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Active lifestyle for older adults with dementia: Wheelchair biking versus other recreational therapy interventions

Linda Buettner, PhD, LRT, CTRS†, Suzanne Fitzsimmons, MSN, GNP, ARNP, Jeffrey D. Labban, MS, PhD, Beth E. Barba, PhD, RN, FAGHE, FAAN


This article provides a secondary analysis of data collected from a recreation therapy intervention trial for older adults with dementia and neuropsychiatric symptoms. In a subsample of 54 individuals who received wheelchair (WC) biking on some days and other recreation therapy interventions on other days, a comparison of engagement levels, time engaged, and encouragement needed was completed. The analysis showed that WC biking provided significantly more time on task and significantly higher levels of engagement, and less encouragement was needed. Collecting recreation therapy session engagement data was found to be a simple and useful method of comparing effectiveness of recreation therapy interventions.


recreation therapy intervention, older adults with dementia, long-term care, engagement, wheelchair biking

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World Health Organization: What is Active Aging? Available at Accessed January 10, 2012.

Stessman J, Hammerman-Rozenberg R, Cohen A, et al.: Physical activity, function, and longevity among the very old. Arch Intern Med. 2009; 169(16): 1476-1483.

Buettner L, Fitzsimmons S: AD-Venture Program: Therapeutic biking for the treatment of depression in long term care residents with dementia. Am J Alzheimers Dis Other Demen. 2002; 17(2): 121-127.

Chen YM: Perceived barriers to physical activity among older adults residing in long-term care institutions. J Clin Nurs. 2009; 19(3-4): 432-439.

Resnick B: The restoration of independence. Am J Nurs. 2001; 101(10): 11.

McRae PG, Schnelle J, Simmons S, et al.: Physical activity levels of ambulatory nursing home residents. J Aging Phys Activity. 1996; 4: 264-278.

Center for Disease Control: Chronic Disease Resources. Available at Accessed January 1, 2012.

Buettner LL, Fitzsimmons S, Atav S, et al.: Cognitive stimulation for apathy in probable early-stage Alzheimer’s. J Aging Res. 2011; 2011: 1-6.

Buettner L, Fitzsimmons S: Activity calendars for older adults with dementia: What you see is not what you get. Am J Alzheimers Dis Other Demen. 2003; 18(4): 215-226.

Fitzsimmons S: Evidence-based practice guideline: Wheelchair biking for the treatment of depression. J Gerontol Nurs. 2011; 37(7): 8-15.

Buettner L, Fitzsimmons S: (2010). Recreational therapy interventions: A fresh approach to treating apathy and mixed behaviors in dementia. Non-Pharmacol Ther Demen. 2001; 1(1): 27-42.

Buettner LL, Fitzsimmons S, Dudley WN: Impact of underlying depression on treatment of neuropsychiatric symptoms in older adults with dementia. Res Gerontol Nurs. 2010; 3(3): 221-232.

Buettner L, Fitzsimmons S: NEST: Practice Guideline: Treatment of Disturbing Behaviors in Dementia. State College, PA: Venture Publishing, 2009.

Cohen-Mansfield J, Dakheel-Ali M, Marx MS: Engagement in persons with dementia: The concept and its measurement. Am J Geriatr Psychiatry. 2009; 17(4): 299- 307.

Folstein F, Folstein SE, McHugh PR: Mini-mental state, a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12: 189-198.

Reisberg B, Ferris SH, de Leon MJ, et al.: The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982; 139(9): 1136-1139.

Buettner L, Martin S: Therapeutic Recreation in the Nursing Home. State College, PA: Venture Publishing, 1994.

Buettner L, Richeson N, Connolly P: Content validity, reliability, and treatment outcomes of the Buettner Assessment of Needs, Diagnoses, and Interests for Recreational Therapy in long-term care (BANDI-RT). Am J Recreat Ther. 2011; 10(30): 39-54.



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