Objectives. The provision of options in the occupational form that encourages meaningful choices and subsequent purposeful occupational performances is a basic premise of occupational therapy. This study examines the preferences of elderly nursing home residents when presented with an occupationally embedded exercise versus a rote exercise and addresses the methodological problems identified in similar past research.

Method. Fifty-two elderly nursing home residents were presented with a choice between an occupationally embedded exercise that involved unilateral dunking of a small, spongy ball into a basketball hoop and a rote exercise that involved moving the arm above the head in a simulation of the dunking exercise. Both exercises required flexion of the shoulder joint. Random assignment of the 52 subjects into one of four groups controlled for the order of the presentation of the exercises and the order of the choice statements.

Results. Sixty-nine percent of the subjects chose the occupationally embedded exercise. Analysis with the significance of a proportion statistic revealed a statistically significant difference (z = 2.77; p (one-tailed) = .003).

Conclusion. Results were consistent with the hypothesis that elderly nursing home residents would tend to choose the occupationally embedded exercise. To further confirm this basic premise of occupational therapy, future studies that investigate therapeutic patterns of movement embedded in common occupations are recommended.