Rehabilitation for older people in long-term care

Rehabilitation treatments may be effective in improving the physical condition of older people in long-term care. In 1997 the number of over-65 year olds constituted 6.6% of the world's population, and this is predicted to increase to 10% by 2025.  It is expected that this will lead to a rise in demand for long-term residential care. There is therefore a demand for ways of preventing any deterioration in health and increasing independence in activities of daily living, for example walking and dressing, among residents. Physical rehabilitation (interventions based on the exercising the body) may have a role and this review examines the evidence available. Forty-nine trials are included in this review, 30 of which were conducted in the USA. In total, 3611 participants with an average age of 82 years were involved, more than two-thirds of whom were female. Most interventions in some way addressed disability in routine daily life, for example walking, eating and dressing. The trial outcomes addressed by this review are disability in daily life, strength, flexibility, balance, general physical condition, mood, cognitive status, participant drop out, session attendance, death, illness, and  unwanted effects associated with the intervention, such as injuries. Due to the wide variety of outcome measures used, the studies could not be summarised statistically, therefore a narrative review is provided. While variations between the trials means specific recommendations cannot be made, they were overwhelmingly successful, demonstrating that many different types of physical rehabilitation have benefits to physical health with few reports of unwanted events relating to the intervention.