From the Guidelines
Physical inactivity in residential aged care is defined as an insufficient physical activity level to meet present physical activity recommendations, characterized by excessive time spent in sedentary behaviors such as sitting or lying down, with minimal engagement in purposeful physical movement or exercise. This definition is based on the World Health Organization's 2020 guidelines on physical activity and sedentary behaviour 1. In the context of residential aged care, physical inactivity can manifest as residents spending most of their day seated or in bed, with limited participation in structured exercise programs, recreational activities, or even basic activities of daily living.
The consequences of physical inactivity in this population are significant, including:
- Accelerated functional decline
- Muscle atrophy
- Decreased bone density
- Impaired cardiovascular health
- Increased risk of falls
- Negative impacts on mental health, cognitive function, and quality of life
Understanding this definition is crucial for developing appropriate interventions that promote movement and reduce the harmful effects of sedentary behavior in this vulnerable population. Recent studies have highlighted the importance of nurse-led physical activity interventions in nursing homes, which can include a range of activities such as classic or technology-supported physical exercises, care-integrated physical activity, outdoor or walking activities, and dancing 2, 3, 4, 5. However, the implementation of these interventions can be influenced by various factors, including the availability of time and resources, the motivation of participants, and the presence of barriers such as fatigue, misunderstanding of tasks, and high workload 4, 5.
Key factors that can facilitate the implementation of physical activity interventions in residential aged care include:
- Participation in preferred physical activities
- Individually tailored compilation of exercises
- Easy way of implementation with short preparation time
- Possibility of group exercises
- Additional training sessions, interdisciplinary consultations, and more time 4, 5
Overall, addressing physical inactivity in residential aged care requires a comprehensive approach that takes into account the unique needs and challenges of this population, and prioritizes the development of effective interventions that promote movement and reduce sedentary behavior.
From the Research
Definition of Physical Inactivity
Physical inactivity in the context of residential aged care can be defined as a state of being sedentary for a large portion of the day, with limited engagement in physical activities. This can include:
- Spending a high percentage of time (around 85%) in sedentary behavior, such as sitting or lying down 6
- Accumulating sedentary time in bouts of greater than 30 minutes 6
- Engaging in physical activity for short durations (less than 10 minutes) and at low intensities (around 12% of the time) 6
- Having a low level of moderate-to-vigorous physical activity (around 1% of the time) 6
Factors Influencing Physical Inactivity
Several factors can contribute to physical inactivity in residential aged care, including:
- Ageism and negative perceptions of exercise 7
- Limited social capital and support from staff 7
- Pain and other health conditions 7
- Use of sedative medications, which can negatively impact movement behavior and reduce physical activity levels 8
- Anticholinergic burden, which can be associated with limitations in physical and cognitive function 9
Implications of Physical Inactivity
Physical inactivity can have significant implications for the health and well-being of residents in aged care facilities, including: