Elastic Band Exercises Improved Sleep Quality and Depression of Nursing Home Older Adults in Wheelchairs

Purpose: Sleep disturbances and depression are costly and potentially disabling conditions affecting a considerable proportion of older adults. Physical activity is associated with decreased state of depression and enhanced sleep quality of older adults. This study aimed to test the effectiveness of six months of elastic band exercises on sleep quality and depression of nursing home older adults in wheelchairs.

Methods: A cluster randomized control trial was used. 127 older adults from 10 nursing homes participated voluntarily, and 114 of them completed the study. Participants were randomly assigned to two groups based on the nursing homes where they lived: the experimental group (five nursing homes, n = 59) and the control group (five nursing homes, n = 55). A 40-minute Wheelchair-bound Senior Elastic Band (WSEB) exercise program was implemented three times per week for six months for the experimental group participants. The program has two levels (basic vs. advanced), and each level has three phases (warm-up, aerobic motion, and harmonic stretching). The basic level was practiced for the first three months followed by the advanced level for another three months. Sleep quality (the Pittsburgh Sleep Quality Index) and depression (the Taiwanese Depression Questionnaire) of the participants were examined at baseline, after three-month, and at the end of the six-month study.

Results: After the WSEB exercises, participants had longer sleep duration, better habitual sleep efficiency, and less depression than their baseline (all p < .05). Participants in the experimental group had longer sleep duration, better habitual sleep efficiency, and less depression than the control group at three months of the study and maintained throughout the six-month study (all p < .05).

Conclusion: Regular practice of WSEB exercises significantly improved sleep quality and decreased depression of nursing home older adults in wheelchairs. Nursing home directors could recruit volunteers to learn the program and lead the elderly residents in wheelchairs to practice the WSEB exercises regularly in the facilities.