By Monique Ryan, Feros Care
The discovery that exercise therapy was considered the norm for community dwelling seniors, yet only passive physiotherapy was government funded for residents of aged care, led Feros Care physiotherapist Jennie Hewitt to run a four-year research trial through the University of Sydney.
“I was shocked that massage and electrical devices for pain relief were funded and yet therapeutic exercise programs were not,” Jennie said.
“I set out to find scientific evidence to dispute this approach and discovered there was very little resident-specific research available.”
Jennie wanted to change both the health funding structures and also attitudes about physiotherapy within aged care. She realised the best way to do this was to prove the value of strength and balance exercises using a clinical trial.
In 2012 Jennie began conducting a four-year cluster, randomised controlled trial into the effects of an individually prescribed, physiotherapist-directed exercise program on falls among residents in aged care facilities, versus usual care.
The study measured falls per person, as well as quality of life and mobility. A cost-effectiveness analysis will also be performed to inform policy makers.
“My personal buzz has been seeing groups of residents enjoying themselves, the pride in their faces, telling their families that they’re going to the gym for a workout. It’s that sort of intangible thing that has most motivated me,” Jennie said.
Eight residential aged care facilities were assigned to the exercise group while eight carried on as usual.
Participants in the exercise groups were assessed by a physiotherapist and prescribed an individualised progressive resistance training program using specialised gym equipment from HUR Australia.
“We can divulge that the exercise program has proven a statistically significant reduction in falls and improvement in mobility in the exercise group” - researcher Jennie Hewitt
They also performed a circuit of high-level balance exercises at each session. Classes were in groups of up to 10 participants and lasted one hour.
As well as falls-prevention, Jennie said that quality and enjoyment of life, and social participation, are also benefits of exercise for residents.
“We have had some great stories from the residents who joined the exercise programs. One of our participants is 93 years old and reported slipping on wet tiles: ‘I felt myself project forward suddenly but I just kept moving and felt the strength in my legs and abdomen, I saved myself! If it wasn’t for these exercises I’d have landed flat on my face’, the resident said.
“Another woman approached me at one of the villages in Sydney and said, ‘Thank you so much for what you have done for my mother with this gym program. She used to be in and out of hospital every month with falls, but she hasn’t fallen once in the six months since she started the program - it’s amazing!’”
All the data collected is currently being analysed and results from this trial will be submitted for peer review and publication in an international journal over the next few months."
“However, we can divulge that the exercise program has proven a statistically significant reduction in falls and improvement in mobility in the exercise group,” Jennie said.
“This evidence is timely, as the Aged Care Funding Instrument is currently under review.”
Jennie has been contacted by peak bodies to write best practice guidelines for physiotherapy for aged care residents. She presented the trial at the 2016 World Congress of Active Ageing.
“There’s no doubt that the study and the data collected are important to inform policy and make best practice recommendations, but the individual stories about lives changed…well they are priceless!”, she added.