Abstract
After hospitalization, further disability among seniors could be prevented through exercise. Nonetheless, a one-on-one rehabilitation is not realistic for the volume of seniors that are experiencing disability. Currently available educational material for improving disability is so vast and non-specific that passive dissemination may pose a barrier to behaviour change. The aim of this pilot study was to estimate the extent to which an individualized, exercise-focused, self-management program (MMOVES), in comparison to exercise information, is more effective in improving mobility after 6 months among seniors recently discharged from hospital. The physiotherapy-facilitated intervention consisted of 1) evaluation of mobility capacity; 2) setting short and long term goals; 3) delineation of an exercise treatment plan. In addition, MMOVES participants received an educational booklet to enhance mobility self-management skills and were followed-up with monthly telephone calls. Control group received a booklet with information on exercises targeting mobility limitations in seniors. Mobility, pain, and health status were assessed at baseline and at 6 months using multiple indicators drawn from DASH, LEFS, SF-36. After imputing missing data, generalised estimating equations (GEE) estimated the odds of response for people receiving the intervention in comparison to the odds of response in the control group. Each person was classified as having made a response, deterioration, or no change on each measure based on change of one level on the ordinal scale. 26 people were randomized to the intervention (mean age 81 ± 8; 39% women), 23 were randomized to the control (mean age 79 ± 7; 33% women). The OR for the mobility outcomes combined was 3.08 and the 95%CI excluded 1 (1.65 – 5.77). The ORs for pain and health perception favoured the MMOVeS group; but, the 95%CI included the null value. Our individualized, exercise-focused, self-management program was more effective than exercise information in improving mobility outcome for seniors.
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