Impact of an individual personalised rehabilitation program on mobility performance in older-old people.

Abstract

Studies have shown benefits of exercise interventions on preferred and fast gait speed in healthy older adults, but the impact of a personalised rehabilitation program targeting a large cohort of non-disabled older-old adults has rarely been examined. The purpose was to determine whether personalised intervention-related improvements in gait and mobility performance in older-old adults were dependent on cognitive status and/or history of falls. Based on a pre-post design, 483 older-old persons (mean age: 83.3 ± 5.1years) were followed during a personalised rehabilitation program over a period of 7 weeks, with twice-weekly sessions (45min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), static postural sway, Timed Up and Go test, Five Times Sit to Stand test, the ability to rise from the floor, and handgrip strength test were assessed. Using a pre-post analysis of covariance, a significant increase in preferred gait speed (+ 20.1%), fast gait speed (+ 15.8%), and dual-task speed while counting (+ 13.4%) was observed after the rehabilitation, regardless of the baseline cognitive status and fall history. Similar improvements in TUG and maximal handgrip force were observed, with a significant reduction of performance time (-19.5%) or an increase of handgrip strength (+ 6.2%). Results suggest the effectiveness of personalised intervention to improve a battery of physical performance measures in older-old adults, even for the frailest participants. Implementing a personalised intervention for targeting the high-risk older-old adults in priority is critical regarding the clinically meaningful change in gait speed.