title: Preventing Loss of Independence through Exercise (PLIÉ): qualitative analysis of a clinical trial in older adults with dementia.
abstract: OBJECTIVE
  Preventing Loss of Independence through Exercise (PLIÉ) is a novel, integrative exercise program for individuals with dementia that combines elements of different conventional and complementary exercise modalities (e.g. tai-chi, yoga, Feldenkrais, and dance movement therapy) and focuses on training procedural memory for basic functional movements (e.g., sit-to-stand) while increasing mindful body awareness and facilitating social connection. This study presents analyses of qualitative data collected during a 36-week cross-over pilot clinical trial in 11 individuals.
  
  
  METHODS
  Qualitative data included exercise instructors' written notes, which were prepared after each class and also following biweekly telephone calls with caregivers and monthly home visits; three video-recorded classes; and written summaries prepared by research assistants following pre- and post-intervention quantitative assessments. Data were extracted for each study participant and placed onto a timeline for month of observation. Data were coded and analyzed to identify themes that were confirmed and refined through an iterative, collaborative process by the entire team including a qualitative researcher (SA) and the exercise instructors.
  
  
  RESULTS
  Three overarching themes emerged: (1) Functional changes included increasing body awareness, movement memory and functional skill. (2) Emotional changes included greater acceptance of resting, sharing of personal stories and feelings, and positive attitude toward exercise. (3) Social changes included more coherent social interactions and making friends.
  
  
  CONCLUSIONS
  These qualitative results suggest that the PLIÉ program may be associated with beneficial functional, emotional, and social changes for individuals with mild to moderate dementia. Further study of the PLIÉ program in individuals with dementia is warranted.
authors.affiliation: a Osher Center for Integrative Medicine , University of California , San Francisco , CA , USA.
authors.forename: Eveline
authors.initials: E
authors.lastname: Wu
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Barnes
authors.forename: Sara L
authors.initials: SL
authors.lastname: Ackerman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lee
authors.forename: Margaret
authors.initials: M
authors.lastname: Chesney
authors.forename: Wolf E
authors.initials: WE
authors.lastname: Mehling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D003704:Dementia / Q000628:therapy*; D004644:Emotions; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008568:Memory; D026441:Mind-Body Therapies / Q000379:methods / Q000523:psychology*; D036301:Qualitative Research; D012495:San Francisco
keywords: Alzheimer's disease; general; other dementias; qualitative methods