Rhythmic movement training for nursing home residents: Implications for improving quality of movement

With aging, a variety of physical changes occur related to disuse of body parts and evidenced by decreases in functional skills. Most dramatically affected is that elderly group who live in long term care facilities where up to 85% suffer from major mobility deficits. Exercise is a means of improving physical fitness and motor skills which can help slow down and minimize the debilitating changes that do occur. Exercise skills involve coordinated movement patterns which incorporate the essential component of rhythm. The ability to respond rhythmically can be developed through practice. Recent research is showing that rhythmic stimulation can have a powerful effect on movement behaviors even in people functioning at very low levels of motor skill.^ Forty 62-96 year old nursing home residents participated in this rhythmic movement study. Training twice a week for ten weeks was conducted using rhythm stick activities for the upper extremities and tap dancing activities for the lower extremities. This intensity was sufficient in both frequency and duration to produce significant improvements in the performance of both upper and lower extremity nonequilibrium coordination tasks. Improvements were documented as changes in the quality of movements, most significantly as increased accuracy of movement and increased ability to hold extremities in unsupported positions while performing skilled movements. Also notable was a decrease in the dominance of synergistic movement patterns as skills improved with more specific muscular control and efficiency. Movements were accomplished more smoothly, more rhythmically and without hesitation or noticeable fatigue.^ Repeated Measures Analysis of Covariance with follow-up Newman-Keuls detected a significant difference between experimental and control groups (p $\u3c$.00) but no significant group effect to distinguish among methods. There was a significant effect for time (p $\u3c$.001) and a significant group x time interaction (p $\u3c$.001). Multivariate analysis of covariance was significant at p $\u3c$.001 indicating a multivariate effect attributable to training method. Multiple discriminant function analysis identified upper extremity coordination skills, movement accuracy, movement synergy and posture holding as those variables which could successfully distinguish between all but one possible pairs of groups.