title: Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents: A Randomized Controlled Trial.
abstract: The preservation of physical functions such as muscle strength, balance and mobility is fundamental to maintaining independence in activities of daily living (ADL). The physical activity level of most nursing home residents is very low, which implies that they are often subject to a decline in health, mobility, autonomy and social contacts and are also at risk of suffering a decline in mental well-being. In a previous study, we demonstrated that transfers, balance and physical activity level improved after 3 months of individually tailored intervention in nursing home residents.
  
  
  
  To evaluate the long-term effects on ADL, balance function, physical activity level, physical performance, falls-related self-efficacy, well-being and cognitive function 3 months after the completion of our intervention in nursing home residents.
  
  
  
  The study was a multicenter randomized, controlled clinical trial with a parallel-group design. It was conducted in nursing homes in Sweden, Norway and Denmark, with an intervention period lasting 3 months and a follow-up at 6 months. Initially, 322 nursing home residents with a mean age of 85 years were included; 85 from Sweden, 171 from Norway and 66 from Denmark. Of these, 241 [129 intervention group (IG), 112 control group (CG)] were eligible for the 6-month follow-up tests. The level of dependence in ADL, physical activity level, several dimensions of physical function, well-being, falls-related self-efficacy and cognitive function were assessed with reliable and valid instruments at baseline, immediately after 3 months of intervention and 3 months later at the 6-month follow-up.
  
  
  
  After 3 months of intervention and an additional period of 3 months without intervention, only the following 2 variables demonstrated significant group differences: social and cognitive function, measured by the Functional Independence Measure n-r, where the IG deteriorated while the CG was almost stable. However, regarding transfers, the IG deteriorated significantly less than the CG.
  
  
  
  Without supervised physical exercise that challenged the individuals' capability, gains in ADL function, balance and transfer ability deteriorated during the 3 months following the intervention period. Thus, continuous, individually adjusted and supported physical activity seems crucial for the maintenance of physical functions in these vulnerable elderly persons.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Frändin
authors.forename: Helena
authors.initials: H
authors.lastname: Grönstedt
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.forename: Astrid
authors.initials: A
authors.lastname: Bergland
authors.forename: Mette
authors.initials: M
authors.lastname: Andresen
authors.forename: Lis
authors.initials: L
authors.lastname: Puggaard
authors.forename: Karin
authors.initials: K
authors.lastname: Harms-Ringdahl
authors.forename: Randi
authors.initials: R
authors.lastname: Granbo
authors.forename: Karin
authors.initials: K
authors.lastname: Hellström
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008603:Mental Health; D053580:Muscle Strength / Q000502:physiology; D009735:Nursing Homes; D004856:Postural Balance / Q000502:physiology; D057285:Precision Medicine; D011788:Quality of Life; D012537:Scandinavian and Nordic Countries; D013997:Time Factors