Should Structured Exercise Be Promoted As a Model of Care? Dissemination of the Department of Veterans Affairs Gerofit Program

• Autores: Miriam C. Morey, Cathy C. Lee-, Steven Castle, Willy M. Valencia, Leslie I. Katzel, Jamie Giffuni, Teresa Kopp, Heather Cammarata, Michelle McDonald, Kris A. Oursler, Timothy Wamsley, Chani Jain, Janet P. Bettger, Megan P. Pearson, Kenneth M. Manning, Orna Intrator, Peter Veazie, Richard Sloane, Jiejin Li, Daniel C. Parker
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 66, Nº. 5, 2018, págs. 1009-1016
• Idioma: inglés
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• Resumen

  • Exercise provides a wide range of health‐promoting benefits, but support is limited for clinical programs that use exercise as a means of health promotion. This stands in contrast to restorative or rehabilitative exercise, which is considered an essential medical service. We propose that there is a place for ongoing, structured wellness and health promotion programs, with exercise as the primary therapeutic focus. Such programs have long‐lasting health benefits, are easily implementable, and are associated with high levels of participant satisfaction. We describe the dissemination and implementation of a long‐standing exercise and health promotion program, Gerofit, for which significant gains in physical function that have been maintained over 5 years of follow‐up, improvements in well‐being, and a 10‐year 25% survival benefit among program adherents have been documented. The program has been replicated at 6 Veterans Affairs Medical Centers. The pooled characteristics of enrolled participants (n = 691) demonstrate substantial baseline functional impairment (usual gait speed 1.05 ± 0.3 m/s, 8‐foot up and go 8.7 ± 6.7 seconds, 30‐second chair stands 10.7 ± 5.1, 6‐minute walk distance 404.31 ± 141.9 m), highlighting the need for such programs. Change scores over baseline for 3, 6, and 12 months of follow‐up are clinically and statistically significant (P < .05 all measures) and replicate findings from the parent program. Patient satisfaction ratings of high ranged from 88% to 94%. We describe the implementation process and present 1‐year outcomes. We suggest that such programs be considered essential elements of healthcare systems.