Rehabilitation nursing program to improve functional capacity in incarcerated older adults: A case series
DOI:
https://doi.org/10.29352/mill0230.46554Keywords:
rehabilitation nursing; older adults; prisons; muscle strength; functional statusAbstract
Introduction: Aging in prison settings is associated with an accelerated decline in muscle health and functional capacity, requiring timely and appropriate Rehabilitation Nursing interventions.
Objective: To evaluate the effects of a Rehabilitation Nursing program on muscle health and functional capacity in older adults living in prison.
Methods: A descriptive case-series study was conducted with nine older adults. A Rehabilitation Nursing program was implemented based on the principles of exercise prescription, including frequency, intensity, time, type, volume and progression, complemented by recovery criteria, safety, effectiveness, risk management/adverse event control, biological principles, response monitoring and systematic assessment procedures. Participants completed three weekly sessions over five weeks.
Pre- and post-intervention assessments included physical activity and occupational activity levels, environmental conditions, functional per-formance tests (Sit-to-Stand, Timed Up and Go, Single Leg Stance), handgrip strength, muscle power (absolute, relative and allometric), effort tolerance and perceived exertion (global and self-care related), SARC-F questionnaire, quadriceps circumference, and pain monitoring, including delayed onset muscle soreness (DOMS).
Results: Significant improvements were observed in muscle power (+25.7% to +34.7%), handgrip strength (+3% to +19%), functional mobility (+11%), balance (+16%), Sit-to-Stand performance (+33%), reduction in perceived exertion (-21% to -35%) and reduction in sarcopenia risk (-21%).
Conclusion: The Rehabilitation Nursing Program proved to be feasible and safe, demonstrating potential to improve muscle health and functional capacity among older adults in prison settings.
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References
Aebi, M. F., & Cocco, E. (2024). Prison populations and ageing in Europe. Council of Europe. https://shre.ink/3U2u
Alcazar, J., Losa-Reyna, J., Rodríguez-López, C., Alfaro-Acha, A., Rodríguez-Mañas, L., Ara, I., García-García, F. J., & Alegre, L. M. (2018). The sit-to-stand muscle power test: An easy, inexpensive and portable procedure to assess muscle power in older people. Experimental Gerontology, 112, 38–43. https://doi.org/10.1016/j.exger.2018.08.006
American College of Sports Medicine. (2022). ACSM's Guidelines for Exercise Testing and Prescription (11th ed.). Wolters Kluwer.
American College of Sports Medicine. (2024). ACSM's Guidelines for Exercise Testing and Prescription (12th ed.). Wolters Kluwer.
Beauchet, O., Fantino, B., Allali, G., Muir, S. W., Montero-Odasso, M., & Annweiler, C. (2011). Timed up and go test and risk of falls in older adults: A systematic review. The Journal of Nutrition, Health & Aging, 15(10), 933–938. https://doi.org/10.1007/s12603-011-0062-0
Blair, S. N., Kohl, H. W., Paffenbarger, R. S., Clark, D. G., Cooper, K. H., & Gibbons, L. W. (1989). Physical fitness and all-cause mortality: A prospective study of healthy men and women. JAMA, 262(17), 2395–2401. https://doi.org/10.1001/jama.262.17.2395
Bright, A. M., Higgins, A., & Grealish, A. (2023). Nursing in a prison context: A focused mapping review and synthesis of international nursing literature. Journal of Advanced Nursing, 79(11), 4127–4136. https://doi.org/10.1111/jan.15751
Chan, I. (2025). Health optimization of older people in prision. Healthcare Management Forum, 38(1), 35-40. https://doi.org/10.1177/08404704241255284
Cinarli, F. S., Ulubaba, H. E., Ucar, O., Kilinc, D. C., Ciftci, R., Karayigit, R., Aldhahi, M.I., Al-Mhanna, S.B., & Gülü, M. (2024). Relationship between quadriceps muscle architecture and lower limb strength and physical function in older adults community-dwelling individuals: A cross-sectional study. Frontiers in Public Health, 12,1398424. https://doi.org/10.3389/fpubh.2024.1398424
Coelho, E., Martins, R., & Carvalho, N. (2025). Eficácia de um programa de enfermagem de reabilitação na resposta ao esforço físico e na qualidade de vida em idosos. Millenium - Journal of Education, Technologies, and Health, 2(16e), e37204. https://doi.org/10.29352/mill0216e.37204
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A. A., Schneider, S. M., Sieber, C. C., Topinková, E., Vandewoude, M., Visser, M., & 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
Direção-Geral da Saúde. (2021). Plano Nacional de Saúde 2021–2030. https://shre.ink/3Uce
Direção-Geral de Reinserção e Serviços Prisionais. (2024). Proposta de plano para a saúde em contexto de privação da liberdade 2023–2030. https://shre.ink/3Ucg
Doma, K., Matoso, B., Protzen, G., Singh, U., & Boullosa, D. (2023). The repeated bout effect of multiarticular exercises on muscle damage markers and physical performances: A systematic review and meta-analyses. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000004762
El Hadouchi, M., Kiers, H., de Vries, R., Leij-Halfwerk, S., & van Dieën, J. H. (2022). Effectiveness of power training compared to strength training in older adults: A systematic review and meta-analysis. European Review of Aging and Physical Activity, 19, 18. https://doi.org/10.1186/s11556-022-00297-x
Faria, A. D. C. A., Martins, M. M. F. P. S., Aguilera, J. A. L., Ribeiro, O. M. P. L., & Silva, J. M. A. V. (2022). Construction and validation of a rehabilitation nursing program for fragile elderly. Revista Brasileira de Enfermagem, 75(Suppl. 4). https://doi.org/10.1590/0034-7167-2021-0562
Filip-Stachnik A, Krzysztofik M, Kaszuba M, Leznicka K, Kostrzewa M, Del Coso J, Wilk M. (2021). Effects of acute caffeine intake on power output and movement velocity during a multiple-set bench press exercise among mild caffeine users. Journal of Human Kinetics. 78, 219-228. https://doi.org/10.2478/hukin-2021-0044
Freitas, S. R., Cruz-Montecinos, C., Ratel, S., & Pinto, R. S. (2024). Powerpenia should be considered a biomarker of healthy aging. Sports Medicine - Open, 10, 27. https://doi.org/10.1186/s40798-024-00689-6
Ganbat, U., Feldman, B., Tang, P., Byambaa, A.O., Arishenkoff, S., Meneilly, G.S., Little, J., Liu-Ambrose, T., Madden, K.M., Reference values of quadriceps muscle thickness measured by point-of-care ultrasound by sex and age groups in older adults. Canadian Geriatrics Journal, 29(1), 28-30. https://doi.org/10.5770/cgj.29.913
Ghorbanzadeh, M., Bakhtiari, A., Hajian-Tilaki, K., & Abbaszadeh-Amirdehi, M. (2025). Association of multidimensional frailty and dynapenia with fall risk in older adults. BMC geriatrics, 25(1), 442. https://doi.org/10.1186/s12877-025-06097-z
Izquierdo, M., Merchant, R. A., Morley, J. E., Anker, S. D., Aprahamian, I., Arai, H., Aubertin-Leheudre, M., Bernabei, R., Cadore, E. L., Cesari, M., Chen, L. K., Gomez-Cabrera, M. C., & Vellas, B. (2021). International exercise recommendations in older adults (ICFSR): Expert consensus guidelines. The Journal of Nutrition, Health & Aging, 25(7), 824–853. https://doi.org/10.1007/s12603-021-1665-8
Luo, H., Zheng, Z., Yuan, Z., Hu, H., & Sun, C. (2024). The effectiveness of multicomponent exercise in older adults with cognitive frailty: A systematic review and meta-analysis. Archives of Public Health, 82(1), 229. https://doi.org/10.1186/s13690-024-01441-y
Malmstrom, T. K., & Morley, J. E. (2013). SARC-F: A simple questionnaire to rapidly diagnose sarcopenia. Journal of the American Medical Directors Association, 14(8), 531–532. https://doi.org/10.1016/j.jamda.2013.05.018
Morrison, R. T., Taylor, S., Buckley, J., Twist, C., & Kite, C. (2023). High-velocity power training has similar effects to traditional resistance training for functional performance in older adults: A systematic review. Journal of Physiotherapy, 69(3), 148–159. https://doi.org/10.1016/j.jphys.2023.05.018
Ordem dos Enfermeiros. (2019). Regulamento das competências específicas do enfermeiro especialista em enfermagem de reabilitação (Regulamento n.º 392/2019). Diário da República.
Patel, H., Le, K. D. R., Wang, A. J., & Tay, S. B. P. (2025). Integration of resistance exercise into a multimodal approach to prehabilitation for patients with sarcopenia prior to surgery: A narrative review. Frontiers in Rehabilitation Sciences, 6, 1481233. https://doi.org/10.3389/fresc.2025.1481233
Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
Rocha, P. (2025). Aging behind bars: Barriers and solutions in Norwegian correctional rehabilitation. International Journal of Prison Health, 8, 21. https://doi.org/10.1108/IJOPH-12-2024-0078
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019(1), CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
Shin, H., & You, M. (2026). Aging behind bars: The growth of the older incarcerated adult population and emerging penal reform. Laws, 15(3), 35. https://doi.org/10.3390/laws15030035
Smith, T. M., Hester, G. M., Ha, P. L., Olmos, A. A., Stratton, M. T., VanDusseldorp, T. A., Feito, Y., & Dalton, B. E. (2020). Sit-to-stand kinetics and correlates of performance in young and older males. Archives of Gerontology and Geriatrics, 91, 104215. https://doi.org/10.1016/j.archger.2020.104215
Springer, B. A., Marin, R., Cyhan, T., Roberts, H., & Gill, N. W. (2007). Normative values for the unipedal stance test with eyes open and closed. Journal of Geriatric Physical Therapy, 30(1), 8–15. https://doi.org/10.1519/00139143-200704000-00003
Steinbrink, G. M., Martinez, J., Swartz, A. M., & Strath, S. J. (2024). Sit-to-stand power is a stronger predictor of gait speed than knee extension strength. Journal of Functional Morphology and Kinesiology, 9(2), 103. https://doi.org/10.3390/jfmk9020103
Stern, G., Psycharakis, S. G., & Phillips, S. M. (2023). Effect of high-intensity interval training on functional movement in older adults: A systematic review and meta-analysis. Sports Medicine - Open, 9(1), 5. https://doi.org/10.1186/s40798-023-00551-1
Tanaka, H., Monahan, K.D., Seals, D.R. (2001). Development of a new equation for predicting maximal heart rate. Journal of the American College of Cardiology, 37(1), 153–156. https://org/10.1016/s0735-1097(00)01054-8
Vaishya, R., Misra, A., Vaish, A., Ursino, N., & D'Ambrosi, R. (2024). Hand grip strength as a proposed new vital sign of health: A narrative review of evidence. Journal of Health, Population and Nutrition, 43(1), 7. https://doi.org/10.1186/s41043-024-00500-y van der Kruk, E., Silverman, A.K., Reilly, P., & Bull, A.M.J. (2021). Compensation due to age-related decline in sit-to-stand and sit-to-walk. Journal of Biomechanics, 122, 110411. https://doi.org/10.1016/j.jbiomech.2021.110411 van der Kruk, E., Strutton, P., Koizia, L. J., Fertleman, M., Reilly, P., & Bull, A. M. J. (2022). Why do older adults stand-up differently to young adults? investigation of compensatory movement strategies in sit-to-walk. npj Aging 8, 13. https://doi.org/10.1038/s41514-022-00094-x
Van der Veen, R., Prinsen, E. C., Bramer, W., & Speksnijder, C. M. (2026). Effectiveness of functional tasks exercise on functional ability and health-related quality of life in community-dwelling older adults: A systematic review and meta-analysis. Physiotherapy, 102332. https://doi.org/10.1016/j.physio.2026.102332
Vieira, M. S. M. (2023). Organização de cuidados para um envelhecimento saudável. Revista Portuguesa de Enfermagem de Reabilitação, 5(1). https://doi.org/10.33194/rper.2023.316
Wiecha, S., Posadzki, P., Prill, R., & Płaszewski, M. (2024). Physical Therapies for Delayed Onset Muscle Soreness. Journal of Clinical Medicine, 13(7), 2006. https://doi.org/10.3390/jcm13072006
World Health Organization. (2015). World report on ageing and health. World Health Organization. https://www.who.int/publications/i/item/9789241565042
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Xiao, Y., Ding, L., Xu, Z., Liu, J., Guo, L., Barnes, M. J., Cao, Y., & Girard, O. (2025). Effects of acute caffeine intake on muscular power during resistance exercise: A systematic review and meta-analysis. Frontiers in Nutrition, 12, 1686283. https://doi.org/10.3389/fnut.2025.1686283
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