Abstract
BackgroundMany older people suffer from mobility limitations and reduced health-related quality of life (HRQOL) after discharge from hospital. A consensus regarding the most effective exercise-program to optimize physical function and HRQOL after discharge is lacking. This study investigates the effects of a group-based multicomponent high intensity exercise program on physical function and HRQOL in older adults with or at risk of mobility disability after discharge from hospital.MethodsThis single blinded parallel group randomised controlled trial recruited eighty-nine home dwelling older people (65–89 years) while inpatient at medical wards at a general hospital in Oslo, Norway. Baseline testing was conducted median 49 (25 percentile, 75 percentile) (26, 116) days after discharge, before randomisation to an intervention group or a control group. The intervention group performed a group-based exercise program led by a physiotherapist twice a week for 4 months. Both groups were instructed in a home-based exercise program and were encouraged to exercise according to World Health Organisation’s recommendations for physical activity in older people. The primary outcome, physical performance, was measured by the Short Physical Performance Battery (SPPB). Secondary outcomes were 6-min walk test (6MWT), Berg Balance Scale (BBS), grip strength, Body Mass Index (BMI), and HRQOL (the Short-Form 36 Health Survey (SF-36)). Data were analysed according to the intention-to-treat principle. Between-group differences were assessed using independent samples t-test.ResultsThe groups were comparable at baseline. Intention-to-treat analysis showed that the intervention group improved their functional capacity (6MWT) and the physical component summary of SF-36 significantly compared to the control group. No further between group differences in change from baseline to 4 months follow-up were found.ConclusionsA high intensity multicomponent exercise program significantly improved functional capacity and physical HRQOL in older adults with or at risk of mobility disability after discharge from hospital. The study suggests that this population can benefit from systematic group exercise after hospital-initial rehabilitation has ended.Trial registrationClinicalTrials.gov. NCT02905383. September 19, 2016.
Highlights
Many older people suffer from mobility limitations and reduced health-related quality of life (HRQOL) after discharge from hospital
Intention-to-treat analysis showed that the intervention group improved their functional capacity (6MWT) and the physical component summary of SF-36 significantly compared to the control group
Hospitalization often exacerbates the effects of ageing on physical function, and many older people suffer from mobility limitations and reduced HRQOL after discharge [2,3,4,5]
Summary
Many older people suffer from mobility limitations and reduced health-related quality of life (HRQOL) after discharge from hospital. This study investigates the effects of a group-based multicomponent high intensity exercise program on physical function and HRQOL in older adults with or at risk of mobility disability after discharge from hospital. Hospitalization often exacerbates the effects of ageing on physical function, and many older people suffer from mobility limitations and reduced HRQOL after discharge [2,3,4,5]. Older adults with poor mobility are recommended to perform physical activity to enhance balance and prevent falls on at least 3 days per week Those who are not able to meet the recommendations due to health conditions are encouraged to engage in as much physical activity as their abilities and conditions allow [11]
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