Evidence map›Paper›PMID 37461117›Full record

ArticlePilot and feasibility studies2023

The Geras virtual frailty rehabilitation program to build resilience in older adults with frailty during COVID-19: a randomized feasibility trial.

Chinenye Okpara, George Ioannidis, Lehana Thabane, Jonathan Derrick Adachi, Alexander Rabinovich, Patricia Hewston, Justin Lee, Caitlin McArthur, Courtney Kennedy, Tricia Woo and 15 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pilot and feasibility studies, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04500366 (GERAS Frailty Rehabilitation at Home), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04500366 nacompletednot on this map

GERAS Frailty Rehabilitation at Home: Virtual Bundled Care for Seniors Who Are Frail to Build Strength and Resilience During COVID-19

TypeinterventionalSponsorMcMaster UniversityRan2020 to 2021Enrolled70ConditionsFrailtyArmsSocialization, Virtual Group Exercise, Nutrition Consult and Protein Supplementation, Medication Review
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 7 institutions in 2 countries.

Chinenye OkparaDepartment of Health Research Methodology, Evidence and Impact, McMaster University, Hamilton, ON, Canada. okparc1@mcmaster.ca.ORCID http://orcid.org/0000-0002-8859-7942
George IoannidisDepartment of Health Research Methodology, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Health Research Methodology, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Jonathan Derrick AdachiDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Alexander RabinovichDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Patricia HewstonGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Justin LeeGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Caitlin McArthurGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Courtney KennedyGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Tricia WooGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Pauline BoulosDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Raja BobbaDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Mimi WangDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Samuel ThrallDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Derelie ManginDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
Sharon MarrDepartment of Medicine, University of Toronto, Hamilton, ON, Canada.
David ArmstrongDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Christopher PattersonDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Steven BrayDepartment of Kinesiology, McMaster University, Hamilton, ON, Canada.
Kerstin de WitDepartment of Emergency Medicine, Queen's University, Kingston, ON, Canada.
Shyam MaharajDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Brian MisiaszekDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Jessica Belgrave SookhooGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Karen ThompsonGeras Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada.
Alexandra PapaioannouDepartment of Health Research Methodology, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
McMaster University · CAHamilton Health Sciences · CAImpact · CADalhousie University · CAQueen's University · CAUniversity of Johannesburg · ZAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Coronavirus (COVID-19) pandemic has exacerbated the risk for poor physical and mental health outcomes among vulnerable older adults. Multicomponent interventions could potentially prevent or reduce the risk of becoming frail; however, there is limited evidence about utilizing alternative modes of delivery where access to in-person care may be challenging. This randomized feasibility trial aimed to understand how a multicomponent rehabilitation program can be delivered remotely to vulnerable older adults with frailty during the pandemic.

methodsParticipants were randomized to either a multimodal or socialization arm. Over a 12-week intervention period, the multimodal group received virtual care at home, which included twice-weekly exercise in small group physiotherapy-led live-streamed sessions, nutrition counselling and protein supplementation, medication consultation via a videoconference app, and once-weekly phone calls from student volunteers, while the socialization group received only once-weekly phone calls from the volunteers. The RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework was used to evaluate the feasibility of the program. The main clinical outcomes were change in the 5-times sit-to-stand test (5 × STS) and Depression, Anxiety and Stress Scale (DASS-21) scores. The feasibility outcomes were analyzed using descriptive statistics and expressed as frequencies and mean percent with corresponding confidence intervals (CI). Analysis of covariance (ANCOVA) was used for the effectiveness component.

resultsThe program enrolled 33% (n = 72) of referrals to the study (n = 220), of whom 70 were randomized. Adoption rates from different referral sources were community self-referrals (60%), community organizations (33%), and healthcare providers (25%). At the provider level, implementation rates varied from 75 to 100% for different aspects of program delivery. Participant's adherence levels included virtual exercise sessions 81% (95% CI: 75-88%), home-based exercise 50% (95% CI: 38-62%), protein supplements consumption 68% (95% CI: 55-80%), and medication optimization 38% (95% CI: 21-59%). Most participants (85%) were satisfied with the program. There were no significant changes in clinical outcomes between the two arms.

conclusionThe GERAS virtual frailty rehabilitation study for community-dwelling older adults living with frailty was feasible in terms of reach of participants, adoption across referral settings, adherence to implementation, and participant's intention to maintain the program. This program could be feasibly delivered to improve access to socially isolated older adults where barriers to in-person participation exist. However, trials with larger samples and longer follow-up are required to demonstrate effectiveness and sustained behavior change.

trial registrationClinicalTrials.gov NCT04500366. Registered August 5, 2020, https://clinicaltrials.gov/ct2/show/NCT04500366.

Indexed as

COVID-19Feasibility studiesFrailtyOlder adultsVirtual rehabilitation

Identifiers

PMID37461117
PMCPMC10351184
OpenAlexW4384524944

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.