Prospective

Yu Sau Fung, Doris

Rm 729, Esther Lee Building, the Nethersole School of Nursing, the Chinese University of Hong Kong

3943 4289

dyu@cuhk.edu.hk

The Nethersole School of Nursing, the Chinese University of Hong Kong

Hong Kong

Doris, Sau-fung Yu

Rm 729, Esther Lee Building, the Nethersole School of Nursing, the Chinese University of Hong Kong

852-39434289

dyu@cuhk.edu.hk

The Nethersole School of Nurisng, Faculty of Medicine, The Chinese University of Hong Kong

Hong Kong

運動訓練對中度睡眠困擾的長者之影響:順序性混合方法研究

Yes

2014-10-30

Joint CUHK-NTEC Clinical Research Ethics Committee

2010.157-T

Other

Moderate-intensity exercise-based intervention

The moderate-intensity endurance exercise training will be conducted by a research assistant with baccalaureate training in physical education or sport medicine (RA1). The Co-Is (S. Ng and P.Siu) who are academicians in physiotherapy and exercise physiologist will conduct a 3-day training to the RA1. The exercise training is designed with the assistance of the Co-Is according to the recommendations of the American College of Sports Medicine (ACSM)’s position stand on Exercise and Physical Activity for Older Adults. Our proposed exercise intervention is a moderate-intensity 7.5cm-high bench stepping exercise program for Seniors. It is a 16-week program, with three 60-minute group training sessions (group size: around 10) per week. Each session starts with a 10-minute warm-up period using stretching exercise and stationary mobilizing exercise for trunk and limb joints at both upper and lower bodies (e.g. shoulders, elbows, wrists, hips, knees and ankles), and followed by a session of moderate-intensity endurance exercise. The duration of the endurance exercise will increase gradually from 20 minutes to the targeted 40 minutes in four weeks’ time. The endurance exercise includes bench stepping exercise using a 7.5cm-high stable wooden platform. This exercise has been shown to be very suitable for older people who are less physically active or have reduced joint flexibility and reduced bone strength. Subjects will perform the bench stepping exercise in bouts of at least 10 minutes each (with maximum 5 minutes of rest in between the exercise bouts) to reach the targeted duration (i.e. 40 minutes of endurance exercise). Close monitoring and verbal encouragement will be provided by the attending RA. Moderate-intensity exercise has been widely used among older people and is even safe for older patients with chronic diseases. The Borg Rate of Perceived Exertion will be used to monitor the exercise intensity. This 15-point scale with scores ranging from 6-20. Descriptors are attached throughout the scale with higher scores indicating more perceived exertion. Physical activity that results in a rating of 12-14 (descriptor: “somewhat hard”) on the Borg RPE is identified as reaching a moderate intensity.24 The RA1 will explain the Borg RPE scale to the subjects and instruct them to speed up or slow down their movements in order to achieve a feeling of ‘somewhat hard’ at the Borg RPE rating of 12-14. The training session will end with a 10-minute cool down session with walking exercise and stationary trunk and limb mobilizing exercise involving joints of shoulders, elbows, wrists, hips, knees, and ankles. The training will follow the ACSM safety guidelines with assessment done on BP, HR and contradictory symptoms prior to training. Attendance rate and adverse events will be recorded. The PI (Professional Nurse) and Co-I (J Woo; Geriatrician) will manage any adverse events.

16-week program, with three 60-minute group training sessions (group size: around 10) per week

16-week program, with three 60-minute group training sessions (group size: around 10) per week

16 weeks

3 sessions/ week for 16 weeks

The 16-week health education programme will be delivered as a non-active attention placebo by a part-time research nurse (RA2). It includes sixteen 60-minute education sessions delivered on a weekly basis. Various health topics on home safety, brain health, foot care, flu prevention, medication management, aging and nutrition, common chronic illness among older adults, voucher scheme for elderly, smart grandparenthood, tips in choosing health screening, etc. will be included. No information relating to sleep and physical activity will be included.

weekly session for 16 weeks

Sixteen 60-minute education sessions on weekly basis

sixteen weeks

weekly session for 16 weeks

aged 60 or above

have moderate sleep complaints, as assessed by the 3-item Sleep Questionnaire and Assessment of Wakefulness

sleep disorder with an organic cause such as sleep apnea,

a medical problem (e.g. pain,) responsible for the sleep complaint

receiving sleep disorder treatment,

cognitive impairment as indicated by an Abbreviated Mental Test score of ≤ 6

engaging in > 60 minutes per week of moderate or more vigorous exercise in the previous six months,

acute muscular-skeletal problem, stroke or cardio-respiratory disease

60

N/A

Both Male and Female

Randomized

Block randomization with a block size of about 20 using a restricted shuffled approach will be used

Active

Single-blind

Investigator/research team

Parallel

4

1) A 16-week moderate-intensity endurance exercise training has greater effect than a non-active attention placebo (i.e. a general health education program) in improving sleep quality and sleep pattern.

No