A Feasibility Study of a Multifaceted Walking Intervention to Maintain Functional Mobility, ADL Function, and Quality of Llife among Nursing Home Residents with Dementia

Aim: To determine the feasibility, acceptability, and efficacy of a multifaceted walking intervention (MWI) to maintain the functional mobility, activities of daily living (ADL) function, and quality of life (QOL) of nursing home residents with dementia. Setting: Two nursing homes in the GTA. Method and Analysis: An interrupted time series design was used with a 2-month pre-intervention phase followed by a 4-month intervention phase. Measures of functional mobility (2MWT, TUG, gait speed), ADL function (FIM), and QOL (ARQOL) were collected before and after the pre-intervention, and at the middle and end of the intervention by a blinded assistant. RM-ANOVA was used to explore efficacy over time. The MWI components: a)one-to-one walking regime tailored to the resident up to 4 times a week for 4 months and b)individualized communication careplans that were used during the sessions. The MWI was informed by multiple interviews to collect biographical data, communication assessments, and resident observations. Results: The MWI was feasible, based on a high recruitment rates of resident (86.6%, n=26), PSWs (100%) and POAs (100%) and retention rate (96.1%). Interventionist adherence to the protocol was high (i.e. intervention could be delivered as designed). The POA and PSW staff acceptability was high before and after the intervention, and resident adherence also indicated high acceptability. During the pre-intervention phase, residents experienced significant declines in functional mobility as measured by the TUG, 2MWT, gait speed, a significant decline in their ADL function, as well as QOL. Over the intervention phase, the TUG improved by 32.14% (P=0.000), 2MWT improved by 51.25% (P=0.000), gait speed improved by 55.11% (P=0.000), ADL function increased by 25% (P=0.000) and QOL by 7.8% (P=0.063). No adverse events were related to the intervention and no significant environmental influence was found. Significance: This is the first intervention to deliver individualized physical activity to residents with dementia using a person-centered approach. The MWI appears to be a promising solution to maintain outcomes; however, a larger trial is required. This study informs a future trial, as well as provides a greater understanding about the role person-centered care can play when delivering physical activity to frail populations.Ph.D