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Should Structured Exercise Be Promoted As a Model of Care? Dissemination of the Department of Veterans Affairs Gerofit Program
Author(s) -
Morey Miriam C.,
Lee Cathy C.,
Castle Steven,
Valencia Willy M.,
Katzel Leslie,
Giffuni Jamie,
Kopp Teresa,
Cammarata Heather,
McDonald Michelle,
Oursler Kris A.,
Wamsley Timothy,
Jain Chani,
Bettger Janet P.,
Pearson Megan,
Manning Kenneth M.,
Intrator Orna,
Veazie Peter,
Sloane Richard,
Li Jiejin,
Parker Daniel C.
Publication year - 2018
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15276
Subject(s) - medicine , veterans affairs , promotion (chess) , health promotion , physical therapy , gerontology , baseline (sea) , health care , family medicine , nursing , public health , politics , economic growth , political science , law , economics , geology , oceanography
Exercise provides a wide range of health‐promoting benefits, but support is limited for clinical programs that use exercise as a means of health promotion. This stands in contrast to restorative or rehabilitative exercise, which is considered an essential medical service. We propose that there is a place for ongoing, structured wellness and health promotion programs, with exercise as the primary therapeutic focus. Such programs have long‐lasting health benefits, are easily implementable, and are associated with high levels of participant satisfaction. We describe the dissemination and implementation of a long‐standing exercise and health promotion program, Gerofit, for which significant gains in physical function that have been maintained over 5 years of follow‐up, improvements in well‐being, and a 10‐year 25% survival benefit among program adherents have been documented. The program has been replicated at 6 Veterans Affairs Medical Centers. The pooled characteristics of enrolled participants (n = 691) demonstrate substantial baseline functional impairment (usual gait speed 1.05 ± 0.3 m/s, 8‐foot up and go 8.7 ± 6.7 seconds, 30‐second chair stands 10.7 ± 5.1, 6‐minute walk distance 404.31 ± 141.9 m), highlighting the need for such programs. Change scores over baseline for 3, 6, and 12 months of follow‐up are clinically and statistically significant ( P < .05 all measures) and replicate findings from the parent program. Patient satisfaction ratings of high ranged from 88% to 94%. We describe the implementation process and present 1‐year outcomes. We suggest that such programs be considered essential elements of healthcare systems.