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Table 4 Data extraction table for included studies

From: Barriers and facilitators to adherence to walking group exercise in older people living with dementia in the community: a systematic review

Author(s) and year Study design Aim of the study Type of intervention Sample details Main barriers Key facilitators Adherence data
van Uffelen et al. 2009 [44] RCT with a factorial design To examine feasibility of regular moderate-intensity walking program, to assess association of exercise attendance and cognition 1 year, twice a week, 60 min, moderate intensity walking program vs. low intensity activity program 122 Lack of interest
Weather
Walking difficulties
Health-related problems
Keeping up to date with participants’perceptions about the program and how they are coping with exercise intensity
Attending at least one session – trying exercise
Median attendance 71%
van Uffelen 2008 [46] Double blind randomized placebo-controlled trial To examine effect of aerobic exercise or vitamin B supplementation on cognitive function 1 year, twice weekly, group based, moderate-intensity walking program vs. low intensity placebo activity program and vitamin B supplementation or placebo 152 Illness
Too busy
Location too far
Uncomfortable intensity
Health-related problems
Living with a partner Median session attendance 63%
Bantry White and Montgomery 2016 [35] Mixed-methods study Wandering, getting lost and hence being restricted from walking can be a barrier to walking outdoors alone Self-administered questionnaire 14 professionals Factors associated with getting lost and of harm while missing Ensuring safe physical environment and appropriate landscape and surfaces to walk on, schedule adverse risks objectively – safe walking assessment, tailoring walks and assessments to individual circumstances Not reported
Author(s) and year Study design Aim of the study Type of intervention Sample details Main barriers Key facilitators Adherence data
King et al. 2018 [37] Randomized trial To evaluate feasibility of implementing The Enhance Mobility Program 8 months, group exercise and walking (at least 20 min, at least 3 times a week) 28 Space reallocation
Adequate staffing and time needed to recruit clients to participate
Lower MMSE
Social aspect of group walking
Refreshment offer at the end of walking session
Participation on walking program ranged 0–76 days out of 96 days with the walking program (M = 20.2, SD 19.6)
McCurry et al. 2010 [42] Clinical trial To examine factors associated with adherence to walking program Walking 30 continuous mina day 66 dyads Depression
Higher behavioral disruption scores (RMBPC)
Spousal caregiver
Lower perceived stress
47% participants were still walking 5 or more days a week at 6-months follow up
Lowery et al. 2014 [41] Single blind parallel group trial To evaluate effectiveness of a simple dyadic exercise regimen Individually tailored progressive walking regimen, 20–30 min, at least 5 times a week 131 dyads Low adherence levels Carers‘involvement
Overall BPSD (behavioural and psychological symptoms of dementia) lower if adherence is maintained
116 completed the trial (89%)
Prescribed frequency of walks was achieved by 31% of treatment group, prescribed intensity in 53% of walks
Author(s) and year Study design Aim of the study Type of intervention Sample details Main barriers Key facilitators Adherence data
Rantakokko et al. 2017 [43] Life-Space Assessment, Self-reported ability to walk 2 km was assessed Task modifications in walking may help community-dwelling older people to postpone life-space mobility decline   848/816/761 Walking difficulty, becoming home bound Self reported modifications in walking, using mobility devices  
Phinney et al. 2016 [36] Ethnographic study, participant observation To explore how community-based programming can promote social citizenship, Every day leisure group walk in neighborhood 15 Emotionally safe environment, overstressing dementia, medicalising/overmedicalising environment, not interacting with participants, not being able to accommodate weaker members, Social view on the walking program – being part of the community, belonging, non medicalised atmosphere, normal everyday activities, keeping the focus off dementia, emotionally safe environment, outdoors & being able to observe and react to things happening around, enjoyment of each other’s company, sharing cards with public explaining aims of this particular group makes them more welcome in the community, group resting on principles of compassion and empowerment Not reported
Author(s) and year Study design Aim of the study Type of intervention Sample details Main barriers Key facilitators Adherence data
Alphen et al. 2016 [34] Systematic review To reveal factors that facilitate or hamper participation of dementia patients on PA Review including also walking programs 7 studies with 39 dementia patients and 36 caregivers Physical and mental limitations
Difficulties with guidance
Organization of PA by caregivers
Service providers familiar with exercise benefits
Strategies to avoid health problems Convenient and personalized options of PA
Not reported
ROG HARRISON, KIM STRACHAN, SHEILA THORBURN 2017 – stirling dementia project grey lit Grey literature – report To evaluate the second year of a dementia friendly walking group project, to explore the attendees’ experiences of attending the walking groups. Every day leisure group walks in urban, suburban and rural areas. 6 walking groups – 1 person with dementia and 1 carer from each group for individual interviews. Focus group interviews involved all the walk attendees and volunteer walk leaders in each walking group (numbers not reported) Environmental issues making walking routes challenging/inaccessible
Not having funded walk organisers
Challenges posed by joining a walking group for the first time
Therapeutic impact of being outdoors
Having an effective walk leader and ensuring funding remained in place to employ walk leaders
Social support provided by the group for both people with dementia and their carers
Having accessible walking routes
Individual tailoring of walking routes
Having inclusive/mixed groups, rather than making walks exclusively for people living with dementia
Not reported