Effects of quantitative progressive exercise rehabilitation on muscle function, functional performance, and quality of life of assisted living residents.

摘要

Assisted Living (AL) is a popular choice of residence for older adults who require assistance with some activities of daily living (ADLs) and have limited need for nursing care. While most residents intend for an assisted living facility (ALF) to be their final home, 64% are transferred to nursing homes as their functional abilities decline. Functional assessments are not mandated as part of AL services and because of this, subtle declines in function can be missed. ALF are not mandated to provide prevention programs for decline in functional performance. The purpose of this study was to (1) test the effectiveness of an eight week-quantitative progressive resistance exercise program (QPER) for improving muscle function (strength, endurance and contraction speed), functional performance (walking speed and endurance, chair rise and stair climb times, ADLs, and Quality of Life, and (2) examine the effect of QPER on maintaining function in AL residents for six months after the QPER intervention. Forty-five ALF residents were randomized to either an exercise group (EX) (n=30, mean age=84.7+/-6.1 yrs) or a control group (C) (n=15, mean age=87.1+/-6.2 yrs). Assessments of maximal strength and endurance of the quadriceps and hamstrings, quadriceps contraction speed, 6-minute walk, 50' walk, Timed Up and Go and ADLs and life satisfaction (LIFEwareRTM) were conducted at baseline, after the eight-week intervention (QPER) and then six-months post-QPER. Thirty participants completed the eight month study. In general, after QPER, EX had statistically significant improvements in muscle strength, endurance and functional performance that were still significantly above baseline six months later. Conversely, C showed significant declines in strength, endurance and functional performance, after eight weeks and the six-month follow-up. Neither group reported a change in life satisfaction ratings during this study. The changes measured for both groups may impact their long-term ability to age in place -- positively for the exercise group and negatively for the control group. Further research needs to address the long-term effect of QPER for aging in place and for training ALF staff to provide QPER to AL residents. The theoretical basis and results of the study are described in this dissertation.