Abstract
BackgroundPoor nutrition and age per see add to the development of sarcopenia, i.e. loss of muscle mass and strength, which contributes to increased risk of impaired activities of daily living (ADL) and reduced independence. Protein deficiency plays an important role in the development of sarcopenia. In order to increase the muscle mass protein intake should be combined with physical exercise. A daily physical activity, the sit-to-stand exercise, has been proven to decrease older persons’ dependence in ADL. Our study aims to evaluate the effects of the sit-to-stand exercise in combination with a protein-rich nutritional supplement, on physical function and independence in frail nursing home residents. The resident’s perceptions and experiences of the intervention and the staff’s experiences of supporting the resident to complete the intervention will also be explored.MethodsThe study is a two-arm cluster-randomized controlled trial which will be performed in nursing homes at two municipalities in Sweden. We will recruit 120 residents, age 75 or older and able to stand up from a seated position. Residents (n = 60) randomized to the intervention group will perform the sit-to-stand exercise at four occasions daily and will be offered a protein-rich oral supplement, twice a day. The intervention period will last for 12 weeks and measures of physical function, nutritional status, quality of life and health economy will be performed at baseline and at 12-weeks follow-up. The primary outcome will be the number of chair rises performed in 30 s. The control group will receive standard care. Data will be analysed by intention-to-treat analysis and with mixed effect models. During the last part of the intervention period individual interviews with the residents, on the topic of feasibility with the OPEN concept will be held. Likewise, focus-group-interviews with staff will be performed.DiscussionThe residents’ physical and mental health could be expected to improve. Even the work situation for staff could be positively affected. One innovative feature of the OPEN study is the simple intervention consisting of a basic daily activity that can be performed by several nursing home residents with the support of existing staff and available resources.Trial RegistrationClinicalTrials.gov Identifier: NCT02702037.
Highlights
Poor nutrition and age per see add to the development of sarcopenia, i.e. loss of muscle mass and strength, which contributes to increased risk of impaired activities of daily living (ADL) and reduced independence
Reduced activity and impaired mobility increases the risk of falls, pressure ulcers and incontinence [10, 11] all of which can lead to complications, hospitalization and reduced health-related quality of life [12]
The main hypothesis of the Older person’s exercise and nutrition study (OPEN) study is that physical exercise performed as a daily routine along with a protein supplement, will result in improved physical function status and independence in everyday life activities and thereby enhance health-related quality of life in older persons living in nursing homes
Summary
Poor nutrition and age per see add to the development of sarcopenia, i.e. loss of muscle mass and strength, which contributes to increased risk of impaired activities of daily living (ADL) and reduced independence. In spite of the knowledge of the health-related benefits of active aging and daily physical activity [2, 4], a majority of NH residents are inactive most of the time and with little social interaction [4,5,6]. This sedentary living is not necessarily due to medical conditions or decreased mobility function. Residents that are unable to move around independently, and even must rely on lifts for ambulation, often bears greater costs of care [13]
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