Hinrichs, Timo;
Bücker, Bettina;
Klaaßen‐Mielke, Renate;
Brach, Michael;
Wilm, Stefan;
Platen, Petra;
Mai, Anna
Home‐Based Exercise Supported by General Practitioner Practices: Ineffective in a Sample of Chronically Ill, Mobility‐Limited Older Adults (the HOMEfit Randomized Controlled Trial)
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Media type:
E-Article
Title:
Home‐Based Exercise Supported by General Practitioner Practices: Ineffective in a Sample of Chronically Ill, Mobility‐Limited Older Adults (the HOMEfit Randomized Controlled Trial)
Contributor:
Hinrichs, Timo;
Bücker, Bettina;
Klaaßen‐Mielke, Renate;
Brach, Michael;
Wilm, Stefan;
Platen, Petra;
Mai, Anna
imprint:
Wiley, 2016
Published in:Journal of the American Geriatrics Society
Description:
<jats:sec><jats:title>Objectives</jats:title><jats:p>To evaluate the effects a home‐based exercise program delivered to ill and mobility‐limited elderly individuals on physical function, physical activity, quality of life, fall‐related self‐efficacy, and exercise self‐efficacy.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Randomized controlled trial (<jats:styled-content style="fixed-case">ISRCTN</jats:styled-content> Registry, Reg.‐No. <jats:styled-content style="fixed-case">ISRCTN</jats:styled-content>17727272).</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Fifteen general practitioner (<jats:styled-content style="fixed-case">GP</jats:styled-content>) practices and participants' homes.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Chronically ill and mobility‐limited individuals aged 70 and older (N = 209).</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>An exercise therapist delivered the experimental intervention—a 12‐week multidimensional home‐based exercise program integrating behavioral strategies—in individual counseling sessions at the <jats:styled-content style="fixed-case">GP</jats:styled-content>s' practices and over the telephone. The control intervention focused on promoting light‐intensity activities of daily living. Interventions took place between February 2012 and March 2013.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>The primary outcome was functional lower body strength (chair‐rise test). Secondary outcomes were physical function (battery of motor tests), physical activity (step count), health‐related quality of life (Medical Outcomes Study 8‐item Short‐Form Survey), fall‐related (Falls Efficacy Scale—International Version), and exercise self‐efficacy (Selbstwirksamkeit zur sportlichen Aktivitaet (<jats:styled-content style="fixed-case">SSA</jats:styled-content>) scale). Postintervention differences between the groups were tested using analysis of covariance (intention to treat; adjusted for baseline value and <jats:styled-content style="fixed-case">GP</jats:styled-content> practice; significance level <jats:italic>P</jats:italic> ≤ .05).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Participants had a mean age ± standard deviation of 80 ± 5, 74% were female, 87% had three or more chronic diseases, and 54% used a walking aid. The difference (intention to treat; experimental minus control) between adjusted postintervention chair‐rise times was −0.1 (95% confidence interval = −1.8–1.7). Differences for all secondary outcomes were also nonsignificant.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The program was ineffective in the target population. Possibilities for improving the concept will have to be evaluated.</jats:p></jats:sec>