Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents: A Randomized Controlled Trial

Gerontology - Tập 62 Số 6 - Trang 571-580 - 2016
Kerstin Frändin1, Helena Grönstedt1,2, Jorunn L. Helbostad3,4, Astrid Bergland5, Mette Andresen6, Lis Puggaard7, Karin Harms‐Ringdahl1,2, Randi Granbo8, Karin Hellström9
1Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and
2Department of Physiotherapy, Karolinska University Hospital Huddinge, Huddinge, Sweden
3Clinical Services, Department of Geriatrics, St. Olav University Hospital, Trondheim, and
4Department of Neuroscience, Norwegian University of Science and Technology, and
5Faculty of Health Science, Oslo and Akershus University College, Oslo, Norway
6Department of Research and Innovation, University College Sjaelland, Naestved, and
7University of Southern Denmark, Odense, Denmark
8Faculty of Health Education and Social Work, Sør-Trøndelag University College, Trondheim, Norway
9Department of Neuroscience, Uppsala University, Uppsala, Sweden

Tóm tắt

<b><i>Background:</i></b> The preservation of physical functions such as muscle strength, balance and mobility is fundamental to maintaining independence in activities of daily living (ADL). The physical activity level of most nursing home residents is very low, which implies that they are often subject to a decline in health, mobility, autonomy and social contacts and are also at risk of suffering a decline in mental well-being. In a previous study, we demonstrated that transfers, balance and physical activity level improved after 3 months of individually tailored intervention in nursing home residents. <b><i>Objective:</i></b> To evaluate the long-term effects on ADL, balance function, physical activity level, physical performance, falls-related self-efficacy, well-being and cognitive function 3 months after the completion of our intervention in nursing home residents. <b><i>Methods:</i></b> The study was a multicenter randomized, controlled clinical trial with a parallel-group design. It was conducted in nursing homes in Sweden, Norway and Denmark, with an intervention period lasting 3 months and a follow-up at 6 months. Initially, 322 nursing home residents with a mean age of 85 years were included; 85 from Sweden, 171 from Norway and 66 from Denmark. Of these, 241 [129 intervention group (IG), 112 control group (CG)] were eligible for the 6-month follow-up tests. The level of dependence in ADL, physical activity level, several dimensions of physical function, well-being, falls-related self-efficacy and cognitive function were assessed with reliable and valid instruments at baseline, immediately after 3 months of intervention and 3 months later at the 6-month follow-up. <b><i>Results:</i></b> After 3 months of intervention and an additional period of 3 months without intervention, only the following 2 variables demonstrated significant group differences: social and cognitive function, measured by the Functional Independence Measure n-r, where the IG deteriorated while the CG was almost stable. However, regarding transfers, the IG deteriorated significantly less than the CG. <b><i>Conclusion:</i></b> Without supervised physical exercise that challenged the individuals' capability, gains in ADL function, balance and transfer ability deteriorated during the 3 months following the intervention period. Thus, continuous, individually adjusted and supported physical activity seems crucial for the maintenance of physical functions in these vulnerable elderly persons.

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Gerontology

Tập 62 Số 6

571-580

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