Results for 'physical exercise'
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WHAT WORKS CENTRE FOR WELLBEING
This briefing summarises the key findings from a qualitative evidence review into the role of place and space in enhancing wellbeing or alleviating loneliness when taking part in participatory arts and sport or physical activity. The review identified five key themes in the evidence base which highlight processes by which participatory arts and sport increase wellbeing and/ or reduce loneliness. They are: belonging and identity; relationships to community and locality; therapeutic and sensory spaces; safe spaces; and pace and rhythm of a space and place. The briefing concludes by suggesting how the evidence could be implemented.
MANSFIELD Louise, et al
This review identifies evidence on the role of place and space in enhancing wellbeing or alleviating loneliness when taking part in participatory arts and sport or physical activity. The review looked at studies published worldwide between 2009 and 2019, found 59 sources. The qualitative studies included focus on understanding and conceptualising place and space, wellbeing and/or loneliness in participatory arts,
sport or physical activity. In these studies, five key thematic areas and their findings have been identified: (i) belonging and identity in place and space (ii) places and spaces of community and locality, (iii) therapeutic and sensory spaces, (iv) safe spaces and (v) temporal aspects of place and space. These themes point to processes by which participatory arts and sport operate to enhance wellbeing and/or alleviate loneliness. Based on the findings, the review has high confidence that places and spaces and placemaking are important in enhancing wellbeing and potentially alleviating loneliness by creating a positive sense of belonging and identity, community and therapeutic or sensory experience in participatory arts, sport or physical activity. It has moderate confidence that places and spaces and placemaking are important in enhancing wellbeing by creating safe spaces for those facing physical or emotional harm via participatory arts, sport or physical activity. It has moderate confidence that the pattern and timing of activities in places and spaces for participatory arts, sport or physical activity i.e. when, how long, who with and what types of activity occur, have a positive influence of wellbeing.
FARAG Inez, et al
Objective: The aim of this study was to determine the cost‐effectiveness of a 6‐month minimally supervised exercise program for people with PD. Methods: An economic analysis was conducted alongside a randomized, controlled trial in which 231 people age 40 years and over with PD were randomized into a usual care control group or an exercise group. Cost‐effectiveness was estimated using incremental cost per fall prevented (using falls calendars) as the primary analysis and cost per extra person avoiding mobility deterioration (defined as an improvement or no change in the 12‐point Short Physical Performance Battery Score between baseline and 6 month). A cost‐utility analysis using the Short Form‐6D was also performed. Uncertainty was represented using cost‐effectiveness scatter plots and acceptability curves. Planned subgroup analyses for the low‐disease‐severity group were also undertaken. Results: All results are reported in Australian dollars ($A). The average cost of the intervention was $A1,010 per participant. Incremental cost‐effectiveness of the program relative to usual care was $A574 per fall prevented, $A9,570 per extra person avoiding mobility deterioration, and $A338,800 per quality‐adjusted life year gained. The intervention had an 80% probability of being cost‐effective, relative to the control, at a threshold of $A2,000 per fall prevented. Subgroup analyses for the low‐disease‐severity group indicate the program to be dominant, that is, less costly and more effective than usual care for all health outcomes. Conclusion: The exercise intervention appeared cost‐effective with regard to fall prevention in the whole sample and cost saving in the low disease severity group, when compared with usual care.
ROGERSON Mike, et al
This study investigated the efficacy of medium-term Green Exercise (GE; being physically active within a natural environment) interventions for improving wellbeing, by pooling data collected at the start and end of participants’ engagement with a range of GE interventions. Hypotheses were that (i) interventions would show good efficacy for improving wellbeing in the overall sample; (ii) compared to participants reporting ‘average to high’ wellbeing at the start of their project, participants with ‘low’ starting wellbeing would report greater improvements post-intervention; and (iii) improvements would significantly differ between age groups. The pooled dataset was categorized in line with UK norms (n = 318) and analyzed using a standardized meta-analysis approach. Effect size was large: g = 0.812 (95% CI [0.599, 1.025]), and differences in wellbeing changes associated with project duration, age or sex were not statistically significant. Compared to those reporting ‘average-high’ starting wellbeing, participants reporting ‘low’ starting wellbeing exhibited greater improvements (BCa 95% CI [−31.8, −26.5]), with 60.8% moving into the ‘average-high’ wellbeing category. GE can play an important role in facilitating wellbeing and can provide alternative pathways for health and social care practice. Public health commissioners should consider integrating such interventions for patients experiencing low wellbeing or associated comorbidities.
MACKENZIE Lynette, CLIFFORD Amanda
Falls are common events with serious consequences for older people. With an ageing population and increasing health-care costs, information and communication technologies (ICT) will have a potential role in future health-care delivery. However, research on technology acceptance in health care for older people is limited and its application to falls prevention is unknown. The aims of this study were to explore and describe the perceptions of community-dwelling Australian and Irish older people about their current use of technology, and the potential use of technology for falls prevention. Qualitative data were collected from three focus groups conducted in and around Limerick in Ireland, and three in the Sydney area, Australia. A total of 35 older people participated. Data were analysed using thematic analysis. Four themes emerged from the data: (a) perceptions of vulnerability to falls, (b) preferences for exercise interventions, (c) participation in and ownership of technology, and (d) perceptions about applications of technology for falls prevention. As the use of technology is an instrumental activity of daily living, health professionals need to assess the capacity of older people to adopt these technologies, and provide falls prevention interventions to accommodate the technology skills of older people. Some participants were reluctant to embrace technology and barriers to the effective use of technology to assist in preventing falls may conflict with future health service trends.
PRICE Sian, HOOKWAY Amy, KING Sian
Summary findings from an evidence mapping to share evidence on the effectiveness and practice of social prescribing to improve the health and well-being of individuals with social, emotional or practical needs. Sixty-two sources met the inclusion criteria for the evidence map. Two main types of social prescribing were identified. Those targeting psychosocial needs and those intended for people who are sedentary and/or overweight or obese. In total six types of social prescribing initiative are described: link worker programmes (schemes linking people to a facilitator who assessed them and referred them on to community support); community arts programmes; a horticultural programme; exercise referral schemes; commercial weight loss programmes and referral to welfare rights advice. The evidence mapping aims to support professionals looking to implement social prescribing interventions within primary and community care settings across Wales
GILLESPIE Lesley D., et al
Background: Approximately 30 per cent of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009.Objective: To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. Search methods: this review searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Selection criteria: Randomised trials of interventions to reduce falls in community-dwelling older people. Main results: this review included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials). Findings: Group and home‐based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow‐up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti‐slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community‐dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.
ALLEN Kerry, GLASBY Jon
There is a need to invest more fully and strategically in both prevention and rehabilitation for older people, to help them stay healthier, more independent and more socially included for longer and to recover these capacities as fully as possible when they do require hospital treatment. While there is growing recognition that only a more preventative agenda will be sufficient to respond to current and future pressures, there is much less clarity about how to do this in practice. This paper seeks to identify the most promising ‘10 high impact changes’ with regards to prevention in older people’s services. The paper draws on two main sources. The first is an EU review of prevention and long-term care in older people’s services across 14 European counties known as Interlinks. The second key source is a recent review of the social and economic benefits of adult social care, commissioned by the Department of Health and Downing Street. This paper identifies and reviews the following 10 prevention strategies: promoting healthy lifestyles; vaccination; screening; falls prevention; housing adaptations and practical support; telecare and technology; intermediate care; reablement; partnership working; and personalisation.
BURTON Elissa, et al
The proportion of older adults is increasing around the world and most wish to live in their home until they die. To achieve this, many will require services in the home to remain living independently. To maintain function (ie, strength, balance, and endurance), physical activity needs to be undertaken on a regular basis, and is essential as a person ages. Unfortunately, as people age there is a tendency to reduce activity levels, which often leads to loss of function and frailty, and the need for home care services. This updated systematic review includes a mix of study methodologies and meta-analysis, and investigated the effectiveness of physical activity/exercise interventions for older adults receiving home care services. Eighteen studies including ten randomized controlled trials meeting the selection criteria were identified. Many of the studies were multi-factorial interventions with the majority reporting aims beyond solely trying to improve the physical function of home care clients. The meta-analysis showed limited evidence for effectiveness of physical activity for older adults receiving home care services. Future exercise/physical activity studies working with home care populations should consider focusing solely on physical improvements, and need to include a process evaluation of the intervention to gain a better understanding of the association between adherence to the exercise program and other factors influencing effectiveness.
MEYER Claudia, O'KEEFE Fleur
Objective: Aged care services increasingly respond to the needs of people with dementia. Non-pharmacological approaches are preferable to reduce responsive behaviours, improve/maintain functional capacity and reduce emotional disorders. This rapid review of systematic reviews aimed to consolidate the evidence for non-pharmacological interventions and determine outcome effectiveness. Methods: Systematic review literature was comprehensively searched for non-pharmacological interventions for dementia in residential care. Quality ratings used adapted GRADE methodology, and ease of implementation assessed. Results: Of 629 abstracts screened, 81 full-text articles were retrieved, 38 articles included. The strongest evidence for reducing responsive behaviours was music, sensory stimulation, simulated presence and validation therapies. Exercise and light therapy improved/maintained activities of daily living, while cognitive stimulation and reminiscence improved cognition. Strongest evidence for reducing emotional disorders was music, psychological interventions and reminiscence. Conclusion: Much evidence of varying quality exists, with resource-constrained residential care providers now able to make evidence-based decisions about non-pharmacological interventions.
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