Systematic Review of Exercise for Caregiver-Care Recipient Dyads: What Is Best for Spousal Caregivers-Exercising Together or Not at All?

BACKGROUND AND OBJECTIVES: Though exercise for care recipients receives considerable emphasis, few dyadic studies focus on caregivers. This systematic review identified dyadic exercise interventions, which measured outcomes for older adult caregivers. Studies that met inclusion criteria were examined to better understand whether caregivers derived greater benefit from exercising with care recipients, or not exercising at all. RESEARCH DESIGN AND METHODS: PRISMA guidelines were followed to identify quantitative studies of dyadic exercise interventions in which caregivers enrolled with care recipients, and either coparticipated in exercise; or while their care recipients exercised independently, caregivers received a separate, nonexercise intervention or usual care (UC). To be included, studies had to measure physical or psychosocial outcomes for caregivers. Study quality was assessed via the Downs and Black checklist. RESULTS: Eleven studies met inclusion criteria. In six, the dyad exercised; in five, care recipients exercised while caregivers received a separate program, or UC. Results suggest that caregivers may improve both psychosocial and physical health when exercising together with care recipients. Caregivers who did not exercise but received a separate, nonexercise intervention, such as support, education, or respite, showed psychosocial benefits. Those who received UC were less likely to derive physical or psychosocial benefits. Included studies were fair to good quality with moderate to high risk of bias. DISCUSSION AND IMPLICATIONS: Often examined secondarily, caregivers are overlooked for participation in interventions with care recipients. This analysis suggests that caregivers may benefit from dyadic interventions in which they either exercise together with their care recipients or receive a separate nonexercise intervention or respite.

The Effects of Systematic Environmental Manipulation on Gait of Older Adults.

Quantification of gait changes in response to altered environmental stimuli may allow for improved understanding of the mechanisms that influence gait changes and fall occurrence in older adults. This study explored how systematic manipulation of a single dimension of one's environment affects spatiotemporal gait parameters. A total of 20 older adult participants walked at a self-selected pace in a constructed research hallway featuring a mobile wall, which allowed manipulation of the hallway width between three conditions: 1.14 m, 1.31 m, and 1.48 m. Spatiotemporal data from participants' walks were captured using an instrumented GAITRite mat. A repeated measures ANOVA revealed older adults spent significantly more time in double support in the narrowest hallway width compared to the widest, but did not significantly alter other spatiotemporal measures. Small-scale manipulations of a single dimension of the environment led to subtle, yet in some cases significant changes in gait, suggesting that small or even imperceptible environmental changes may contribute to altered gait patterns for older adults.