Preventing Loss of Independence through Exercise (PLIÉ) Guiding Principles.

*Physical therapy is a health care profession that focuses on maintaining, restoring and improving movement, activity and health to promote optimal function and quality of life.[53] This is accomplished by examining, evaluating and diagnosing clients and working with them to identify their specific goals and develop an action plan that includes physical exercises such as stretching, strengthening and coordination activities to improve function in daily activities. Physical therapy has a participant-centered goal orientation (Guiding Principal [GP] 4) and exercises are repeated with variations (GP 1) and often involve progressive functional movements (GP 2). Occupational therapy is a health care profession that helps people to participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).[54] It involves performing an individualized evaluation to determine a person’s goals related to functional activities, developing a customized intervention that may include adaptation of the environment as well as specific activities to improve the person’s ability to perform daily activities and reach the goals, and an outcomes evaluation to ensure that the goals are being met and to make changes to the intervention plan as needed, recognizing the functional and social/emotional needs of clients. Occupational therapy has a participant-centered goal orientation (GP 4) and may involve physical exercises that repeat with variations (GP 1) or target progressive functional movements (GP 2); in addition, occupational therapy interventions in people with dementia often utilize a slow pace and step-by-step instruction (GP 3) and emphasize social interaction (GP 6) and positive emotions (GP 7). Yoga is a movement practice from India that seeks to join the mind, body and spirit in a harmonious experience.[55] Yoga primarily includes physical postures, conscious breathing techniques, and meditation practice and sometimes incorporates visualization and the use of sounds or chanting. While hatha yoga is the form of yoga first popularized in the west, there are many forms of yoga, and our study integrated a form of yoga called Healing Yoga[56] that emphasizes nonjudgmental instruction, comfort while moving, and attention to breathing and body sensations. Yoga typically involves repetition of movements with variation (GP 1); a slow pace and step-by-step instruction (GP 3); a focus on body awareness, mindfulness and breathing (GP 6); and promotion of positive emotions (GP 7). Tai chi is a mind-body health practice that originated in China as an internal martial art.[57] It involves performing slow, fluid movement sequences following established forms that are learned over time. Sometimes called ‘moving meditation,’ tai chi practice emphasizes staying aligned, grounded and balanced while moving, with attention to mental and physical relaxation, promoted by deep, diaphragmatic breathing.[58] Tai chi involves repetition of movements with variation (GP 1); a slow pace and step-by-step instruction (GP 3); training of body awareness, mindfulness and breathing (GP 5), and a focus on positive emotions (GP 7). The Feldenkrais Method is a form of somatic (of the body) education that seeks to improve movement, function, range of motion, flexibility and coordination.[59] It is designed to provide an opportunity for neuromuscular re-education through sensory-motor awareness through hundreds of movement sequences called ‘Awareness Through Movement’ that progress in complexity, using variations in positions, attention to body sensation, gentle movement and frequent rests as strategies to change habitual ways of moving, sensing, thinking and feeling.[60] Feldenkrais involves performing basic functional movements that gradually increase in complexity (GP 2); movements are typically taught in a slow, step-by-step manner (GP 3) and are designed to enhance body awareness (GP 5) and promote positive emotions (GP 7). Rosen Method movement classes are set to music and involve slow, easy movements that are designed to improve alignment and flexibility, increase range of motion and ease of breathing, and deepen awareness of the body.[61] The group format of movement classes utilizes social interaction to facilitate a nonjudgmental, relaxed learning environment. It involves learning progressive functional movements (GP 2) in a slow, step-by-step manner (GP 3) with a focus on body awareness, mindfulness and breathing (GP 5), social interaction (GP 6) and positive emotions (GP 7). Dance Movement Therapy is defined as the psychotherapeutic use of movement to promote emotional, social, cognitive and physical integration of the individual.[62] Dance movement therapy in groups with seniors are often in a circle seated formation, usually have a beginning greeting and closing ritual, and involve nonjudgmental explorations combined with verbal processing to facilitate emotional growth and social relatedness.[63] Dance movement therapy includes repetition of dance movement sequences with variations (GP 1), step-by-step instructions (GP 3), and a focus on social interactions (GP 6) and positive emotions (GP 7).
Preventing Loss of Independence through Exercise (PLIÉ) Guiding Principles.