Integrating Reminiscence Technology Into Exercise Programs in Subacute Care

Study Overview
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Brief Summary
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This study evaluates the feasibility of a randomized controlled trial to evaluate the impact of motivating reminiscence-based therapy on exercise adherence, mood and physical health within a subacute rehabilitation population. The jDome BikeAround technology displays user-specified Google Earth images onto a domed screen as the user pedals on a stationary bike, which fosters the experience of bicycling through that given environment. Participants will use the technology for 12 weeks during their regularly scheduled therapy sessions.

Detailed Description
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Adherence to physical activity in older adults and those in a low-intensity rehabilitation program is important with respect to achieving the demonstrated benefits in mobility, physical function and overall health maintenance. Physical activities that incorporate motivational strategies can improve long-term adherence to therapy programs. The jDome BikeAround technology is one example, as it involves reminiscence therapy coupled with stationary bicycling. Participant's are able to visit any familiar locations or places they have wished to visit, thus providing a positive and interactive experience as they engage in physical activity. Participants will be enrolled for a total of 12 weeks. They will have three 10 minute weekly sessions with the jDome BikeAround during their regularly scheduled therapy sessions. Feasibility will be evaluated by participant recruitment, program completion, rate of adverse events and staff acceptance.

Official Title
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Integrating Reminiscence Technology Into Exercise Programs in Subacute Care

Conditions
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Rehabilitation

Intervention / Treatment
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* Other: Motivating reminiscence physical therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admitted to the LIR (Low-intensity rehabilitation) or CMP (complex medical program) unit/floor where the research study is being conducted. Of note, both units receive low intensity rehabilitation services at baseline. Participants capable of providing informed consent or have a SDM capable of providing consent on their behalf Sufficient visual abilities to observe images on the domed screen Able to comprehend and communicate in English or French Minimum height requirement of 5'2 or 157cm in order to successfully fit the BikeAround system's stationary bike. Exclusion Criteria: Physical limitations (as determined by the SVH healthcare/physiotherapy team) that prevent use of the jDome BikeAround. This includes: 1) Inability to coordinate/move lower limbs effectively to complete pedaling task 2) The pedaling exercise causes discomfort/pain greater than expected with physical activity 3) Medical treatment prevents usage of the system (i.e. continuous ventilatory needs for patients admitted within the CMP unit) Cognitive impairment (as determined by the SVH healthcare/physiotherapy team) that prevent use of the jDome BikeAround, such as: 1) Inability to sustain attention to focus on pedaling task 2) Inability to follow one-step commands. Known behavioral abnormalities (e.g. overly aggressive behavior) that in the opinion of the clinical care team might impede any meaningful participation in the project Those who are in the opinion of, the attending physician or clinical team, too unwell to participate in the project

Ages Eligible for Study
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Minimum Age: 18 Years

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: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: All recruited participants will use the reminiscence based physical therapy technology, three times weekly for a total of 12 weeks (average admission duration). The expected study enrolment period is 6 months to allow for multiple sets of participants to be recruited from the same medical unit.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Reminiscence-based physical therapy<br>Participants will use the reminiscence-based technology (jDome BikeAround) for 10-minute sessions for three times per week during the 12 week study enrolment period. | Other: Motivating reminiscence physical therapy<br>* The jDome BikeAround system involves participants using a stationary bike while their selected location is displayed in front of them on a domed projector screen using Google Street View. Using pedals on the bike they can propel themselves down the street, steer and change direction as they wish.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participant Recruitment | Determine the feasibility of a future randomized controlled trial to evaluate the impact of the jDome BikeAround system on exercise adherence, mood and physical health within a subacute rehabilitation population. Feasibility will be determined by the ability to recruit 60 participants (based on the average number of patients admitted to the rehab units). | Baseline | 
| Number of participants retained | Determine the feasibility of a future randomized controlled trial to evaluate the impact of the jDome BikeAround system on exercise adherence, mood and physical health within a subacute rehabilitation population. Feasibility will be determined by the number of sessions participants attended, out of the total number of sessions offered. | Week 12 | 
| Rate of adverse events | The number of adverse events experienced by participants related to the use of the jDome BikeAround will be monitored to evaluate the feasibility of a future randomized controlled trial using this technology. | Week 12 | 
| Staff Acceptance | Staff Acceptance will be determined by measuring the number of sessions staff assign participants to use the jDome BikeAround, out of their total number of therapy sessions (I.e. total sessions assigned to use jDome BikeAround out of total therapy sessions which is 3 weekly sessions x 12 weeks). | Week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Endurance | Total distance (meters) travelled during each jDome BikeAround therapy bike session. | Total distance (meters) will be measured after each participant session (10 minutes) using the jDome BikeAround. This will occur 3 times per week throughout study duration for 12 weeks | 
| Mood changes | Participant mood changes will be measured following their jDome BikeAround session using The Face Scale developed by Lorish and Maisiak (1986) | Weekly after a jDome BikeAround session (for 12 weeks) | 
| Functional Independence Measure (FIM score) | Standardized measure of disability used in rehabilitation populations. Measure evaluating 18 functional tasks on a scale of 1 (total care) to 7 (independent). Maximum 126 (best) and minimum is 18 (worst). | Baseline, week 6, week 12 | 
| Satisfaction using jDome BikeAround - Participants | This measure will be assessed using semi-structured interviews | Baseline, week 6, week 12 | 
| Satisfaction using jDome BikeAround - Staff | This measure will be assessed using online surveys for rehabilitation staff. 5-point scale from strongly disagree, disagree, neutral, agree, strongly agree | Baseline, week 6, week 12 | 
| Emotional Impact | This measure will be assessed using semi-structured interviews with participants. This will assessed depending on participant verbal responses, not using any particular scale. | Baseline, week 6, week 12 | 
| Impact on overall therapy experience - Participants | This measure will be assessed using semi-structured interviews with participants | Baseline, week 6, week 12 | 
| Impact on overall therapy experience - Staff | This measure will be assessed using online surveys for rehabilitation staff. 5-point scale from strongly disagree, disagree, neutral, agree, strongly agree | Baseline, week 6, week 12 | 
| Ease of instruction - Participants | This measure will be assessed using semi-structured interviews with participants | Baseline, week 6, week 12 | 
| Ease of instruction - Staff | This measure will be assessed using online surveys for rehabilitation staff. 3 questions graded on a 5-point scale from strongly disagree, disagree, neutral, agree, strongly agree | Baseline, week 6, week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Motivating Reminiscence Technology, Feasibility, Exercise Adherence