The Combined Effect of Multisensory Stimulation and Therapist Support on Physical and Mental Health of Older Adults Living in Nursing Homes: Pilot Randomized Controlled Trial
Authors: Khatib Sewar , Palgi Yuval , Ashar Yoni K , Polyvyannaya Natalya , Goldstein Pavel 
Published: November 2024

Background
Increasing life expectancy has led to a rise in nursing home admissions, a context in which older adults often experience chronic physical and mental health conditions, chronic pain, and reduced well-being. Nonpharmacological approaches are especially important for managing older adults’ chronic pain, mental health conditions (such as anxiety and depression), and overall well-being, including sensory stimulation (SS) and therapist support (TS). However, the combined effects of SS and TS have not been investigated.

Objective
This randomized controlled trial examines the specific and combined effects of brief SS and TS interventions on older adults’ physical and mental health and pain intensity levels, among individuals living in nursing homes.

Methods
A total of 96 patients aged 65-99 years from a nursing home were randomly assigned to 3 groups: SS, TS, and combined SS+TS interventions, each delivered as four 20-minute sessions. SS was implemented using a multisensory Snoezelen room. Pain intensity levels (per a Visual Analog Scale), blood pressure, heart rate, blood oxygen saturation, and hand grip strength (using a Jamar hand dynamometer) were measured before and after each of the 4 weekly therapeutic sessions. In addition, life satisfaction (per the Satisfaction with Life Scale) and anxiety (per the 7-item General Anxiety Disorder Scale) were evaluated before and after the whole intervention. Mixed model analyses tested the relative efficacy of the 3 interventions, applying simple slope analysis with Tukey correction. Study rationale and analytical plans were preregistered.

Results
The combined intervention of SS and TS (SS+TS) resulted in reduced pain levels compared with SS (B=0.209, P=.006) and TS alone (B=0.23, P=.002) over 4 sessions (F6,266=2.62; P=.017; R2=0.23). Further, the combined SS+TS intervention resulted in reduced systolic blood pressure versus SS (B=0.09, P=.01) and TS alone (B=0.016, P<.001) groups (F6,272=5.42; P<.001; R2=0.29). In addition, the combined SS+TS intervention resulted in an increased grip strength versus SS (B=–0.35, P=.003) and TS alone (B=–0.032, P=.008) groups (F6,273=2.25; P=.04; R2=0.19). Moreover, combined SS+TS resulted in an improvement in life satisfaction (B=–4.29, P<.0001) compared with SS (B=–2.38, P=.0042) and TS alone (B=–1.20, P=.13) groups (F2,39=3.47; P=.04). Finally, SS+TS demonstrated greater improvement in symptoms of general anxiety disorder (B=10.64, P<.0001) compared with SS (B=3.30 P=.01) and TS alone (B=1.13, P=.37) (F2,38=13.5; P<.001) groups. No differences between the interventions were shown for blood oxygen saturation (F6,273=2.06; P=.06), diastolic blood pressure (F6,272=1.12; P=.35), and heart rate (F6,273=1.33; P=.23).

Conclusions
The combined intervention of SS and TS showed therapeutic benefits for pain management and physical and mental health of older adults living in nursing homes, relative to each therapeutic component in isolation. This brief intervention can be readily implemented to improve well-being and optimize therapeutic resources in nursing home settings.

Trial Registration
ClinicalTrials.gov NCT05394389; https://clinicaltrials.gov/ct2/show/NCT05394389