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, η_p² = 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, η_p² = 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, η_p² = 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, η_p² = 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.

中文翻译：

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多组分运动可改善无法行走的疗养院居民的运动功能、认知和幸福感——一项随机对照试验

背景

老年疗养院居民的特征通常是多发病和对日常生活活动的依赖性。在这种情况下，大多数运动研究针对的是尽管有大量无法行走的居民，但仍然能够行走的居民。因此，对于改善该目标群体的认知和运动功能以及幸福感的有效性知之甚少，例如，通过使用基于椅子的锻炼。本研究的目的是确定为期 16 周的多组分椅子运动干预对无法行走的疗养院居民的运动功能、认知和幸福感的影响。

方法

一项双臂单盲多中心随机对照试验整合了N  = 52 名平均年龄为 81 ± 11 岁的疗养院居民（63% 为女性），随机分配接受培训（n = 26、16 周；每周两次； 60 分钟）或等待名单控制组（n = 26）。干预遵循 FITT 原则（频率、强度、时间和类型），并不断适应居民的表现水平。结果运动功能（手握力、坐姿平衡、手灵巧）、认知表现（认知状态、工作记忆）和社会心理资源（身心健康 (SF12)、生活满意度 (SWLS)、抑郁症状 (CES) -D)) 在基线（测试前）和 16 周后（治疗后）进行评估。使用方差分析进行重复测量进行统计。

结果

方差分析的结果显示干预组的握力有显着改善（前：M  = 12.67，SD  = 5.28；后：M  = 13.86，SD  = 4.79；组×时间：F（1, 17） = 10.816，p  = .002, η _p ² = 0.241), 手巧（Pre: M  = 4.50, SD  = 5.17; Post: M  = 5.30, SD  = 4.25; Group × Time: F (1, 7) = 9.193, p  = .008, η _p ² = 0.365), 认知 (Pre: M  = 10.31, SD = 6.87; 后：M  = 11.06，SD  = 7.50；组×时间：F (1, 15) = 12.687, p  = .001, η _p ² = 0.284), 抑郁（Pre: M  = 5.19, SD  = 5.12; Post: M  = 4.38, SD  = 4.62; Group ×时间：F (1, 14) = 5.135, p  = .031, η _p ² = 0.150) 而对照组的值下降。

结论

超过 16 周的多组件椅子干预能够改善无法行走的疗养院居民的运动功能和认知能力。干预组内的其他心理因素保持稳定，可以解释为该目标组的良好结果。所有研究的参数都显示出对照组的显着下降。即使在非常老的时候，这种干预似乎也会引起生理适应。研究结果鼓励在行动能力方面进一步区分养老院居民的异质群体，并将基于椅子的干预措施作为可行的计划，以防止功能表现进一步下降并保持日常生活活动的独立性，以改善身心健康.