The Effect of a Nordic Walking Group Training on the Physical and Mental Health of Older Adults Evacuated From Their Homes to Haifa- A Pilot Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 24
- 试验地点
- 2
- 主要终点
- Adherence (number of patients that attended training sessions during the intervention time and throughout 4 months post intervention)
研究概览
简要总结
Abstract:
The purpose of this pilot study is to examine the effect and feasibility of a Nordic walking group training intervention on the physical and mental health of older adults evacuated from their homes to Haifa.
Participants:
The study will include 31 participants aged 65 and over who are in stable health and have been cleared by their physician to participate in this NW program.
Intervention:
The intervention will consist of two 60-minute Nordic walking (NW) sessions per week for two months, 16 sessions in total. Participants will be provided with walking sticks to use during the sessions. The sessions will be led by certified health professionals (PT, RN), assisted by trained undergraduate and graduate physiotherapy students.
Outcomes:
The primary outcome will be endurance to the walking sessions, and average weekly and monthly number of steps, measured by a smartphone application. Secondary outcomes will include three physical tests: 30-second sit-to-stand test, 4-meter walk test and heel raise test.
mental health (PHQ-9 depression scale, GAD-7 anxiety scale, WHOQOL- BREF quality of life scale, PANAS short form positive and negative affect scale), and perceived global effect of the intervention.
Design:
The study will use a single-group pre-test/post-test design. Participants will be assessed at baseline, after two months of intervention, and at six months follow-up.
Data Analysis:
Data will be analyzed using descriptive statistics and mixed-effects linear regression models.
Significance:
This pilot study will provide valuable information on the feasibility and effect of this group NW intervention for older adults evacuated from their homes. The findings will be used to plan and design a larger longitudinal RCT.
详细描述
Introduction The outbreak of the Israeli-Hamas conflict on October 7, 2023, triggered widespread displacement, with over 115,000 Israelis evacuated, including 8685 individuals seeking refuge in Haifa. Among these evacuees, older adults face heightened health risks exacerbated, such as PTSD, depression and anxiety, by the trauma of displacement. Evacuation under the threat of war disturb normal living and leads towards a multitude of difficulties spanning various aspects of the evacuees' lives, including economic, environmental, physical and emotional well-being. Studies reveal that maintaining physical activity is crucial for reduction risk of cardiovascular mortality, cancer, recurrent falls, functional and mental decline and maintenance of well-being, yet it becomes challenging amidst the chaos of conflict and relocation.
The WHO recommends 150 minutes of weekly physical activity as a minimum to prevent common health disorders. However, older evacuees, having been displaced from their homes, may struggle to maintain an active lifestyle. After spending four months away from their natural environment, there is a pressing need to reintegrate them into physical activity routines to mitigate potential health risks. Due to the unclear future location of this population, it is important to provide them with the skills, and group support to empower them for sustainable independent walking for the long term.
Nordic walking (NW) is fitness walking with specifically designed poles and a learned technique to create a low stress, total body workout. NW has positive effects on mobility, rehabilitation, and general functioning. In older adults, NW was found effective in improving various age-related disorders: cardiovascular; metabolic; early Parkinson; obesity, and osteoarthritis. NW has also been shown to improve depression, mood, and quality of life.
NW has several biomechanical advantages over walking without poles: it increases gait speed, cardiovascular metabolism, and reduces lower limb and back loads. Increased exercise intensity and energy expenditure that are required in NW are advantageous for older adults to enhance muscle activation and strength. The poles' forward ambulation in NW induces longer steps, and a forceful foot takeoff facilitating higher intensity compared to walking without poles. This study aims to utilize NW benefits for regaining physical activity in a special population at these times of war- the older evacuees.
The proposed Nordic walking group training in Haifa seems to be the first to conduct such a program in Israeli evacuees, and if successful it could be implemented across the country.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
盲法说明
The assessor will be external, not part of the training team, to avoid bias due to trainer/therapist- training participant subjective biases.
Therefore there is assessor blinding but not to allocation as there is one arm.
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Participants in stable health and have been cleared by their doctor to participate in physical activity.
排除标准
- •Using an assisting device for walking
- •Any health condition that may prevent participants from doing physical activity according to their medical doctor.
- •Unstable gait with high risk of fall by subjective and physical assessment,
- •Dizziness, visual or hearing impairment that cannot be corrected.
结局指标
主要结局
Adherence (number of patients that attended training sessions during the intervention time and throughout 4 months post intervention)
时间窗: participation will be monitored during the 8 weeks of intervention. Follow up evaluation of independent walking throughout 4 months after intervention completion.
Adherence to the walking program: participation in the 16 trained sessions during the intervention, and adherence to 150min/week during follow up period of 4 months post intervention. Optimal adherence outcome will be up to 20% absence.
Steps count by a smartphone application.
时间窗: Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.
weakly and monthly average of steps count will be retrieved from the cellular application.
次要结局
- The Positive and Negative Affect Schedule (score in the questionnaire to assess mood)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- Patient Health Questionnaire (score in depression questionnaire to assess the risk of developing mental health problems)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- Generalized Anxiety Disorder (score in anxiety questionnaire to assess the risk of developing mental health problems)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- The World Health Organization quality of life assessment (score in the questionnaire to assess quality of life)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- Heel Raise Test (number of repetitions for measuring ankle plantarflexion strength)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- Two-minute walk test ( distance in meters for measuring functional endurance and gait performance)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- Global perceived effect (score in the questionnaire to assess perceived effect of the NW intervention)(immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
- 30 seconds Sit to stand test (number of repetitions for measuring lower limb strength and balance)(Baseline; immediately after intervention completion (week 8); 2,4 months post intervention follow-up.)
研究者
Hilla Sarig Bahat
Dr.
University of Haifa