Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study

Marinda Henskens, Ilse M. Nauta, Erik J.A. Scherder, Frits G.J. Oosterveld, Susan Vrijkotte

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Abstract
Background: The prevalence of dementia is expected to increase rapidly, and institutionalization is a common
consequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization and
a determinant for the quality of life (QoL). A promising method to increase functional independence in nursing
homes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) is
derived from the concept of FFC and restorative care and focuses on the integration of physical activity in
the daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective of
this study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursing
home residents with dementia.
Methods: In this quasi-experimental 12-month study, the effects of MRC were compared to care as usual in 61
nursing home residents with moderate to severe dementia. The outcome measures were ADL independence and QoL.
These outcomes were measured five times (i.e. at baseline, and after 3, 6, 9, and 12 months). Additionally, data was
collected regarding the degree of implementation, and the barriers to the implementation process. The effect of the
intervention was analyzed using linear mixed model analyses.
Results: There was no significant overall intervention effect on ADL independence and QoL. A significant group-bytime
interaction was found for the QoL subscale positive self-image: after a 12 month intervention period, the MRC
group scored significantly better than the control group on positive self-image. Regarding the other subscales and the
total score of the QoL, as well as ADL, no significant group-by-time interactions were found.
Conclusions: MRC did not demonstrate significant improvements in ADL or QoL. After a 12-month intervention
period, residents who received MRC showed higher scores on positive self-image compared to the control group. This
study contributes to the limited research regarding the effect of MRC on resident outcomes. Further large-scale studies
are recommended.
Trial registration: The trial was retrospectively registered in http://clinicaltrials.gov on February 2, 2017: NCT03001232.
Keywords: Dementia, Movement, Quality of life, Activities of daily living, Institutionalization
Original languageEnglish
Article number243
Pages (from-to)1-11
Number of pages11
JournalBMC Geriatrics
Volume17
DOIs
Publication statusPublished - 23 Oct 2017

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Nursing Homes
Activities of Daily Living
Quality of Life
Dementia
Institutionalization
Control Groups
Non-Randomized Controlled Trials
Linear Models
Outcome Assessment (Health Care)
Research

Keywords

  • Activities of daily living
  • Dementia
  • Institutionalization
  • Movement
  • Quality of life

Cite this

@article{acc06821486d42fd8d277dbbd5a25bfa,
title = "Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study",
abstract = "AbstractBackground: The prevalence of dementia is expected to increase rapidly, and institutionalization is a commonconsequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization anda determinant for the quality of life (QoL). A promising method to increase functional independence in nursinghomes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) isderived from the concept of FFC and restorative care and focuses on the integration of physical activity inthe daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective ofthis study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursinghome residents with dementia.Methods: In this quasi-experimental 12-month study, the effects of MRC were compared to care as usual in 61nursing home residents with moderate to severe dementia. The outcome measures were ADL independence and QoL.These outcomes were measured five times (i.e. at baseline, and after 3, 6, 9, and 12 months). Additionally, data wascollected regarding the degree of implementation, and the barriers to the implementation process. The effect of theintervention was analyzed using linear mixed model analyses.Results: There was no significant overall intervention effect on ADL independence and QoL. A significant group-bytimeinteraction was found for the QoL subscale positive self-image: after a 12 month intervention period, the MRCgroup scored significantly better than the control group on positive self-image. Regarding the other subscales and thetotal score of the QoL, as well as ADL, no significant group-by-time interactions were found.Conclusions: MRC did not demonstrate significant improvements in ADL or QoL. After a 12-month interventionperiod, residents who received MRC showed higher scores on positive self-image compared to the control group. Thisstudy contributes to the limited research regarding the effect of MRC on resident outcomes. Further large-scale studiesare recommended.Trial registration: The trial was retrospectively registered in http://clinicaltrials.gov on February 2, 2017: NCT03001232.Keywords: Dementia, Movement, Quality of life, Activities of daily living, Institutionalization",
keywords = "Activities of daily living, Dementia, Institutionalization, Movement, Quality of life",
author = "Marinda Henskens and Nauta, {Ilse M.} and Scherder, {Erik J.A.} and Oosterveld, {Frits G.J.} and Susan Vrijkotte",
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Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study. / Henskens, Marinda; Nauta, Ilse M.; Scherder, Erik J.A.; Oosterveld, Frits G.J.; Vrijkotte, Susan.

In: BMC Geriatrics, Vol. 17, 243, 23.10.2017, p. 1-11.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study

AU - Henskens, Marinda

AU - Nauta, Ilse M.

AU - Scherder, Erik J.A.

AU - Oosterveld, Frits G.J.

AU - Vrijkotte, Susan

PY - 2017/10/23

Y1 - 2017/10/23

N2 - AbstractBackground: The prevalence of dementia is expected to increase rapidly, and institutionalization is a commonconsequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization anda determinant for the quality of life (QoL). A promising method to increase functional independence in nursinghomes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) isderived from the concept of FFC and restorative care and focuses on the integration of physical activity inthe daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective ofthis study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursinghome residents with dementia.Methods: In this quasi-experimental 12-month study, the effects of MRC were compared to care as usual in 61nursing home residents with moderate to severe dementia. The outcome measures were ADL independence and QoL.These outcomes were measured five times (i.e. at baseline, and after 3, 6, 9, and 12 months). Additionally, data wascollected regarding the degree of implementation, and the barriers to the implementation process. The effect of theintervention was analyzed using linear mixed model analyses.Results: There was no significant overall intervention effect on ADL independence and QoL. A significant group-bytimeinteraction was found for the QoL subscale positive self-image: after a 12 month intervention period, the MRCgroup scored significantly better than the control group on positive self-image. Regarding the other subscales and thetotal score of the QoL, as well as ADL, no significant group-by-time interactions were found.Conclusions: MRC did not demonstrate significant improvements in ADL or QoL. After a 12-month interventionperiod, residents who received MRC showed higher scores on positive self-image compared to the control group. Thisstudy contributes to the limited research regarding the effect of MRC on resident outcomes. Further large-scale studiesare recommended.Trial registration: The trial was retrospectively registered in http://clinicaltrials.gov on February 2, 2017: NCT03001232.Keywords: Dementia, Movement, Quality of life, Activities of daily living, Institutionalization

AB - AbstractBackground: The prevalence of dementia is expected to increase rapidly, and institutionalization is a commonconsequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization anda determinant for the quality of life (QoL). A promising method to increase functional independence in nursinghomes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) isderived from the concept of FFC and restorative care and focuses on the integration of physical activity inthe daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective ofthis study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursinghome residents with dementia.Methods: In this quasi-experimental 12-month study, the effects of MRC were compared to care as usual in 61nursing home residents with moderate to severe dementia. The outcome measures were ADL independence and QoL.These outcomes were measured five times (i.e. at baseline, and after 3, 6, 9, and 12 months). Additionally, data wascollected regarding the degree of implementation, and the barriers to the implementation process. The effect of theintervention was analyzed using linear mixed model analyses.Results: There was no significant overall intervention effect on ADL independence and QoL. A significant group-bytimeinteraction was found for the QoL subscale positive self-image: after a 12 month intervention period, the MRCgroup scored significantly better than the control group on positive self-image. Regarding the other subscales and thetotal score of the QoL, as well as ADL, no significant group-by-time interactions were found.Conclusions: MRC did not demonstrate significant improvements in ADL or QoL. After a 12-month interventionperiod, residents who received MRC showed higher scores on positive self-image compared to the control group. Thisstudy contributes to the limited research regarding the effect of MRC on resident outcomes. Further large-scale studiesare recommended.Trial registration: The trial was retrospectively registered in http://clinicaltrials.gov on February 2, 2017: NCT03001232.Keywords: Dementia, Movement, Quality of life, Activities of daily living, Institutionalization

KW - Activities of daily living

KW - Dementia

KW - Institutionalization

KW - Movement

KW - Quality of life

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