Cited by 145Geriatric Care and Nursing HomesAging, Health, and DisabilityNutrition and Health in Aging

Nursing rehabilitation and exercise strategies in the nursing home

Morris, J. N., Fiatarone, M., Kiely, D. K., Belleville-Taylor, P., Murphy, K., Littlehale, S., Ooi, W. L., O'Neill, E. +1 more·1999·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences

Abstract

BACKGROUND: The purpose of this study was to evaluate how weight training or nursing-based rehabilitative care programs in nursing homes impact on resident performance of Activities of Daily Living (ADL) and objectives tests of physical performance. METHODS: This study involved a quasi-experimental control, longitudinal comparison of functional status over a 10-month period, where baseline status was adjusted through a weighting procedure based on functional status, cognitive status, and age. All residents from six residential care nursing home facilities were eligible except those with a terminal prognosis, a projected stay of less than 90 days, or with health complications that prohibited contact. Homes were placed into matched triplets based on patient characteristics: two members of each triplet were randomly designated to be experimental sites, the third became the control site. Baseline data were available for 468 subjects, follow-up for 392. ADL self-performance measures derived from the Minimum Data Set, including indicators of early loss ADL, locomotion, and late loss ADL; a number of objective functional tests (including measures of balance, power, and endurance); and mood state as measured by the Geriatric Depression Scale. RESULTS: Mean ADL values in the two experimental groups declined at a significantly lower rate than did rates for the controls. Functional decline was also lower in more specific measures: locomotion, early loss ADL, and late loss ADL. CONCLUSIONS: With both interventions, facilities were able to implement a broad-based intervention that resulted in a significant reduction in ADL decline rates. A facility-wide nursing rehabilitation program can play a useful role in reversing functional decline, helping residents to maintain their involvement in a broad spectrum of ADL activities.

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Crossref · 10.1093/gerona/54.10.m494

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  • In a RCT of 704 nursing home residents with frailty, after 17 months, residents in both resistance/balance/aerobic exercise and nursing rehabilitation intervention homes had significantly less decline in ADL functioning than those in control homes.

    “After 17 months, residents in both types of intervention homes had significantly less decline in ADL functioning than those in control homes [506].”
  • In a RCT of 704 nursing home residents with frailty, resistance, balance, and aerobic exercise or nursing rehabilitation resulted in significantly less decline in ADL functioning than control after 17 months.

    “After 17 months, residents in both types of intervention homes had significantly less decline in ADL functioning than those in control homes [506].”

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Research works printed but not linked: 12

  1. Morris IN, Fries BE, Mehr DR, et al. MDS Cognitive Performance Seale. J Gerontol. 1994;49:M174-M182.
  2. Ferris M. What's really the problem in nursing hornes? (Letter.) JAGS. 1990;37:392.
  3. Sheridan, JE, White, J, Fairchild, Tl Ineffective staff, ineffective supervi- sion, or ineffective adrninistration? Why some nursing hornes fail to pro- vide adequate care. Gerontologist. 1992;32:334-341.
  4. Aroskar MA, Urv-Wong, EK, Kane RA. Building an effective caregiving staff: transforming the nursing service. In Kane RA, Caplan AL, eds. Everyday Ethics: Resolving Dilemmas in Nursing Home Life. New York, NY: Springer; 1990; 271-290.
  5. Coons DH. Training direct service staff members to work in dementia care units. In Coons DH, ed. Specialized Dementia Care Units. Baltimore: Johns Hopkins University Press; 1991; 126-143.
  6. Mace N. Dementia care units in nursing hornes. In Coons DH, ed. SpecializedDementia Care Units. Baltimore: Johns Hopkins University Press; 1991; 55-82.
  7. Young A. Exercise physiology in geriatrie practice. Aeta Med Scand Suppl. 1986;711:227-232.
  8. Lundgren-Lindquist B, Sperling L. Functional studies in 79-year-01ds. II. Upper extremity function. Scand 1 Rehab Med. 1983;15:117-123.
  9. Morris JN, Nonernaker S, Murphy K, et al. Commitment to change: revi- sion ofHCFA's RAI. lAGS. 1997;45:1011-1016.
  10. Hawes C, Morris JN, Phillips CD, Mor V, Fries BE, Nonemaker S. Reliabi1ityestirnates for the mnimum data set for nursing home residents and care screening (MDS). Gerontologist. 1995;35:172-178.
  11. Morris JN, Morris SA. ADL assessment measures for use with frai1 el- ders. In: Teresi JA, Lawton Mp, Holmes D, Ory M, eds. Measurement in Elderly Chronic Care Populations. New York, NY: Springer; 1997: 130-156.
  12. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High intensity strength training in nonagenarians. lAMA. 1990; 263:3029-3034. ReceivedMay 16,1998 Accepted October 2,1998

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Authors
Morris, J. N., Fiatarone, M., Kiely, D. K., Belleville-Taylor, P., Murphy, K., Littlehale, S., Ooi, W. L., O'Neill, E., & Doyle, N.
Affiliations
Harvard University (US)
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Published
1999-10-01
Volume
54
Issue
10
Pages
M494-M500
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
OpenAlex
W2164668623
Cited by
145
References
15
Citations by year
2025: 2 · 2024: 2 · 2022: 2 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 6 · 2016: 4 · 2015: 1 · 2014: 3 · 2013: 10 · 2012: 4
FWCI
17.43
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5p50ag011719-05)
  • National Institute on Aging (AG11719)
Topics
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Keywords
rehabilitation nursing, nursing homes, weight training, exercise intervention, activities of daily living, functional decline, physical performance, balance, endurance, mood, geriatric depression, older adults
MeSH terms
Activities of Daily Living, Aged, Exercise Therapy, Homes for the Aged, Humans, Nursing Homes, Geriatric Assessment, Rehabilitation Nursing

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