Zeitschrift für Gerontologie und Geriatrie

, Volume 52, Issue 1, pp 61–67 | Cite as

Feasibility of the lifestyle integrated functional exercise concept in cognitively impaired geriatric rehabilitation patients

  • Nacera BelalaEmail author
  • Michael Schwenk
  • Anna Kroog
  • Clemens Becker
Original Contributions


Background and objective

Increasing numbers of cognitively impaired older persons are admitted for inpatient hospital treatment. Therefore, new approaches are needed to prevent a loss of mobility during hospital stays and improve outcomes of this vulnerable patient group. The lifestyle integrated functional exercise (LiFE) concept uses activities of daily living (ADL) situations as opportunities to improve balance and strength. A pilot study was performed to test the feasibility and acceptability of the LiFE exercises in a geriatric rehabilitation setting.

Methods and patients

A sample of 20 moderately cognitively impaired rehabilitation patients (mean age 84.5 years) tested the feasibility and acceptability of the LiFE exercises.


The testing resulted in floor effects for every tested exercise. Of the exercises two were too difficult for over the half of the participants, namely stepping over objects and walking on heels. In contrast, the sit to stand exercise was feasible for 95% of the patients. The frequency of floor effects for the remaining exercises varied between 20% and 40%.


In this group of moderately cognitively impaired rehabilitation patients the exercises were feasible mostly under supervised conditions and frequently included additional physical support. An adjustment of the LiFE exercises in this setting is required before a trial should be performed in the acute care setting.


Cognitive impairment Exercise program Feasibility study Functional decline Geriatrics 

Machbarkeit des Lifestyle-Integrated-Functional-Exercise-Konzeptes bei kognitiv eingeschränkten geriatrischen Rehabilitationspatienten


Hintergrund und Zielsetzung

Eine steigende Anzahl kognitiv beeinträchtigter älterer Menschen wird stationär aufgenommen. Daher werden neue Ansätze benötigt, um einen Verlust der Mobilität während des Krankenhausaufenthalts zu verhindern und die Outcomes dieser vulnerablen Patientengruppe zu verbessern. Das LiFE-Konzept („lifestyle integrated functional exercise“) verwendet Situationen der Aktivitäten des täglichen Lebens (ADL) als Gelegenheit zur Verbesserung des Gleichgewichts und der Kraft. Eine Pilotstudie wurde durchgeführt, um die Machbarkeit und Akzeptanz der LiFE-Übungen in der geriatrischen Rehabilitation zu testen.

Methodik und Patienten

Eine Stichprobe von 20 kognitiv mittelschwer beeinträchtigten Rehabilitationspatienten (84,5 Jahre) testete die Machbarkeit und Akzeptanz der LiFE Übungen.


Die Untersuchung ergab Bodeneffekte für jede getestete Übung. Zwei Übungen waren für über die Hälfte der Teilnehmer zu schwierig, nämlich „Steigen über Objekte“ und „Fersengang“. Im Gegensatz dazu war die „Sitz-zum-Stand“-Übung für 95 % der Patienten durchführbar. Die Häufigkeit der Bodeneffekte für die verbleibenden Übungen variierte zwischen 20 % und 40 %.


In dieser Gruppe kognitiv mittelschwer beeinträchtigter Rehabilitationspatienten waren die Übungen größtenteils unter supervidierten Bedingungen und häufig einschließlich zusätzlicher körperlicher Unterstützung durchführbar. Eine Anpassung der LiFE-Übungen in dieser Umgebung ist somit erforderlich, ehe eine Studie in der Akutstation durchgeführt werden kann.


Kognitive Beeinträchtigung Bewegungsprogramm Machbarkeitsstudie Funktionsverlust Geriatrie 



We thank Professor Lindy Clemson, Professor in Ageing and Occupational Therapy and Research Leader at the Faculty of Health Science, University of Sydney as well as the developer of the original LiFE program for supporting us in proof reading. This study was supported by a doctoral scholarship from the Robert Bosch Foundation (RBS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the RBS.

Compliance with ethical guidelines

Conflict of interest

N. Belala, M. Schwenk, A. Kroog and C. Becker declare that they have no competing interests.

All procedures performed in this study involving human participants were in accordance with the standards of the ethics committee of the University of Tübingen and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018
corrected publication August 2018

Authors and Affiliations

  1. 1.Network Aging ResearchHeidelberg UniversityHeidelbergGermany
  2. 2.Department of Geriatrics and Clinic for Geriatric RehabilitationRobert-Bosch-HospitalStuttgartGermany

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