their activities of daily living (ADL) as their balance, mobility, and fine motor skills become compromised ( Telenius, Engedal, & Bergland, 2015 ). Requirements for higher levels of care result in more individuals with dementia living in nursing homes ( Australian Institute of Health and Welfare, 2011
Lindsey Brett, Victoria Traynor, Paul Stapley and Shahla Meedya
Priscilla G. MacRae, John F. Schnelle, Sandra F. Simmons and Joseph G. Ouslander
The purpose of this study was to describe the physical activity levels of ambulatory nursing home residents (N = 95) and identify factors that predicted these activity levels. The residents’ physical activity levels (standing, walking, and wheelchair propulsion), as measured by time-sampled observations and Caltrac motion sensors, indicated that restraint use was the major predictor of low physical activity. Both the physically restrained and the physically unrestrained groups, however, were inactive, with 93.8% and 83.5% of the observations, respectively, representing either lying or sitting. In the unrestrained group, scores measuring the resident’s fall risk, self-selected walking speed, upper and lower body strength, and body mass index were significant predictors of physical activity level. In the restrained group, scores measuring the resident’s fall risk and upper body strength were significant predictors of activity level.
Sonja Kalinowski, Ines Wulff, Marita Kölzsch, Kirsten Kopke, Reinhold Kreutz and Dagmar Dräger
To explore different institutional barriers to and facilitators of physical activity (PA) in nursing homes.
Cross-sectional survey of 40 German nursing homes and 217 nursing-home residents (NHRs; M ± SD age 80 ± 10.2 yr, 55% women, MMSE ≥20). Quantitative data were collected on the structural characteristics of nursing homes and the PA services available.
Forms of exercise available were not adequately communicated to residents. Overall participation was below 50%. Awareness was significantly higher in residents with informed relatives (p = .003). A broad range of forms of exercise was generally available (M ± SD 5 ± 2.22, range 0–10), but they were rarely tailored to NHRs’ needs and their effectiveness remains questionable.
Multidimensional opportunities to promote PA in NHRs are identified.
Ellen F. Binder
This pilot study evaluated (a) the feasibility of a group exercise program in an institutionalized population with dementia; (b) the effects of such a program on physical performance measures; and (c) the potential additional effects of vitamin D supplementation on gait and muscle strength. Nursing home residents (N = 25) with chronic dementia and mobility impairments attended a thrice weekly exercise class for 8 weeks. They were randomly assigned to receive either a vitamin D supplement or no supplement throughout the program. Between-group differences in the effectiveness of the exercise intervention were analyzed. Pre-to-post changes were also assessed for both groups combined. In postexercise comparisons of both groups, knee extensor torque at 0°/sec declined by 18.6% while performance of 1-RM for hip extension increased by 16.1%. Balance also improved. Although vitamin D levels increased significantly in the supplement group, the two groups did not differ in their response to the exercise intervention.
Nobuo Takeshima, Keizo Shimada, Mohammod M. Islam, Hiroaki Kanehisa, Yoshie Ishida and William F. Brechue
To clarify the progression of muscle loss in nursing home residents, frail women (n = 16; age: 85 ± 9 years; residence time: 764 days) were assessed for physical activity, caloric intake, and site-specific muscle thickness (MTH) and subcutaneous fat thickness (SFT) using B-mode ultrasound at nine anatomical sites at four intervals over one year. Height, body weight, and BMI did not change. Physical activity (246 steps/day) and nutritional intake (1,441 kcal, 60.3 g protein/day) were unaltered throughout the study. Subjects experienced a significant, progressive loss of muscle indicated by decrements in anterior upper arm (20%), posterior upper arm (25%), abdomen (20%), subscapular (33%), anterior thigh (15%), posterior thigh (22%), anterior lower leg (11%), posterior lower leg (13%), and forearm (15%) MTH. At study inception, prevalence of sarcopenia was related to muscle loss in the upper leg, while upper body muscle wasting contributed to sarcopenia later and was unrelated to physical activity, nutritional input, or duration of residence.
Afroditi Stathi and Piers Simey
Life in the Fourth Age has been typified as a time of continued functional decline and reduced quality of life. Exercise might positively affect this experience. This study explored the exercise experiences of nursing home residents age 86–99 years who participated in a 6-month exercise intervention. An interpretive phenomeno-logical approach was adopted. Twenty-one interviews were held with 14 residents at baseline and 7 residents at follow-up. Although their expectations were initially conservative, by the end of the intervention participants noted improved quality of life through better mobility, decreased fear of falling, and feelings of achievement and success. They valued the program as an opportunity to do something for themselves, to add something to their weekly routine, to meet other people, and to be more active generally. The professionalism of the exercise instructor appears to have been critical, balancing principles of safe and effective practice with the need to ensure that participants had fun in a supportive environment.
Annette J. Raynor, Fiona Iredale, Robert Crowther, Jane White and Julie Dare
dementia in nursing homes: Views of staff and family carers . Journal of Aging & Physical Activity, 26 ( 1 ), 89 – 96 . PubMed ID: 28513238 doi: 10.1123/japa.2016-0368 Exercise and Sports Science Australia (ESSA) (Producer). ( 2015 ). What is an accredited exercise physiologist? Retrieved from
Koren L. Fisher, Elizabeth L. Harrison, Brenda G. Bruner, Joshua A. Lawson, Bruce A. Reeder, Nigel L. Ashworth, M. Suzanne Sheppard and Karen E. Chad
Science, 14 ( 5 ), 489 – 496 . 10.1007/s11121-012-0325-y Olsen , C.F. , Telenius , E.W. , Engedal , K. , & Bergland , A. ( 2015 ). Increased self-efficacy: The experience of high-intensity exercise of nursing home residents with dementia– A qualitative study . BMC Health Services Research
Mieke G. Wasner and James H. Rimmer
This study evaluated nontherapeutic exercise programs offered in senior living facilities (SLFs), which included nursing homes, licensed and nonlicensed continuing care retirement communities, and senior independent living apartments. Exercise programs were evaluated on five criteria: number of different classes offered, instructors’ employment titles, exercise setting, program staffing levels, and amount and type of exercise equipment. Data revealed that chair exercises were the most common form of exercise, followed by stretching and supervised walking. The majority of exercise leaders were employed full-time (60%) but did not have degrees in exercise science, physical education, nursing, or physical therapy. Programs were mainly offered in multipurpose rooms or in other areas such as dining rooms, hallways, or lounges. Less than 27% of the SLFs followed American College of Sports Medicine exercise guidelines. This study found little consistency in the type of exercise programs offered to older adults in SLFs. Future research should evaluate the effectiveness of exercise classes offered in these facilities.
Helen Hawley, Dawn A. Skelton, Malcolm Campbell and Chris Todd
Little is known about the relationship between attitudes and characteristics of instructors and uptake and adherence of older people to exercise classes. This article explores these issues.
The authors surveyed 731 UK exercise instructors with specialist older adult exercise qualifications. A questionnaire investigated instructors’ characteristics and attitudes toward older adults’ participation in exercise.
For mostly seated classes, EXTEND qualification (B = 0.36, p = .005) had a positive effect on instructors’ attitudes. Later Life Training qualification (B = −2.80, p = .003), clinical background (B = −3.99, p = .005), and delivering classes in National Health Services (B = −3.12, p < .001), leisure centers (B = −2.75, p = .002), or nursing homes (B = −2.29, p = .005) had a negative effect on attitudes. For mostly standing classes, experience (B = 0.20, p = .003) and delivering in leisure centers (B = 0.46, p = .032) had a positive and clinical background (B = −1.78, p = .018) had a negative effect on instructors’ attitudes.
Most instructors have positive attitudes, but training and work context can influence attitudes toward older people’s participation in exercise classes both positively and negatively.