title: Strength training, walking, and social activity improve sleep in nursing home and assisted living residents: randomized controlled trial.
abstract: OBJECTIVE
  To compare the effects of physical resistance strength training and walking (E), individualized social activity (SA), and E and SA (ESA) with a usual care control group on total nocturnal sleep time in nursing home and assisted living residents.
  
  
  METHODS
  Pretest-posttest experimental design with assignment to one of four groups for 7 weeks: E (n=55), SA (n=50), ESA (n=41), and usual care control (n=47).
  
  
  METHODS
  Ten nursing homes and three assisted living facilities.
  
  
  METHODS
  One hundred ninety-three residents were randomly assigned; 165 completed the study.
  
  
  METHODS
  The E group participated in high-intensity physical resistance strength training 3 days a week and on 2 days walked for up to 45 minutes, the SA group received social activity 1 hour daily 5 days a week, the ESA group received both E and SA, and the control group participated in usual activities provided in the homes.
  
  
  METHODS
  Total nocturnal sleep time was measured using 2 nights of polysomnography before and 2 nights of polysomnography after the intervention. Sleep efficiency (SE), non-rapid eye movement (NREM) sleep, rapid eye movement sleep, and sleep onset latency were also analyzed.
  
  
  RESULTS
  Total nocturnal sleep time was significantly greater in the ESA group than in the control group (adjusted means 364.2 minutes vs 328.9 minutes), as was SE and NREM sleep.
  
  
  CONCLUSIONS
  High-intensity physical resistance strength training and walking combined with social activity significantly improved sleep in nursing home and assisted living residents. The interventions by themselves did not have significant effects on sleep in this population.
authors.affiliation: Biobehavioral and Health Sciences Division, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. kathyr@nursing.upenn.edu
authors.forename: Kathy C
authors.initials: KC
authors.lastname: Richards
authors.forename: Corinne
authors.initials: C
authors.lastname: Lambert
authors.forename: Cornelia K
authors.initials: CK
authors.lastname: Beck
authors.forename: Donald L
authors.initials: DL
authors.lastname: Bliwise
authors.forename: William J
authors.initials: WJ
authors.lastname: Evans
authors.forename: Gurpreet K
authors.initials: GK
authors.lastname: Kalra
authors.forename: Morton H
authors.initials: MH
authors.lastname: Kleban
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lorenz
authors.forename: Karen
authors.initials: K
authors.lastname: Rose
authors.forename: Nalaka S
authors.initials: NS
authors.lastname: Gooneratne
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Sullivan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D009735:Nursing Homes; D011379:Prognosis; D012890:Sleep; D012893:Sleep Wake Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D016138:Walking / Q000502:physiology*