Introduction

This project sets out to investigate social innovations for the enhancement of quality of life and well-being—especially the healthy life expectancy—for older people. The project acts on the assumption that despite strong evidence for activity promotion in elderly people in institutional settings, increased and diversified activity is currently only implemented at a rudimentary level. Therefore, the primary objective of this sub-project is to increase and systematically promote the implementation and understanding regarding various aspects of activity patterns, physical fitness, and social participation of nursing home residents; staff members and environmental setting will also be addressed.Instead of a rigorous design, however—such as a randomized, control-trial intervention study—we will pursue an innovative, partially controlled pilot project accounting for content and methodology.

For regular progress updates, please see the presentations from each of the INNOVAGE Forums:

Methodology

 

Project Aims

Specific aims of the project are:

  • Systematic review of the current state of research about mobility and activity promotion in long-term care settings

    A systematic review of the existing research will be conducted preparing the psychosocial and physical interventions. Based on this review, the project intervention actions will be planned and pre-tested in the institutional context.

  • Monitoring of nursing home residents’ activity

    In order to objectively assess their daily activity, nursing home residents will be monitored with unobtrusive, highly sensitive accelerometer-based activity sensors; these will be worn at the hip for approximately three consecutive days. We will use cutting-edge technologogical solutions in the field of mobility monitoring, pursuing four endpoints: (1) To demonstrate the exhaustive feasibility and usability of this methodologically sophisticated assessment for the general population of nursing home residents; (2) To collect data allowing a better understanding of mobility patterns of nursing home residents in general; (3) To carry out a pre-, post-, and a 6-month follow-up measurement based on this methodology, in the context of the predicted mobility and activity promotion; (4) To show that these kinds of technologies may provide practical knowledge for professionals in institutional settings about nursing home residents’ mobility patterns, demonstrating that they can be helpful to implement and supervise mobility-promoting measures in institutional settings.

Exemplary illustration of data obtained with specific activity sensors

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  • Physical activity intervention

    The standardized group trainings which were developed and evaluated by the work group of Prof. Klaus Hauer in previous research will mainly comprise resistance training and functional exercises tailored to the needs of older adults with and without cognitive impairment. The exercise program will focus on the improvement of key motor skills (such as gait, posture, sit-to-stand ability) essential for mobility, autonomy, and movement security. These training components will be complemented by specific cognitive tasks (i.e., dual task).

  • Psychosocial intervention

    Besides activity-based parameters, health-related and psychological aspects will enrich the training. In addition to the physical exercise program, a psychosocial intervention is intended to create incentives and activity occasions, respectively (e.g., finding an activity partner; comprehension of elements concerning one’s own aging process, reduction of age stereotypes, or improvements of self-efficacy). This component will be structured in a way that will be suited for healthy and cognitively impaired seniors (e.g., persons with dementia) alike.Furthermore, staff members as well as family members, will be included.

  • Serious games: virtual gaming

    Unfortunately, conventional exercise programs seldom motivate persons to achieve higher rates of physical activity. This demographic of person in particular can profit from virtual activity programs that integrate movement tasks into a game setting and thus provide opportunity to address other motives of movement (acting jointly in a play-likeway). The so called “serious games” can be understood as an advancement allowing training of the movements required for a target-oriented training (e.g., walking or keeping posture while solving memory tasks), while keeping a gaming component. In the course of a pilot study, the “serious games” approach will be investigated regarding its ability to promote activity in institutional settings in order to integrate this concept into the physical activity intervention.

Assessment of Effectiveness of Interventions

The central aim of the study is to enhance physical activity of nursing home residents in the short-term as well as long-term through the implementation of physical and psychosocial interventions; the study should contribute to the healthy life expectancy and independence of nursing home residents. In order to assess whether the residents’ activity was increased immediately after the interventions, their pre- and post-intervention activity levels will be compared using mobility-monitoring, questionnaires, and proxy ratings. For the assessment of long-term effects, the residents’ activity will be reassessed after 6 months and compared to the activity levels at baseline and immediately after the intervention phase. In addition, the results will be compared to a control nursing home of equitable nature, in which no such intervention has been accomplished yet.

Project Directorship

  • Prof. Dr. Klaus Hauer (Bethanien Hospital Heidelberg)
  • Prof. Dr. Hans-Werner Wahl

Scientific Project Staff

  • Dr. Katrin Claßen, psychologist (Dipl.-Psych.)
  • Carl-Philipp Jansen, sport scientist (M.A.)

Visit the website at http://www.psychologie.uni-heidelberg.de/ae/apa/forschung/innovage.html

Findings

The first deliverable is a guidebook which aims to describe the intervention components used in the interdisciplinary research project "Long-Term Care in Motion" as part of the INNOVAGE consortium. The intervention program is meant as a social innovation in the nursing home setting and should enable professionals working in this context to enhance the physical activity of residents.    The guidebook was fully revised in the last quarter of 2015 and the new version is now available for download here: Guidebook

The second deliverable is a paper in BMC Geriatrics Assessing the effect of a physical activity intervention in a nursing home ecology: a natural lab approach authored by Carl-Philipp Jansen, Katrin Claßen, Klaus Hauer, Mona Diegelmann and Hans-Werner Wahl from Heidelberg University in Germany.  Read it online here: http://www.biomedcentral.com/1471-2318/14/117 

Published in May 2015, a third paper is one of our project milestones.   Published in the European Journal of Ageing, this is a review synthesising the existing evidence on interventions in long-term care institutions and critically reviewing their assessment methods.     The formal citation is:  Jansen, C.-P., Claßen, K., Wahl, H.-W. & Hauer, K. (2015). Effects of interventions on physical activity in nursing home residents. European Journal of Ageing. Published online. DOI 10.1007/s10433-015-0344-1, and the article is available here.

 

Annual updates

Yearly reports, and final summary of findings, are downloadable below

2013
2014
2015
Summary of findings

Funded by the European Commission's Seventh Framework Programme
FP7-HEALTH-2012-INNOVATION-1/No 306058

©Copyright INNOVAGE 2013