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Randomized Controlled Trial
. 2017 Sep 12;17(1):214.
doi: 10.1186/s12877-017-0615-0.

Development of a home-based training program for post-ward geriatric rehabilitation patients with cognitive impairment: study protocol of a randomized-controlled trail

Martin Bongartz  1 , Rainer Kiss  2 , Phoebe Ullrich  2 , Tobias Eckert  2 , Jürgen Bauer  2   3 , Klaus Hauer  2
Affiliations
Randomized Controlled Trial

Development of a home-based training program for post-ward geriatric rehabilitation patients with cognitive impairment: study protocol of a randomized-controlled trail

Martin Bongartz et al. BMC Geriatr. .

Abstract

Background: Geriatric patients with cognitive impairment (CI) show an increased risk for a negative rehabilitation outcome and reduced functional recovery following inpatient rehabilitation. Despite this obvious demand, evidence-based training programs at the transition from rehabilitation to the home environments are lacking. The aim of this study is to evaluate the efficacy of a feasible and cost-effective home-based training program to improve motor performance and to promote physical activity, specifically-tailored for post-ward geriatric patients with CI.

Methods: A sample of 101 geriatric patients with mild to moderate stage CI following ward-based rehabilitation will be recruited for a blinded, randomized controlled trial with two arms. The intervention group will conduct a 12 week home-based training, consisting of (1) Exercises to improve strength/power, and postural control; (2) Individual walking trails to enhance physical activity; (3) Implementation of patient-specific motivational strategies to promote behavioral changes. The control group will conduct 12 weeks of unspecific flexibility exercise. Both groups will complete a baseline measurement before starting the program, at the end of the intervention, and after 24 weeks for follow-up. Sensor-based as well as questionnaire-based measures will be applied to comprehensively assess intervention effects. Primary outcomes document motor performance, assessed by the Short Physical Performance Battery, and level of physical activity (PA), as assessed by duration of active episodes (i.e., sum of standing and walking). Secondary outcomes include various medical, psycho-social, various PA and motor outcomes, including sensor-based assessment as well as cost effectiveness.

Discussion: Our study is among the first to provide home-based training in geriatric patients with CI at the transition from a rehabilitation unit to the home environment. The program offers several unique approaches, e.g., a comprehensive and innovative assessment strategy and the integration of individually-tailored motivational strategies. We expect the program to be safe and feasible in geriatric patients with CI with the potential to enhance the sustainability of geriatric rehabilitation programs in patients with CI.

Trial registration: International Standard Randomized Controlled Trial (# ISRCTN82378327 ). Registered: August 10, 2015.

Keywords: Cognitive impairment; Home-based training; Motor performance; Physical activity promotion; Post-ward (patients) geriatric rehabilitation.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval for the study was received from the internal review board at the Medical Faculty of the University of Heidelberg, Germany (ref: S-252/2015; 26/06/2015). Written informed consent will be requested from subjects and/or their legal representatives (in case those were nominated for persons with severe cognitive impairment) before the onset of the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Schematic illustration of the study design
Fig. 2
Fig. 2
Illustration of the exercise provided on a poster and used in the intervention. The upper row displays balance exercise (a-c), the lower row represents strength exercises (d-f)
See this image and copyright information in PMC

References

    1. McGilton KS, Davis A, Mahomed N, Flannery J, Jaglal S, Cott C, Naglie G, Rochon E. An inpatient rehabilitation model of care targeting patients with cognitive impairment. BMC Geriatr. 2012;12:21. doi: 10.1186/1471-2318-12-21. - DOI - PMC - PubMed
    1. Poynter L, Kwan J, Sayer AA, Vassallo M. Does cognitive impairment affect rehabilitation outcome? J Am Geriatr Soc. 2011;59(11):2108–2111. doi: 10.1111/j.1532-5415.2011.03658.x. - DOI - PubMed
    1. Handels RL, Wolfs CA, Aalten P, Verhey FR, Severens JL. Determinants of care costs of patients with dementia or cognitive impairment. Alzheimer Dis Assoc Disord. 2013;27(1):30–36. doi: 10.1097/WAD.0b013e318242da1d. - DOI - PubMed
    1. von Renteln-Kruse W, Neumann L, Klugmann B, Liebetrau A, Golgert S, Dapp U, Frilling B: Geriatric patients with cognitive impairment. Dtsch Arztebl Int. 2015;112(7):103–12. - PMC - PubMed
    1. Zekry D, Herrmann FR, Grandjean R, Meynet MP, Michel JP, Gold G, Krause KH. Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status. Age Ageing. 2008;37(1):83–89. doi: 10.1093/ageing/afm132. - DOI - PubMed

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