Feasibility
cognitive impairment, dementia, fatigue, pain
ADVERSE EVENTS, EVENT, RECRUITMENT
The following criteria were used to determine the feasibility of the program: recruitment (% approached who agreed to participate), completion of the intervention (retention), attendance, overall adherence, dropout rate, adverse events (falls, muscle/joint pain), any modification in the exercise program delivery (optimisation of program structure) and supervision needs of the participants. High variability (25.5%-84%) has been reported in studies for adherence to exercise intervention in people with dementia in aged-care settings [Safety was assessed as follows: any falls (defined as an event when the participant ‘inadvertently comes to rest on the ground, floor or other lower level’ (WHO Global Report on Falls Prevention in Older Age [Physical activity program optimisation / adaptations to the program structure were assessed by documenting any modifications to the method of delivery of the overall exercise program and/or individual exercise sessions (e.g. exercise length, session duration) due to safety concerns, and other reasons (e.g. mental or physical fatigue). During the maintenance phase (after completion of the formal supervised component, from 12 to 24-weeks post baseline), the exercise instructor/staff supervised the residents and encouraged them to be more independent and to gradually self-manage the way they used the equipment and exercise. Exercise behaviours of each participant were monitored and recorded by the exercise instructor and/or the aged care staff. Field notes (post session reflection notes) were completed by the research staff noting down any variations of the program, participant’s behaviour and any other relevant aspects identified by the staff.Supervision requirements were assessed via documenting the supervision ratio, which was reassessed regularly and adjusted if needed, based on discussion with the staff involved in the program delivery around safety and the need to guide and support residents. Due to the potential complexity of running an exercise program with people living with cognitive impairment and potential mobility problems (e.g., usage of walking aid), we aimed initially for one qualified instructor (Exercise Physiologist/Physiotherapist) and another supervisor (from the aged-care staff) with 3–4 participants for each supervised outdoors exercise park session.