​​​

By: McMaster University

Virtually-delivered rehabilitation for seniors living with frailty is a feasible way of delivering care, shows a study led by researchers from the Geras Centre for Aging Research, a research centre of Hamilton Health Sciences, affiliated with McMaster University. Geras' goal is to improve the lives of older adults by bringing the most up-to-date research into frontline care.

The study, published in Pilot and Feasibility Studies in 2023, defined frailty, a consequence of aging, as a decline in function and physiological reserve in multiple bodily systems. Older adults who are frail have a higher risk of falls, disability, hospitalization and admission to long-term care

Frailty impacts approximately 1.5 million older adults in Canada, and frail seniors account for a large proportion of users of rehabilitation programs and home care services. The findings of the study disprove concerns that virtual programming would not be effectively delivered to older adults.

“Virtually-delivered care is an alternative to in-person programs, especially with long wait lists for in-person services and could help prevent a decline function in people living with frailty," said first author Chinenye Okpara, a PhD candidate at McMaster's Department of Health Research Methods, Evidence, and Impact.

“Another benefit of virtually delivered care is that we can reach more people at the same time when running sessions such as physiotherapy, which are typically conducted on a one-to-one basis when delivered in-person."

Researchers ran the pilot project from August 2020 to November 2021, when the COVID-19 pandemic was at its peak and seniors were encouraged to stay home. Investigators recruited 72 participants from a wait list of more than 200 for the study and randomized participants into either a virtual care group or control group. Those receiving virtual care received twice-weekly live-streamed exercise sessions, one phone call a week from McMaster student volunteers, medication review consultations and nutrition counselling via videoconference, and protein supplementation, over a 12-week period. The control group only received once-weekly calls from volunteers.

“I enjoyed that I was doing the exercises with other older adults and the instructor, and was able to see exactly what the instructor was doing so that I could repeat the steps," said Janine Stonehouse, a study participant. “It felt as if I was in the same room with the instructor but from home. It gave me the opportunity to meet new people in a different setting. We had something in common and that created a bond."

Results showed that strong adherence to the virtual program made it a feasible option for delivering care to older adults, with 81 per cent of participants in the virtual care group attending the exercise classes, above a predicted 75 per cent adherence rate.

“With the growing population of older adults in Canada, health care needs to develop new, innovative models that support older adults being able to live in their own homes," said Dr. Alexandra Papaioannou, a geriatrician and executive director of Geras. Papaioannou is also a professor in the Department of Medicine at McMaster University and principal investigator of the study.

“Our model on virtual frailty rehabilitation resulted in improvements such as being able to cross the street, rise from the chair without needing assistance and allow people to remain in their own homes with the support of their families and the health care system," said Papaioannou.

The success of the Geras Virtual Frailty Rehabilitation program shows how useful technology can be in caring for frail older adults. Many older adults often struggle to access in-person services because of living in remote areas or having limited transportation options. The program tackles these challenges by reducing barriers and social isolation through connecting older adults with peers, caregivers, and health care providers. 

This connection is important for their mental and emotional well-being. By closing the gap in access to essential health services, Geras Virtual Frailty program ensures that older adults, no matter where they live, can get the care and support they need.

The authors say that more evidence of the program's effectiveness is needed, which can only be obtained by a larger-scale trial conducted in a post-pandemic setting.

Funding for the study was received from both McMaster University and the Juravinski Research Institute.