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Published on: October 6, 2016
A 10-week physical therapist-supervised exercise program for nursing home residents with dementia: a single arm,
Dennis Boer1,2,3, Bente Winkler1, Charlotte Schmidt1
1Department of Strategy and Innovation, Kennemerhart, Haarlem, The Netherlands.
Background:
Evidence on the effectiveness of exercise interventions for nursing home residence with dementia is scarce, with considerable practice variation with respect to their contents and dosage. This study aimed to evaluate the feasibility of an adequately dosed, personalized exercise intervention with respect to the assessment instruments, participants' adherence and the occurrence of serious adverse events (primary feasibility outcomes) as well as the participant recruitment and participants' and supervisors' perceptions and experiences (secondary feasibility outcomes).
Design:
Single-arm observational study.
Setting:
Two nursing homes in Haarlem, the Netherlands.
Participants:
Nursing home residents with a confirmed diagnosis of dementia who were able to walk 50 meters (with or without walking aid), without expected resistance to the intervention.
Intervention:
10-week program, with two group-based sessions including strength and balance exercises, and two individual exergaming cycling sessions per week. The sessions were tailored to the participant via standardized assessments and supervised by a physical therapist.
Results:
Of 59 residents screened, 11 enrolled. Four of six clinical assessments were completed by all, and two by nine and ten participants, respectively. Nine participants completed both components, one only the individual exergaming part, and one participant dropped out. Adherence rates were 92 % for the group and 87 % for the individual sessions. Among 137 reported adverse events, nine were possibly related to the intervention, all minor and transient. The median participant appraisal score was 4.3 (out of five). Supervisors highlighted dementia-specific knowledge, individualized communication, and tailored approaches as facilitators, while scheduling conflicts posed challenges.
Conclusion:
A 10-week, personalized, physical therapist-led exercise program for nursing home residents with dementia is feasible, with high adherence and positive evaluations. A pilot study to refine the recruitment and intervention procedures as well as pre-and post-intervention outcome measurements is needed prior to scaling up to a larger clinical trial assessing effectiveness.
