Mangyo R1, Yamada T2
1Mejiro University, Department of Physical Therapy, Faculty of Health Sciences, Saitama-shi, Japan, 2Tokyo Metropolitan University, Department of Physical Therapy, Graduate School of Human Health Sciences, Arakawa-Ku, Japan
Background: Japan has the world's fastest growing aging population. Even with a national long-term care insurance system, controlling the increasing long-term care costs is a national concern. Local municipalities are implementing health promotion measures for the local frail elderly. Although multiple studies have observed the effectiveness of the duration of exercise for the elderly, few studies have examined this at a policy level. However, there is a need to investigate whether anticipated benefits are achieved by increasing the duration of intervention.
Purpose: In the current study, we examined the effectiveness of extending the duration of intervention at frail elderly-targeted exercise classes in A-Municipality in Tokyo. Furthermore, we aimed to create a basic data set for future cost-benefit performance studies.
Methods: Subjects were 351 frail elderly (mean age, 81 years) living in A-municipality and participating in exercise classes between 2012 and 2017. Participants were selected through a screening test conducted in A-municipality. Physical therapists conducted the weekly 1-h exercise classes, primarily for improving physical function. Improvement was evaluated individually at a council meeting arranged by A-municipality to determine whether individuals should stop or continue for 6 months depending on their results. Variables, namely, age, body mass index, 5-m usual walking time, 5-m maximum walking time, grip test, standing on one leg with eyes open test, and timed up and go test, were recorded at the beginning of the intervention and once every 6 months. The subjects were divided into four groups based on the duration of intervention: 6 months (n = 66; mean age, 81 years), 12 months (n = 129; mean age, 82 years), 18 months (n = 75; mean age, 80 years), and ≥18 months (n = 81; mean age, 81 years). For statistical analysis, measurements obtained at the beginning (baseline measurements) and end of the intervention (end measurements) were used as variables. Variance analysis was conducted to compare the rate of variability.
Results: There was no difference observed in the baseline measurements for all groups. The rate of variability between end and baseline measurements was calculated, with no significant difference between the means for all groups. For measurements observed at the end of the intervention, the normal walking time for 5 m for the 18-month group (4.9 s) was higher than that of the 6-month (5.7 s) and ≥18-months (5.5 s) groups. For all groups, the end measurements improved compared with the baseline.
Conclusion(s): Our investigation on whether or not to continue the intervention every 6 months showed that all groups ultimately had similar levels of improvement. We found that addition of this assessment for extension of duration of intervention helped to achieve the expected effects of physical function improvement. For future initiatives, it will be necessary to assess the cost-benefit performance of intervention.
Implications: Physical therapists are involved in municipal level interventions (exercise classes) and duration extension planning. Involvement of these specialists in examining physical function for the evaluation and prognosis prediction of physical function is important in determining the most appropriate duration of interventions for the frail elderly.
Keywords: Frail elderly, physical function, intervention duration
Funding acknowledgements: None
Purpose: In the current study, we examined the effectiveness of extending the duration of intervention at frail elderly-targeted exercise classes in A-Municipality in Tokyo. Furthermore, we aimed to create a basic data set for future cost-benefit performance studies.
Methods: Subjects were 351 frail elderly (mean age, 81 years) living in A-municipality and participating in exercise classes between 2012 and 2017. Participants were selected through a screening test conducted in A-municipality. Physical therapists conducted the weekly 1-h exercise classes, primarily for improving physical function. Improvement was evaluated individually at a council meeting arranged by A-municipality to determine whether individuals should stop or continue for 6 months depending on their results. Variables, namely, age, body mass index, 5-m usual walking time, 5-m maximum walking time, grip test, standing on one leg with eyes open test, and timed up and go test, were recorded at the beginning of the intervention and once every 6 months. The subjects were divided into four groups based on the duration of intervention: 6 months (n = 66; mean age, 81 years), 12 months (n = 129; mean age, 82 years), 18 months (n = 75; mean age, 80 years), and ≥18 months (n = 81; mean age, 81 years). For statistical analysis, measurements obtained at the beginning (baseline measurements) and end of the intervention (end measurements) were used as variables. Variance analysis was conducted to compare the rate of variability.
Results: There was no difference observed in the baseline measurements for all groups. The rate of variability between end and baseline measurements was calculated, with no significant difference between the means for all groups. For measurements observed at the end of the intervention, the normal walking time for 5 m for the 18-month group (4.9 s) was higher than that of the 6-month (5.7 s) and ≥18-months (5.5 s) groups. For all groups, the end measurements improved compared with the baseline.
Conclusion(s): Our investigation on whether or not to continue the intervention every 6 months showed that all groups ultimately had similar levels of improvement. We found that addition of this assessment for extension of duration of intervention helped to achieve the expected effects of physical function improvement. For future initiatives, it will be necessary to assess the cost-benefit performance of intervention.
Implications: Physical therapists are involved in municipal level interventions (exercise classes) and duration extension planning. Involvement of these specialists in examining physical function for the evaluation and prognosis prediction of physical function is important in determining the most appropriate duration of interventions for the frail elderly.
Keywords: Frail elderly, physical function, intervention duration
Funding acknowledgements: None
Topic: Older people; Health promotion & wellbeing/healthy ageing; Outcome measurement
Ethics approval required: Yes
Institution: Mejiro University
Ethics committee: Ethical Committee of Mejiro University
Ethics number: 18-015
All authors, affiliations and abstracts have been published as submitted.
