Helena Grönstedt1, Sofia Vikström2, Tommy Cederholm3, Erika Franzén4, Yvette C Luiking5, Åke Seiger6, Anders Wimo7, Gerd Faxén-Irving8, Anne-Marie Boström9. 1. Stockholms Sjukhem R&D Unit, Stockholm, Sweden; Allied Health Professionals, Function Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. 2. Stockholms Sjukhem R&D Unit, Stockholm, Sweden; Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden. 3. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Stockholm, Sweden; Department of Geriatric Medicine, Uppsala University Hospital, Uppsala, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden. 4. Stockholms Sjukhem R&D Unit, Stockholm, Sweden; Allied Health Professionals, Function Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. 5. Danone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands. 6. Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden. 7. Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden. 8. Stockholms Sjukhem R&D Unit, Stockholm, Sweden; Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden; Allied Health Professionals, Function Area Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden. 9. Stockholms Sjukhem R&D Unit, Stockholm, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Western Norway University of Applied Sciences, Haugesund, Norway. Electronic address: anne-marie.bostrom@ki.se.
Abstract
OBJECTIVES: Nursing home (NH) residents are often undernourished and physically inactive, which contributes to sarcopenia and frailty. The Older Person's Exercise and Nutrition Study aimed to investigate the effects of sit-to-stand exercises (STS) integrated into daily care, combined with a protein-rich oral nutritional supplement (ONS), on physical function, nutritional status, body composition, health-related quality of life, and resource use. DESIGN: Residents in 8 NHs were randomized by NH units into an intervention group (IG) or a control group (CG) (n = 60/group). The IG was a combination of STS (4 times/day) and ONS (2 bottles/day providing 600 kcal and 36 g protein) for 12 weeks. SETTING AND PARTICIPANTS: The participants resided in NH units (dementia and somatic care), were ≥75 years of age, and able to rise from a seated position. METHODS: The 30-second Chair Stand Test was the primary outcome. Secondary outcomes were balance, walking speed, dependence in activities of daily living, nutritional status and body composition, health-related quality of life, and resource use. RESULTS: Altogether, 102 residents (age 86 ± 5 years, 62% female) completed the study. No improvement in the physical function assessments was observed in the IG, whereas body weight increased significantly (2.05 ± 3.5 kg, P = .013) vs the CG. Twenty-one (of 52) participants with high adherence to the intervention (ie, at least 40% compliance to the combined intervention) increased their fat free mass (2.12 kg (0.13, 4.26 interquartile range), P = .007 vs CG). Logistic regression analyses indicated that the odds ratio for maintained/improved 30-second Chair Stand Test was 3.5 (confidence interval 1.1, 10.9, P = .034) among the participants with high adherence compared with the CG. CONCLUSIONS/IMPLICATIONS: Twelve-week intervention of daily STS combined with ONS in NH residents did not improve physical function, but increased body weight. Subgroup analyses indicated that high adherence to the combined intervention was associated with maintained or improved physical function and a gain of fat free mass.
OBJECTIVES: Nursing home (NH) residents are often undernourished and physically inactive, which contributes to sarcopenia and frailty. The Older Person's Exercise and Nutrition Study aimed to investigate the effects of sit-to-stand exercises (STS) integrated into daily care, combined with a protein-rich oral nutritional supplement (ONS), on physical function, nutritional status, body composition, health-related quality of life, and resource use. DESIGN: Residents in 8 NHs were randomized by NH units into an intervention group (IG) or a control group (CG) (n = 60/group). The IG was a combination of STS (4 times/day) and ONS (2 bottles/day providing 600 kcal and 36 g protein) for 12 weeks. SETTING AND PARTICIPANTS: The participants resided in NH units (dementia and somatic care), were ≥75 years of age, and able to rise from a seated position. METHODS: The 30-second Chair Stand Test was the primary outcome. Secondary outcomes were balance, walking speed, dependence in activities of daily living, nutritional status and body composition, health-related quality of life, and resource use. RESULTS: Altogether, 102 residents (age 86 ± 5 years, 62% female) completed the study. No improvement in the physical function assessments was observed in the IG, whereas body weight increased significantly (2.05 ± 3.5 kg, P = .013) vs the CG. Twenty-one (of 52) participants with high adherence to the intervention (ie, at least 40% compliance to the combined intervention) increased their fat free mass (2.12 kg (0.13, 4.26 interquartile range), P = .007 vs CG). Logistic regression analyses indicated that the odds ratio for maintained/improved 30-second Chair Stand Test was 3.5 (confidence interval 1.1, 10.9, P = .034) among the participants with high adherence compared with the CG. CONCLUSIONS/IMPLICATIONS: Twelve-week intervention of daily STS combined with ONS in NH residents did not improve physical function, but increased body weight. Subgroup analyses indicated that high adherence to the combined intervention was associated with maintained or improved physical function and a gain of fat free mass.
Authors: S Vikström; H K Grönstedt; T Cederholm; E Franzén; G Faxén-Irving; Å Seiger; A-M Boström Journal: BMC Geriatr Date: 2021-02-05 Impact factor: 3.921