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 wheelchair‐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 DVD‐guided sessions (all P < .05). Conclusion Volunteer‐led sessions followed by DVD‐guided sessions of resistance band exercise is effective and practical in institutional settings.