Joette Jindra, OTR/L and director of rehabilitation at ManorCare in Tacoma, WA was interested in learning what type of interventions should be utilized by the therapists on her team. Therefore, the purpose of this critically appraised topic (CAT) was to examine the current literature on the effectiveness of activity-based intervention (meaningful or nonmeaningful) and rote exercise for improving physical performance outcomes in patients residing in skilled nursing facilities (SNF). The student researchers examined the literature on articles comparing the outcomes of activity-based interventions to those of rote exercise. Articles describing the outcomes of the two interventions independently were also examined. A total of 36 peer-reviewed articles were reviewed. Both activity-based interventions and rote exercise were shown to be effective in improving physical performance outcomes of clients in inpatient facilities. However, when directly comparing the two types of intervention, activity-based interventions were consistently found to be more beneficial than rote exercise for clients receiving therapy services in residential and inpatient facilities. These findings can help therapists make informed decisions to use activity-based interventions during their treatment session to increase client outcomes.

With these findings, the student researchers provided an in-service presentation and pre- and post-survey to the occupational therapy team at ManorCare. The results of the pre- and post-surveys were used to measure the knowledge translation. It is recommended that Jindra and her team continue to advocate and utilize activity-based interventions at ManorCare.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

Kirsten Wilbur, Ed.D., OTR/L

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound