The effects of a long-term care walking program on balance, falls and well-being

Abstract

BackgroundThe effects of a regular and graduated walking program as a stand-alone intervention for individuals in long-term care are unclear. Exercise and fall prevention programs typically studied in long-term care settings tend to involve more than one exercise mode, such as a combination of balance, aerobic, strengthening, and flexibility exercises; and, measures do not always include mental health symptoms and behaviors, although these may be of even greater significance than physical outcomes.Methods/designWe are randomly assigning residents of long-term care facilities into one of three intervention groups: (1) Usual Care Group - individuals receive care as usual within their long-term care unit; (2) Interpersonal Interaction Group - individuals receive a comparable amount of one-on-one stationary interpersonal interaction time with study personnel administering the walking program; and, (3) Walking Program Group – individuals participate in a supervised, progressive walking program five days per week, for up to half an hour per day. Assessments completed at baseline, 2 and 4 months during intervention, and 2 and 4 months post-intervention include: gait parameters using the GAITRite® computerized system, grip strength, the Berg Balance Scale, the Senior Fitness Test, the Older Adult Resource Services Physical Activities of Daily Living, the Geriatric Depression Scale Short Form, the Cornell Scale for Depression in Dementia, the Revised Memory and Behavior Problems Checklist, the Short Portable Mental Status Questionnaire, the Coloured Analogue Scale, pain assessment scales, and the number and nature of falls. Sophisticated data analytic procedures taking into account both the longitudinal nature of the data and the potential for missing data points due to attrition, will be employed.DiscussionResidents in long-term care have a very high number of comorbidities including physical, mental health, and cognitive. The presence of dementia in particular makes standardized research protocols difficult to follow, and staff shortages, along with inconsistencies related to shift changes may impact on the accuracy of caregiver-rated assessment scales. Practical challenges to data collection validity and maintenance of inter-rater reliability due to the large number of research staff required to implement the interventions at multiple sites are also posed.Trial registrationClinicalTrials.gov NCT01277809

Years of life lost due to lower extremity injury in association with dementia, and care need: a 6-year follow-up population-based study using a multi-state approach among German elderly

“…Second, LEI restricts physical activity, mobility and social participation, at least during some periods of time [ 9 , 10 ], thus restricting these potential preventive factors of dementia [ 22 , 23 ]. The decreased mobility in long-term care residents, in particular, is associated with various psychosocial impairments such as depression and feeling of isolation [ 57 ]. Also, falls and the consequent fear of falling might lead to activity restriction in the long run [ 58 , 59 ].…”

An evaluation of a walking and socialization program in long-term care: Impact on injurious falls

“…This paper is part of a larger investigation of falls in LTC, for which study methods and design were published in detail by Dal Bello-Haas et al 12 . In summary, this study involved a prospective, randomized, three-group experimental design with multiple outcome variables.…”

“…The evidence for beneficial outcomes related to exercise interventions for older adults in LTC has been limited and equivocal 12 . Many studies were methodologically limited and could not allow for the adequate separation of the effects of exercise from socialization.…”

Elderly Friendly Exercises: A PRISMA-Guided Review of the Literature to Enable Awareness of Exercise that are Recommended for Elderly

“…Aerobic: All the studies were conducted between 2000-2022. A randomized control trial has been used for most of the studies [4,5,7,[9][10][11][12][14][15][16][17][18][19][20]26]. The majority of the studies have been conducted in the United States of America.…”