Increasing physical activity levels in care homes for older people: a quantitative scoping review of intervention studies to guide future research

Purpose: Physical activity (PA) levels in older care home residents are low. This has detrimental effects on health. Little is known about the nature of interventions to increase physical activity in this population.

Methods: A scoping review to: (1) identify and describe interventions to increase PA in older care home residents, and (2) describe the extent to which interventions address care home context, systemised by social-ecological models. We systematically searched databases for peer-reviewed intervention studies to increase PA in older people resident in care homes. Data were extracted using the template for intervention description and replication (TIDieR) and mapped against a social-ecological framework to locate the intervention focus.

Results: The 19 included studies consisted of interventions tested in randomised or quasi-experimental trial designs. Interventions consisted of single or multiple components and predominantly addressed individual resident level factors (such as muscle strength) rather than broader social and environmental aspects of context. Interventions were not all fully described. For most interventions a distinct theoretical foundation was not identified. Interventions were mostly delivered by health professionals and research staff external to care homes.

Conclusions: Future interventions should address contextual care home factors and should be clearly described according to intervention description guidance.

Implications for rehabilitation

• Physical activity holds promise as an effective means of improving health and function in older care home residents, but physical activity levels in this population are low.

• Several reasons beyond the individual resident but related to care home contextual factors may explain low PA in care homes

• To date, contextual factors influencing PA in care homes have been poorly addressed in interventions.

• Wider care home context (social, cultural, and environmental factors) must be considered in future interventions.