Physical training can help improve or maintain gait ability in older long-term nursing home (LTNH) residents, according to a systematic review published online on December 6 in Maturitas.

Physical exercise programs based on multicomponent interventions are feasible, effective, and safe – and significantly improve or maintain gait ability in older adults living in long-term nursing homes,” said Dr. Haritz Arrieta of the University of the Basque Country in Leioa, Bizkaia, Spain,

“This report should encourage the development of recommendations for implementing exercise programs in LTNHs and other geriatric care facilities,” Dr. Arrieta, also an author of the current study.

While exercise reduces mortality and fall and fracture risk in older adults living in the community, little research has been done on the efficacy of exercise programs in LTNH residents, Dr. Arrieta and colleagues noted.

They reviewed seven studies (involving a total of more than 500 patients), including six of multicomponent exercise programs and one that focused on gait retraining. Duration of exercise interventions ranged from four weeks to 12 months; exercise sessions lasted 30 to 60 minutes.

For five of the studies looking at multicomponent interventions, timed up-and-go (TUG) performance and walking speed improved significantly or showed a trend toward improvement, compared with non-intervention control groups. The gait retraining program also significantly improved TUG and walking speed (vs. control).

“All the included studies in this systematic review have evaluated exercise programs at low-to-moderate training intensities, showing that it could be enough to maintain or improve the gait ability in older adults living in LTNHs,” Dr. Arrieta said.

“However, the dose-response relationship between the intensity of training and functional performance was not taken into account in any of the studies. It is possible that high-intensity progressive training performed by frail older adults could result in greater functional improvements than low to moderate programs.”

Dr. Arrieta said, “Further research is needed to determine the optimum intensity for the physical exercise programs that focus more on safety and feasibility of multicomponent exercise programs in a LTNH environment.”