Requirements of a cognitive-motor spatial orientation training for nursing home residents: an iterative feasibility study

Abstract

A sedentary lifestyle in nursing home residents is often accompanied with reduced life space mobility and in turn affects satisfaction with life. One of the reasons for this may be limited ability to find one’s way around the care facility and its environment. However, spatial orientation exercises might reduce these problems if they are integrated into an adequate cognitive-motor training. Therefore, we integrated six novel and target group-specific spatial orientation exercises into an established multicomponent cognitive-motor group training for nursing home residents and evaluated its feasibility. Forty nursing home residents (mean age: 87.3 ± 7 years) participated in the spatial orientation cognitive motor training (45–60 min, twice a week over a period of 12 weeks). The main outcomes included the feasibility criteria (adherence, completion time, acceptance, instructions, motor performance, materials/set up, complexity) and first measurements of mobility and satisfaction with life (SPPB [Short Physical Performance Battery], SWLS [Satisfaction with Life Scale]). Adherence increased over time. The increase was associated with the adaptions and modifications of the spatial orientation exercises that were made to meet the participants’ requirements. A positive trend was discerned for mobility and life satisfaction, comparing pre- and posttraining data. In summary, the feasibility analysis revealed that future interventions should consider that (a) instructions of demanding spatial tasks should be accompanied by an example task, (b) trainers should be encouraged to adjust task complexity and materials on an individual basis, (c) acceptance of the training should be promoted among nursing staff, and (d) surroundings with as little disturbance as possible should be selected for training.

Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project

“…Due to these changes to different physiological systems, older adults deal with higher amounts of uncertainty in motor control and, thus, require an increase in executive control to, e.g., maintain posture during gait [ 19 ]. In addition to basic EF, cognitive decline may affect higher-level cognitive functions necessary for ADLs, such as planning or reasoning, for spatial orientation [ 11 ]. In sum, cognitive functioning has a small to moderate impact on the functional status, but not exclusively, via the motor control/objective performance pathway.…”

“…After moving to a nursing home, most residents are physically inactive, spending most of their time sitting or lying [ 10 ], negatively influencing their physical performance. Furthermore, mobility restrictions resulting in sedentary behavior reduce social interactions and limit cognitive stimulation [ 11 ]. Conversely, increasing physical and cognitive performance limitations minimize physical activity and mobility [ 3 ].…”

“…Cognitive decline exceeding a certain threshold can lead to reduced ADL performance [ 21 ]. In addition, cognitive decline often manifests in reduced performance of secondary tasks (dual-tasking), e.g., walking and following signs to navigate the environment [ 11 , 22 , 23 ]. However, the reported studies did not directly examine the interaction of EF, dual-tasking, and ADLs.…”

Exercise and physical activity for health promotion and rehabilitation in community dwelling very old adults or nursing home residents

“…To combine the positive effects of DT managing training with orientation aspects, a study by Fricke et al (2021) present an innovative program in this issue. They integrated six novel and target group-specific spatial orientation exercises into an established DT multicomponent training for nursing home residents and evaluated their feasibility.…”

“…Instead, we present a variety of studies: Regarding the "pathways" above, four papers relate to (1) physical activity and tailored exercises to increase different outcomes of cognitive and motor fitness, three papers to (2) social engagement, psychosocial parameters, and mental health and three papers to (3) cognitive stimulation, which is also associated withphysical and global functioning. Most of the papers relate to preparation (Fricke et al, 2021;Wolter et al, 2021;Prinz et al, 2021) and conduction (Hezel et al, 2021;Bezold et al, 2021) of specified interventions. Two papers deal with the development and validation of instruments (Klotzbier et al, 2021;Schott et al, 2021).…”