scholarly journals Enriched gardens improve cognition and independence of nursing home residents with dementia: a pilot controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Etienne Bourdon ◽  
Joël Belmin
Keyword(s):  
Nursing Homes ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Nursing Home Residents ◽  
Control Group ◽  
Timed Up And Go ◽  
Staff Members ◽  
Risk Of Falls ◽  
Walking Balance ◽  
And Control

Abstract Background Dementia is a major issue worldwide, and considerable efforts were made to design therapeutic mediation tools and evaluate their benefits on the health of patients. Methods Design: Multi-center cluster-controlled pilot trial. Settings and participants: Four nursing homes that offered separated access to one conventional sensory garden (CSG) and one enriched garden (EG). The participants were residents with dementia, independent for walking and with no severe dementia or behavioural troubles. Eligible residents were divided into three groups according to the proximity of their room: close to the CSG or EG gardens for the first two groups and further from the gardens for the third (control) group. Interventions: We asked staff members to frequently invite residents to visit the EG or the CSG depending on their group allocation. No invitation to gardens was made to the control group. We installed 12 enrichment modules in the EG that stimulated cognitive, independence and walking/balance functions. Measures: Cognitive function (MMSE), independence for activities of daily living (ADL) and risk of falls (unipodal stance and timed up and go – (TUG)) were assessed at baseline and after 6 months. Results The 120 participants were 81·0 ± 3·5 years old and comprised of 83 women. Their MMSE score was 17·5 ± 2·9. Patients’ characteristics were not significantly different between the three groups. Among the participants invited to visit the EG group, 6-month changes in MMSE showed improvement compared to other groups (+ 0·93 ± 0·65 vs −0·25 ± 0·71 and −0·24 ± 0·73 in the EG vs CSG and control groups, respectively, P < 0·0001). Changes in ADL, TUG and unipodal stance were significantly improved in the group visiting the EG as compared to other groups, which indicates better functioning. Conclusions EGs offer a new approach to therapeutic mediation for residents of nursing homes with dementia.

scholarly journals Enriched gardens improve cognition and independence of nursing home residents with dementia: a controlled trial

2021 ◽  
Author(s):  
Etienne Bourdon ◽  
Joel Belmin
Keyword(s):  
Nursing Homes ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Easy Access ◽  
Control Group ◽  
Timed Up And Go ◽  
Staff Members ◽  
Risk Of Falls ◽  
Walking Balance ◽  
And Control

Abstract Background: Dementia is a major issue worldwide, and considerable efforts were made to design therapeutic mediation tools and evaluate their benefits on the health of patients. Methods:Design: Multi-center cluster-controlled trial. Settings and participants: Four nursing homes that offered separated access to one conventional sensory garden (CSG) and one enriched garden (EG). The participants were residents with dementia, independent for walking and with no severe dementia or behavioural troubles. Eligible residents were distributed into three groups based on the proximity of their rooms to the CSG or EG for the first two groups respectively, and without easy access to either garden for the third (control) group. Interventions: We asked staff members to frequently invite residents to visit the EG or the CSG depending on their group allocation. No invitation to gardens was made to the controls. We installed 12 enrichment modules in the EG that stimulated cognitive and walking/balance functions.Measures: Cognitive function (MMSE), independence for activities of daily living (ADL) and risk of falls (unipodal stance and Timed up and go – (TUG)) were assessed at baseline and after six months.Results: The 120 participants were 81·0 +/- 3·5 years old and comprised of 83 women. Their MMSE score was 17·5 +/- 2·9. Patients characteristics were not significantly different between the three groups. Among the participants invited to visit the EG group, six months changes in MMSE showed improved compared to other groups (+ 0·93 +/- 0·65 vs -0·25 +/- 0·71 and -0·24 +/- 0·73 in the EG vs CSG and control groups, respectively, P < 0·0001). Changes in ADL, TUG and unipodal stance were significantly improved in the group visiting the EG as compared to other groups, which indicates better functioning. Conclusions: EGs offer a new approach to therapeutic mediation for residents of nursing homes with dementia.

scholarly journals Balance Strategy Exercise versus Lower Limb-ROM Exercise for Reducing the Risk of Falls among Older People

2021 ◽  
Vol 11 (1) ◽  
pp. 114-123
Author(s):  
Zakia Azkia ◽  
Rahmi Setiyani ◽  
Lita Heni Kusumawardani
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Range Of Motion ◽  
Lower Limb ◽  
Institutional Care ◽  
Control Group ◽  
Timed Up And Go ◽  
Term Care ◽  
Risk Of Falls ◽  
Balance Strategy

Background: Falls are a significant health problem and the most common cause of injuries in older people. Different types of exercise have been recommended to prevent falls, including balance exercise and range of motion. However, there is a lack of evidence to compare the effect of the two exercises.Purpose: This study aimed to compare the effect of Balance Strategy Exercise (BSE) and Lower Limb-Range of Motion (ROM) exercise on reducing the risk of falls among older people living in long-term care facilities. Methods: This was a quasi-experimental study using a pre-post design without a control group. A total of 30 older adults from two nursing homes who met the inclusion and exclusion criteria participated in the study. A cluster randomization technique was used to assign the older people into either BSE or Lower-Limb ROM groups evenly. Treatment was given for 30 minutes per session, three sessions per week for three weeks. The risk of falls was measured using the Timed Up and Go (TUG) test. The paired t-test, Wilcoxon and Mann-Whitney U-test were used to analyze the data. Results: Results showed significant differences in the TUG scores before and after the intervention within both the BSE (p=0.001) and the Lower Limb-ROM group (p=0.001). However, the Lower Limb-ROM group demonstrated a significantly higher reduction in TUG score than the BSE group after the intervention (p=0.008).Conclusion: Lower Limb-ROM exercise is better to reduce the risk of falls among older people living in institutional care than BSE. This exercise can be applied as part of a fall prevention program in nursing homes.

Effectiveness of acupuncture vs. core stability training in balance and functional capacity of women with fibromyalgia: a randomized controlled trial

2020 ◽  
Vol 34 (5) ◽  
pp. 630-645 ◽  
Author(s):  
Elisa María Garrido-Ardila ◽  
María Victoria González-López-Arza ◽  
Maria Jiménez-Palomares ◽  
Agustín García-Nogales ◽  
Juan Rodríguez-Mansilla
Keyword(s):  
Functional Capacity ◽  
Dynamic Balance ◽  
Controlled Trial ◽  
Berg Balance Scale ◽  
Core Stability ◽  
Control Group ◽  
Timed Up And Go ◽  
Randomized Controlled ◽  
Physiotherapy Programme ◽  
And Control

Objective: This study investigated the effectiveness of a core stability training physiotherapy programme vs. acupuncture for the management of balance and functional capacity impairments of women with Fibromyalgia. Design: Single-blind randomized controlled trial. Setting: Outpatients setting. Subjects: Women with Fibromyalgia and balance impairment. Interventions: Participants were randomized to a core stability physiotherapy programme group ( n = 45), acupuncture treatment group ( n = 45) and control group ( n = 45) for 13 weeks. Main Measures: Measures were taken at baseline (week 0), postintervention (week 6) and follow-up (week 13). The primary outcome measures were static balance (posturography) and dynamic balance and functional mobility (Berg Balance Scale, timed up and go test and 10-m walk). The secondary outcome measure was functional capacity (Fibromyalgia Health Assessment Questionnaire and the physical function item from the Spanish Fibromyalgia Impact Questionnaire). Results: In all, 103 participants completed the study. The results showed statistically significant improvements in the acupuncture and physiotherapy groups vs. the control group at week 6 regarding Berg Balance Scale ( P = 0.00, both groups), timed up and go test ( P = 0.00 and P = 0.01, respectively) and 10-m walk test at comfortable speed ( P = 0.02 and P = 0.03, respectively). The 10-m walk test at maximum speed showed significance when comparing the physiotherapy and control group ( P = 0.03). However, no significant differences were found between the physiotherapy and the acupuncture groups. In relation to functional capacity, the improvements achieved after the treatments were not statistically significant. Conclusion: Core stability-based physiotherapy and acupuncture improve dynamic balance and postural control in women with Fibromyalgia.

scholarly journals Effects of vibration on chronic leg edema in chair-bound older adults: A randomized pilot trial

2020 ◽  
Author(s):  
Sayumi Tsuchiya ◽  
Aya Sato ◽  
Terumi Ueda ◽  
Misako Dai ◽  
Mayumi Okuwa ◽  
...  
Keyword(s):  
Pilot Trial ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Interquartile Range ◽  
Control Group ◽  
Control Groups ◽  
Post Intervention ◽  
Leg Edema ◽  
Clinical Trials Registry ◽  
And Control

Abstract BackgroundElderly individuals can easily develop leg edema that can become chronic, which may result in various problems. Therefore, appropriate care for the edema should be provided. In some cases, chronic leg edema among elderly individuals cannot be controlled by the standard care such as leg elevation or compression. A previous study reported that vibration benefited upper limb lymphedema; however, its effects on chronic leg edema are not yet clarified. Therefore, this study aimed to clarify the effects of vibration for reducing chronic leg edema among chair-bound elderly individuals.MethodsFor participant allocation, a computer-generated list of random numbers was used. Nursing home residents aged ≥65 years with chronic leg edema who spent more time sitting than standing or lying during the day were randomly assigned to the intervention (n = 7) or control group (n = 7). The intervention group underwent vibration therapy three times a day for 2 weeks at 47 Hz and 1.78 m/s2 frequency and horizontal vibration acceleration, respectively. The pitting test was performed at 22 sites, and participants’ pitting scores were calculated based on the pitting depth. Pitting score changes at pre- and post-intervention were compared between the intervention and control groups. Both participants and investigators were not blinded to group assignment.ResultsThe median age of the intervention and control groups was 86 and 84 years, respectively. Participants’ characteristics and edema severity at baseline were not significantly different. The median total pitting score change in the intervention group was −0.4 (interquartile range: −5.3–1.8), which was significantly lower than that of the control group (2.0 [interquartile range: 1.0－5.3], P = 0.01). The intervention group was more likely to have controlled edema (64.3%) than the control group (21.4%) (χ2 (1) = 5.25, P = 0.02).ConclusionsThe intervention group was more likely to have controlled edema than the control group, suggesting that vibration could prevent the worsening of chronic leg edema in chair-bound elderly individuals.Trial registration: UMIN Clinical Trials Registry, UMIN000017716. Registered 1 July 2015, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000020522

scholarly journals Randomised controlled pilot trial of an exercise plus behaviour change intervention in people with multiple sclerosis: the Step it Up study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016336 ◽  
Author(s):  
Sara Hayes ◽  
Marcin Kacper Uszynski ◽  
Robert W Motl ◽  
Stephen Gallagher ◽  
Aidan Larkin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Effect ◽  
Cognitive Theory ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Intervention Group ◽  
Control Group ◽  
Timed Up And Go ◽  
Double Blind ◽  
Exercise Guidelines

ObjectiveTo investigate feasibility of multiple sclerosis (MS) exercise guidelines for inactive people with MS (PwMS) and to examine preliminary efficacy for walking. To investigate effect of augmenting that intervention with education based on social cognitive theory (SCT).DesignPilot multicentre, double-blind, randomised, parallel, controlled trial.SettingCommunity-delivered programme.ParticipantsSixty-five physically inactive PwMS walked independently, scored 0–3 on the Patient Determined Disease Steps Scale, had no MS relapse or change in MS medication in 12 weeks.Interventions10-week exercise plus SCT education (SCT) compared with exercise plus attention control education (CON).Outcome measuresSix-Minute Walk Test (6MWT), Timed Up and Go (TUG) test and Multiple Sclerosis Walking Scale-12 (MSWS-12).Results174 expressed interest, 92 were eligible and 65 enrolled (SCT, n=32; CON, n=33). The intervention was feasible and delivered as intended. 68% of SCT group and 50% of control group met the exercise guidelines after intervention. Using linear mixed effects models, intention-to-treat basis, there was insufficient evidence for difference between the groups over the trial (6MWT, p=0.30; TUG, p=0.4; MSWS-12, p=0.8). Using secondary analysis of a cohort with data for≥3 assessments (SCT, n=21; CON, n=20), there was significant treatment effect favouring the intervention group (p=0.04) with mean effect for 6MWT 39.0 m (95% CI 2.26 to 75.73) at 12 weeks and 40.0 m (95% CI 2.3 to 77.8) at 36 weeks. Both groups improved significantly in 6MWT following 10-week intervention (SCT, mean ∆=83.02, SD=60.1, p≤0.01; CON, mean ∆=56.92, SD=73.5, p≤0.01), TUG (SCT, ∆=−0.70, SD=1.25, p≤0.01; CON, ∆=−0.54, SD=0.95, p≤0.01) and MSWS-12 (SCT, ∆=−8.03, SD=16.18, p=0.02; CON, ∆=−0.86, SD=18.74, p=0.81).ConclusionsA 10-week exercise programme based on the MS exercise guidelines for improving walking in previously inactive PwMS was feasible. There is marginal evidence of a treatment effect in favour of the exercise plus SCT intervention at 12 and 36 weeks.Trial registration numberNCT02301442; Results.

scholarly journals Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Noorolla Zahedian-Nasab ◽  
Azita Jaberi ◽  
Fatemeh Shirazi ◽  
Somayyeh Kavousipor
Keyword(s):  
Virtual Reality ◽  
Nursing Homes ◽  
Elderly People ◽  
Fear Of Falling ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Timed Up And Go ◽  
Xbox Kinect ◽  
The Impact

Abstract Background Deficient balance and fear of falling in elderly people can lead to disturbed daily activities, falling, and finally reduced quality of life. Therefore, evaluation of low-risk methods that might partially improve balance in this group of people is of utmost importance. The present study aimed to investigate the impact of Virtual Reality (VR) exercises based on Xbox Kinect on balance and fear of falling among elderly people. Methods This clinical trial was performed on 60 elderly individuals living in nursing homes divided into two groups of control and Xbox. The participants in the intervention group received VR exercises based on Xbox Kinect in form of two 30–45-min sessions held on a weekly basis for 6 weeks. The individuals in the control group, on the other hand, received routine exercises of the nursing homes. The research tools used in this study included a demographic questionnaire, the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and the Falling Efficacy Scale (FES). Results The findings of the current study demonstrated that the scores of BBS and TUG test as the indices of balance among elderly people improved significantly in the Xbox group after the intervention (p < 0.001 for both BBS and TUG test). Moreover, the score of fear of falling diminished significantly in the intervention group compared to the control group (p < 0.001). Conclusion According to the results of the present investigation, 6 weeks of VR balance exercises could enhance balance and fear of falling among elderly people living in nursing homes. Trial registration Code:IRCT20190727044347N1, Date: 17-8-2019.

scholarly journals Effect of the Sonas Programme on Communication in People with Dementia: A Randomized Controlled Trial

2017 ◽  
Vol 7 (1) ◽  
pp. 122-135 ◽  
Author(s):  
Benedicte Sørensen Strøm ◽  
Knut Engedal ◽  
Jurate Saltyte Benth ◽  
Ellen-Karine Grov
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Control Group ◽  
Reading Group ◽  
Severe Dementia ◽  
Randomized Controlled ◽  
People With Dementia ◽  
Communication Ability ◽  
And Control

Background: Strategies to improve communication in people with dementia are warranted. We examined the effect of the Sonas programme on communication ability in persons with moderate to severe dementia. Methods: A 24-week 3-armed (Sonas, reading, and control group) randomized controlled trial including 120 nursing home residents with dementia was conducted; 105 completed the follow-up assessments. The main outcome was change in communication abilities measured by the Holden Communication Scale (HCS). Results: We found no overall significant effect of the Sonas programme with regard to communication ability as measured by the HCS. However, an effect between the Sonas group and the reading group and between the Sonas group and the control group from T0 to T1 and T2 was found, as well as a significant improvement in communication in the Sonas group. Among people with severe dementia, the Sonas group scored significantly better on the HCS compared to the reading group after 12 weeks, but not after 24 weeks. Conclusion: This study failed to document an overall effect of the Sonas programme on communication; however, the findings indicate that the Sonas programme has a significant effect on communication among those with severe dementia.

scholarly journals Can theory of mind of healthy older adults living in a nursing home be improved? A randomized controlled trial

2021 ◽  
Author(s):  
Elena Cavallini ◽  
Irene Ceccato ◽  
Silvana Bertoglio ◽  
Andrea Francescani ◽  
Federico Vigato ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Theory Of Mind ◽  
Nursing Homes ◽  
Cognitive Skills ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Mental States ◽  
Control Group ◽  
Healthy Older Adults

Abstract Background Research in nursing homes mainly focused on interventions for residents affected by cognitive decline. Few studies have considered healthy older adults living in nursing homes, and this research targeted cognitive functioning. Aims To evaluate whether socio-cognitive abilities can be improved by means of a theory of mind (ToM) training conducted by nursing home’s operators. Methods Results Results revealed that older adults benefitted from the ToM intervention in both practiced and non-practiced tasks, while the control group showed no change from pre- to post-test evaluation. Analyses on errors scores indicated that the ToM intervention led to a reduction of both excessive mentalizing and absence of mental states inference. Discussion The conversation-based ToM intervention proved to be effective in improving socio-cognitive skills in cognitively healthy nursing home residents. Notably, older adults were able to transfer the skills acquired during the training to new material. Conclusions Promoting healthy resident’s ToM ability could positively impact on their social cognition, consequently increasing their quality of life. Our findings showed that the intervention can be feasibly managed by health care assistants within the residential context.

The effect of the implementation of a good medical practice booklet on nursing home residents’ drug prescriptions: a difference-in-differences analysis based on data from electronic pill dispensers (Preprint)

2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Medical Practice ◽  
Intervention Group ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Control Group ◽  
Multilevel Regression ◽  
Difference In Differences ◽  
Good Medical Practice ◽  
The Impact

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.

scholarly journals A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

2021 ◽  
pp. 1-13
Author(s):  
Julie L. O’Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

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