Feasibility and acceptability of an unsupervised and adapted physical activity program (PACE tool) as pragmatic care in a geriatric outpatient clinic

Abstract

Background: Physical inactivity accelerates the ageing process, leading functional incapacities and physical dependence. Although physical activity (PA) is known to counteract these effects, its integration as a prescription in healthcare is uncommon due to the lack of pragmatic solutions. Aims: This study aimed to assess the feasibility and acceptability of implementing a pragmatic, unsupervised and adapted PA program in geriatric outpatient clinics. Methods: In a 4-month pilot study, a 12-week adapted unsupervised PA program was prescribed using the Promote the Autonomy through exerCisE (PACE) tool. Feasibility was assessed by measuring patient inclusion, program adherence, healthcare professional workload and the tool usability score. Acceptability (Likert scale) was assessed through healthcare professional and patient satisfaction, as well as reported pain, falls and feelings of safety during program practice. Pre- and post-intervention tests were conducted to explore adaptations in physical performance adaptations. Results: Out of the 250 eligible patients, 76 were included, with 67 consenting to the prescribed PA intervention. Ultimately, 37 participants completed the full 12-week program, averaging 3.3 weekly sessions. Notably, 70.2% adhered to the daily walking prescription. Physicians found the PACE tool ‘highly relevant’ and non-disruptive. Beliefs in PA benefits and kinesiologist support facilitated adoption, whilst existing pain and lack of motivation hindered adoption. No meaningful change in functional performance was noted post-intervention. Conclusion: The results suggest that implementing PACE as a prescription exercise care regimen is feasible and acceptable to both healthcare professionals and patients. However, further randomised controlled trials are needed to evaluate its health effects compared to usual care.