Should Structured Exercise Be Promoted As a Model of Care? Dissemination of the Department of Veterans Affairs Gerofit Program.

Autor: Morey MC; Geriatric Research, Education, and Clinical Center, Veterans Affairs Health Care System, Durham, North Carolina.; Center for the Study of Aging/Claude D. Pepper Older Americans Independence Center, Department of Medicine, Duke University Medical Center, Durham, North Carolina., Lee CC; Geriatric Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.; David Geffen School of Medicine, University of California, Los Angeles, California., Castle S; Geriatric Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.; David Geffen School of Medicine, University of California, Los Angeles, California., Valencia WM; Geriatric Research, Education, and Clinical Center, Miami Healthcare System, Miami, Florida.; University of Miami, Miller School of Medicine, Miami, Florida., Katzel L; Geriatric Research, Education and Clinical Center, Veterans Affairs Maryland Health Care System, Baltimore, Maryland.; School of Medicine, University of Maryland, Baltimore, Maryland., Giffuni J; Geriatric Research, Education and Clinical Center, Veterans Affairs Maryland Health Care System, Baltimore, Maryland., Kopp T; Veterans Affairs Medical Center, Canandaigua, New York., Cammarata H; Veterans Affairs Medical Center, Canandaigua, New York., McDonald M; Geriatric Rehabilitation and Clinical Center, Veterans Affairs Pacific Health Care System, Honolulu, Hawaii., Oursler KA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salem, Virginia., Wamsley T; Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salem, Virginia., Jain C; Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salem, Virginia., Bettger JP; Department of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina., Pearson M; Geriatric Research, Education, and Clinical Center, Veterans Affairs Health Care System, Durham, North Carolina., Manning KM; Geriatric Research, Education, and Clinical Center, Veterans Affairs Health Care System, Durham, North Carolina., Intrator O; Geriatrics and Extended Care Data and Analysis Center, Veterans Affairs Medical Center, Canandaigua, New York.; University of Rochester Medical Center, Rochester, New York., Veazie P; Geriatrics and Extended Care Data and Analysis Center, Veterans Affairs Medical Center, Canandaigua, New York.; University of Rochester Medical Center, Rochester, New York., Sloane R; Center for the Study of Aging/Claude D. Pepper Older Americans Independence Center, Department of Medicine, Duke University Medical Center, Durham, North Carolina., Li J; Geriatrics and Extended Care Data and Analysis Center, Veterans Affairs Medical Center, Canandaigua, New York.; University of Rochester Medical Center, Rochester, New York., Parker DC; Geriatric Research, Education, and Clinical Center, Veterans Affairs Health Care System, Durham, North Carolina.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2018 May; Vol. 66 (5), pp. 1009-1016. Date of Electronic Publication: 2018 Feb 12.
DOI: 10.1111/jgs.15276
Abstrakt: Exercise provides a wide range of health-promoting benefits, but support is limited for clinical programs that use exercise as a means of health promotion. This stands in contrast to restorative or rehabilitative exercise, which is considered an essential medical service. We propose that there is a place for ongoing, structured wellness and health promotion programs, with exercise as the primary therapeutic focus. Such programs have long-lasting health benefits, are easily implementable, and are associated with high levels of participant satisfaction. We describe the dissemination and implementation of a long-standing exercise and health promotion program, Gerofit, for which significant gains in physical function that have been maintained over 5 years of follow-up, improvements in well-being, and a 10-year 25% survival benefit among program adherents have been documented. The program has been replicated at 6 Veterans Affairs Medical Centers. The pooled characteristics of enrolled participants (n = 691) demonstrate substantial baseline functional impairment (usual gait speed 1.05 ± 0.3 m/s, 8-foot up and go 8.7 ± 6.7 seconds, 30-second chair stands 10.7 ± 5.1, 6-minute walk distance 404.31 ± 141.9 m), highlighting the need for such programs. Change scores over baseline for 3, 6, and 12 months of follow-up are clinically and statistically significant (P < .05 all measures) and replicate findings from the parent program. Patient satisfaction ratings of high ranged from 88% to 94%. We describe the implementation process and present 1-year outcomes. We suggest that such programs be considered essential elements of healthcare systems.
(© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)
Databáze: MEDLINE
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