Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Denmark.
Gerontology. 2013;59(3):220-9. doi: 10.1159/000345416. Epub 2012 Dec 20.
Nursing home residents are extremely inactive and deterioration in health and an increasing dependence in activities of daily living (ADL) are common. Physical activity and exercise play a major role in the preservation of physical function and quality of life late in life. However, evidence for the benefit of rehabilitation in nursing home residents is conflicting and inconclusive.
To evaluate the effect of an individually tailored intervention program of 3 months, for nursing home residents, on ADL, balance, physical activity level, mobility and muscle strength.
In this single-blind randomized clinical trial with parallel groups, nursing home residents >64 years of age from three Nordic countries were included. The intervention group (IG) was assigned to individually tailored physical and daily activities, while the control group (CG) received ordinary care. Primary outcomes were ADL and balance, and secondary outcomes physical activity level, mobility and muscle strength.
At baseline, 322 nursing home residents were included, of whom 266 were assessed after 3 months of intervention. Following the intervention, a significant difference was found between participants in the IG and CG on measures of balance, physical activity and transfers. The IG significantly improved walking/wheelchair speed and functional leg muscle strength. The CG had significantly deteriorated in ADL, balance and transfers. Persons who had taken part in the intervention for more than 150 min/week significantly improved their balance and physical activity level. Participation in more than 10 weeks of intervention significantly improved physical activity and walking/wheelchair speed, while a deterioration was seen in those who had participated less.
Individually tailored intervention in nursing home residents focusing on physical and daily activities is effective in improving transfers, balance and physical activity level compared to usual care. The effect of the intervention is dependent on the total activity time.
养老院居民的活动量极低，健康状况恶化和日常生活活动（ADL）能力的逐渐丧失较为常见。身体活动和运动对于保持晚年的身体功能和生活质量起着重要作用。然而，针对养老院居民康复益处的证据存在冲突且不明确。
评估针对养老院居民的 3 个月个体化定制干预计划对 ADL、平衡、身体活动水平、移动能力和肌肉力量的影响。
这是一项在北欧三个国家进行的、采用平行分组的、单盲随机临床试验，纳入了年龄＞64 岁的养老院居民。干预组（IG）被分配进行个体化定制的身体和日常活动，而对照组（CG）接受常规护理。主要结局是 ADL 和平衡，次要结局是身体活动水平、移动能力和肌肉力量。
在基线时，纳入了 322 名养老院居民，其中 266 名在干预 3 个月后接受了评估。干预后，IG 参与者与 CG 参与者在平衡、身体活动和转移方面的测量值存在显著差异。IG 显著改善了行走/轮椅速度和功能性腿部肌肉力量。CG 在 ADL、平衡和转移方面显著恶化。每周参加干预超过 150 分钟的人平衡和身体活动水平显著改善。参加干预超过 10 周显著改善了身体活动和行走/轮椅速度，而参加时间较短的人则出现恶化。
针对养老院居民的个体化定制干预侧重于身体和日常活动，与常规护理相比，在改善转移、平衡和身体活动水平方面更有效。干预的效果取决于总活动时间。
