Adaptation of the subjective effort induction scale (SEIS-3) for strength training: A clinical application for older adults with dementia syndrome

Objective

This study aimed to adapt and validate the Subjective Effort Induction Scale (SEIS-3) for advise strength training prescription in older adults with dementia, examining its reliability and stratifying results by dementia stage.

Methods

This is a cross-sectional study conducted in two phases: Phase 1 involved reviewing the SEIS-3 instrument development and making necessary adaptations based on international guidelines. Phase 2 included testing the adapted SEIS-3 instrument in older adults with diagnosis of dementia syndrome. A sample size of 32 individuals aged between 62 and 90 years was selected based on previous work. Participants were diagnosed with dementia. The SEIS-3D was proposed. Effort assessment involved grip strength measurements using an electronic hand dynamometer, with intra- and inter-rater reliability assessed through Intraclass Correlation Coefficient calculations. The Bland-Altman method was used to examine agreement and systematic bias, while Standard Error of Measurement calculations determined measurement precision.

Results

The study validated the effort gradations (weak, medium, strong) with significant differences in grip strength. High intra- and inter-rater reliability was demonstrated across all effort levels, particularly at strong effort levels. Although most measurements indicated consistent agreement, systematic bias was observed in specific intra- and inter-rater assessments.

Conclusion

The SEIS-3D has been validated and shown to be a reliable tool, effective for use in determining strength training intensity to elderly with mild to moderate dementia. For severe dementia, its reliability improves with stronger prescribed effort levels.