Barriers and facilitators to implementation of physical activity programs for individuals with dementia living in aged care homes: A systematic review

• Published in: Archives of gerontology and geriatrics Vol. 126; p. 105535
• Main Authors: Andrews, Mitchell, Cheema, Birinder S., Siette, Joyce
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.11.2024
• Subjects: Aged; Aged care; Barriers; Dementia; Dementia - rehabilitation; Exercise - psychology; Facilitators; Homes for the Aged - organization & administration; Humans; Implementation; Nursing Homes; Physical activity; Aged care; Facilitators; Physical activity; Barriers; Implementation; Dementia
• ISSN: 0167-4943; 1872-6976; 1872-6976
• DOI: 10.1016/j.archger.2024.105535

•Key barriers to physical activity implementation for dementia residents in aged care homes included understaffing, fatigue, lack of motivation, and distrust of staff.•Key facilitators were structured and tailored programs, group exercise sessions for social interaction, and frequent sessions.•Addressing these barriers and optimising these facilitators has the potential to improve physical activity program implementation and support the quality of life of residents with dementia. This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes. A search was conducted using the databases Medline, PubMed, PsycINFO, CINAHL, Embase, and ProQuest, and captured articles were assessed for inclusion in the review. Included studies were appraised using the Mixed Methods Appraisal Tool (MMAT). Data extraction was performed for study characteristics, identified barriers and facilitators to physical activity implementation, and synthesised narratively. Following full-text screening, 13 articles were included in the review. Reporting quality was high in the majority of studies (69 %). Overall, barriers to implementation of physical activity programs were linked to factors related to the resident or the aged care facility, rather than inherently with the physical activity itself. The most identified barriers were understaffing (62 %), resident fatigue or lack of motivation (46 %), distrust of staff (31 %), and fear of injury (31 %). The most identified facilitators were having a structured physical activity protocol (46 %), opportunities for social interaction (38 %), instructor-led sessions (38 %) and offering an individually tailored program (31 %). Addressing barriers of understaffing and resident fatigue whilst simultaneously offering structured, personalised group physical activity programs led by instructors may help optimise implementation. Future research should focus on developing tailored implementation plans, evaluating their effectiveness and cost-effectiveness, and identifying best practices to support the delivery of physical activity interventions in residential aged care settings. CRD42022372308.