Maayken van den Berg1, Catherine Sherrington2, Maggie Killington1, Stuart Smith3, Bert Bongers4, Leanne Hassett2, Maria Crotty1. 1. Department of Rehabilitation, Aged and Extended Care, Flinders University. 2. The George Institute for Global Health, Sydney Medical School, The University of Sydney. 3. Faculty of Arts and Business, University of the Sunshine Coast, Sippy Downs. 4. Faculty of Design, Architecture and Building, University of Technology, Sydney, Australia.
Abstract
QUESTION: Does adding video/computer-based interactive exercises to inpatient geriatric and neurological rehabilitation improve mobility outcomes? Is it feasible and safe? DESIGN: Randomised trial. PARTICIPANTS: Fifty-eight rehabilitation inpatients. INTERVENTION: Physiotherapist-prescribed, tailored, video/computer-based interactive exercises for 1 hour on weekdays, mainly involving stepping and weight-shifting exercises. OUTCOME MEASURES: The primary outcome was the Short Physical Performance Battery (0 to 3) at 2 weeks. Secondary outcomes were: Maximal Balance Range (mm); Step Test (step count); Rivermead Mobility Index (0 to 15); activity levels; Activity Measure for Post Acute Care Basic Mobility (18 to 72) and Daily Activity (15 to 60); Falls Efficacy Scale (10 to 40), ED5D utility score (0 to 1); Reintegration to Normal Living Index (0 to 100); System Usability Scale (0 to 100) and Physical Activity Enjoyment Scale (0 to 126). Safety was determined from adverse events during intervention. RESULTS: At 2 weeks the between-group difference in the primary outcome (0.1, 95% CI -0.2 to 0.3) was not statistically significant. The intervention group performed significantly better than usual care for Maximal Balance Range (38mm difference after baseline adjustment, 95% CI 6 to 69). Other secondary outcomes were not statistically significant. Fifty-eight (55%) of the eligible patients agreed to participate, 25/29 (86%) completed the intervention and 10 (39%) attended > 70% of sessions, with a mean of 5.6 sessions (SD 3.3) attended and overall average duration of 4.5hours (SD 3.1). Average scores were 62 (SD 21) for the System Usability Scale and 62 (SD 8) for the Physical Activity Enjoyment Scale. There were no adverse events. CONCLUSION: The addition of video/computer-based interactive exercises to usual rehabilitation is a safe and feasible way to increase exercise dose, but is not suitable for all. Adding the exercises to usual rehabilitation resulted in task-specific improvements in balance but not overall mobility. REGISTRATION: ACTRN12613000610730.
RCT Entities:
QUESTION: Does adding video/computer-based interactive exercises to inpatient geriatric and neurological rehabilitation improve mobility outcomes? Is it feasible and safe? DESIGN: Randomised trial. PARTICIPANTS: Fifty-eight rehabilitation inpatients. INTERVENTION: Physiotherapist-prescribed, tailored, video/computer-based interactive exercises for 1 hour on weekdays, mainly involving stepping and weight-shifting exercises. OUTCOME MEASURES: The primary outcome was the Short Physical Performance Battery (0 to 3) at 2 weeks. Secondary outcomes were: Maximal Balance Range (mm); Step Test (step count); Rivermead Mobility Index (0 to 15); activity levels; Activity Measure for Post Acute Care Basic Mobility (18 to 72) and Daily Activity (15 to 60); Falls Efficacy Scale (10 to 40), ED5D utility score (0 to 1); Reintegration to Normal Living Index (0 to 100); System Usability Scale (0 to 100) and Physical Activity Enjoyment Scale (0 to 126). Safety was determined from adverse events during intervention. RESULTS: At 2 weeks the between-group difference in the primary outcome (0.1, 95% CI -0.2 to 0.3) was not statistically significant. The intervention group performed significantly better than usual care for Maximal Balance Range (38mm difference after baseline adjustment, 95% CI 6 to 69). Other secondary outcomes were not statistically significant. Fifty-eight (55%) of the eligible patients agreed to participate, 25/29 (86%) completed the intervention and 10 (39%) attended > 70% of sessions, with a mean of 5.6 sessions (SD 3.3) attended and overall average duration of 4.5hours (SD 3.1). Average scores were 62 (SD 21) for the System Usability Scale and 62 (SD 8) for the Physical Activity Enjoyment Scale. There were no adverse events. CONCLUSION: The addition of video/computer-based interactive exercises to usual rehabilitation is a safe and feasible way to increase exercise dose, but is not suitable for all. Adding the exercises to usual rehabilitation resulted in task-specific improvements in balance but not overall mobility. REGISTRATION: ACTRN12613000610730.
Authors: Fernando L Vázquez; Patricia Otero; J Antonio García-Casal; Vanessa Blanco; Ángela J Torres; Manuel Arrojo Journal: PLoS One Date: 2018-12-11 Impact factor: 3.240
Authors: Leanne Hassett; Maayken van den Berg; Richard I Lindley; Maria Crotty; Annie McCluskey; Hidde P van der Ploeg; Stuart T Smith; Karl Schurr; Maggie Killington; Bert Bongers; Kirsten Howard; Stephane Heritier; Leanne Togher; Maree Hackett; Daniel Treacy; Simone Dorsch; Siobhan Wong; Katharine Scrivener; Sakina Chagpar; Heather Weber; Ross Pearson; Catherine Sherrington Journal: BMJ Open Date: 2016-06-06 Impact factor: 2.692