Less is more: Implementation of a nurse-led physical activity program for nursing home residents. An intervention...

Older adults in nursing homes, particularly those with dementia, experience rapid physical decline and elevated fall risk, while nurse-led physical activity programs remain rare and difficult to implement.

This study aimed to identify key components of effective nurse-led physical activity programs through a systematic review and expert consultation. The resulting best-practice program - ViSTA - was piloted in a Swiss nursing home, focusing on feasibility, acceptance, adherence, and trends in physical function.

A 16-week quasi-experimental mixed-methods pilot was conducted with 14 residents (mean age 87.2 years), including those with mild to moderate dementia able to follow instructions and ambulate. Physical and cognitive function were assessed at baseline, week 6, and week 16. Adherence was tracked via session logs, while feasibility and acceptance were explored through questionnaires and interviews with residents and professionals. Data were analyzed using Creswell's convergence model.

Ten of 14 residents completed the program (71%). Mean attendance was 1.37 of four planned weekly sessions (∼20%), though session durations exceeded expectations (24.9 vs. 15 min). Most used tools included a TV-based non-interactive group activity ("Stay fit - join in!") and the Smart Peg Board®. Functional outcomes varied across participants. Professionals appreciated the program's simplicity and adaptability but noted time constraints and limited institutional support as major barriers. Some elements were maintained post-study.

ViSTA promises a low-threshold, sustainable physical activity program in nursing homes, especially with adequate staffing, training, and leadership support, highlighting the potential of nurse-led initiatives to enhance resident engagement and functional health.