[The "Lübeck Worlds of Movement Model"-multidimensional prevention in inpatient care institutions through a program promoting physical activity]. / Das "Lübecker Modell Bewegungswelten" ­ Multidimensionale Prävention in stationären Pflegeeinrichtungen durch ein bewegungsförderndes Programm.

In inpatient care there is a need for prevention and health promotion offers that are specific to the target group. In the course of implementing the Prevention Act, those interventions should be chosen for sustainable implementation that are conceptually sound, standardized, workable, low-threshold, and demonstrably effective.The "Lübeck Worlds of Movement Model" is a physically, cognitively, and socially activating prevention program for elderly people in need of care that was developed by the Lübeck Geriatrics Research Group (FGL). It has been implemented in inpatient care facilities since the end of 2015. It takes multimorbidity into account in a multidimensional intervention approach and is characterized by comprehensive motor-cognitive promotion as well as long-term attractiveness.In accordance with sports science principles, exercises were integrated into a "world of movement," making each training session a "cognitive excursion." Twice weekly, one-hour group training is supplemented by individual training to achieve the recommended minimum of 150 min of moderate exercise weekly. The topic-related content encourages seniors to share and exchange stories.So far, standardized planning and documentation sheets have been developed to design training sessions for 17 worlds of movement. More than a thousand of these completed sheets have been sent to the FGL by coaches after completion of the training and addition of comments. Based on these records and on-site feedback, continuous further development of the model is intended, considering findings made in the fields of sports science, nursing science, and geriatrics/gerontology. This includes the extension of the range of topics as well as further differentiation of the offer according to the individual capability of every participating senior citizen.

[The "Lübeck Worlds of Movement Model"-results of the effects evaluation]. / Das "Lübecker Modell Bewegungswelten" ­ Ergebnisse der Effektevaluation.

BACKGROUND: There are few standardized and evaluated intervention programs for elderly people in need of care that consider motor, cognitive and social aspects. Therefore, the "Lübeck Worlds of Movement Model" was developed by the Lübeck Geriatrics Research Group as a multidimensional standardized intervention program for continuous use in the nursing home. OBJECTIVES: The model was evaluated for its effects over the course of one year in the areas of self-care competence (primary endpoint), mobility, coordination, flexibility, strength, endurance, and cognition. The results are presented in this article. MATERIALS AND METHODS: The sample recruitment took place in 6 nursing homes in Kiel (control group) and 10 in Lübeck (intervention group). Care-dependent senior citizens from the neighborhood were also allowed to participate. Inclusion criteria were the ability to walk at least 6 m independently and the cognitive and sensory capacities to follow the group training. The evaluation study had 255 subjects. To verify the effects of the intervention, various tests were performed at baseline and after 3, 6, 9, and 12 months: Barthel Index, Timed Up and Go, 4­meter walk test, Romberg stand, one-leg stand, 20-Cents Test, 8­Point Reach Test, hand force, 5­Chair-Rise Test, 2­Minute Step Test, and Six-Item Screener. RESULTS: Comparison of the control group with the subjects who had participated in at least half of the training sessions (per-protocol analysis) showed the highest effect size in the multivariate analysis of variance after one year for the Barthel index, followed by the Timed Up and Go, cumulated over all times for the Romberg stand and 5­Chair-Rise Test. The maximum effect measured over the entire assessment occurred after 6 months (partial eta square ηp2 = 0.332). CONCLUSIONS: The model developed preventive effects on all investigated dimensions over the course of a year, but with differences in intensity and time of maximum effect. The motivation for long-term participation was high.