A WALKING PROGRAM FOR NURSING-HOME RESIDENTS - EFFECTS ON WALK ENDURANCE, PHYSICAL-ACTIVITY, MOBILITY, AND QUALITY-OF-LIFE

OBJECTIVES: To determine the effects of a 12-week walking program on w alk endurance capacity, physical activity level, mobility, and quality of life in ambulatory nursing home residents who had been identified as having low physical activity levels and low walk endurance capaciti es. To determine the effects of 12 versus 22 weeks of walk training on walk endurance capacity, physical activity level, mobility, and quali ty of life in ambulatory nursing home residents.DESIGN: Experiment 1: Residents of one nursing home campus were assigned to the walking prog ram, and residents of a second campus were assigned to the social visi t control group. Outcome measures were taken before and after 12 weeks . Experiment 2: Pretest/posttest with outcome measures taken before an d, again, after 12 and 22 weeks of walking. SETTING: Two campuses of t he Jewish Homes for the Aging in the Los Angeles area. PARTICIPANTS: E xperiment 1: Nineteen of 22 residents in the walking group completed t he walking program, and 12 of 15 residents in the control group comple ted the study. Experiment 2: Thirty of 41 residents (from the two nurs ing homes) completed the 22-week walking program. INTERVENTION: Experi ment 1: The walking program involved each resident walking with resear ch staff at his/her self-selected walking pace, 5 days per week for 12 weeks, for a maximum of 30 minutes per day; while the control group h ad weekly individual social visits, which lasted 30 minutes, from a re search assistant. Experiment 2: All residents, those in both the walki ng and the control group, were offered the opportunity to complete 22 weeks of walking. MAIN OUTCOME MEASURES: Maximal walk endurance capaci ty, the resident's maximum walk time performed in a single day of walk ing (distance and speed also were measured); physical activity level b ased on time-sampled obser vations and physical activity monitors; mob ility as measured with the Timed-Up-and-Go test, left handgrip strengt h, and Tinetti's Mobility Assessment; and quality of life as assessed with the Geriatric Depression Scale (a bodily pain scale) and the Dart mouth Primary Care Cooperative Information Project (COOP) physical wor k chart. RESULTS: Experiment 1: The walking group significantly improv ed their maximal walk endurance time by 77% and distance by 92%, with no significant change in walk speed; however, the control group showed no significant changes in these variables. There were no significant group by time interactions on measures of physical activity, mobility, and quality of life. Experiment 2: No further significant changes wer e found from 12 to 22 weeks in walk endurance capacity, physical activ ity, mobility, or quality of life. CONCLUSION: Twelve weeks of daily w alking at a self-selected walking pace by ambulatory nursing home resi dents produced significant improvements in walk endurance capacity. No other significant changes were noted in physical activity level, mobi lity, or quality of life in either group after the intervention. Also, there were no side effects, such as increases in falls or cardiovascu lar complications, due to the walking intervention. Lengthening the wa lking program to 22 weeks produced no further significant changes in a ny outcome measures.