Pilot Study Using MoveMor™ Lower Body Trainer for Frail, Long-Term Retirement Home Residents across the United States

Sara McVean Kyle, Ph.D., Catherine Reade, MS, RD., Kiran Kanwar, Ph.D.,Jana Russell, MS, CTRS

NEEDS ANALYSIS

The MoveMor™ Lower Body Trainer is aninnovative piece of exercise equipment developed by Resistance Dynamics, Inc in Littleton, Colorado. PreviousMoveMor™ Lower Body Trainer pilot studies have identified positive results in manual muscle testing, Timed Up and Go, and self-reported fear of falling in a clinical physical therapy setting in long-term care and community based residents, but there has not been a study evaluating the effects on mobility, strength, flexibility,or fall reduction in a designated “frail” population.

PURPOSE

To determine if implementing a simple and brief resistance training program using the MoveMor™ Lower Body Trainer will help improve mobility, ankle flexibility, and reduced fall(s), and ADL scores(Activities of Daily Living) during exercise intervention and six months post study

METHODS

Phase 1Residents were recruited fromtwo skilled nursing homes; Lakeside in San Antonio, Texas (n=8) and Cottonwood Creek in Round Rock, Texas (n=5).Phase 2Residents were recruited from a Continuing Care Retirement Community (CCRC) Orlando Lutheran Towers in Orlando, Florida (n=8).Phase 3 Residents were recruited from Someren Glen in Centennial, Colorado (n=12) and Bonnell Good Samaritan in Greeley, Colorado(n=7) for a total n=40 possible participants in each category.

Independent Variable – Exercise Protocol using MoveMor™ Lower Body Trainer.

Dependent Variables – TUG results, ankle flexibility, number of falls and Activities of Daily Living (ADL) scores.

The information listed below was collected within a 7 day period prior to intervention and 7 days post intervention of the 8-week exercise program using theMoveMor™ Lower Body Trainer. All participants were identified as “frail” based on standardized scores of the Timed up and Go (TUG).Residents who participated in the study were not on a formal physical therapy plan, nor were any other fall reduction interventions enlisted during study time (physical or environment).All residents were 65+ years of age, residing in a long term care setting

Baseline Measurement prior to Session 1 Participation

  • 8ft Timed Up and Go (if able)
  • Ankle Dorsiflexion (goniometer)
  • Ankle Plantar Flexion
  • Number of falls in previous 6 months
  • Activities of Daily Living (if applicable)

Post Study Measurement after Week 8

  • 8ft Timed Up and Go (if able)
  • Ankle Dorsiflexion (goniometer)
  • Ankle Plantar Flexion (goniometer)
  • Number of falls 6 months post-test (phase 1 and 2 only)
  • Activities of Daily Living (if applicable)

Exercise Procedures

Take 10 to MoveMor™- 10 exercises, 10 repetitions, 10 minutes (repeated once or twice with a break in between)

Program Length: 8 weeks

Frequency: Two times per week

Exercises: 10

Goal:Address major muscle groups to regain strength, mobility and independence.

Joint MoveMor™ Exercise Muscles Strengthened Importance
Ankles Toe & Heel Lifts Dorsi / plantar flexors Walking Lift toes to prevent tripping/ Push/propel forward Step forward on level surfaces or carry you
up hills on uneven terrain. Helps pump blood from legs to upper-body & brain. Knee stabilization
Toe Fans (inversion & eversion) Invertors/evertors Ankle stability and mobility
Ankle O’s Range of motion Ankle flexibility and ability to move your ankle upward and downward.
Knees Slide Walk Quads/hamstrings Ability to stand and balance
Merry-Go-Round(clockwise and counter-clockwise circles) Quadriceps/hamstrings Internal/ext. rotators Gluteals Stability and mobility of muscles, tendons and ligaments surrounding knee
Midline Cross Quads/hamstrings/gluteals Takes stress and strain off knee joint.
Leg Extension Quadriceps Range of motion
Hips Out & In Adductors/abductors/gluteals Endurance for walking and side-stepping objects
Get in and out of a car
March Hip Flexors Core Lift leg when walking and climbing stairs Stand up from chair, get out of bed
Sweep In & Out Internal/external rotators Hip stabilization and mobility, balanced muscles, reduce lower extremity injuries and low back pain.

ANALYSIS

Data was first collected on site by the fitness director and then entered into SPSS 22.0 where all analysis was conducted. Paired correlations were used to show the measure of association between the dependent variables and twice weekly exercise intervention

using the MoveMor™ Lower Body Trainer. Paired t-tests were used to measure the pre and post-test differencesof the participants. A 95% confidence interval (p = .05) was used for all analysis.

Paired Samples Statistics

Paired Samples Statistics

 

Mean

N

Std. Deviation

Std. Error Mean

Pair 1

TUGPre

22.7343

30

25.36681

4.63132

TUGPost

22.3103

30

23.44548

4.28054

Pair 2

DorsiLPre

11.3030

33

5.68158

.98904

DorsiLPost

13.5152

33

4.26557

.74254

Pair 3

DorsiRPre

2.0278

36

4.42387

.73731

DorsiRPost

10.6667

36

5.15475

.85912

Pair 4

PlantarLPre

27.4063

32

14.03420

2.48092

PlantarLoPost

31.5625

32

11.86738

2.09788

Pair 5

PlantarRPre

26.5152

33

13.64304

2.37495

PlantarRPost

32.1818

33

10.58730

1.84301

Pair 6

FallsPre

.9474

38

1.55871

.25286

FallsDuring

.3421

38

.96636

.15676

Pair 7

FallsPost

.7632

38

1.30351

.21146

FallsDuring

.3421

38

.96636

.15676

Pair 8

FallsPre

.9474

38

1.55871

.25286

FallsPost

.7632

38

1.30351

.21146

                                                                                                                                 

Paired Samples Correlations

 

N

Correlation

Sig.

Pair 1

TUGPre & TUGPost

30

.986

.000

Pair 2

DorsiLPre & DorsiLPost

33

.608

.000

Pair 3

DorsiRPre & DorsiRPost

36

-.174

.311

Pair 4

PlantarLPre & PlantarLoPost

32

.930

.000

Pair 5

PlantarRPre & PlantarRPost

33

.793

.000

Pair 6

FallsPre & FallsDuring

38

.156

.350

Pair 7

FallsPost & FallsDuring

38

.645

.000

Pair 8

FallsPre & FallsPost

38

.273

.097

 

 

 

 

 

Paired Samples Test

 

Paired Differences

t

df

Sig. (2-tailed)

Mean

Std. Deviation

Std. Error Mean

95% Confidence Interval of the Difference

Lower

Upper

Pair 1

TUGPre – TUGPost

.42400

4.54369

.82956

-1.27264

2.12064

.511

29

.613

Pair 2

DorsiLPre – DorsiLPost

-2.21212

4.58092

.79744

-3.83645

-.58780

-2.774

32

*.009

Pair 3

DorsiRPre – DorsiRPost

-8.63889

7.35295

1.22549

-11.12677

-6.15101

-7.049

35

*.000

Pair 4

PlantarLPre – PlantarLoPost

-4.15625

5.28607

.93445

-6.06208

-2.25042

-4.448

31

*.000

Pair 5

PlantarRPre – PlantarRPost

-5.66667

8.31665

1.44774

-8.61562

-2.71771

-3.914

32

*.000

Pair 6

FallsPre – FallsDuring

.60526

1.70118

.27597

.04610

1.16443

2.193

37

*.035

Pair 7

FallsPost – FallsDuring

.42105

1.00355

.16280

.09119

.75091

2.586

37

*.014

Pair 8

FallsPre – FallsPost

.18421

1.73759

.28187

-.38692

.75534

.654

37

.517

*significance

CONCLUSION

Using a 95% Confidence Interval (p = .05) Paired T-tests show that there is a statistically significant difference between the following variables:

Paired T-Tests

  • Dorsiflexion Left Pre – Dorsiflexion Left Post
  • Dorsiflexion Right Pre – Dorsiflexion Right Post
  • PlantarLeft Pre – PlantarLeft Post
  • PlantarRight Pre – PlantarRight Post
  • FallsPre – FallsDuring
  • FallsPost – FallsDuring

The post study tests using the “Take 10 to MoveMor™” exercise protocol clearly show that the MoveMor™ Lower Body Trainerhas an impact on fall incidence during exercise intervention.  An increase in the four ankle range of motion tests as measured in dorsi and plantar flexion movements was significant.

Significance in the Falls Pre and Falls During and Falls Post and During show significance that during the intervention and six months post intervention, fall incidence is reduced or participants who used the MoveMor™ Lower Body Trainer.

These chances are not due to chance, rather are directly the result of use of the intervention.

The mean scores of the Timed up and Go (TUG) show only minimal change in velocity and lack significance with the current sample size.

LIMITATIONS

Activities of Daily Living were not used in paired t-tests because a third of the sample size did not assess ADL’s or give an accurate score through a trained individual with experience scoring Activities of Daily Living.  Phase 3 participants are not yet six months post-test to assess falls post study. 

There are gaps in data due to physical and cognitive limitations of participants.  Additionally, levels of active engagement using the board vary based on physical endurance and function as well as the ability to accurately perform the movements as they are demonstrated. 

Regardless of ability, it is important to include exercise requiring lower body resistance training to a frail, older population as an ongoing treatment intervention despite coordinator or the inability to perfectly perform the movement.