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An exercise programme for community-dwelling, mobility-restricted and chronically ill older adults with structured support by the general practitioner’s practice (HOMEfit)

From feasibility to evaluation

Ein Bewegungsprogramm für zu Hause lebende, mobilitätseingeschränkte und chronisch kranke Ältere mit strukturierter Unterstützung durch die hausärztliche Praxis (HOMEfit)

Von der Machbarkeit zur Evaluation

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Abstract

Programmes containing health-enhancing physical exercise should be evaluated using standards that are just as rigorous as those required for drug development. In contrast to new medicines, exercise programmes are highly complex. This has to be taken into account when designing the research plan. In order to illustrate the development process of a “complex intervention”, we use the example of an exercise programme for community-dwelling, mobility-restricted and chronically ill older adults. Based on a framework for evaluation of complex interventions (Medical Research Council [MRC], UK), a research plan was set up containing the phases: development, feasibility, evaluation, implementation. The development phase resulted in the design of a home-based exercise programme in which the target group is approached and supported via their general practitioner and an exercise therapist. A feasibility study was performed. Three quantitative criteria for feasibility (adoption, safety, continuing participation) were statistically confirmed which permitted the decision to proceed with the research plan. So far, the MRC framework has proved to be valuable for the development of the new programme.

Zusammenfassung

Bewegungstherapeutische Programme sollten nach denselben Standards entwickelt und evaluiert werden wie Medikamente. Im Gegensatz zu neuen Medikamenten sind bewegungstherapeutische Programme allerdings in hohem Maße „komplex“, was bei der Erstellung des Forschungsplans berücksichtigt werden muss. Im vorliegenden Artikel wird der Entwicklungsprozess einer „komplexen Intervention“ anhand eines bewegungstherapeutischen Programms für zu Hause lebende, mobilitätseingeschränkte und chronisch kranke Ältere dargestellt. Basierend auf einem Evaluationsmodell für komplexe Interventionen des Medical Research Council (MRC, UK) wurde ein Forschungsplan aufgestellt, der die Phasen Entwicklung, Machbarkeit, Evaluation und Implementation beinhaltet. Die Entwicklungsphase resultierte in einem Heimübungsprogramm, bei dem die Zielgruppe über eine Kooperation zwischen Hausärzt(inn)en und Bewegungstherapeut(inn)en erreicht und unterstützt wird. In einer Machbarkeitsstudie wurden drei quantitative Machbarkeitskriterien (Annahme, Sicherheit, anhaltende Teilnahme) statistisch bestätigt. Dies erlaubte die Entscheidung, in die nächste Phase des Forschungsplans überzugehen. Bislang hat sich das Modell des MRC als nützlich und wertvoll für den Entwicklungs- und Evaluationsprozess des neuen Programms herausgestellt.

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Acknowledgments

The HOMEfit project (http://www.rub.de/homefit) is funded by the German Federal Ministry of Education and Research (01ET0720 and 01ET1005 A) within the research cooperation PRISCUS (‘Prerequisites for a new health care model for elderly people with multimorbidity’; http://www.priscus.net).

Conflict of interest

The corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Sports Medicine and Sports Nutrition, University of Bochum, Bochum, Germany

    T. Hinrichs, C. Bucchi, A. Moschny & P. Platen

  2. Institute of Sport and Exercise Science, University of Muenster, Muenster, Germany

    M. Brach

  3. Institute of General Practice and Family Medicine, University of Witten/Herdecke, Witten, Germany

    S. Wilm

  4. Department of Medical Informatics, Biometry and Epidemiology, University of Bochum, Bochum, Germany

    U. Thiem

  5. Department of Geriatrics, University of Bochum, Marienhospital Herne, 44627, Herne, Germany

    U. Thiem

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  1. T. Hinrichs
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  2. M. Brach
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  3. C. Bucchi
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  4. A. Moschny
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  5. S. Wilm
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  6. U. Thiem
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  7. P. Platen
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Correspondence to U. Thiem.

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Hinrichs, T., Brach, M., Bucchi, C. et al. An exercise programme for community-dwelling, mobility-restricted and chronically ill older adults with structured support by the general practitioner’s practice (HOMEfit). Z Gerontol Geriat 46, 56–63 (2013). https://doi.org/10.1007/s00391-012-0329-z

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  • DOI: https://doi.org/10.1007/s00391-012-0329-z

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