Thomas Cordes1, Katharina Zwingmann2, Julian Rudisch3, Claudia Voelcker-Rehage4, Bettina Wollesen5. 1. Institute of Human Movement Science, University of Hamburg, Mollerstr, 10, 20148 Hamburg, Germany. Electronic address: thomas.cordes@uni-hamburg.de. 2. Institute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, Germany. Electronic address: katharina.zwingmann@hsw.tu-chemnitz.de. 3. Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Horstmarer Landweg 62 b, 48149 Muenster, Germany. Electronic address: julian.rudisch@uni-muenster.de. 4. Institute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, Germany; Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Horstmarer Landweg 62 b, 48149 Muenster, Germany. Electronic address: claudia.voelcker-rehage@uni-muenster.de. 5. Institute of Human Movement Science, University of Hamburg, Mollerstr, 10, 20148 Hamburg, Germany; Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany. Electronic address: bettina.wollesen@uni-hamburg.de.
Abstract
BACKGROUND:Older nursing home residents are often characterized by multimorbidity and dependency in activities of daily living. Most exercise studies in this setting aim at residents who are still able to walk despite the huge group of residents that is unable to walk. Thus, little is known about the effectiveness to improve cognitive and motor functions as well as well-being within this target group, e.g., by use of chair-based exercises. The aim of this study was to determine the effects of a 16-week multicomponent chair-based exercise intervention on motor functions, cognition and well-being for nursing home residents who are unable to walk. METHODS: A two-arm single-blinded multicenter randomized controlled trial integrated N = 52 nursing home residents with a mean age of 81± 11 years (63% female), randomly assigned to a training (n = 26, 16 weeks; twice a week; 60 min) or a wait-list control group (n = 26). The intervention followed the F.I.T.T. principles (frequency, intensity, time and type) and was continuously adapted to residents' performance level. The outcomes motor function (hand grip strength, sitting balance, manual dexterity), cognitive performance (cognitive status, working memory) and psychosocial resources (physical and mental well-being (SF12), satisfaction with life (SWLS), depressive symptoms (CES-D)) were assessed at baseline (pre-test) and after 16-weeks (post-treatment). Statistics were performed using ANOVA for repeated measures. RESULTS: The results of the ANOVA showed significant improvements of the intervention group for hand grip strength (Pre: M = 12.67, SD = 5.28; Post: M = 13.86, SD = 4.79; Group × Time: F(1, 17) = 10.816, p = .002, ηp2 = 0.241), manual dexterity (Pre: M = 4.50, SD = 5.17; Post: M = 5.30, SD = 4.25; Group × Time: F(1, 7) = 9.193, p = .008, ηp2 = 0.365), cognition (Pre: M = 10.31, SD = 6.87; Post: M = 11.06, SD = 7.50; Group × Time: F(1, 15) = 12.687, p = .001, ηp2 = 0.284), and depression (Pre: M = 5.19, SD = 5.12; Post: M = 4.38, SD = 4.62; Group × Time: F(1, 14) = 5.135, p = .031, ηp2 = 0.150) while the values of the control group decreased. CONCLUSION: The multicomponent chair-based intervention over 16 weeks was able to improve motor functions and cognition in nursing home residents who are unable to walk. Other psychological factors remained stable within the intervention group, which can be interpreted as a good result for this target group. All of the investigated parameters showed a significant decrease in the control group. The intervention seemed to cause physiological adaptations even in very old age. Study results encourage to further differentiate the heterogeneous group of nursing home residents concerning mobility aspects and to include chair-based interventions as feasible program to prevent further decline of functional performance and maintain independence in activities of daily living for a better physical and mental well-being.
RCT Entities:
BACKGROUND: Older nursing home residents are often characterized by multimorbidity and dependency in activities of daily living. Most exercise studies in this setting aim at residents who are still able to walk despite the huge group of residents that is unable to walk. Thus, little is known about the effectiveness to improve cognitive and motor functions as well as well-being within this target group, e.g., by use of chair-based exercises. The aim of this study was to determine the effects of a 16-week multicomponent chair-based exercise intervention on motor functions, cognition and well-being for nursing home residents who are unable to walk. METHODS: A two-arm single-blinded multicenter randomized controlled trial integrated N = 52 nursing home residents with a mean age of 81 ± 11 years (63% female), randomly assigned to a training (n = 26, 16 weeks; twice a week; 60 min) or a wait-list control group (n = 26). The intervention followed the F.I.T.T. principles (frequency, intensity, time and type) and was continuously adapted to residents' performance level. The outcomes motor function (hand grip strength, sitting balance, manual dexterity), cognitive performance (cognitive status, working memory) and psychosocial resources (physical and mental well-being (SF12), satisfaction with life (SWLS), depressive symptoms (CES-D)) were assessed at baseline (pre-test) and after 16-weeks (post-treatment). Statistics were performed using ANOVA for repeated measures. RESULTS: The results of the ANOVA showed significant improvements of the intervention group for hand grip strength (Pre: M = 12.67, SD = 5.28; Post: M = 13.86, SD = 4.79; Group × Time: F(1, 17) = 10.816, p = .002, ηp2 = 0.241), manual dexterity (Pre: M = 4.50, SD = 5.17; Post: M = 5.30, SD = 4.25; Group × Time: F(1, 7) = 9.193, p = .008, ηp2 = 0.365), cognition (Pre: M = 10.31, SD = 6.87; Post: M = 11.06, SD = 7.50; Group × Time: F(1, 15) = 12.687, p = .001, ηp2 = 0.284), and depression (Pre: M = 5.19, SD = 5.12; Post: M = 4.38, SD = 4.62; Group × Time: F(1, 14) = 5.135, p = .031, ηp2 = 0.150) while the values of the control group decreased. CONCLUSION: The multicomponent chair-based intervention over 16 weeks was able to improve motor functions and cognition in nursing home residents who are unable to walk. Other psychological factors remained stable within the intervention group, which can be interpreted as a good result for this target group. All of the investigated parameters showed a significant decrease in the control group. The intervention seemed to cause physiological adaptations even in very old age. Study results encourage to further differentiate the heterogeneous group of nursing home residents concerning mobility aspects and to include chair-based interventions as feasible program to prevent further decline of functional performance and maintain independence in activities of daily living for a better physical and mental well-being.
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