Nicolás Martínez-Velilla1,2,3, Mikel L Sáez de Asteasu1,2, Robinson Ramírez-Vélez1,2, Fabricio Zambom-Ferraresi1,2, Antonio García-Hermoso1,4, Mikel Izquierdo1,2. 1. Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain. 2. CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain. 3. Department of Geriatric Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain. 4. Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile.
Abstract
BACKGROUND: During the period of hospitalization, patients can develop functional decline. The main aim of our study was to assess the natural trajectory of each activity of daily living (ADL) and to assess how in-hospital exercise could influence short-term trajectory of ADLs. METHOD:Acutely hospitalized patients (n = 297, 56.5% women) were randomly assigned to the intervention or control (usual care) group within the first 48 hours of admission. An exercise training program was prescribed in 2 daily sessions (morning and evening) of 20 minutes duration during 5-7 consecutive days for the intervention group. The primary endpoint was the change in every ADL (assessed with the Barthel Index) from 2 weeks before admission to hospital discharge. RESULTS: Acute hospitalization per se led to significant in-patient's functional ability impairment in ADLs during hospitalization, whereas the exercise intervention reversed this trend (3.7 points; 95% CI: 0.5-6.8 points). After analyzing the trajectory of each one of the ADLs, patients in the control group significantly worsened all activities, but with a different degree of loss. For the between-group analysis, significant differences were obtained in many ADLs including bathing, dressing, grooming, bladder control, toilet use, transfers, mobility, and climbing stairs (p < .05). The control group had the greatest impairment in all domains analyzed (ie, feeding, bathing, dressing, grooming, bowel control, bladder control, toilet use, transfers, mobility, and climbing stairs; p < .05). CONCLUSIONS: An individualized multicomponent exercise training program in older adults is effective to reverse the loss of specific ADLs that frequently occurs during hospitalization. Each patient profile should receive an individualized prescription of exercise during hospitalizations. CLINICAL TRIALS REGISTRATION NUMBER: NCT02300896.
RCT Entities:
BACKGROUND: During the period of hospitalization, patients can develop functional decline. The main aim of our study was to assess the natural trajectory of each activity of daily living (ADL) and to assess how in-hospital exercise could influence short-term trajectory of ADLs. METHOD: Acutely hospitalized patients (n = 297, 56.5% women) were randomly assigned to the intervention or control (usual care) group within the first 48 hours of admission. An exercise training program was prescribed in 2 daily sessions (morning and evening) of 20 minutes duration during 5-7 consecutive days for the intervention group. The primary endpoint was the change in every ADL (assessed with the Barthel Index) from 2 weeks before admission to hospital discharge. RESULTS: Acute hospitalization per se led to significant in-patient's functional ability impairment in ADLs during hospitalization, whereas the exercise intervention reversed this trend (3.7 points; 95% CI: 0.5-6.8 points). After analyzing the trajectory of each one of the ADLs, patients in the control group significantly worsened all activities, but with a different degree of loss. For the between-group analysis, significant differences were obtained in many ADLs including bathing, dressing, grooming, bladder control, toilet use, transfers, mobility, and climbing stairs (p < .05). The control group had the greatest impairment in all domains analyzed (ie, feeding, bathing, dressing, grooming, bowel control, bladder control, toilet use, transfers, mobility, and climbing stairs; p < .05). CONCLUSIONS: An individualized multicomponent exercise training program in older adults is effective to reverse the loss of specific ADLs that frequently occurs during hospitalization. Each patient profile should receive an individualized prescription of exercise during hospitalizations. CLINICAL TRIALS REGISTRATION NUMBER: NCT02300896.
Authors: S Le Gentil; S Prampart; M Karakachoff; M L Bureau; G Chapelet; L De Decker; A Rouaud; A-S Boureau Journal: J Nutr Health Aging Date: 2022 Impact factor: 5.285
Authors: Sergi Blancafort Alias; César Cuevas-Lara; Nicolás Martínez-Velilla; Fabricio Zambom-Ferraresi; Maria Eugenia Soto; Neda Tavassoli; Céline Mathieu; Eva Heras Muxella; Pablo Garibaldi; Maria Anglada; Jordi Amblàs; Sebastià Santaeugènia; Joan Carles Contel; Àlex Domingo; Antoni Salvà Casanovas Journal: Int J Environ Res Public Health Date: 2021-06-02 Impact factor: 3.390