title: Effects of individually tailored physical and daily activities in nursing home residents on activities of daily living, physical performance and physical activity level: a randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Denmark. helena.gronstedt@ki.se
authors.forename: Helena
authors.initials: H
authors.lastname: Grönstedt
authors.forename: Kerstin
authors.initials: K
authors.lastname: Frändin
authors.forename: Astrid
authors.initials: A
authors.lastname: Bergland
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.forename: Randi
authors.initials: R
authors.lastname: Granbo
authors.forename: Lis
authors.initials: L
authors.lastname: Puggaard
authors.forename: Mette
authors.initials: M
authors.lastname: Andresen
authors.forename: Karin
authors.initials: K
authors.lastname: Hellström
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D053580:Muscle Strength; D009735:Nursing Homes; D026741:Physical Therapy Modalities; D004856:Postural Balance; D057285:Precision Medicine; D012046:Rehabilitation; D016138:Walking; D014910:Wheelchairs