Effects of interventions on physical activity in nursing home residents

Carl-Philipp Jansen, Katrin Claßen, Hans-Werner Wahl, Klaus Hauer, Carl-Philipp Jansen, Katrin Claßen, Hans-Werner Wahl, Klaus Hauer

Abstract

The aim of this review was to evaluate current evidence regarding the effects of interventions on physical activity in the subgroup of nursing home residents as well as to critically review the assessment methods used in this regard. Published studies through January 2015 were searched in The Cochrane Library, PubMed, CINAHL, Web of Knowledge, PsycInfo, Psyndex, Psycarticles, CC Med, and DissOnline; and by manual search. For randomized controlled trials (RCTs) to be included, an intervention had to be conducted with nursing home residents aged 65 years and above and physical activity had to be assessed using standardized, quantitative methods. Study quality was evaluated using an established Cochrane rating tool for RCTs. Eight studies met the inclusion criteria. Only one intervention study with main focus on a modification of physical activity behavior could be identified. Physical activity assessments used in the studies were partly limited regarding objectivity or psychometric quality. Hence, the documentation of effects of interventions is restricted. Six studies reported significant increases of physical activity in nursing home residents and thus positive intervention effects, which points at the feasibility and high potential of intervention programs to promote physical activity in this setting. Enhanced individual contact as well as physical exercise combined with behavioral interventions and the inclusion of nursing staff seems to be most effective in this regard. As only one study involved post-intervention follow-up assessments, sustainability of effects remained unclear.

Keywords: Intervention; Nursing home residents; Older people; Physical activation.

Figures

Fig. 1
Fig. 1
Flowchart of literature search and study selection

References

    1. Allet L, Knols RH, Shirato K, de Bruin E. Wearable systems for monitoring mobility-related activities in chronic disease: a systematic review. Sensors. 2010;10:9026–9052. doi: 10.3390/s101009026.
    1. Bassett DR, Ainsworth BE, Swartz AM, Strath SJ, O’Brien WL, King GA. Validity of four motion sensors in measuring moderate intensity physical activity. Med Sci Sports Exerc. 2000;32:S471–S480. doi: 10.1097/00005768-200009001-00006.
    1. Bates-Jensen BM, Alessi CA, Cadogan M, Levy-Storms L, Jorge J, Yoshii J, Al-Samarrai NR, Schnelle JF. The minimum data set bedfast quality indicator—differences among nursing homes. Nurs Res. 2004;3:260–272. doi: 10.1097/00006199-200407000-00009.
    1. *Chin A Paw MJ, van Poppel MN, van Mechelen W (2006) Effects of resistance and functional-skills training on habitual activity and constipation among older adults living in long-term care facilities: a randomized controlled trial. BMC Geriatr 6: 9. doi:10.1186/1471-2318-6-9
    1. Cohen J. Statistical power analysis for the behavioral sciences. 2. Hillsdale: Lawrence Erlbaum Associates; 1988.
    1. Crocker T, Forster A, Young J, Brown L, Ozer S, Smith J, Green J, Hardy J, Burns E, Glidewell E, Greenwood DC (2013) Physical rehabilitation for older people in long-term care (Review). The Cochrane Library 2013, Issue 2. doi:10.1002/14651858. CD004294.pub3
    1. De Bruin E, Hartmann A, Uebelhart D, Murer K, Zijlstra W. Wearable systems for monitoring mobility-related activities in older people: a systematic review. Clin Rehab. 2008;22:878–895. doi: 10.1177/0269215508090675.
    1. De Vries OJ, Ligthart GJ, Nikolaus T. Differences in period prevalence of the use of physical restraints in elderly inpatients of European Hospitals and Nursing Homes. J Gerontol: Med Sci. 2004;59:M922–M923. doi: 10.1093/gerona/59.9.M922.
    1. Eschweiler GW, Leyhe T, Klöpperl S, Hüll M. Neue Entwicklungen in der Demenzdiagnostik. Deutsches Ärztebl Int. 2010;107:677–683.
    1. European Commission (DG ECFIN), Economic Policy Committee (AWG) (2009) The 2009 ageing report: economic and budgetary projections for the EU-27 Member States (2008–2060). . Accessed 05 June 2013. doi:10.2765/80301
    1. *Fiatarone MA, O’Neill EF, Doyle RN, Clements KM, Solares GR, Nelson ME, Roberts SB, Kehayias JJ, Lipsitz LA, Evans WJ (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. New Engl J Med 330: 1769–1775
    1. Foster C, Hillsdon M, Thorogood M, Kaur A, Wedatilake T (2005) Interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2005, Issue 1. doi:10.1002/14651858.CD003180.pub2
    1. *Galik E, Resnick B, Hammersla M, Brightwater J (2014) Optimizing function and physical activity among nursing home residents with dementia: testing the impact of function-focused care. Gerontologist 54: 930–943. doi:10.1093/geront/gnt108
    1. German Network for Quality Development in Care - Deutsches Netzwerk für Qualitätsentwicklung in der Pflege (DNQP) (2006) Expertenstandards Sturzprophylaxe in der Pflege. Entwicklung, Konsertierung, Implementierung. DNQP, Osnabrück
    1. *Grönstedt H, Frändin K, Bergland A, Helbostad JL, Granbo R, Puggaard L, Andresen M, Hellström K (2012) Effects of individually tailored physical activities in nursing home residents on activities of daily living, physical performance and physical activity level: a randomized controlled trial. Gerontol 59: 220–229. doi:10.1159/000345416
    1. Hauer K, Lord SR, Lindemann U, Lamb SE, Aminian K, Schwenk M. Assessment of physical activity in older people with and without cognitive impairment. J Aging Phys Act. 2011;19:347–372.
    1. Kapasi ZF, Ouslander JG, Schnelle JF, Kutner M, Fahey JL. Effects of an exercise intervention on immunologic parameters in frail elderly nursing home residents. J Gerontol A. 2003;58:636–643. doi: 10.1093/gerona/58.7.M636.
    1. Klauer KJ. Handbuch kognitives training. Göttingen: Hogrefe; 2001.
    1. Latham NK, Anderson CS, Lee A, Bennett DA, Moseley A, Cameron ID. A randomized, controlled trial of quadriceps resistance exercise and vitamin d in frail older people: the frailty interventions trial in elderly subjects (FITNESS) J Am Ger Soc. 2003;51:291–299. doi: 10.1046/j.1532-5415.2003.51101.x.
    1. *Lobo A, Carvalho J, Santos P (2010) Effects of training and detraining on physical fitness, physical activity patterns, cardiovascular variables, and HRQoL after 3 health-promotion interventions in institutionalized elders. Int J Fam Med. doi:10.1155/2010/486097
    1. MacRae PG, Schnelle JF, Simmons SF, Ouslander JG. Physical activity levels of ambulatory nursing home residents. J Aging Phys Act. 1996;4:264–278.
    1. McAuley E, Blissmer B. Self-efficacy determinants and consequences of physical activity. Exerc Sport Sci Rev. 2000;28:85–88.
    1. Phillips EM, Schneider JC, Mercer GR. Motivating elders to initiate and maintain exercise. Arch Phys Med Rehabil. 2004;85:52–57. doi: 10.1016/j.apmr.2004.03.012.
    1. Plasqui G, Westerterp KR. Physical activity assessment with accelerometers: an evaluation against doubly labeled water. Obes. 2007;15:2371–2379. doi: 10.1038/oby.2007.281.
    1. Potter R, Ellard D, Rees K, Thorogood M. A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia. Int J Ger Psychiatr. 2011;26:1000–1011. doi: 10.1002/gps.2641.
    1. Riedl M, Mantovan F, Them C. Being a nursing home resident—a challenge for one’s identity. Pflegez. 2012;65:280–285.
    1. Rodrigues R, Huber M, Lamura G, editors. Facts and figures on healthy ageing and long-term care. Vienna: European Centre for Social Welfare Policy and Research; 2012.
    1. Rydwik E, Frändin K, Akner G. Effects of physical training on physical performance in institutionalised elderly patients (70 +) with multiple diagnoses. Age Ageing. 2004;33:13–23. doi: 10.1093/ageing/afh001.
    1. Scherder EJ, Bogen T, Eggermont LH, Hamers JP, Swaab DF. The more physical inactivity, the more agitation in dementia. Int Psychoger. 2010;22:1203–1208. doi: 10.1017/S1041610210001493.
    1. *Schnelle JF, MacRae PG, Ouslander JG, Simmons SF, Nitta M (1995) Functional incidental training, mobility performance, and incontinence care with nursing home residents. J Am Ger Soc 43: 1356–1362
    1. Schnelle JF, Alessi C, Simmons SF, Al-Samarrai NR, Beck JC, Ouslander JG. Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents. Am J Ger Soc. 2002;50:1476–1483. doi: 10.1046/j.1532-5415.2002.50401.x.
    1. *Schnelle JF, Leung FW, Rao SSC, Beuscher L, Keeler E, Clift JW, Simmons S (2010) A controlled trial of an intervention to improve urinary and fecal incontinence and constipation. J Am Ger Soc 58: 1504–1511. doi:10.1111/j.1532-5415.2010.02978.x
    1. *Simmons SF, Schnelle JF (2004) Effects of an exercise and scheduled-toileting intervention on appetite and constipation in nursing home residents. J Nutr, Health Aging 8: 116–121
    1. Slaughter SE, Estabrooks CA, Jones CA, Wagg AS. Mobility of Vulnerable Elders (MOVE): study protocol to evaluate the implementation and outcomes of a mobility intervention in long-term care facilities. BMC Geriatr. 2011;11:84. doi: 10.1186/1471-2318-11-84.
    1. Stel VS, Smit JH, Pluijm SMF, Visser M, Deeg DJH, Lips P. Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. J Clin Epidemiol. 2004;57:252–258. doi: 10.1016/j.jclinepi.2003.07.008.
    1. Tinetti ME, Ginter SF. The nursing home life space diameter. A measure of extent and frequency of mobility among nursing home residents. J Am Ger Soc. 1990;38:1311–1315. doi: 10.1111/j.1532-5415.1990.tb03453.x.
    1. Van der Bij AK, Laurant MG, Wensing M. Effectiveness of physical activity interventions for older adults. Am J Prev Med. 2002;22:120–133. doi: 10.1016/S0749-3797(01)00413-5.
    1. World Health Organization (2010) Global recommendations on physical activity for health. . Accessed 10 April 2013

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi