Table 2 Accepted statements
From: Developing the principles of chair based exercise for older people: a modified Delphi study
| Â | Statement | % of agreement | When was consensus reached |
|---|---|---|---|
Definition | CBE should be considered as part of a continuum of exercise for frail older people where progression is encouraged | 100 | Round 2 |
CBE should be used flexibly to respond to the changing needs of frail older people | 100 | Round 2 | |
The purpose of using a chair is to promote stability in both sitting and standing | 87.5 | Round 2 | |
Where possible CBE should be used as starting point to progress to standing programmes | 76.5 | Round 1 | |
CBE is primarily a seated exercise programme | 75 | Round 2 | |
Intended users | CBE can be considered as part of a progressive falls exercise pathway with the aim of progressing to evidence based standing programmes | 93.75 | Round 2 |
For use with older people who are unable to carry out standing exercises as a consequence of an acute medical problem from which they might improve and progress to weight bearing exercises | 88.2 | Round 1 | |
For use with older people with an activity limitation who cannot participate in other forms of exercise | 76.5 | Round 1 | |
Potential benefits | If tailored appropriately CBE can be beneficial in improving the following: | Â | Â |
  - mood and well-being | 100 | Round 1 | |
  - certain activities of daily living | 93.75 | Round 2 | |
  - mobility around joints | 93 | Round 3 | |
  - social interaction | 88.2 | Round 1 | |
  - muscle strength | 88.2 | Round 2 | |
  - certain personal activities of daily living | 87.5 | Round 2 | |
  - co-ordination | 78.25 | Round 3 | |
  - confidence with activities of daily living | 70.6 | Round 1 | |
Structure | The delivery of sessions and exercises can be tailored to individual preference within a structured programme | 93.75 | Round 2 |
All CBE programmes should include progressive resistance training that is tailored to the individual | 93.7 | Round 2 | |
Each session should begin with an appropriate warm up | 88.2 | Round 1 | |
Music can be beneficial as part of programmes if used appropriately and it is welcomed by participants | 87.5 | Round 2 | |
Strength training can include the use of resistance bands, weights and body weight resistance exercises | 87.5 | Round 2 | |
Cardiovascular interval training should be performed to prevent fatigue, if appropriate and tailored | 87.5 | Round 4 | |
Participants should be encouraged to work at an intensity which is appropriately challenging for them | 86 | Round 3 | |
Each session should include developmental stretches | 82.3 | Round 1 | |
Each sessions should end with an appropriate cool down | 82.3 | Round 1 | |
Each session should include a component of strength resistance training, endurance training and cardiovascular fitness | 76.3 | Round 1 | |
Strength training should be targeted to meet nominated programme aims | 76.3 | Round 1 | |
Cardiovascular training should be performed at a moderate intensity for all participants | 76.3 | Round 1 | |
Format | Each session should be carried out at least once a week | 94.1 | Round 1 |
Rolling programmes are appropriate with new participants joining at any point | 94.1 | Round 1 | |
Gradually building up the duration of sessions can be beneficial for fail older adults with reduced exercise tolerance | 93.75 | Round 2 | |
Each session should last no longer than an hour | 88.2 | Round 1 | |
Programmes should be tailored to meet individual needs | 88.2 | Round 1 | |
The goal of CBE should be clearly defined for each individual participant | 88.2 | Round 1 | |
The number of CBE sessions should be tailored to the individual needs of the participants | 81.25 | Round 2 | |
Each CBE session should be a minimum of 10Â minutes long with a view to increasing further | 75 | Round 4 | |
Risk management | All programmes should be run by a suitably skilled and trained leader | 100 | Round 1 |
Instructors should have knowledge and skills of working with frail older people | 100 | Round 1 | |
Programmes do not have to be delivered by healthcare professionals | 94 | Round 1 | |
An individual health assessment should be carried out prior to commencing a CBE programme | 93.75 | Round 4 | |
Instructors should be aware of medical conditions which could disqualify participation or which require careful monitoring throughout sessions on the grounds of safety | 87.5 | Round 2 | |
CBE training programmes need to be regulated to ensure that they meet the agreed training curriculum | 86 | Round 3 | |
All instructors should have completed a regulated CBE training programme | 81.25 | Round 4 | |
Evaluation | Participants of CBE should be encouraged to actively feedback on each session | 100 | Round 3 |
Participant reported outcome measures are useful for evaluating the effectiveness of programmes | 94.1 | Round 1 | |
If CBE’s are undertaken for health gains, a standardised outcome measure should be used routinely throughout programmes to evaluate effectiveness | 70.6 | Round 1 |