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The effect of a high-intensity functional exercise program on activities of daily living: a randomized controlled trial in residential care facilities


Littbrand, Håkan, Lundin-Olsson, Lillemor, Gustafson, Yngve, Rosendahl, Erik


Journal Of The American Geriatrics Society, Volume: 57, No.: 10, Pages.: 1741-1749

Year of Publication



Objectives: To evaluate whether a high-intensity functional weight-bearing exercise program reduces dependency in activities of daily living (ADLs) in older people living in residential care facilities, focusing on people with dementia.; Design: Randomized, controlled trial.; Setting: Nine residential care facilities.; Participants: One hundred ninety-one older people dependent in ADLs and with a Mini-Mental State Examination score of 10 or greater. One hundred (52.4%) of the participants had dementia.; Intervention: A high-intensity functional weight-bearing exercise program or a control activity consisting of 29 sessions over 3 months.; Measurements: The Barthel ADL Index; follow-up at 3 months (directly after the intervention) and 6 months with intention-to-treat analyses.; Results: There were no statistically significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a smaller proportion of participants in the exercise group had deteriorated in indoor mobility at 3 months (exercise 3.5% vs control 16.0%, P=.01) and 6 months (7.7% vs 19.8%, P=.03). For people with dementia, there was a significant difference in overall ADL performance in favor of the exercise group at 3 months (mean difference 1.1, P=.03) but not at 6 months.; Conclusion: A high-intensity functional weight-bearing exercise program seems to reduce ADL decline related to indoor mobility for older people living in residential care facilities. The program does not appear to have an overall effect on ADLs. In people with dementia, the exercise program may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect.;

Bibtex Citation

@article{Littbrand_2009, doi = {10.1111/j.1532-5415.2009.02442.x}, url = {}, year = 2009, month = {oct}, publisher = {Wiley-Blackwell}, volume = {57}, number = {10}, pages = {1741--1749}, author = {H{~{A}}{textyen}kan Littbrand and Lillemor Lundin-Olsson and Yngve Gustafson and Erik Rosendahl}, title = {The Effect of a High-Intensity Functional Exercise Program on Activities of Daily Living: A Randomized Controlled Trial in Residential Care Facilities}, journal = {Journal of the American Geriatrics Society} }


activities of daily living, aged, aged, 80 and over, dementia, exercise, female, homes for the aged, humans, male, physiopathology, weightbearing

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes



Long Term Residential Care without medically trained staff

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Exercise (inc. dancing)