TY - JOUR
T1 - Exercise testing and training in frail older adults with an orthopedic impairment participating in a geriatric rehabilitation program
T2 - an international Delphi study
AU - Groen, Wim G.
AU - Wattel, Elizabeth M.
AU - de Groot, Aafke J.
AU - Meiland, Franka J.M.
AU - Hertogh, Cees M.P.M.
AU - Gerrits, Karin H.L.
N1 - Funding Information: This research was funded by ZonMw (national funding body for medical research), (project number 839120007). Additional funding was provided by Gerion(educational institute for the training of elderly care physicians). Publisher Copyright: © 2023, The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - Background: Little is known about exercise testing and training in orthopedic geriatric rehabilitation. This study aims to obtain expert-consensus-based recommendations on this matter. Methods: Using an online Delphi study we aimed to reach international expert consensus on statements related to testing and training of endurance capacity and muscle strength. Participants needed to have relevant research or clinical expertise. Statements were evaluated and explanatory comments could be provided. After each round anonymous results were presented to participants. Statements could be adjusted or new ones could be formulated if necessary. Consensus was defined as > 75% of participants agreeing. Results: Thirty experts completed the first round. Twenty-eight (93%) the second and 25 (83%) completed the third round. The majority of experts were physical therapists. Consensus was reached on a total of 34 statements. The statements and comments reflected the need for a pragmatic and tailored approach in this population both for testing and training. For example, for testing endurance capacity, a 6 Minute walk test was promoted and for testing muscle strength, performance in a functional activity was suggested. Ratings of perceived exertion were promoted for monitoring intensity of endurance and muscle strength training in patients without cognitive impairment. Conclusion: In orthopedic GR, endurance and muscle strength testing should be pragmatic and is preferably performed in functional activities. For endurance training existing guidelines of the American College of Sports Medicine can be strived for but adapted as needed and for muscle strength training only lower intensities are agreed upon.
AB - Background: Little is known about exercise testing and training in orthopedic geriatric rehabilitation. This study aims to obtain expert-consensus-based recommendations on this matter. Methods: Using an online Delphi study we aimed to reach international expert consensus on statements related to testing and training of endurance capacity and muscle strength. Participants needed to have relevant research or clinical expertise. Statements were evaluated and explanatory comments could be provided. After each round anonymous results were presented to participants. Statements could be adjusted or new ones could be formulated if necessary. Consensus was defined as > 75% of participants agreeing. Results: Thirty experts completed the first round. Twenty-eight (93%) the second and 25 (83%) completed the third round. The majority of experts were physical therapists. Consensus was reached on a total of 34 statements. The statements and comments reflected the need for a pragmatic and tailored approach in this population both for testing and training. For example, for testing endurance capacity, a 6 Minute walk test was promoted and for testing muscle strength, performance in a functional activity was suggested. Ratings of perceived exertion were promoted for monitoring intensity of endurance and muscle strength training in patients without cognitive impairment. Conclusion: In orthopedic GR, endurance and muscle strength testing should be pragmatic and is preferably performed in functional activities. For endurance training existing guidelines of the American College of Sports Medicine can be strived for but adapted as needed and for muscle strength training only lower intensities are agreed upon.
KW - Delphi study
KW - Exercise
KW - Fractures
KW - Geriatric rehabilitation
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U2 - https://doi.org/10.1007/s41999-023-00819-5
DO - https://doi.org/10.1007/s41999-023-00819-5
M3 - Article
C2 - 37400662
SN - 1878-7649
VL - 14
SP - 985
EP - 997
JO - European Geriatric Medicine
JF - European Geriatric Medicine
IS - 5
ER -