A study published in The Lancet Healthy Longevity describes the results of physical exertion on the physical function of older adults staying in residential care facilities.

Study: Effects of physical exertion on physical function in older adults in residential care: a scientific review and network meta-analysis of randomised controlled trials. Image Credit: belushi / Shutterstock

Background

Declining physical function is considered one of the main challenges experienced by older adults of their each day life. Healthy aging, in response to the World Health Organization (WHO), is characterised by the preservation of physical and mental capacities over time.

An inverse correlation exists between physical function and the chance of varied age-related health outcomes, including hospitalization, admission to residential care, and mortality. Unfortunately, no pharmacological intervention is offered to stop physical decline in older adults. Nevertheless, evidence suggests a possible role of routine physical exertion in stopping age-related physical decline and improving physical function.

The proportion of older adults staying in residential care facilities is increasing globally. Functional dependency, multimorbidity, and polypharmacy are common problems amongst older people. Furthermore, they mostly live a sedentary life with minimal physical activity, which further worsens their physical capabilities.

This systematic review and meta-analysis of randomized controlled trials have been done to grasp the impact of routine physical exertion on the physical function of older adults staying in residential care facilities.

Study design

Various scientific databases were searched to discover randomized controlled trials investigating the effect of physical exertion on physical function (functional independence, physical performance, and other related parameters) in older adults aged 60 years and above who’re staying in residential care facilities. Studies published as much as mid-January 2023 were included within the systematic review.

The outcomes of physical function that were reported in at the least ten studies were included within the meta-analysis. Furthermore, subgroup analyses were conducted to find out the marginal effects of the intervention (exercise type, training volume, and duration of intervention) and the study population (cognitive and functional status) characteristics.

Essential observations

A complete of 147 randomized controlled trials, with 12,059 participants in total, were included within the systematic review. The participants (age range: 67 – 92 years) were staying in long-term care facilities, assisted living facilities, or congregate housing for older adults.

The participants conducted physical exercises under expert supervision for 4 – 96 weeks. The interventions included 1 – 7 sessions per week, with a session duration of 8 – 90 minutes. In many of the studies, a combined intervention including two or more sorts of exercises (mobility, balance, endurance, and resistance exercises) was implemented.   

The interventions applied to the control group participants included social, cultural, or musical activities or low-intensity exercises. The general quality of the included studies was good.

A complete of 105 good-quality studies were included within the meta-analysis. The findings revealed that exercise interventions significantly improve the physical function of older adults in comparison with usual care.   

The findings of subgroup analyses identified essentially the most significant effect of physical exertion amongst older adults staying in nursing homes. Furthermore, a moderate-to-large effect of exercise intervention was observed amongst older adults with cognitive impairment, functional dependence, or age-related weakness (frailty).

The useful effects provided by exercise intervention were comparable across all exercise types. The most important effect size was observed for balance exercises; nevertheless, this data suffered a big degree of inaccuracy.

Amongst all exercise types, endurance training provided essentially the most consistent advantages. The findings of the rating analyses indicated that endurance training is the most certainly to be effective.       

Exercising for 110 minutes per week provided essentially the most consistent advantages. Similarly, the best profit was observed with 170 minutes of exercise per week. Nevertheless, this data also suffered a big degree of inaccuracy.

Study significance

This systematic review and meta-analysis highlight the importance of physical exertion in improving the physical function of older adults staying in residential care facilities, no matter their functional and cognitive abilities. The advantages they get from exercise include functional independence for daily-life activities and enhancements in muscle strength, physical performance, balance, and adaptability.

Based on these findings, scientists recommend routine implementation of exercise interventions in long-term care facilities.