Rehabilitation for older people in long-term care (Review)

Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK, BD9 6RJ.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2009; 2(1):CD004294. DOI: 10.1002/14651858.CD004294.pub2
Source: PubMed


Rehabilitation treatments may be effective in improving the physical health of older people in long-term care. In 2010, 7.6% of the world's population were over 65 years old, and this is predicted to increase to 13% by 2035. It is expected that this will lead to a rise in demand for long-term residential care. This has increased interest in ways to prevent deterioration in health and activities of daily living, for example, walking and dressing, among care home residents. Physical rehabilitation (interventions based on exercising the body) may have a role, and this review examines the evidence available. This review included 67 trials, 36 of which were conducted in North America, 20 in Europe, and seven in Asia. In total, 6300 participants with an average age of 83 years were involved. Most interventions in some way addressed difficulties in activities of daily living. This review investigates the effects of physical rehabilitation on activities of daily living, strength, flexibility, balance, mood, cognition (memory and thinking), exercise tolerance, fear of falling, death, illness, and unwanted effects associated with the intervention, such as injuries. While variations between trials meant that we could not make specific recommendations, individual studies were often successful in demonstrating benefits to physical health from participating in different types of physical rehabilitation.

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Available from: Eileen Burns, Oct 29, 2015
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    • "Four reviews contained insufficient evidence to draw a conclusion about the impact of physical activity on ADL outcomes; the reviews focused on older people (Forbes et al. 2008), people with arthritis (Lee et al. 2007), people with cancer (Lowe et al. 2009) and people with mental health problems (Schuch et al. 2011). Findings were conflicting or inconsistent within each of the remaining four reviews on older people (Daniels et al. 2008, Forster et al. 2009) people with osteoarthritis (Hall et al. 2009) and people with long-term conditions (Gillison et al. 2009). However, strong meta-analytic evidence in two of these reviews (Gillison et al. 2009, Hall et al. 2009) showed positive impacts. "
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    • "An important amount of evidence (Abdulla et al., 2013; Crocker et al., 2013; Karinkanta, Piirtola, Sievänen, Uusi-Rasi, & Kannus, 2010; Rubenstein, 2006; Valenzuela, 2012; Warburton, Charlesworth, Ivey, Nettlefold, & Bredin, 2010; Weening- Dijksterhuis, de Greef, Scherder, Slaets, & van der Schans, 2011) suggests that exercise should be implemented as a preventive and therapeutic intervention for older nursing home (NH) residents. Despite this, very little information is available about the real amount of exercise (i.e., planned and purposeful physical activities generally developed to improve participants' physiological and physical capacities) NH residents do in their daily lives. "
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