A 10-week physical therapist-supervised exercise program for nursing home residents with dementia: a single arm, observational feasibility study - 03/11/25

Doi : 10.1016/j.jarlif.2025.100043 
Dennis Boer a, b, c, , Bente Winkler a, Charlotte Schmidt a, Shanty Sterke d, e, Wilco Achterberg f, Thea Vliet Vlieland b, c
a Department of Strategy and Innovation, Kennemerhart, Haarlem, The Netherlands 
b Department of Physiotherapy, University of Applied Sciences Leiden, Leiden, The Netherlands 
c Department of Orthopedics, Rehabilitation and Physiotherapy, Leiden University Medical Center, Leiden, The Netherlands 
d Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands 
e Department of Physiotherapy, Aafje Nursing Homes, Rotterdam, The Netherlands 
f Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands 

Corresponding author.

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Abstract

Background

Evidence on the effectiveness of exercise interventions for nursing home residence with dementia is scarce, with considerable practice variation with respect to their contents and dosage. This study aimed to evaluate the feasibility of an adequately dosed, personalized exercise intervention with respect to the assessment instruments, participants’ adherence and the occurrence of serious adverse events (primary feasibility outcomes) as well as the participant recruitment and participants’ and supervisors’ perceptions and experiences (secondary feasibility outcomes).

Design

Single-arm observational study.

Setting

Two nursing homes in Haarlem, the Netherlands.

Participants

Nursing home residents with a confirmed diagnosis of dementia who were able to walk 50 meters (with or without walking aid), without expected resistance to the intervention.

Intervention

10-week program, with two group-based sessions including strength and balance exercises, and two individual exergaming cycling sessions per week. The sessions were tailored to the participant via standardized assessments and supervised by a physical therapist.

Results

Of 59 residents screened, 11 enrolled. Four of six clinical assessments were completed by all, and two by nine and ten participants, respectively. Nine participants completed both components, one only the individual exergaming part, and one participant dropped out. Adherence rates were 92 % for the group and 87 % for the individual sessions. Among 137 reported adverse events, nine were possibly related to the intervention, all minor and transient. The median participant appraisal score was 4.3 (out of five). Supervisors highlighted dementia-specific knowledge, individualized communication, and tailored approaches as facilitators, while scheduling conflicts posed challenges.

Conclusion

A 10-week, personalized, physical therapist-led exercise program for nursing home residents with dementia is feasible, with high adherence and positive evaluations. A pilot study to refine the recruitment and intervention procedures as well as pre-and post-intervention outcome measurements is needed prior to scaling up to a larger clinical trial assessing effectiveness.

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Keywords : Exercise, Dementia, Alzheimer’s disease, Long-term care


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