A randomized outcome evaluation of group exercise programs in long-term care institutions

Background. Physical activity programs in nursing homes typically consist o f seated, range of motion (ROM) exercises, regardless of resident abilities . The Functional Fitness for Long-Term Care (FFLTC) Program was designed no t only to maintain ROM, but also to improve strength, balance, flexibility mobility, and function. In addition, it was tailored to meet the needs of b oth high and low mobility residents. Methods. The feasibility and efficacy of the FFLTC Program were evaluated w ith 68 residents (mean age 80) from five institutions. Persons were classif ied as low or high mobility and randomized into either the FFLTC program or a seated ROM program. Classes were conducted in groups of 4 to 10 residents by trained facility staff for 45 minutes, three times per week. Assessment s at baseline and 4 months consisted of mobility, balance, gait, flexibilit y, Functional capacity, and several upper and lower extremity strength meas ures. Results. Attendance averaged 86% For the FFLTC and 79% for the ROM classes. Four months of exercise led to significant improvements in mobility (16%), balance (9%), flexibility (36%), knee (55%), and hip (12%) strength For th e FFLTC group. Shoulder strength was the only improvement found for the ROM group. The ROM group significantly deteriorated in some areas, particularl y hip strength, mobility, and functional ability Conclusions. Institutionalized seniors, even those who are physically frail , incontinent and/or have mild dementia, can respond positively to a challe nging exercise program. The FFLTC program demonstrated clear benefits over typical, seated ROM exercises. Moreover, with minimal training, the program can be safely delivered at low cost by institutional staff and volunteers.