Mobility Decline Prevention
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Modules - Mobility Decline Prevention
Functional Incidental Training, Mobility Performance, and Incontinence Care with Nursing Home Residents
John F. Schnelle, Priscilla G. MacRae, Joseph G. Ouslander, Sandra Simmons, and Misty Nitta, 1995, in Journal of the American Geriatrics Society;43:1356-1362
Severely demented, inactive, and physically frail nursing home residents can significantly increase their mobility endurance and physical activity when regularly offered the opportunity to exercise, according to the study reported in this article. The study evaluated an intervention called Functional Incidental Training or FIT, which integrates prompted voiding for incontinent residents with low-intensity exercises such as walking, wheelchair propulsion, and sit-to-stands. Findings showed that the highly deconditioned, cognitively impaired residents who enrolled in the study not only complied with the exercise protocol, completing 75% of all exercise sessions offered four times per day, but also achieved 100% of their individualized exercise goals on 80% of these sessions. In contrast to more traditional, once-a-day exercise programs, this intervention distributed exercise over the course of the day, with brief sessions offered by nurse aides once every two hours in conjunction with incontinence care for the individual. This strategy reduced injury risks from over-exertion and deployed staff more efficiently. Nevertheless, the intervention requires significantly more to time to provide than usual care-an estimated 18 additional minutes per resident per day. The authors conclude, "The increased cost of this intervention must be evaluated both in terms of clinical outcomes and by the reality that the target group for this intervention is very frail and will continue to require nursing home care, even assuming an excellent response to the intervention."
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