Date Presented 04/05/19
Productive aging is a key area for research and intervention to meet the needs of our rapidly aging society. For older adults living in a skilled-nursing facility, the opportunity for productive aging is often lost as a result of physical and cognitive deficits, and the incidents of depression in skilled-nursing facilities is high. This pilot study examined the effects of a six-week therapeutic biking program designed to provide an opportunity for extended mobility outside in a social context.
Primary Author and Speaker: Tammy Bickmore
Additional Authors and Speakers: Nick Viti, Angela Hunt
PURPOSE: In the spring of 2017, the study, “Therapeutic Biking & the Effects on Depression in Long-term Care Residents" was conducted. Residents who had a history of depression were offered the opportunity to participate in a six-week therapeutic biking program to provide an opportunity to enjoy extended mobility, be outdoors and socialize through occupational therapy.The purpose was to explore whether the biking program helped treat depression and improve the quality of life for residents.This research addresses a gap in the OT literature related to the effect of participation in occupation based interventions on depression symptoms of persons living in long term care settings.
DESIGN: This descriptive quantitative pilot study utilized the residents of a long term care section of a facility. Participants in the study had to meet the following criteria: a positive history of depression, ability to sit in an upright position, medically stable, predictive behavior and agreed to participate in the study. Participants were recruited by the occupational therapist in the facility through the biking program in the facility.
METHOD: The program administered a short 8-item survey to the participants as part of each ride. Trained student assistants helped record responses. The assistants also recorded their own observations of the participants’ enjoyment, socialization and mood changes. The clinical staff conducted the Geriatric Depression Scale: Short Form before and after the program. Finally, the pilot program also provided Mood and Behavior assessment data that is conducted for all residents quarterly. The data analysis included matched pre- and post- responses where possible and appropriate, and conducted basic descriptive analysis of each of the tools.
RESULTS: Because each participant engaged in multiple rides, in some cases we analyzed the aggregate ride data (n=92), rather than the individual participant experience (n=12).
There were 12 residents who participated in the pilot study. Overwhelmingly, the 10 residents who filled out the forms thought the rides were time well spent (99% of the time) and enjoyed the ride 93% of the time. Resident moods also appeared to improve after the rides. According to the assistants, participants enjoyed about 75% of the rides and 71% of the time they thought the participant would do another ride. Of the 12 participants, 10 had a completed depression screening before and after the program. Of those, seven showed positive improvement, two stayed the same and one worsened. The Behavior and Mood assessments showed little changes before and after the program with one exception: of the seven participants who had both a pre- and post- screening assessment, four showed improvement in terms of feeling tired or having little energy.
CONCLUSION: Overall, the 12 program participants enjoyed the rides and seemed to benefit somewhat in terms of depressive indicators. For these participants, the program appears to have had some positive effects, and did not appear to have any negative ones. This pilot study shows promise in the use of occupation bases interventions such as a biking program to helped treat depression and improve the quality of life for long-term care residents. This research is important to the field of occupational therapy practice as we research occupational therapy intervention at a population level and advocate for the integration of occupational engagement at a facility level to support quality of life and well being for productive aging within a residential long term care setting. This research supports the AOTA research agenda and focuses on the AOTA identified Productive Aging as a key practice area in the 21st century.
References
Chippendale, T., & Bear-Lehman, J. (2012). Effect of life review writing on depressive symptoms in older adults: A randomized controlled trial. American Journal of Occupational Therapy, 66, 438-446
Fine, Jonathan (2001). The effect of leisure activity on depression in the elderly: Implications for the field of occupational therapy. Occupational Therapy In Health Care, 13:1, 45-59, doi:10.1080/J003v13n01_04
Buettner, L. L. (2002, March 01). AD-venture program: Therapeutic biking for the treatment of depression in long-term care residents with dementia. American Journal of Alzheimer’s Disease and Other Dementias, 17(2), 121-127. doi:10.1177/153331750201700205
