Clinical Trial This clinical trial aims to determine the impact of physiotherapy interventions on mental health, quality of life, and spinal mobility in older adults. The physiotherapy intervention will consist of group exercise therapy (3 times a week, 40 minutes, 4 weeks in total), walking activities (3 times a week, 30 minutes, 4 weeks in total), and education on optimal positions and movements in daily activities (one session lasting 60 minutes)

The main questions it aims to answer are:

1. Are group exercise therapy and walking optimal for reducing symptoms of depression and anxiety and improving quality of life in older adults placed in nursing homes in a short period of time
2. Do physiotherapy interventions improve spinal mobility (anteflexion and extension)?

Population ageing is a worldwide phenomenon resulting from increased living standards, improved healthcare, and decreased birth rates. The proportion of people aged 60 and over continues to grow and is expected to exceed two billion by 2050, with 80% of them living in developed countries.

Ageing is associated with a decline in physical and mental capacities, increased risk of chronic diseases, and social isolation, leading to higher healthcare and social costs. However, many of these challenges can be prevented or mitigated through timely interventions. Global health initiatives promote Healthy and Active Ageing, focusing on maintaining longevity, well-being, and quality of life. Physical activity and exercise therapy are the most effective interventions for promoting physical and mental health, highlighting the essential role of physiotherapy. Physiotherapists are well-positioned to promote healthy ageing due to their accessibility, cost-effectiveness, and expertise in managing a wide range of health conditions. Increasing evidence shows that physiotherapy not only enhances physical function but also contributes significantly to the mental well-being of older adults.

Recent systematic reviews with meta-analyses have reported positive effects of exercise therapy and physical activity on reducing depression, anxiety, and improving quality of life among older adults. An umbrella review reports high benefits of physical activity for improving symptoms of depression, anxiety, and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders, and people with chronic disease. A systematic review with meta-analysis confirmed exercise as an effective treatment for anxiety. However, the heterogeneity of the included studies does not provide clearer information about the optimal exercise methods, as well as the necessary parameters and ways of implementing exercise therapy. In addition, individual studies show conflicting results on the effects of physical activity in nursing home residents; one reports benefits of a structured exercise program on depressive symptoms and quality of life, while another finds no significant improvement with supervised moderate aerobic and resistance training.

Thus, this study aim is to determine the optimal methods of exercise therapy and physical activity, as well as other parameters such as frequency, intensity, supervision, and method of implementation, in improving mental health and quality of life in elderly people in a nursing home.

Inclusion Criteria:

• both sexes, aged ≥ 65 years, with an optimal level of functional and cognitive abilities necessary to perform the exercises and understand the measurement scales.

Exclusion Criteria:

• significant cognitive and neurological impairments, functionally immobile persons, and persons who refuse to participate.