Prevention and health promotion also play an important role in care facilities; despite physical, mental or cognitive impairments, residents have health potential that can be promoted. The tigo has the potential to foster a culture of physical activity in the residential care setting.

Physical changes in old age are accompanied by a loss of strength, endurance, flexibility and mobility, as well as cognitive abilities. However, physical activity can help to maintain physical and cognitive performance, enabling the continuation of daily living activities [1]. Maintaining physical activity is therefore particularly important for people requiring care, as it ensures the ongoing development and support of their physical skills, cognitive abilities and psychosocial well-being [2].

Inactivity is widespread

National and international studies show that residents of care facilities spend most of their time in their rooms, walk only a few steps per day and spend the majority of their waking hours lying down or sitting [3]. This puts their behaviour well below the national exercise recommendations for people with multimorbidity [4]. People with multimorbidity should exercise as much as their current health situation allows. It is important to emphasise that even short periods of physical activity are beneficial to health, as any physical activity is advantageous [4]. There are many reasons for physical inactivity, including among residents of care facilities [5]. In addition to physical conditions and attitudes towards exercise, the spatial environment and philosophy of the care facility can significantly influence the (in)activity of care facility residents.

Feasibility study on the use of tigo in the care setting

The THERA-Trainer tigo is a motorised movement exerciser (bicycle and hand crank ergometer) for the lower and upper extremities and can be operated from a chair or wheelchair. This makes it easier to use for people who are dependent on a wheelchair, as there is no need to transfer to the training device. The device can be used for active (muscle-powered) or passive (motor-powered) training. The positive health effects of ergometer training are also well researched and have been proven numerous times in past studies [6, 7]. The feasibility of placement, application, user behaviour, independent use and acceptance of the tigo in the residential care setting have now been evaluated in a pilot project.

For this project, the THERA-Trainer tigo was placed in a fixed, freely accessible location in the care facilities for a period of 16 weeks. In this way, a highly stimulating exercise programme was created, which residents could use at any time. At the start of the testing phase, several orientation sessions were offered at each facility to train the staff on how to use the tigo. In addition, a poster with 6-step instructions on how to use the device was put up next to the recumbent bike (see Figure 1). All additional materials, such as various handles, safety belts and the operating instructions, were stored in an adjacent cabinet and were freely accessible. Depending on the participating care facility (sortition), the use of the THERA-Trainer tigo was supervised either by trained external staff in addition to the internal employees or exclusively by the facility’s own staff.

Evaluation and conclusion

The applicability of tigo in care facilities was evaluated in a workshop. Residents and employees of the care facilities took part in this workshop. Within this framework, usage behaviour as well as experiences and feedback from the perspectives of staff and residents were gathered.

Feasibility, application and user behaviour: The training programme on the THERA-Trainer tigo was very well received by the residents. It was always possible to position the device appropriately, and training was also easy to carry out. The user behaviour of the movement exerciser requires active control and coordination.

Independent use and acceptance: Interested residents specifically sought out the exercise programme and were particularly keen to take part in supervised individual training. Independent use of the motorised movement exerciser by residents was possible in individual cases if they were confident enough to do so themselves or if the care staff encouraged them (because they had confidence in the residents’ ability). As a rule, however, some support was required in using the machine. The support included hooking the safety belts onto a chair or wheelchair, fastening and securing the lower extremities, releasing and attaching the handles, and starting and ending the programme. The residents also generally needed assistance with unbuckling and leaving the tigo. A training session of 15–20 minutes was recommended, and was considered suitable and appropriate by the residents.

In summary, the residents’ interest in the THERA-Trainer tigo was very high, it was always feasible to accommodate the device in the participating facilities, and the implementation of brief training sessions with the movement exerciser was straightforward. The promotion of physical activity could be effectively implemented when responsibilities were clearly defined and agreed. However, it is still uncertain how to facilitate the adoption for residents without extra assistance.