This interventional study aims to see if involving caregivers as exercise partners with the physiotherapist throughout in-hospital geriatric rehabilitation and the first six weeks following discharge is feasible. Caregivers will receive hands-on training from physiotherapists so that they can assist their family members with their exercises. The caregivers will provide 30-minute exercise sessions three times each week in addition to the standard physiotherapy. The researchers want to know how many people are eligible for GAPP+CARE and how willing they are to participate. The researchers also want to know about the program's hindering and facilitating elements, as well as its fidelity and retention rate. Apart from that, the researchers want to examine if an effectiveness study and the used outcome measures are viable.
To meet the WHO guideline for daily exercise during and after hospitalization, physiotherapists must find ways for geriatric patients to be active outside of therapy time. Geriatric patients require assistance or supervision to exercise safely, yet physiotherapists and nurses are short on time. Instead, by providing carers with tools and instruction, the researchers might turn them into exercise partners for the physiotherapist. The investigators designed an exercise program (GAPP+Care) customized to the caregiver's ability to exercise safely with their loved one, based on the ideas and exercises of our standard physiotherapy program, the Geriatric Activation Program Pellenberg (GAPP). Through semi-structured interviews, patients and their caregivers were involved in developing and validating GAPP+Care, including the exercise booklet. GAPP+Care consists of GAPP (the usual physiotherapy treatment) and three additional 30-minute exercise sessions with the caregiver each week (+Care). +Care will continue at home for the first six weeks after discharge, and GAPP will be replaced with physiotherapy performed by a private physiotherapist, as described at discharge (a prescription for home physiotherapy 3 times a week, for 60 sessions F-pathology or 18 sessions). The initial +Care session is with a ward physiotherapist who will show the caregiver how to utilize the GAPP+Care handbook and the exercises and teach them how to support the patient during the exercises. During hospitalization, one of the three weekly sessions will be led by a ward physiotherapist to reinforce the hands-on skills and knowledge. These physiotherapy-patient-caregiver sessions will consist of two home visits and four phone calls after the patient has been discharged. The goal of this exploratory study is to see if GAPP+Care is feasible. The researchers want to know how many people are eligible and how willing they are to participate. The researchers also want to assess the program's hindering and facilitating elements, as well as its fidelity and retention rate. Aside from that, the researchers want to evaluate if an effectiveness study and the used outcome measures are viable.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
13
standard physiotherapy 45 minutes per day, 5 day a week (GAPP) \+ 3 extra exercise sessions led by a caregiver (+Care)
3 extra exercise moments led by a caregiver: one physiotherapist-caregiver-patient exercise session: the physiotherapist will educate and train the caregiver on the exercises and hands-on skills. Two caregiver-patient exercise sessions
Healthcare workers in the geriatric rehabilitation ward will be interviewed on their opinions on GAPP+Care
Universitaire Ziekenhuizen Leuven, campus Pellenberg
Pellenberg, Belgium
Proportion of eligible individuals and their willingness to participate in GAPP+Care
Number of available patients on the ward and number of eligible patients and caregivers and number of patients and caregivers who participate
Time frame: 1 year
Feasibility, appropriateness, and the hindering and facilitating factors of GAPP+Care
Semi-structured interviews with patients, caregivers and healthcare providers
Time frame: patients and caregivers 2 times (at day of discharge and at the end of week 6 after discharge), healthcare providers 1 time (in the last 6 months of the study)
Fidelity to GAPP+Care
Number of exercise moments with physiotherapist; Noted in exercise diary Number of exercise moments with caregiver; Exercise Diary Number and kind of exercises with caregiver; Exercise Diary
Time frame: up to 12 weeks
Retention rate of participants
Number of dropouts
Time frame: 1 year
Number of falls during the +Care sessions
number of falls noted in the exercise diary or mentioned during the interviews
Time frame: up to 12 weeks
Private physiotherapy after discharge
number of sessions per week
Time frame: 6 weeks
Use of the activity monitor MOX, Maastricht Instruments
measuring daily activity in minutes/24hours (sedentary - standing - dynamic)
Time frame: first week at baseline, first week after discharge (starting at day of discharge), and week 6 after discharge
Functional balance
Berg Balance Scale (BBS) 0-56, a higher score means a better outcome
Time frame: 3 times over 10 weeks: baseline, at day of discharge (up tot 6 weeks after baseline) and at end of week 6 after discharge
Hand squeeze force
Maximum handgrip with dominant hand, measured with the Martin Vigory dynamometer, in kPa
Time frame: 3 times over 10 weeks: baseline, at day of discharge (up tot 6 weeks after baseline) and at the end of week 6 after discharge
Walking speed
4m walking test (4mWT), m/s
Time frame: 3 times over 10 weeks: baseline, at day of discharge (up tot 6 weeks after baseline) and at the end of week 6 after discharge
Quality of life patient and caregiver
Visual analog scale of quality of life (VAS QoL), 0-10 a higher score means a better outcome
Time frame: 3 times over 10 weeks: baseline, at day of discharge (up tot 6 weeks after baseline) and at end of week 6 after discharge
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