Supplementary Material for: Integration of Complementary Medicine in Geriatric Nursing Homes: A Prospective Comparative Observational Study

Introduction
A healthy lifestyle is considered to be an important factor for healthy aging. Kneipp therapy (KT) includes a combination of hydrotherapy, herbal medicine, mind-body medicine, physical activities and healthy nutrition. In this study, we investigated the effectiveness of KT care on activities of daily living, health and quality of life in residents of nursing homes.
Methods
We conducted a prospective, two-armed comparative observational study to compare matched nursing homes with KT (Kneipp group) vs. nursing homes with common preventive interventions (control group) over a 12-month period.. Outcome measures included activities of daily living (Barthel Index), cognition (Mini-Mental State Examination (MMSE)) and quality of life (QUALIDEM; Short-Form 12 (SF-12)).
Results
We included 7 nursing homes (n=105 residents) for the Kneipp group and 6 nursing homes (n=69) as control. Except for Barthel Index, there were no time point dependent differences between the groups. The Barthel Index showed a smaller difference from baseline in the control group (mean diff. 0.94, 95%CI [-1.94; 3.82]) compared to Kneipp group (- 4.08, 95%CI [-6.46; -1.69]; p=0.009) after 6 months.
Pooled over the timepoints the SF-12 mental health sum scale exhibited a smaller difference from baseline in the Kneipp group (-1.3, 95%CI [-3.6; 0.9]) compared to the control group (-3.8, 95%CI [-6.3; -1.4]; p=0.027). Furthermore, the MMSE sumscore, decreased less in the Kneipp group compared to control (-1.1, 95%CI [-2.2, -0.1]; p=0.033) after 12 months.
A post hoc comparison of residents from both groups who received at least 30 preventive interventions monthly exhibited better values for QUALIDEM items “social relations”, “social isolation” and “feeling at home”.
Conclusion
This comparative observational study showed only small differences in outcome measures between the groups. The frequency of treatments may positively influence social components of behavior and well-being in residents. High-quality pragmatic randomized trials are needed for further investigations.