Home Exercise Program for Homebound Older Adults

NCT04034888 | Completed DMC

• 1 other identifier: UMaryland
• Study Type: interventional
• Target: 19
• Locations: 1 country
• Sites: 1

Brief Summary

Exercise can be beneficial for older adults by promoting health, delaying or reversing functional decline, reducing chronic disease risk, decreasing falls, increasing strength and stamina, improving ability to perform activities of daily living (ADL), and improving overall quality of life (QOL). Developing and implementing exercise programs for homebound older adults for whom traveling to routine clinic-based appointments may not be feasible or safe becomes critical. Homebound, older adults are at increased risk for recurrent hospitalization, use of emergency care, nursing home placement, and death. Indeed, one study shows patients had significantly higher risk of being admitted into a hospital or nursing home, higher mortality, and higher health care expenditures compared to those in a comparison group. The purpose of this pilot is to develop and implement a pragmatic and feasible intervention to improve physical functioning in older homebound adults with chronic mobility disability. Unfortunately, little is known about the feasibility and utility of pragmatic home-based exercise rehabilitation in older adults with severe mobility limitations. The investigators propose to develop and implement an intervention targeting functional limitations in this population with mobility disability. Our overall goals are to maintain and restore physical functioning and QOL for older, homebound adults. This research carries direct benefits for these patients as even modest improvements in disabled older adults may translate into significantly better QOL, reduce disability, minimize or reverse gradual declines related to serious chronic disease, resort functional independence, and increase community living capacity. Thus, the specified objectives of finalizing and implementing a sustainable home-based exercise program have practical implications for disabled older adults. Were homebound patients even slightly higher in terms of functional capacity, it could provide a partial degree of functional independence, impacting QOL for both patients and caregivers.

Conditions

Aging

Outcome Measures

Primary Outcomes (1)

• Change in Short Physical Performance Battery

  captures domains of strength, endurance, and balance and is highly predictive of disability. The SPPB score is based on timed measures of standing balance, walking speed, and ability to rise from a chair.

  Baseline, 6 weeks, 12 weeks

Secondary Outcomes (4)

• Change in 30-second sit-to-stand test

  Baseline, 6 weeks, 12-weeks

• Change in 30-second arm curl test

  Baseline, 6 weeks, 12-weeks

• Change in Grip Strength

  Baseline, 6 weeks, 12 weeks

• Change in Lower Extremity Strength

  Baseline, 6 weeks, 12 weeks

Other Outcomes (5)

• Change in Mobility

  Baseline, 6 weeks, 12 weeks

• Change in Barthel Index of Activities of Daily Living

  Baseline, 6 weeks, 12 weeks

• Change in Life Space Activity (LAS)

  Baseline, 6 weeks, 12 weeks

Study Arms (1)

Home Exercise Program (HEX)

EXPERIMENTAL

Customized home exercise program

Behavioral: HEX

Interventions

HEX BEHAVIORAL

HEX is a customized exercise program with components including: 1) controlled flexibility movements; 2) progressive ADL training focusing on bed mobility, bed to chair transfers, and indoor walking; 3) task-specific seated resistance training to improve ability to get out of bed and; 4) and balance exercises. Participants will be expected to perform their HEX program at least 2 times/week in their home and all individualized exercise sessions will be supervised by an Exercise Physiologist. Each exercise has four levels of difficulty, which will be progressed as tolerated throughout the 12-weeks. Seated resistance exercises were designed to target all the major muscle groups and will include the following: arm curls, shoulder raises (lateral/front), overhead arm raise, wrist curls, leg extensions, hip flexion, hip ab/adduction, sit-to-stands, torso rotation, and marching.

Home Exercise Program (HEX)

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Veteran enrolled in the Veterans Administration Medical Health Care System's Home- Based Primary Care Program
• Aged 65 years or older

You may not qualify if:

• Paraplegia
• Life expectancy of less than 12 months
• Currently engaged in a physical therapy program
• Any medical condition(s) or contraindications precluding patient participation in the study as per medical judgement of study team

Sponsors & Collaborators

• University of Maryland, Baltimore: lead

Study Sites (1)

University of Maryland

Baltimore, Maryland, 21201, United States

Location

Study Officials

• Alyssa Stookey, PhD

  University of Maryland School of Medicine and Baltimore VA Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Health Scientist (GRECC), Research Associate (SOM)

Study Record Dates

• First Submitted: July 16, 2019
• First Posted: July 26, 2019
• Study Start: February 1, 2020
• Primary Completion: May 30, 2024
• Study Completion: May 30, 2024
• Last Updated: December 4, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)