Evidence suggests that targeted exercise is important for people living with dementia. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to walking group exercise of older people living with dementia in the community. We have searched appropriate electronic databases between January 1990 until September 2019, in any language. Additionally, we searched trial registries ( clinicaltrial.gov and WHO ICTRP) for ongoing studies. We included all study designs. Studies were excluded when participants were either healthy older people or people suffering from dementia but living in residential care. Narrative synthesis was used. 10 papers met the inclusion criteria. The narrative analysis focused on barriers, facilitators, and adherence. All studies reported on barriers and facilitators. Barriers included: bio-medical reasons (including mental wellbeing and physical ability); relationship dynamics; and socio-economic reasons and environmental issues. Facilitators included: bio-medical benefits & benefits related to physical ability; staff, group relationship dynamics and social aspect of walking group; environmental issues and individual tailoring; and participants perceptions about the walks & the program. Most studies did not provide data about adherence or attendance; where reported, adherence ranged from 47 to 89%. This systematic review of literature has highlighted known barriers and facilitators to adherence to walking groups type of exercise for people living with dementia in community. Carers’ willingness to engage, their circumstances, perspectives and previous experiences of exercise seem to play a key role in facilitating adherence but there is little research that explores these. Also, the design, location and organisation of walking groups facilitate adherence. This reflects the need for such activities to be part of a wider ‘program of care’, tailored to the needs of the individual, flexible and convenient. Knowledgeable and well-trained instructors or healthcare professionals are recommended as group exercise leaders.

中文翻译：

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社区痴呆症老年人坚持步行团体锻炼的障碍和促进因素：系统评价


有证据表明，有针对性的锻炼对于痴呆症患者很重要。本次审查的目的是收集和综合关于社区痴呆症老年人坚持步行团体锻炼的已知障碍和促进因素的证据。我们在 1990 年 1 月至 2019 年 9 月期间以任何语言检索了适当的电子数据库。此外，我们还检索了试验登记处（clinicaltrial.gov 和 WHO ICTRP）以查找正在进行的研究。我们纳入了所有研究设计。当参与者是健康的老年人或患有痴呆症但住在寄宿护理中的人时，研究被排除在外。使用了叙事合成。符合纳入标准的论文10篇。叙述分析的重点是障碍、促进因素和依从性。所有研究都报告了障碍和促进因素。障碍包括：生物医学原因（包括心理健康和身体能力）；关系动态；以及社会经济原因和环境问题。促进者包括：生物医学益处和与身体能力相关的益处；步行团体的工作人员、团体关系动态和社交方面；环境问题和个性化定制；以及参与者对步行和项目的看法。大多数研究没有提供有关依从性或出勤率的数据；据报道，遵守率在 47% 至 89% 之间。这项对文献的系统回顾强调了社区痴呆症患者坚持步行团体运动的已知障碍和促进因素。护理人员的参与意愿、他们的情况、观点和以前的锻炼经验似乎在促进坚持方面发挥着关键作用，但很少有研究对此进行探讨。 此外，步行小组的设计、位置和组织也有助于遵守。这反映出此类活动需要成为更广泛的“护理计划”的一部分，根据个人的需求量身定制，灵活且方便。知识渊博且训练有素的教练或医疗保健专业人员被推荐作为团体锻炼的领导者。