Is physical rehabilitation for older people in long-term care effective? Findings from a systematic review

Abstract

Objective: to determine the effects of physical rehabilitation for older people resident in long-term care.

Design: systematic review of randomised controlled trials.

Data sources: The Cochrane Central Register of Controlled Trials, Medline, EMBASE, AMED, CINAHL, PEDro, British Nursing Index, ASSIA, IBSS, PsychINFO, DARE, HMIC, NHS EED, HTA, Web of Science, AsLib Index to UK Theses and Dissertation Abstracts, the National Research Register, Medical Research Council Register, CRIB, Current Controlled Trials and HSRPRoj.

Trials: all randomised trials investigating physical rehabilitation for people permanently resident in long-term care aged > or = 60 years. The primary outcome was measures of activity restriction.

Results: 49 trials were identified involving 3,611 subjects with an average age of 82 years. Intervention duration was typically 12 weeks with a treatment intensity of three 30-min sessions per week. Exercise was the main component of the interventions. The mean attendance rate for 17 studies was 84% (range 71-97%). Thirty-three trials, including the nine trials recruiting over 100 subjects, reported positive findings, mostly improvement in mobility but also strength, flexibility and balance.

Conclusion: physical rehabilitation for older people in long-term care is acceptable and potentially effective. Larger scale studies are needed to confirm the findings and should include longer term follow-up and assessment for possible harms.