San Francisco VA Health Care System
Preventing Loss of Independence through Exercise
Preventing Loss of Independence through Exercise (PLIÉ) is a unique group movement program for Veterans with Alzheimer’s disease and dementia. This innovative San Francisco VA Medical Center (SFVAMC) program is a way to improve function and quality of life for these Veterans, and it may reduce the rate of falls and delay hospitalization. PLIÉ recently received a “Spark Seed Spread” grant from the VA Innovators Network to help spread this program to other Medical Centers throughout the VA system.
PLIÉ is part of a joint study between SFVAMC and the UCSF Osher Center for Integrative Medicine. Veterans in PLIÉ participate in one-hour group exercise sessions two days a week for twelve to eighteen weeks. These sessions focus on skills that even Veterans with memory loss can accomplish, including:
1) Training ‘muscle memory.’ The body can still learn to perform sequences of movements to support daily function (e.g., sitting, standing and balancing), even when there is no awareness of learning.
2) Mindful body awareness. Paying attention to breathing and in-the-moment bodily sensations may help orient people with memory loss to the present moment and may help reduce feelings of anxiety about the past or future.
3) Social connection. As memory declines, in-the-moment social connections with others become increasingly important. Moving as a group, including moving with music, may help increase feelings of well-being.
“The focus is on things people with dementia can still do very well,” says Deborah Barnes, PHD, MPH, Research Health Sciences Specialist at SFVAMC and Principal Investigator for the PLIÉ study. “These Veterans can still learn movement through repetition. They are capable of being ‘in the moment,’ so they’re also able to be socially engaged through these group sessions.”
Dr. Barnes notes that many short-term improvements can already be seen in Veterans who have participated in PLIÉ – including cognitive benefits, improved motor functioning, and general improvements in health and wellbeing. In the long term, Dr. Barnes and her fellow investigators are hoping to see fewer falls and reduced hospitalizations in Veterans who have completed the program.
Because of so many wonderful and innovative programs like PLIÉ, SFVAMC is one of the first VA Medical Centers to join the VA Innovators Network. Through this Network, Dr. Barnes was able to secure a “Spark Seed Spread” grant to help spread PLIÉ to other VA Medical Centers. “Coming from the research world, it often takes years and years to see your spread outside of your site,” says Dr. Barnes. “This is a great chance to kick start that process and share the benefits of PLIÉ.” In August 2017, Dr. Barnes and her team had the chance to present their great work with leaders from all over VA – including VA Secretary David Shulkin - at the annual VA Innovation Demo Day in Washington, D.C.