Stand if You Can: A Standing Intervention in Long Term Care

Study Overview
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Brief Summary
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It is currently unknown if reducing sitting time, an activity that is highly prevalent in frail older adults living in long term care (LTC) facilities, is associated with an improvement in physical capacity such as walking speed. Simple tasks such as walking speed is associated with important outcomes for residents in LTC such as autonomy and hospitalization. The investigators hypothesize that standing an additional 100 minutes per week for 5 months will result in a clinically meaningful improvement in walking speed (0.1m/sec) in LTC residents compared to residents receiving a sitting social activity.

Detailed Description
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LTC facilities from Moncton and Fredericton will be recruited, with half of the LTC facilities randomized as the intervention and half as the control group. The investigators are aiming to enrol half of the LTC in Fredericton and half in Moncton. A total of 88 residents (44 in the control group, 44 in the intervention group) will be enrolled in the program.

Official Title
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Stand if You Can- A Randomized Control Trial

Conditions
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Frailty, Sedentary Behavior, Physical Disability

Intervention / Treatment
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* Behavioral: Standing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Resident at one of the selected LTC facilities; Able to provide consent or have a power of attorney agree on behalf of a resident to participate in the study; Able to walk for ten meters, with or without a walking aid; The main outcome is walking speed performed for a distance of 10 meters. Therefore, we want everyone who participates in the study to be able to complete the test at baseline. This way we can answer the main research question, while adhering to our sample size calculation. Exclusion Criteria: If Identified by staff at the facility as too high risk for falling by participating in the intervention.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Long term care (LTC) facilities will be recruited, with half of the LTC facilities randomized as the intervention (n=2) and half as the control group (n=2).
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Standing and Social Intervention<br>Participants be exposed to an additional 100 minutes of standing per week. Participants will do this by standing for 20 minutes Monday through Friday. | Behavioral: Standing<br>* Standing for an additional 100 minutes per week; 20 minutes Monday-Friday<br>|
| No Intervention: Control Group<br>Control group will receive social visits, but no exposure to standing | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Walking Speed | Measured by the 10m walking speed test | Pre and post intervention testing | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Balance | Measured by a portable device (Wii Balance board), which has sensors that detects sway . | Pre and post testing (following the 5 month intervention). Data was collected but investigators are still analyzing findings. | 
| Change in Leg Strength | Using hand-held dynamometer to quantify leg strength through knee extension | Pre-Post Testing (following the 5 month intervention) | 
| Change Lower Limb Power | Using the 30second sit-stand test following senior fitness test protocol | Pre-Post Testing (following the 5 month intervention) | 
| Change in Anxiety Symptoms | The Geriatric Anxiety Inventory (Scale 0-20). A low score means a better outcome. | Pre-Post Testing (following the 5 month intervention) | 
| Depression | Geriatric Depression Scale Short Form (0-15 scale). Lower score is better outcome. | Pre-Post Testing (following the 5 month intervention) | 
| Loneliness | Loneliness was measured using the UCLA Loneliness Scale (20-80). A low score indicates a better outcome | Pre-Post Testing (following the 5 month intervention) | 
| Fall Efficacy | Falls Efficacy Scale-International Questionnaire (16-64 scale). Low score indicates a better score | Pre-Post Testing (following the 5 month intervention) | 
| Rate of Falls | Falls, injuries due to falls and hospitalization will be collected at 3 timepoints | The number of falls will be collected from three timeframes: 1. Between 6 months prior to and the start of program 2. the duration of the program (5 months) 3. From the end of the program to 6 months follow up. Data is still being analyzed at this time. | 
| Metabolic Profile - Triglycerides | Capillary blood analyzed with a cardiochek device. Blood collected via a finger prick and analyzed with a cardiochek device. Note that Total Cholesterol, HDL, Triglycerides, LDL and Glucose were all measured using the cardiochek device. | Pre-Post Testing (before and following the 5 month intervention). | 
| Social Behaviours | Semi-structured interviews with residents (participants and non-participants), family members and staff will be administered at the end of the study | Pre-Post Testing (following the 5-month intervention). Data has been collected, but is still being analyzed | 
| Metabolic Profile - High Density Lipoprotein Cholesterol | High Density Lipoprotein (HDL) cholesterol was analyzed using the CardioChek Professional Analyzer system (PTS Diagnostics, Whitestown, Indiana, USA). A finger prick was conducted using a single use lancet and approximately 60 µL of whole blood was collected for this test. | Pre and post testing (before and after the 5-month intervention) | 
| Metabolic Profile - Low Density Lipoprotein Cholesterol | Low-density lipoprotein was assessed using a CardioChek Professional Analyzer system (PTS Diagnostics, Whitestown, Indiana, USA). | Pre-Post intervention (before and after 5-month intervention) | 
| Metabolic Profile - Blood Glucose | Fasted blood glucose was analyzed using a CardioChek Professional Analyzer system (PTS Diagnostics, Whitestown, Indiana, USA). | Pre-Post Intervention (before and after 5-month intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Long Term Care, Physical Function