Walking Intervention for Cognitive Impairment
(OASIS Trial)
Recruiting in Palo Alto (17 mi)
+1 other location
Overseen byKatherine S McGilton, PhD
Age: 65+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University Health Network, Toronto
Disqualifiers: Palliative
No Placebo Group
Trial Summary
What is the purpose of this trial?The goal of this intervention study is to test the effects of a nurse-led mobility intervention (known as the OASIS Walking Intervention (Older Adults performing Sit to Stands and Walking Intervention)) in older adults with cognitive impairment, such as dementia, in transitional care programs.
The main questions this study aims to answer are:
* Is the study doable and are older adults satisfied with the intervention?
* Does the intervention improve older adults' muscle strength, mobility, functional status and quality of life?
Participants will be asked to do the following:
1. Be interviewed once so that a patient-centred communication care plan can be made
2. Do sit to stand activity
3. Walk as part of a walking program.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the OASIS Walking Intervention treatment for cognitive impairment?
Research shows that walking programs can help maintain or improve daily activities and slow cognitive decline in people with Alzheimer's and mild cognitive impairment. A study found that a six-month walking program improved daily activities and slowed cognitive decline in Alzheimer's patients, suggesting that regular walking may benefit those with cognitive challenges.
12345Is the Walking Intervention for Cognitive Impairment safe for humans?
Research shows that walking interventions, including those using virtual reality or prompting devices, are generally safe for older adults with cognitive impairments. Studies found no major adverse events, and participants were able to complete the programs successfully.
16789How is the OASIS Walking Intervention treatment different from other treatments for cognitive impairment?
The OASIS Walking Intervention is unique because it focuses on a structured walking program to help maintain cognitive function and daily living activities in people with cognitive impairment, unlike other treatments that may not emphasize physical activity. This approach is based on evidence that regular walking can improve mobility and slow cognitive decline, particularly in older adults with conditions like Alzheimer's disease.
124510Eligibility Criteria
This trial is for older adults aged 65 and over with cognitive impairments like dementia, who were living at home before hospitalization. They must be able to walk (with or without help), speak English, have a care partner willing to interview, and get clearance from both a physiotherapist and nurse practitioner.Inclusion Criteria
Were community-dwelling prior to hospitalization
Can speak English
I could walk by myself or with someone's help before I was admitted to the hospital.
+7 more
Exclusion Criteria
I have been diagnosed with Parkinson's disease.
Palliative (having <six months prognosis as documented in the medical chart)
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants engage in the OASIS Walking Intervention, which includes a Patient-Centered Communication Care Plan, Sit to Stand Activity, and Walking Program.
6 weeks for Long-term Care Stream or Rehab Stream; 3 weeks for Reactivation Stream
5 sessions per week
Follow-up
Participants are monitored for satisfaction, muscle strength, mobility, functional status, and quality of life after the intervention.
4 weeks
Participant Groups
The study tests the OASIS Walking Intervention which includes sit-to-stand exercises and walking programs led by nurses. It aims to see if this can improve muscle strength, mobility, functional status, and quality of life in cognitively impaired seniors.
2Treatment groups
Experimental Treatment
Group I: Reactivation Stream Intervention ArmExperimental Treatment1 Intervention
Intervention Dose: up to 45 minutes per session, five sessions per week, for 3 weeks. Approximately up to 30 minutes will be spent walking with the participant and up to 15 minutes will be spent performing the sit-to-stands.
Component 1: Patient-Centered Communication Care Plan. A patient-centered communication care plan will be created, to promote enjoyment and engagement during the sessions. The care plan will be informed by interviews with the participant and their care partner.
Component 2: Sit to Stand Activity. A target number of sit to stands per session will be determined based on a baseline assessment and according to an algorithm; the target will be progressed halfway into the intervention.
Component 3: Walking Program. Based on the findings from the patient-centered assessment interviews as well as the performance of the participants on a walk test at baseline (Time 1), an individualized walking program will be carried out with participants.
Group II: Long-term Care Stream or Rehab Stream Intervention ArmExperimental Treatment1 Intervention
Intervention Dose: Up to 45 minutes per session, 5 sessions per week, for 6 weeks. Approximately up to 30 minutes will be spent walking; up to 15 minutes will be spent performing sit-to-stands.
Intervention Components:
Component 1: Patient-Centered Communication Care Plan. A patient-centered communication care plan will be created, to promote enjoyment and engagement during the sessions. The care plan will be informed by interviews with the participant and their care partner.
Component 2: Sit to Stand Activity. A target number of sit to stands per session will be determined based on a baseline assessment and according to an algorithm; the target will be progressed halfway into the intervention.
Component 3: Walking Program. Based on the findings from the patient-centered assessment interviews as well as the performance of the participants on a walk test at baseline (Time 1), an individualized walking program will be carried out with participants.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Abbeylawn Retirement Home Transitional Care Unit (Operated by Bayshore Health Care)Pickering, Canada
Cedarbrook Lodge Retirement Home Transitional Care Unit (Operated by Bayshore Health Care)Scarborough, Canada
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Who Is Running the Clinical Trial?
University Health Network, TorontoLead Sponsor
Canadian Institutes of Health Research (CIHR)Collaborator
References
A Feasibility Study of a Multifaceted Walking Intervention to Maintain the Functional Mobility, Activities of Daily Living, and Quality of Life of Nursing Home Residents With Dementia. [2021]The aim of the study was to evaluate the feasibility, acceptability, and efficacy of a multifaceted walking intervention (MWI) aimed to maintain the functional mobility, activities of daily living function, and quality of life of long-term care home residents with dementia.
Interventions to Improve Gait in Older Adults with Cognitive Impairment: A Systematic Review. [2021]To review intervention programs that measure gait to investigate what features of the intervention may contribute to improving gait in older adults with cognitive impairment or dementia.
Adherence support strategies for exercise interventions in people with mild cognitive impairment and dementia: A systematic review. [2021]Exercise-based therapy may improve health status for people with Mild Cognitive Impairment (MCI) or dementia but cannot work without adherence, which has proven difficult. This review aimed to evaluate strategies to support adherence among people with MCI or Dementia and was completed in Nottingham/UK in 2017. A narrative synthesis was used to investigate the effectiveness or usefulness of adherence support strategies. Fifteen adherence support strategies were used including theoretical underpinning (programmes based on behavior change theories), individual tailoring, worksheets and exercise booklets, goal setting, phone calls or reminders, newsletters, support to overcome exercise barriers, information, adaptation periods, individual supervision, support for clinicians, group setting, music, accelerometers/pedometers and emphasis on enjoyable activities. Music was the only strategy that was investigated in a comparative design but was found to be effective only for those who were generally interested in participating in activities. A wide range of adherence support strategies are being included in exercise interventions for people with MCI or dementia, but the evidence regarding their effectiveness is limited.
Six-month walking program changes cognitive and ADL performance in patients with Alzheimer. [2022]Motor inactivity is typical in the later stages of Alzheimer's disease although there is evidence that physical exercise can reduce depression and enhance performance of daily activities. The aim of this study was to determine whether a walking program could reduce the functional and cognitive decline of elderly nursing home residents in the later stages of Alzheimer's disease. A total of 21 patients (84 ± 5 years) were randomly assigned to a walking program (WG) or to a control group (CG). A 6-minute walking test (6WT), the Barthel index of activities of daily living (ADLs), and Mini-Mental State Examination (MMSE) tests were performed before and after 24 weeks of the program. The WG showed significant improvement in the 6WT (20%) and ADLs (23%), while the CG decreased in MMSE (-47%), the WG had a slower decline (-13%). This study indicates that it is possible to stabilize the progressive cognitive dysfunctions in nursing home residents with Alzheimer's disease through a specific walking program.
Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment. [2019]This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty participants did not start a program; median attendance in the other 122 participants was 71%. Small but significant associations were observed between attendance and memory in the MI-WP and general cognition in the LI-AP. Associations were no longer significant when both groups were analyzed together. Intensity, assessed using percentage of heart-rate reserve and the Borg scale, equaled intended intensity for both programs. Aerobic fitness improved significantly in participants in the MI-WP. In conclusion, cognition was not clearly associated with attendance in the 62 participants starting the MI-WP, and average attendance was good. The intensity was feasible for participants who continued the MI-WP. The findings support the proposal that regular moderate-intensity walking improves aerobic fitness in adults with MCI.
The Use of Home-Based Nonimmersive Virtual Reality to Encourage Physical and Cognitive Exercise in People With Mild Cognitive Impairment: A Feasibility Study. [2022]Individuals with mild cognitive impairment are at risk of cognitive and physical decline. Virtual reality (VR) exercise may provide beneficial physical and cognitive exercise. The objectives of this study were to assess the feasibility and safety of home-based VR exercise and to provide pilot data for physical and cognitive efficacy. Eleven individuals with mild cognitive impairment (seven males/four females, average 78 years old, and average 3 years since diagnosis) performed a 30-min home-based VR exercise program 5 days a week for 6 weeks. The VR platform was successfully installed in participants' homes, and all participants were able to learn the VR program and progress. Participants completed 99% of the prescribed exercise. There were no major adverse events. Most participants enjoyed the VR program and reported physical benefits; fewer reported cognitive benefits. No physical or cognitive outcome measures showed change after 6 weeks. Home-based VR exercise is safe and feasible in individuals with mild cognitive impairment.
Physical inactivity in older adults with cognitive impairment without dementia: room for improvement. [2023]Persons with cognitive impairment without dementia are at high risk of adverse health outcomes. Tailored intervention targeting moderate-vigorous physical activity (MVPA) may reduce these risks.
Home-based exercise program for older adults with Motoric Cognitive Risk syndrome: feasibility study. [2021]Aim: We developed a home-based goal-directed exercise program with telephonic coaching to overcome barriers to exercise participation in cognitively impaired older adults. Methods: Six patients with Motoric Cognitive Risk syndrome at high risk for dementia were enrolled, three assigned to goal-directed exercises and three to stretching exercises. All participants underwent an in-person training session followed by a session at home with a telephonic coach. Sessions were supervised by a physiatrist, and exercise programs were personalized. Results: In-person training and remote telephonic coaching support promoted adherence. There were no adverse effects and interventions were rated highly. Participant and logistical barriers were identified that can inform design of home-based clinical trials. Conclusion: Home-based exercises are safe and feasible in older adults with Motoric Cognitive Risk.
REducing SEDENTary Behavior Among Mild to Moderate Cognitively Impaired Assisted Living Residents: A Pilot Randomized Controlled Trial (RESEDENT Study). [2022]Older adults in assisted living spend most of their day in sedentary behaviors, which may be detrimental to cognitive function. The primary purpose of this pilot study was to assess the feasibility of using a prompting device to reduce sitting time with light walking among older adults with mild to moderate cognitive impairment residing in an assisted living setting. A secondary purpose was to examine the effectiveness of the intervention on the residents' cognitive function, physical function, and quality of life. The participants (n = 25, mean age = 86.7 [5.3] years) were assigned in clusters into a two-arm 10-week single-site pilot randomized controlled trial. The intervention group was prompted with a watch to interrupt sedentary behaviors and partake in 10 min of light physical activity (i.e., walking) three times a day after a meal. The assessments included hip-worn accelerometers (Actical) and diaries, the Alzheimer's disease assessment scale-cognitive, Timed Up and Go, and the short-form 36 health survey. Adherence was high, as there were no dropouts, and over 70% of the participants completed over 80% of the prescribed physical activity bouts. Significant effects favoring the intervention were shown for all outcomes.
Effect of a multifactorial interdisciplinary intervention on mobility-related disability in frail older people: randomised controlled trial. [2022]Interventions that enhance mobility in frail older people are needed to maintain health and independence, yet definitive evidence of effective interventions is lacking. Our objective was to assess the impact of a multifactorial intervention on mobility-related disability in frail older people.