Preventing Loss of Independence Through Exercise in Community Living Centers

What this study is

Approximately 40,000 older Veterans with complex care needs receive long-term care in VA Community Living Centers (CLCs). Many CLC staff have limited specialized training to engage Veterans with dementia. Preventing Loss of Independence through Exercise (PLIÉ) is a gentle, multi-domain, group movement program for people with cognitive impairment that has shown physical, cognitive, social, and emotional benefits. This effectiveness-implementation study will train interprofessional CLC staff via a remote program and evaluate PLIÉ-CLC delivered as part of routine clinical care at up to 12 VA CLCs. We will assess resident physical function (primary outcome) and secondary outcomes (e.g., social engagement, mood, cognition, behaviors, falls, pain, and quality of life), as well as person-centered care practices, staff engagement, burnout, and workplace climate, and the sustainment of the program after external facilitation ends.

What's being tested

Preventing Loss of Independence through Exercise (PLIE)
Intervention · BEHAVIORAL
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.

Study details

Official title: Preventing Loss of Independence Through Exercise in Community Living Centers: An Effectiveness-Implementation Trial
Sponsor: VA Office of Research and Development
Conditions: Dementia · Cognitive Dysfunction
Enrolling: 288 people
Starts: 2025-10-01
Est. completion: 2029-06-30
Design: Open-label, sequential groups
Record: View on ClinicalTrials.gov ↗

Who can join

Age 18 Years and overSex ALLHealthy volunteers Accepted

internal facilitators/champions

You may qualify if

VA Community Living Centers (CLCs)
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)
Identification and random selection process for Veteran resident participants in PLIÉ-CLC staff training program: For each internal facilitator/champion, the research team will create a list of residents who meet the following eligibility criteria:; Cognitive impairment (defined as documented diagnosis of ADRD or other neurocognitive disorder and/or clinician judgment); Long-stay resident (anticipated length of stay 120 days); Ability to sit in a standard chair or wheelchair unaided for a 1-hour class; English language proficiency; Current clinical care relationship (defined as documentation of one or more clinical encounters or care provided to the resident during the previous 2 months). VA Community Living Centers (CLCs)

You can't join if

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)
Comatose
Bedbound
Severe hearing, visual or communication challenges (i.e., unable to hear, see or understand well enough to participate)
Limited life expectancy
Lack of ability to assent to study procedures and does not have an LAR VA Community Living Centers (CLCs)
VA Community Living Centers (CLCs)

directors

You may qualify if

VA Community Living Centers (CLCs)
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

You can't join if

Lack of willingness or interest in participating
VA Community Living Centers (CLCs)

Sign in and we'll check these against your records.Full criteria on ClinicalTrials.gov ↗

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Study locations (1)

1 open

San Francisco VA Medical Center, San Francisco, CA
San Francisco, California, United States

Study team

Sponsor

VA Office of Research and Development

Study ID IIR 23-027

Principal investigator

Francesca M Nicosia, PhD MA

San Francisco VA Medical Center, San Francisco, CA

Principal investigator

Linda L. Chao, PhD BS