-83.
Schultz M, Rosted E, Sanders S. Frailty is associated with a history with more falls in elderly hospitalised patients. Dan Med J. 2015;62(6).pii:A5058.
Soriano TA, DeCherrie LV, Thomas DC. Falls in the community-dwelling older adult: a review for primary-care providers. Clin Interv Aging. 2007;2(4):545-554.
Borde R, Hortobagyi T, Granacher U. Dose-response relationships of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med. 2015;45(12):1693-1720.
Gine-Garriga M, Roque-Figuls M, Coll-Planas L, Sitja-Rabert M, Salva A. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95(4):753-769.e753.
Shakeel S, Newhouse I, Malik A, Heckman G. Identifying feasible physical activity programs for long-term care homes in the Ontario Context. Can Geriatr J. 2015;18(2):73-104.
