Journal of Multidisciplinary Healthcare (Mar 2024)
Four-Step Co-Designing of the Reablement Strategies Targeting Sarcopenia (ReStart-S): An Exercise-Based Multicomponent Program for Older Adults Residing in Long-Term Care Settings
Abstract
Prabal Kumar,1 Shashikiran Umakanth,2 Emanuele Marzetti,3,4 Sanjay Kalra,5,6 Girish N1 1Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India; 2Department of Medicine, Dr. TMA Pai Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India; 3Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy; 4Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica Del Sacro Cuore, Rome, Italy; 5Department of Endocrinology, Bharti Hospital, Karnal, India; 6University Center for Research & Development, Chandigarh University, Mohali, IndiaCorrespondence: Girish N, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India, Tel +91 9886782114, Email [email protected]; [email protected]: The prevalence of sarcopenia is concerningly high in long-term care settings (LTCS); yet, no exercise programs specifically targeting older adults living in residential care are available.Objective: The goal of the present study was to co-design and validate a program named Reablement Strategies targeting Sarcopenia (ReStart-S) for older long-term care residents.Design: Cross-sectional study with an exploratory phase.Settings: LTCS in Udupi, Karnataka, India.Participants: Sarcopenic older adults diagnosed using Asian Working Group for Sarcopenia 2019 criteria.Material and Methods: The program was designed using a four-step intervention mapping technique involving systematic progression after completing each step. The steps included 1) identifying the appropriate exercise-based intervention for sarcopenia, 2) determining objectives and expected outcomes, 3) seeking expert views through a Delphi consensus approach, and 4) assessing the feasibility of ReStart-S program among older adults living in LTCS.Results: A comprehensive literature review appraised existing exercise programs for managing sarcopenia. A workshop held with six older adults and one caretaker, decided on morning exercise sessions, recommended 2– 7 days/week. The results of the review and workshop were compiled for the Delphi process that had seven experts from 5 countries, achieving a 71% response rate after four rounds. In the last step, a pilot study on eight LTCS residents, two males and six females with a mean age of 78.3 ± 8.3 years, was conducted and the program was found to be feasible.Conclusion: The ReStart-S program for managing sarcopenia among older adults residing in LTCS incorporates evidence from the literature and the engagement of older adults, caregivers, and experts, making it a contextually appropriate intervention. Our study also provides researchers and healthcare professionals insight into co-designing an intervention program for vulnerable older adults. Finally, the program evaluation indicates that a full-scale trial testing the efficacy of the ReStart-S program is feasible.Keywords: reablement, sarcopenia, intervention mapping, older adults, long-term care settings
