Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels

<p>Abstract</p> <p>Background</p> <p>There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial.</p> <p>Methods</p> <p>The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and after one year) (OIL). Secondary outcome was measured by sensorimotor tests and care-related assessments in the beginning and every 16 weeks (ISL), by qualitative outcome descriptions 12 months after group implementation (OIL) and by analysis of media response and structured interviews with stakeholders, also after 12 months (PCL).</p> <p>Conclusion</p> <p>Exemplarily, preventive exercise has been established for a neglected target population. The multi-level approach used here seems to be helpful to overcome institutional and individual (attitude) barriers.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN55213782</p

Innovative Computer Technology in music based interventions for individuals with autism - Moving beyond traditional interactive music therapy techniques

Individuals with autism spectrum disorder (ASD) who exhibit developmental lim- itations in social-emotional interaction and communication, are widely reported to respond positively to music therapy interventions that incorporate active and im- provisational techniques. The fundamental elements of music have been shown to bypass both cognitive and language impairments to help facilitate communication skills, form social relationships and promote cognitive progression. In recent years, computer technologies such as mobile devices and interactive motion capture systems are being developed to provide new approaches to music interaction. When included into new or existing music interventions, digital technology can enhance the music playing experience and motivate children to interact differently with their environ- ment through providing novel and engaging approaches to music interaction and creativity. This review highlights the core symptoms of ASD and presents evidence that supports the use of music therapy techniques within the autistic population, underpinned by neurological studies reporting on benefits of musical intervention. Further to this, it is explained how new technologies such as mobile devices and multi-sensory computer systems can move beyond traditional music instruments to add additional dimensions to music therapy sessions. Finally suggestions of future research are made alongside considerations in designing new and novel auditory interventions