Marina B Pinheiro

Dementia causes cognitive decline, reduced balance and poor mobility. People living with dementia fall twice as often and are three times more likely to break bones and die. 

A physiotherapist can help older people improve their balance and walking. Older people need to do two hours of balance and strengthening exercise per week to reduce their falls risk and maintain their level of independence. This is a challenge in aged care settings, as there are not enough physiotherapists and staff to assist older people living with dementia to exercise safely. COVID-19 exacerbated the situation by restricting physiotherapist’s ability to visit people. Telehealth has emerged as a new way to allow people living with dementia to ‘see’ their physiotherapist online.

Dr Marina Pinheiro and The TOP UP Study collaborated with older people living with dementia, their carers, physiotherapists and aged care service providers to co-design a randomised controlled trial to explore aspects of telehealth physiotherapy in aged care. Dr Pinheiro found that telephysiotherapy was safe and acceptable. However, ongoing commitment and aged care collaborative partnerships are needed. Qualitative analysis of the study revealed that tailored, flexible physiotherapy care with local support and engaging, senior-friendly educational resources enhanced exercise motivation, nurtured feelings of competence and produced high satisfaction rates. The TOP UP study also resulted in positive behaviour changes, with some participants engaging in independent exercise. 

This program will be rolled-out in the aged care industry to assist older people living with dementia to maintain their function and independence for as long as possible.

Read more about this exciting project

Dawson R, Pinheiro M et al. Physiotherapy-led telehealth and exercise intervention to improve mobility in older people receiving aged care services (TOP UP): protocol for a randomised controlled type 1 hybrid effectiveness-implementation trial. BMJ Nutrition, Prevention & Health 2023-12. DOI: 10.1136/bmjnph-2022-000606 

Dawson R, Gilchrist H, Pinheiro M et al. Experiences of Older Adults, Physiotherapists, and Aged Care Staff in the TOP UP Telephysiotherapy Program: Interview Study of the TOP UP Interventions. JMIR Aging 2024-02-07 DOI: 10.2196/53010

Dawson R, Oliveira J, Kwok W, Bratland M, Rajendran I, Sriniva-san A, Chu C, Pinheiro M et al. Exercise Interventions Delivered Through Telehealth to Improve Physical Functioning for Older Adults with Frailty, Cognitive, or Mobility Disability: A Systematic Review and Meta-Analysis. Telemedicine and e-Health 2023-11-17.DOI:  10.1089/tmj.2023.0177

At the time of this award, Dr Marina B Pinheiro was a NHMRC Early Career Fellow at the Institute for Musculoskeletal Health, a partnership between the University of Sydney and Sydney Local Health District.