Resistance Band Exercises Reduce Depression and Behavioral Problems of Wheelchair-Bound Older Adults with Dementia: A Cluster-Randomized Controlled Trial

OBJECTIVES: To test the effects of a 15-month wheel-chair-bound resistance band exercise program on depression and behavioral problems of wheelchair-bound older adults with dementia. DESIGN: Single-blind, cluster-randomized controlled trial with repeated measures. SETTING: Eight nursing homes in southern Taiwan. PARTICIPANTS: Wheelchair-bound nursing home older adults with dementia who participated voluntarily (N = 150) were cluster-randomized to two groups (experimental or control group); 127 completed the study (experimental: four nursing homes, n = 65; control: four nursing homes, n = 62). INTERVENTION: The resistance band exercises were conducted three times per week in 40-minute sessions in the following two sequences: volunteer-led sessions for the first 6 months (Stage I) followed by DVD-guided sessions for the next 9 months (Stage II). MEASUREMENTS: Depression, as measured using the Cornell Scale for Depression in Dementia, and behavioral problems, as measured using the Clifton Assessment Procedures for the Elderly-Behavior Rating Scale, of participants were observed at six time points at 3-month intervals: pretest, two posttests at Stage I, and three posttests at Stage II. RESULTS: By the sixth month of the study, experimental group participants were significantly less depressed and had fewer behavioral problems than control group participants (all P <.05). These small but statistically significant differences persisted throughout the 9 months of the DVDguided sessions (all P <.05). CONCLUSION: Volunteer-led sessions followed by DVDguided sessions of resistance band exercise is effective and practical in institutional settings.