Digital music and movement resources to improve health and wellbeing in older adults in care homes: a pilot randomised trial.

Abstract

Abstract Background: Low physical activity among older adults is related to adverse health outcomes such as depression and loneliness, poor physical function and increased risk of falls. This study was designed to increase physical activity through a digital, group-based, physical activity and music resource and to examine its effectiveness on social, mental and physical health outcomes. Methods: Participants were 34 older adults (65 years+) recruited across four care homes in Scotland to a randomised controlled pilot study with waitlist controls. Surveys were administered at baseline and post-intervention, comprising measures of fear of falling, depression and anxiety, loneliness, sleep satisfaction and quality of life. A battery of physical function tests and saliva sampling for cortisol and dehydroepiandrosterone hormone analysis were also conducted at each time point. Additionally, process evaluation measures (recruitment, intervention fidelity, attendance, retention rates and safety) were monitored. The intervention comprised 12 weeks of three prescribed digital sessions per week: movement to music (n=2) and music-only (n=1), delivered by an activity coordinator in the care home. Post-intervention interviews with staff and participants were conducted to gain qualitative data on the acceptability of the intervention. Results: An average of 88% of prescribed sessions were delivered. The waitlist control group design was not adhered to. Intention-to-treat analysis across all participants revealed significant improvements in anxiety, salivary DHEA, fear of falling and loneliness. There were no significant improvements in health-related quality of life, perceived stress, sleep satisfaction or physical function tests, including handgrip strength. Qualitative analysis highlighted benefits of and barriers to the programme. Conclusions: The digital movement and music intervention was deemed acceptable and delivered with moderate fidelity, justifying progression to a full-scale trial. Although a proper control group would have yielded more confident causal relationships, preliminary psychosocial and biological effects were evident from this trial. To show significant improvements in physical function, it is likely that greater adherence, longer intervention and/or higher exercise volume may be necessary. Trial registration: The trial is registered at ClinicalTrials.gov, number NCT05601102 on 01/11/2022