The importance of participating in regular exercise regardless of age is now widely recognised and well supported by research [1, 2]. A strength and balance program termed Agestrong already exists at many sites across Peninsula Health. Given the popularity of Agestrong and the low rate (20%) of local Residential Aged Care Facilities (RACFs) who offer exercise programs, we hypothesised that Agestrong would be suitable in this setting.

Thirty-eight low level RACFs were invited to participate and 11 accepted. Nine successfully continued exercise classes for three months (Fig 2). An average of 10 residents (range 4-20) attended these classes (Fig 3) and reported enjoyment and benefit from the exercise. Barriers identified by unwilling facilities included lack of financial support and commitment from management.

The Agestrong Unit in partnership with the Residential Outreach Support Service (ROSS) at Peninsula Health sought interest from local low level RACFs. Uptake, implementation and evaluation data was collected from October 2007 until June 2008.

The process is summarised under Figure 1.

We would like to express our gratitude to the Peninsula

GP network (Aged Care Stream) for their support and to

the participating facilities.

The aim of this study was to determine level of interest for introducing Agestrong programs into local low level RACFs and the feasibility of doing so.

Introduction

Aim

Methods Conclusion

Acknowledgements

Alvin Tang Physiotherapist

Residential Outreach Support Service

(ROSS)

Caroline Stapleton (Physiotherapist and Agestrong

Network Coordinator)

Leonie Oldmeadow (Physiotherapy Clinical Research Coordinator

Peninsula Health/Monash University)

References

1. Mazzeo, RS. Cavanagh, P, Evans et al. J. American College of Sports Medicine Position Stand: Exercise and physical activity for older adults. Med Sci Sports Ex 1998; 30 (6): 992-1008

2. Capodaglio P, Capodaglio E, Facioli M, Saibene F. Long-term strength training for community-dwelling people over 75: impact on muscle function, functional ability and life style. Eur J Appl Physiol 2007; 100(5):535-542

Results

Figure 1: Agestrong Implementation Program

Step 1: Development of RCF Agestrong Package

•  Partnership between ROSS Team and Agestrong Network. •  Modification of community Agestrong exercise program •  Development of a train-the-trainer model

The exercise program •  standardised resistance exercise program •  individually tailored •  progressed as able •  led by trained staff

Step 2 : Recruitment and Training of staff

•  Training provided to staff from low level RACFs (nurses, personal care assistants, or diversional therapists). •  Training program:

  Structure of the program   Referral and documentation   Conducting the exercise class   Basic physiology of exercises

Step 3: Implementation

•  Staff given a period of time to set up program. •  Support from ROSS Team includes both onsite and off site support and trouble-shooting session (at least once yearly). •  Feedback obtained via questionnaires and local site interviews.

Step 4: evaluation and future plans

•  Further research regarding barriers to uptake •  Extend program to new sites •  Continuous audit review regarding quality and quantity of exercise uptake in local residential aged care facilities (RACFs).

Figure 2: Low level Aged Care Facilities (Hostels): numbers and commitment to exercise program

While initial interest was low, our results demonstrate that Agestrong was welcome, incorporated and sustained by a small number of facilities and wider interest has now been received. Further research is needed to determine the measurable benefits of regular exercise in this frail and functionally compromised population in order to persuade stakeholders and providers.

Introducing Agestrong Exercise to Residential Aged Care:

A Feasibility Study

Figure 3: Average number of participants in Agesttong Classes for Week 1 and 12.

Picture 1: Residents doing upper limb exercises with weights under the guidance of a trained exercise leader in a RACF.

Picture 2: Residents progressing chair based exercise to normal standing exercise.