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Virginia Henderson International Nursing e-Repository > Independent Submissions > [Legacy Collection] Varied Submissions (Research Study Abstracts) > Attrition In Nursing Home Based Exercise Intervention Studies: Experimental Design Issues

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Type: Researcher Study
Title: Attrition In Nursing Home Based Exercise Intervention Studies: Experimental Design Issues
Attrition In Nursing Home Based Exercise Intervention Studies: Experimental Design Issues

Introduction:Attrition of subjects is an important potential threat to validity of exercise intervention trials. Reasons for attrition of subjects in nursing home-based exercise studies are likely to be different than reasons for attrition in community-based programs. This paper examines the experience from 13 exercise intervention studies lasting greater than 4 weeks, conducted in nursing home residents during the past decade, plus data from a intervention development study recently completed at the Duke Pepper Center.

Methods:All exercise intervention trials in nursing home residents aged 60 years or older of at least 4 weeks duration, reported in journals indexed in Medline( from 1990 to 1996 were reviewed. Descriptive analysis from a 32 week randomized controlled cross-over trial of group strength and flexibility exercise program are also reported.

Findings:The 14 studies reviewed had a total of 801 subjects, and represented a variety of approaches to exercise intervention, including strength, flexibility, and endurance exercise programs( Attrition rates raged from 0 to 48%. When subjects who did not complete baseline measures successfully were excluded from attrition calculations, attrition ranged from 0 to 35%. Reasons for attrition identified by investigators included death unrelated to exercise programs, exacerbation of chronic illness, transfer to another facility, loss of ability to follow study procedures, lack of interest in exercise, and minor injury associated with exercise.

Conclusions:Measurable rates of attrition occur in nursing home-based exercise programs; investigators planning such intervention trials should anticipate rates as high as 20%, and plan specific approaches to reduce attrition. Although the majority of reasons for attrition from these studies were due to factors beyond investigator control, such as declines due to changing chronic disease status, a small amount of attrition may be due to factors related to the design of the exercise program itself. Advantages and disadvantages of several experimental design approaches to decrease biasing effects of attrition will be discussed, including targeting exercise interventions to more homogeneous groups of nursing home residents, using a "run-in" period to examine ability of subjects to comply with study procedures, and incentive programs to maintain interest in the study.

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Repository Posting Date: 28-Oct-2011
Date of Publication: 17-Oct-2011
Appears in Collections: [Legacy Collection] Varied Submissions (Research Study Abstracts)

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