Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

Abstract

BackgroundStructured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the 'feasibility' of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. MethodSix electronic databases were searched by two independent researchers for randomized controlled trials that targeted longterm care residents and included exercise as an independent component of the intervention. ResultsA total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30-45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. ConclusionThis systematic review has identified 'feasible' physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health.

Poor physical fitness is associated with impaired memory, executive function, and depression in institutionalized older adults: a cross-sectional study

“…This is relevant because persons living in LTCFs have poor physical fitness and high physical dependence, which could be associated to poor mental health. 7,27 While the neurobiological mechanisms underlying physical fitness and cognitive function have not been fully elucidated, a number of studies have shown that persons who are more physically active exhibit better mental health. 24,28 Many neurobiological processes related to physical fitness, such as improved cerebral blood flow, increased trophic factors, neurotransmitter synthesis, and synaptic branch enhancement, could be associated with brain integrity.…”

Effects of a giant exercising board game intervention on ambulatory physical activity among nursing home residents: a preliminary study

“… 54 , 55 Supervision by exercise specialists or by trained physiotherapists would be preferable, but will generally involve additional charge for the institution. A review by Shakeel et al, 56 suggest that effective group-based exercise programs can be implemented in nursing homes with trained staff members (nurses or volunteers).…”

The Role of Exercises in Osteoporotic Fracture Prevention and Current Care Gaps. Where Are We Now? Recent Updates

“…One extensive systematic review found that effective group-based exercise programs can be implemented in LTC hospitals with monetary resource constraints, with the use of trained staff members (e.g. nurses, PSWs, and volunteers), using simple and inexpensive equipment, and carried out three times per week for 30–45 minutes per session 68. More research should determine how to optimize the feasibility of exercise programs specifically targeted to the elderly population residing in different long-term settings and/or their homes, and a patient inclusion/exclusion guideline should be created.…”