Effectiveness of Functionally based Physical Activity Programs on Physical, Psychological, Cognitive, and Adverse Outcomes in Older Adults Living in Nursing Homes: Systematic Review

This systematic review aimed to examine the effectiveness of function-oriented physical activity programs on the physical, psychological, cognitive, and adverse outcomes of older adults living in nursing homes. An extensive search was conducted. Two reviewers independently applied eligibility criteria and assessed sources of bias using the Revised Cochrane Risk of Bias Tool for Randomized Trials and the Risk of Bias in Non-randomized Studies of Interventions. Data were analyzed using a narrative synthesis. Twenty-three studies were included. Intervention type was categorized as walking programs (n= 9), activity of daily living practice (n= 6), and functional exercise programs (n= 8). Eighteen studies were rated as serious or high risk of bias and five were rated at moderate or some risk of bias. Walking interventions and functional exercise programs may be effective for improving physical outcomes in nursing home residents. None of the three types of physical activity demonstrated effectiveness for improving psychological outcomes. Cognitive outcomes were only evaluated by a small number of studies in the walking program category, which suggested mixed results. Adverse events were not associated with these interventions. Nursing home residents, including people with dementia, were able to safely engage with and experience benefits from functional physical activity interventions embedded into nursing home care.