Results for 'physical exercise'
THOMSON Linda J., CAMIC Paul M., CHATTERJEE Helen J.
Sets the scene for the conditions under which social prescribing has arisen and considers the efficacy of different referral options. Social prescribing is a non-medical intervention linking patients with social, emotional or practical needs to a range of local, non-clinical services. The review provides definitions, models and notable examples of social prescribing schemes and assesses the means by which and the extent to which these schemes have been evaluated. Models outlined in this review include: Arts on Prescription, Books on Prescription, Education on Prescription, Exercise on Prescription, Green Gyms, Healthy Living Initiatives, Information Prescriptions, Museums on Prescription, Social Enterprise Schemes, Supported Referral, and Time Banks. The report makes recommendations for practice, policy and future research, focusing on best practice guidance for sector workers, frameworks for setting up social prescribing schemes, and methods for evaluating social prescribing schemes.
A brief review of the literature on social prescribing. Social prescribing is a way of linking primary care patients with psycho-social issues, with sources of appropriate, non-medical support in the community. Suitable referrals to social prescribing initiatives are vulnerable and at risk groups such as: people with mild to moderate depression and anxiety; low income single parents; recently bereaved older people; people with long term conditions and frequent attendees in primary and secondary care. The review highlights that prescribed activities have typically included arts and creative activities, physical activity, learning and volunteering opportunities and courses, self-care and support with practical issues such as benefits, housing, debt and employment. The evidence on the impact of social prescribing is currently limited and inconsistent. While some initiatives have shown improved outcomes for patients and potential for cost-savings (in the longer term), few have been subject to economic analysis or the kind of rigorous evaluation which would inform commissioners. The report recommends that any new, local social prescribing initiatives should aim to add to the current evidence base and conduct transparent and thorough.
DAYSON Chris, BASHIR Nadia
Provides a detailed assessment of the social and economic impact of the Rotherham Social Prescribing Pilot from the perspective of key stakeholders. Social prescribing provides a way of linking patients in primary care and their carers with nonmedical sources of support within the community. Over the course of the pilot: 24 voluntary and community organisations (VCOs) received grants with a total value of just over £600,000 to deliver a menu of 31 separate social prescribing services; 1,607 patients were referred to the service, of whom 1,118 were referred on to funded VCS services; the five most common types of funded services referred to were information and advice, community activity, physical activities, befriending and enabling. The evaluation looked at the impact on the demand for hospital care and the economic and social benefits. The findings demonstrate that economic and social outcomes have been created for three main stakeholder groups: patients with LTCs and their carers, who have experienced improved mental health and greater engagement with the community; the local public sector, in particular health bodies, which have benefited from the reduced use of hospital resources; and the local voluntary and community sector, which has benefited from a catalytic investment in community level service provision.
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
Summarises selected new evidence published since the original literature search was conducted for the NICE guidance 16 Occupational therapy and physical activity interventions to promote the mental health wellbeing of older people in primary care and residential care (2008). A search was conducted for new evidence from 1 June 2011 to 28 July 2014 and a total of 8,973 pieces of evidence were initially identified. The 21 most relevant references underwent a critical appraisal process and then were reviewed by an Evidence Update Advisory Group, which advised on the final list of 6 items selected for the Evidence Update. The update provides detailed commentaries on the new evidence focussing on the following themes: occupational interventions, physical activity, walking schemes, and training. It also highlights evidence uncertainties identified.
PUBLIC HEALTH ENGLAND
Examines how local authorities and health teams are working together to improve the health of local communities through prevention and early intervention. The report features seven case studies. Each one describes a particular programme or close partnership between a local authority and local public health or health care teams, often with the additional support of the voluntary sector. Each initiative focuses on a specific area and/or set of activities, including: integrating wellbeing; transforming the food culture in schools; helping people stay in their own homes; GPs linking people to other sources of support; healthy homes and housing conditions; promoting public health in schools; and active living.
There is strong evidence that people with dementia in care homes and hospital wards do not go outside and that, if there is outdoor space, it is not usually dementia friendly. This article reviews the evidence which shows that being outside is essential for mental and physical health and well-being. Vitamin D deficiency is due mainly to a lack of exposure to sunshine, and has been shown to be associated with falls and with a low mood and cognitive impairment. Physical exercise is also important for health and can reduce the risk of falls. Going outside and keeping active have been shown to: improve general health; reduce risk of depression; reduce cognitive decline; provide older people with a sense of freedom; improve sleeping patterns; improve appetite; reduce incontinence; and reduce aggressive behaviour. The article argues that the benefits of being outside, of being exposed to light, and taking part in exercise can lead to a reduction in the use of drugs. Savings in the cost of care can be used in the creation of therapeutic outdoor spaces. A second article will cover the key design features that can enable the use of outside space.
MILLER Kimberly J., et al
Background: Use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity.
Objective: to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation.
Methods: A systematic review searching 12 electronic databases from 1 January 2000–10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality.
Results: Fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported.
Conclusions: Existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.
ORGETA Vasiliki, MIRANDA-CASTILLO Claudia
Objective: Physical exercise has been associated with a range of positive outcomes including improvements in psychological well-being. The aim of the present study was to review current evidence on the effects of physical activity interventions for carers of people with dementia.
Methods: A systematic review using electronic databases and key articles of studies that evaluated the effectiveness of physical activity interventions in improving psychological well-being in carers of people with dementia. Relevant papers were scored according to established criteria set by the Cochrane Review Group. Selection criteria for studies were a randomized controlled trial (RCT) design, and comparing physical activity with a control group receiving no specific physical activity intervention. Two reviewers worked independently to select trials, extract data, and assess risk of bias.
Results: A total of four RCTs met the inclusion criteria. Studies evaluated home-based supervised physical activity of low to moderate intensity, which included either aerobic exercise, or endurance training. Pooled data showed that physical activity reduced subjective caregiver burden in carers.
Conclusions: There is evidence from two RCTs that physical activity reduces subjective caregiver burden for carers of people with dementia. Although statistically significant, the observed benefits should be interpreted with caution as the studies conducted so far have limitations. Further high-quality trials are needed for evaluating the effectiveness of physical activity in improving psychological well-being in carers of people with dementia