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ENROLLING BY INVITATION

NCT06972004

Preventing Loss of Independence Through Exercise in Community Living Centers

Sponsor: VA Office of Research and Development

View on ClinicalTrials.gov

Summary

Approximately 40,000 older Veterans who have complex care needs (for example, a combination of severe cognitive, physical, and mental health conditions) receive long-term care in VA Community Living Centers (CLCs). However, CLC staff members rarely receive specialized training in how to best engage and interact with these Veterans, which can lead to poor care quality, worsening of symptoms, staff burnout, and low morale throughout a facility. The investigators have developed a unique, mind-body, group movement program for Veterans with cognitive impairment called Preventing Loss of Independence through Exercise (PLIÉ) and found that it has physical, cognitive, social and emotional benefits in CLC residents. The investigators recently taught 50 staff members from a variety of professions in 5 CLCs to lead PLIÉ classes. The study will enable us to test whether the PLIÉ,LC staff training program improves outcomes for residents and to learn about the success and sustainment of the training.

Official title: Preventing Loss of Independence Through Exercise in Community Living Centers: An Effectiveness-Implementation Trial

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

288

Start Date

2025-10-01

Completion Date

2029-06-30

Last Updated

2025-10-22

Healthy Volunteers

Yes

Conditions

Dementia Cognitive Dysfunction

Interventions

BEHAVIORAL

Preventing Loss of Independence through Exercise (PLIE)

Preventing Loss of Independence through Exercise (PLIÉ) is a multi-domain, mind-body, group movement program for people with dementia that improves quality of life. Classes begins and ends with fully body tapping/massaging and breathing exercises that bring participants into awareness of their bodies in the present moment and create a calming ritual. Participants are invited to share appreciations of things in their lives that make them feel happy or grateful. Instructors lead participants through progressive, functional movement sequences that are designed to be repetitive (to build procedural or "muscle" memory) and to build slowly in functional complexity over time. Movements are tailored to the ability levels of the group. Resting, breathing and mindful body awareness exercises are incorporated throughout each class to provide breaks and to improve focus and attention. A non-judgmental errorless learning process is used, and all movements are performed slowly and purposefully.

Inclusion Criteria: CLC internal facilitators/champions Inclusion criteria: * Full-time CLC clinical staff member (including registered nurses, certified nursing assistants, nurse aids, recreation therapists, occupational therapists, physical therapists, mental health professionals or others) * Willingness to facilitate PLIÉ-CLC implementation at their site * Willingness to participate in initial and debrief site visit PLIÉ-CLC staff instructors Inclusion criteria: * CLC clinical staff member or volunteer interested in learning to lead PLIÉ-CLC classes * Willingness to participate in remote training process * Willingness to lead PLIÉ classes locally, including tracking attendance and other process measures * Willingness to participate in initial and debrief site visits and biweekly check-ins Veteran residents of Community Living Centers (CLCs) Inclusion criteria: * Long-stay resident (have resided at the facility for at least 45 days and are not expected to be discharged during the study period) * Not planning to be discharged within the next 12 months * Not receiving hospice care. * Cognitive impairment * Ability to sit in a standard chair or wheelchair unaided for a 1-hour class * English language fluency CLC directors Inclusion criteria: * Recommended by VHA leader as likely to be 'early adopter' based on successful implementation of program such as STAR-VA OR * g based on patient population (primarily palliative care or long stay maintenance/custodial care Exclusion Criteria: CLC internal facilitators/champions exclusion Criteria: \- Planning to leave the facility in next 12 months PLIÉ-CLC staff instructors exclusion criteria: \- Planning to leave the facility in next 12 months Veteran residents of Community Living Centers (CLCs) exclusion Criteria: * Comatose * Bedbound * Severe hearing, visual or communication challenges (i.e., unable to hear, see or understand well enough to participate) * Limited life expectancy (e.g., eligible for hospice) * Lack of ability to consent/assent to study procedures CLC Directors exclusion criteria: \- Lack of willingness or interest in participating

Locations (1)

San Francisco VA Medical Center, San Francisco, CA

San Francisco, California, United States