DEVELOPING A CHAIR BASED EXERCISE PROGRAMME FOR OLDER PEOPLE: A DELPHI STUDY

Introduction: Chair based exercise (CBE) is often recommended to engage older people with compromised health and mobility in an accessible form of exercise. A systematic review looking at the benefits of CBE for older people identified a lack of clarity regarding purpose and benefits [Anthony et al, Biomed Research International, 2013, ID: 309506]. In the absence of a strong evidence base consensus development may provide a basis for decision making and further guidance. Objective: To develop consensus on the principles of CBE for older people Methods: The framework for consensus was constructed through a team workshop identifying 42 statements. A four round electronic Delphi study with 17 multi-disciplinary experts was undertaken. A threshold of 70% agreement was used to determine consensus. Free text responses were analysed thematically. Between rounds a number of strategies (e.g. amended wording) were used to move towards consensus. Results: 16 experts completed four rounds of consultation. Consensus (>70% agreement) was reached on 46 statements classified into 7 groups; defining CBE intended users, potential benefits, structure, format, risk management and evaluation. 5 statements were removed following comment. The 5 accepted statements for defining CBE were: 1. CBE is primarily a seated exercise programme (75%), 2.The purpose of using a chair is to promote stability in both sitting and standing (87.5%), 3. CBE should be considered as part of a continuum of exercise for frail older people where progression is encouraged (100%) 4. CBE should be used flexibly to respond to the changing needs of frail older people (100%) and 5. Where possible CBE should be used as starting point to progress to standing programmes (76.5%). Conclusion: Consensus has been reached on a set of principles of CBE for older people providing a clearer underpinning of their purpose and offering a model for implementation that requires further evaluation.