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Frail Institutionalized Older Persons: A Comprehensive Review on Physical Exercise, Physical Fitness, Activities of Daily Living, and Quality-of-Life

Weening-Dijksterhuis, Elizabeth PT; de Greef, Mathieu H.G. PhD; Scherder, Erik J.A. PhD; Slaets, Joris P.J. PhD, MD; van der Schans, Cees P. PhD, PT, CE

American Journal of Physical Medicine & Rehabilitation: February 2011 - Volume 90 - Issue 2 - p 156-168
doi: 10.1097/PHM.0b013e3181f703ef
Literature Review: Aging

The objective of this study was to perform a systematic review on training outcomes influencing physical fitness, activity of daily living performance, and quality-of-life in institutionalized older people. We reviewed 27 studies on older people (age, ≥70 yrs) in long-term care facilities and nursing homes. Our ultimate goal was to propose criteria for an evidence-based exercise protocol aimed at improving physical fitness, activity of daily living performance, and quality-of-life of frail institutionalized older people. The interventions, described in the reviewed studies that showed strong or very strong effect sizes were used to form an exercise prescription. The conclusion is that there is firm evidence for training effects on physical fitness, functional performance, activity of daily living performance, and quality-of-life. The training should contain a combination of progressive resistance training, balance training, and functional training. The proposed intensity is moderate to high, assessed on a 0-10 scale for muscle strengthening activities. The training frequency was three times a week, and the total duration was at least 10 wks.

From Applied Sciences, the Centre for Applied Research in Health Care and Nursing (EWD, CPvdS), Hanze University Groningen, Groningen, The Netherlands; Institute for Human Movement Sciences (MHGdG, EJAS), University of Groningen, Groningen, The Netherlands; Department of Internal Medicine (JPJS), University Medical Centre Groningen, University of Groningen, The Netherlands.

All correspondence and requests for reprints should be addressed to: Elizabeth Weening-Dijksterhuis, PT, Centre for Applied Research in Health Care and Nursing, Hanze University Groningen, Eyssoniusplein 18, 9714 CE Groningen, The Netherlands.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2011 Lippincott Williams & Wilkins, Inc.