Should Structured Exercise Be Promoted As a Model of Care? Dissemination of the Department of Veterans Affairs Gerofit Program
| Autor: | Peter Veazie, Timothy R. Wamsley, Megan Pearson, Steven C. Castle, Chani Jain, Jiejin Li, Daniel C. Parker, Richard Sloane, Orna Intrator, Kris A. Oursler, Teresa Kopp, Heather Cammarata, Leslie I. Katzel, Catherine Lee, Willy Marcos Valencia, Kenneth Manning, Miriam C. Morey, Janet Prvu Bettger, Jamie Giffuni, Michelle McDonald |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Health Promotion 030204 cardiovascular system & hematology Health benefits Physical function Article 03 medical and health sciences 0302 clinical medicine Patient satisfaction Humans Medicine 030212 general & internal medicine Baseline (configuration management) Exercise Veterans Affairs Aged Veterans Aged 80 and over business.industry Walk distance Health Plan Implementation Organizational Innovation United States Walking Speed Gait speed United States Department of Veterans Affairs Health promotion Patient Satisfaction Physical therapy Female Geriatrics and Gerontology business |
| Zdroj: | Journal of the American Geriatrics Society. 66:1009-1016 |
| ISSN: | 1532-5415 0002-8614 |
| DOI: | 10.1111/jgs.15276 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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