Lakke S.E.1, Foijer M.2, Hobbelen H.J.3
1Hanze University Groningen, University of Applied Sciences, International Health Care studies-Physical Therapy and Research Group Healthy Ageing, Allied Healthcare and Nursing, Groningen, Netherlands, 2Hanze University Groningen, University of Applied Sciences, Health Care studies-Physical therapy and Research Group Healthy Ageing, Allied Healthcare and Nursing, Groningen, Netherlands, 3Hanze University Groningen, University of Applied Sciences, Research Group Healthy Ageing, Allied Healthcare and Nursing, Groningen, Netherlands
Background: The prevalence of elderly visiting a physical therapist is high. One of the reasons to visit a physical therapist may be to increase physical activity (PA). Previous studies showed a positive effect of a diversity of types of exercise therapies to increase PA levels.1 To enhance the effect of these therapies it is interesting to look at the so-called common parts of a physical therapy treatment. One of the common parts is patient-therapist communication. In adults, the effect of additional communication is conflicting. Elderly desire more affective communication and discussion about therapy than adults.2 Thus, the effect of patient-therapist communication might be stronger in elderly than in adults.
- Regnaux JP, et al. High-intensity versus low-intensity physical activity or exercise. Cochrane Database Syst. Rev. 2015;29:CD010203
- Greene MG, et al. Problems in communication. J.Geriatr.Psychiatry. 1996;29(1):13-32.
Purpose: This study aims to investigate the additional value of elderly-therapist communication on the effect of physical therapy treatment to increase the physical activity level of elderly.
Methods: A systematic review of RCTs. Literature was searched in the following databases; Pubmed, Embase, Cinahl, Cochrane Trial, Psychinfo, Amed, and Pedro. Eligible RCTs were published between January 1980 and August 2016. Elderly were at least 60 years old. The control group must comprise exercise, the interventions group comparable exercise plus elderly-therapeutic communication. Two reviewers independently performed quality assessments by means of the PEDro scale.
Results: From 5.012 eligible studies, 12 studies were included that fit the inclusion criteria. The methodological quality of eight studies was moderate to high, and of four low. Ten studies included elderly with musculoskeletal dysfunction, two with system diseases (pulmonary and stroke). Two types of outcome measurements were retrieved from the studies, performance based outcome measures muscle strength, walking-test, and Time-up-and-Go-test, or the elderly perceived PA measures motivation to be physical active, physical functioning, and confidence to perform exercises. The communication style in nine studies was coaching, in three information-giving.
The coaching was based on four models. First, the transtheoretical model (n=4) showed in one study a significant positive effect on perceived and performed PA, and in three studies no effect. Second, the model of self-efficacy (n=2) showed positive and no effects on PA. Third, the self-regulation model (n=1) showed no effect on PA. Fourth, self-management (n=1) showed positive effect on perceived PA but no effect on performance. Finally, one coaching study used a compilation of all these models (n=1) and showed no effect after 3 months, but a positive effect at 6 month follow up.
The information-giving was applied as education about an active lifestyle (n=2), resulting in no effect, and more guidance during exercises (n=1) that showed positive and no effects in performed PA.
Conclusion(s): There are minor additional effects of specific communication above exercise in elderly. Self-management has an effect on elderlys perceived PA and a composition of coaching models showed long term effects. Education about an active lifestyle was not effective.
Implications: The finding of this study may lead physical therapists in a conscious use of communication during treatment and can facilitate future research.
Funding acknowledgements: n.a.
Topic: Older people
Ethics approval: No ethical approval was required
All authors, affiliations and abstracts have been published as submitted.
