Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents.
OBJECTIVE
To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention.


METHODS
Randomized controlled trial with blinded assessments of outcomes at three points over 8 months.


METHODS
Four nursing homes.


METHODS
Two hundred fifty-six incontinent residents.


METHODS
Research staff provided the intervention, which integrated incontinence care and exercise every 2 hours from 8:00 a.m. to 4:00 p.m. 5 days a week.


METHODS
Average and maximum distance walked or wheeled, level of assistance required to stand, maximum pounds lifted by arms, fecal and urinary incontinence frequency, and time required to implement intervention.


RESULTS
Intervention residents maintained or improved performance whereas the control group's performance declined on 14 of 15 outcome measures. Repeated measures analysis of variance group-by-time significance levels ranged from P <.0001 to.05. The mean time required to implement the intervention each time care was provided was 20.7 +/- 7.2 minutes. We estimate that a work assignment of approximately five residents to one aide would be necessary to provide this intervention.


CONCLUSIONS
The incontinence care and exercise intervention resulted in significant improvement for most residents, and most who could be reliably interviewed expressed a preference for such care. Fundamental changes in the staffing of most nursing homes will be necessary to translate efficacious clinical interventions into everyday practice.
Schnelle
John F
JF
UCLA Multicampus Program in Geriatric Medicine and Gerontology, Los Angeles, California 91335, USA. jschnell@ucla.edu
Alessi
Cathy A
CA
Simmons
Sandra F
SF
Al-Samarrai
Nahla R
NR
Beck
John C
JC
Ouslander
Joseph G
JG
D000368:Aged; D005081:Exercise Therapy; D005242:Fecal Incontinence / Q000451:nursing*; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D014549:Urinary Incontinence / Q000451:nursing*