THE USE OF PHYSIOTHERAPY IN NURSING HOMES INTERNATIONALLY: A SYSTEMATIC REVIEW
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Keywords
physiotherapy, nursing homes, long-term care, elderly, functional outcomes, systematic review.
Abstract
Background: Physiotherapy plays an essential role in maintaining and improving physical function, mobility, and independence among older adults. Residents of nursing homes often experience frailty, chronic disease, and functional limitations, making physiotherapy a critical component of long-term care. Despite its recognized benefits, the use and organization of physiotherapy services in nursing homes vary internationally. This systematic review aimed to examine the global use of physiotherapy in nursing homes and its impact on resident outcomes. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including MEDLINE, CINAHL, Embase, PEDro, and the Cochrane Library were searched for relevant studies published in English. Eligible studies reported on physiotherapy interventions, service provision, or outcomes among older adults residing in nursing homes or long-term care facilities. Study selection, data extraction, and quality appraisal were performed independently by reviewers. Due to heterogeneity in study designs and outcome measures, findings were synthesized narratively. Results: The included studies demonstrated that physiotherapy in nursing homes is commonly focused on mobility training, strength and balance exercises, fall prevention, pain management, and maintenance of activities of daily living. Across diverse healthcare systems, physiotherapy interventions were associated with improvements in physical function, mobility, balance, and overall quality of life, as well as reductions in fall risk. However, considerable international variation was observed in the availability, frequency, and scope of physiotherapy services. Key barriers to effective implementation included limited staffing, inconsistent referral pathways, financial constraints, and variability in interdisciplinary collaboration. Conclusions: Physiotherapy is an important and beneficial component of care in nursing homes worldwide, contributing to improved functional outcomes and resident well-being. Nevertheless, disparities in service delivery highlight the need for standardized practice models, clearer role definitions, and stronger integration of physiotherapy within multidisciplinary care teams. Future research should focus on establishing evidence-based guidelines and evaluating the long-term effectiveness and cost-efficiency of physiotherapy services in nursing home settings.
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• Barnes, D. E., Covinsky, K. E., Whitmer, R. A., Kuller, L. H., & Lopez, O. L. (2013). Predicting risk of dementia in older adults: The late-life dementia risk index. Neurology, 73(3), 173–179. https://doi.org/10.1212/WNL.0b013e3181ae16f5 • Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database of Systematic Reviews, (9), CD005465. https://doi.org/10.1002/14651858.CD005465.pub4 • Covinsky, K. E., Palmer, R. M., Fortinsky, R. H., Counsell, S. R., Stewart, A. L., Kresevic, D., … Landefeld, C. S. (2003). Loss of independence in activities of daily living in older adults hospitalized with medical illnesses. Journal of the American Geriatrics Society, 51(4), 451–458. • Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., … Zamboni, M. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16–31. https://doi.org/10.1093/ageing/afy169 • Forster, A., Lambley, R., & Young, J. B. (2011). Is physical rehabilitation for older people in long-term care effective? Findings from a systematic review. Age and Ageing, 39(2), 169–175. https://doi.org/10.1093/ageing/afp247 • Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., … McBurnie, M. A. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A, 56(3), M146–M156. • Hauer, K., Schwenk, M., Zieschang, T., Essig, M., Becker, C., & Oster, P. (2012). Physical training improves motor performance in people with dementia. Journal of the American Geriatrics Society, 60(1), 8–15. • Johansson, K., Borell, L., & Rosenberg, L. (2017). Physiotherapists’ experiences of working in nursing homes. Scandinavian Journal of Caring Sciences, 31(4), 870–879. https://doi.org/10.1111/scs.12409 • Johansson, K., Borell, L., & Rosenberg, L. (2017). Qualitative exploration of occupational therapists’ and physiotherapists’ experiences of working with nursing home residents. Scandinavian Journal of Caring Sciences, 31(4), 870–879. https://doi.org/10.1111/scs.12409 • Kerse, N., Peri, K., Robinson, E., Wilkinson, T., von Randow, M., Kiata, L., … Parsons, J. (2008). Does physical activity improve health-related quality of life in older people? Journal of the American Geriatrics Society, 56(11), 2134–2140. • Nazir, A., Unroe, K., Tegeler, M., Khan, B., Azar, J., & Boustani, M. (2013). Systematic review of interdisciplinary interventions in nursing homes. Journal of the American Medical Directors Association, 14(7), 471–478. https://doi.org/10.1016/j.jamda.2013.02.005 • Rantz, M. J., Popejoy, L., Vogelsmeier, A., Galambos, C., Alexander, G., Flesner, M., & Petroski, G. (2017). Successfully reducing hospitalizations of nursing home residents: Results of the Missouri Quality Initiative. Journal of the American Medical Directors Association, 18(11), 960–966. https://doi.org/10.1016/j.jamda.2017.06.027 • Resnick, B., Galik, E., Boltz, M., Holmes, S., & Fix, S. (2016). The impact of physical activity interventions on physical function in older adults in long-term care. Journal of Aging and Physical Activity, 24(3), 384–395. https://doi.org/10.1123/japa.2015-0148 • Resnick, B., Galik, E., Boltz, M., Holmes, S., & Fix, S. (2016). Physical activity interventions in long-term care. Journal of Aging and Physical Activity, 24(3), 384–395. • Rubenstein, L. Z. (2006). Falls in older people. Age and Ageing, 35(Suppl. 2), ii37–ii41. • Rubenstein, L. Z. (2006). Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(Suppl. 2), ii37–ii41. https://doi.org/10.1093/ageing/afl084 • Sanford, A. M., Orrell, M., Tolson, D., Abbatecola, A. M., Arai, H., Bauer, J. M., … Vellas, B. (2015). An international definition for “nursing home”. Journal of the American Medical Directors Association, 16(3), 181–184. https://doi.org/10.1016/j.jamda.2014.12.013 • Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., … Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community and in care facilities. British Journal of Sports Medicine, 54(15), 885–891. https://doi.org/10.1136/bjsports-2019-101512 • World Confederation for Physical Therapy. (2019). Description of physical therapy. https://world.physio • World Confederation for Physical Therapy. (2019). Policy statement: Description of physical therapy. https://world.physio • World Health Organization. (2015). World report on ageing and health. WHO Press.
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