Exercise Intervention
Physiotherapists responsible for delivery of the intervention
received an in depth two day training programme.
This involved teaching on the processes and rationale of
the trial as well as instruction on how to deliver exercise
groups. Each physiotherapist was assigned to certain
homes and liaised with the home manager/senior carer to
arrange suitable times for running the exercise groups.
Individual exercise intensity for each participant was
determined based on their initial assessment, beginning
at a specific level; but which could be progressed:
Level 1: Chair based lower level intensity aerobic
and strength exercises.
Level 2: Moderate intensity exercises performed in
sitting and/or supported standing.
Level 3: Moderate to high intensity exercises
performed more dynamically in sitting and standing
and incorporating walking and dancing activities.
Delivered by the physiotherapist, group exercise sessions
ran twice weekly for 12 months. Set to appropriate music,
groups consisted of a 5–10 minute warm up, a progressive
resistance exercise section lasting approximately 15 minutes,
where, based on the results of individual assessment,
participants used soft hand weights. These weights ranged
initially from 200 g to 1.0 kg and ankle weights from
0.5 kg to 1.5 kg. This was followed by a 15–20 minute
moderate intensity aerobic section and a 5–10 minute
cool down.
However, in general, the majority of groups were delivered
as Level 1 groups due to the needs of the participants
and to ensure safety, as often the groups were
large and delivered solely by the physiotherapist. In
some instances, however, mixed level groups were run
i.e. some residents stood to perform Level 2 exercises
whilst others continued at Level 1. This was only possible
if a member of staff from the home was available to assist
the physiotherapist.
As the intervention was designed as a whole home
approach, all residents, including non-study participants
could potentially be exposed to the intervention.
Consenting to attend the class was done informally,
reflecting best clinical practice. All residents were encouraged
to attend by the physiotherapists or home staff, who
gave them a brief description of the exercise intervention
at the beginning of each session. Residents could then give
consent and participate, or refuse to participate by leaving
the room, or request to leave the room or not do the
exercises [21]. Only data from those who consented
to take part in the OPERA study have been included
in this analysis.