Pedro L Valenzuela1, Javier S Morales2, Adrián Castillo-García3, Jennifer Mayordomo-Cava4, Antonio García-Hermoso5, Mikel Izquierdo6, José A Serra-Rexach7, Alejandro Lucia8. 1. Department of Systems Biology, University of Alcalá, Madrid, Spain. 2. Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain. 3. Fissac - Physiology, Health and Physical Activity, Madrid, Spain. 4. Geriatric Department, Hospital Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria, Hospital Gregorio Marañón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain. 5. Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain; Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago, Chile. 6. Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Department of Health Sciences, Public University of Navarra, Pamplona, Spain. 7. Geriatric Department, Hospital Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria, Hospital Gregorio Marañón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. 8. Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain. Electronic address: alejandro.lucia@universidadeuropea.es.
Abstract
BACKGROUND: Acute hospitalisation can have adverse effects in older adults, notably functional decline. We aimed to summarize evidence on the effects of exercise interventions in acutely hospitalised older adults. METHODS: Relevant articles were systematically searched (PubMed, Web of Science, Rehabilitation & Sports Medicine Source, and EMBASE) until 19th March 2020. Randomized controlled trials (RCTs) of in-hospital exercise interventions versus usual care conducted in older adults (>60yrs) hospitalised for an acute medical condition were included. Methodological quality of the studies was assessed with the PEDro scale. Primary outcomes included functional independence and physical performance. Intervention effects were also assessed for other major outcomes (length of hospital stay, incidence of readmission, and mortality). A meta-analysis was conducted when ≥3 studies analysed the same outcome. RESULTS: Fifteen studies from 12 RCTs (n = 1748) were included. Methodological quality of the studies was overall high. None of the studies reported any adverse event related to the intervention. Exercise interventions improved functional independence at discharge (standardized mean difference [SMD] = 0.64, 95% confidence interval = 0.19-1.08) and 1-3 months post-discharge (SMD = 0.29, 95%CI = 0.13-0.43), as well as physical performance (SMD = 0.57, 95%CI = 0.18-0.95). No between-group differences were found for length of hospital stay or risk of readmission or mortality (all p > 0.05). CONCLUSIONS: In-hospital supervised exercise interventions seem overall safe and effective for improving - or attenuating the decline of - functional independence and physical performance in acutely hospitalised older adults. The clinical relevance of these findings remains to be confirmed in future research.
BACKGROUND: Acute hospitalisation can have adverse effects in older adults, notably functional decline. We aimed to summarize evidence on the effects of exercise interventions in acutely hospitalised older adults. METHODS: Relevant articles were systematically searched (PubMed, Web of Science, Rehabilitation & Sports Medicine Source, and EMBASE) until 19th March 2020. Randomized controlled trials (RCTs) of in-hospital exercise interventions versus usual care conducted in older adults (>60yrs) hospitalised for an acute medical condition were included. Methodological quality of the studies was assessed with the PEDro scale. Primary outcomes included functional independence and physical performance. Intervention effects were also assessed for other major outcomes (length of hospital stay, incidence of readmission, and mortality). A meta-analysis was conducted when ≥3 studies analysed the same outcome. RESULTS: Fifteen studies from 12 RCTs (n = 1748) were included. Methodological quality of the studies was overall high. None of the studies reported any adverse event related to the intervention. Exercise interventions improved functional independence at discharge (standardized mean difference [SMD] = 0.64, 95% confidence interval = 0.19-1.08) and 1-3 months post-discharge (SMD = 0.29, 95%CI = 0.13-0.43), as well as physical performance (SMD = 0.57, 95%CI = 0.18-0.95). No between-group differences were found for length of hospital stay or risk of readmission or mortality (all p > 0.05). CONCLUSIONS: In-hospital supervised exercise interventions seem overall safe and effective for improving - or attenuating the decline of - functional independence and physical performance in acutely hospitalised older adults. The clinical relevance of these findings remains to be confirmed in future research.
Authors: Marcelo A S Carneiro; Cristiane M C Franco; Alan L Silva; Pâmela Castro-E-Souza; Gabriel Kunevaliki; Mikel Izquierdo; Edilson S Cyrino; Camila S Padilha Journal: Geroscience Date: 2021-08-28 Impact factor: 7.713
Authors: Miriam Urquiza; Iñaki Echeverria; Ariadna Besga; María Amasene; Idoia Labayen; Ana Rodriguez-Larrad; Julia Barroso; Mikel Aldamiz; Jon Irazusta Journal: BMC Geriatr Date: 2020-10-16 Impact factor: 3.921