Physical activity interventions are delivered consistently across hospitalized older adults but multimorbidity is associated with poorer rehabilitation outcomes: A population-based cohort study.

摘要: Background Older adults live with multimorbidity including frailty and cognitive impairment often requiring hospitalization. While physical activity interventions (PAIs) are a normal rehabilitative treatment, their clinical effect in hospitalized older is uncertain. Objective To observe PAI dosing characteristics determine impact on performance parameters. Design A single-site prospective observational cohort study an persons' unit. Subjects Seventy-five unit patients ≥65 years. Intervention PAI; therapeutic contact between physiotherapy clinician patient. Measurements Parameters included changes activities-of-daily-living (Barthel Index), handgrip strength, balance confidence, gait velocity, measured admission discharge (episode). Dosing were temporal initiation, frequency, duration. Frailty/cognition status was dichotomized independently per participant yielding 4 subgroups: frail/nonfrail cognitively-impaired/cognitively-unimpaired. Results Median (interquartile range) initiation occurred after 2 days (1-4), frequency 0.4 PAIs day (0.3-0.5), duration episode 3.75 hours (1.8-7.2). All parameters improved significantly across episodes: grip strength median change, 2.0 kg (0.0-2.3) (P < .01); Barthel Index, 5 (3-8) 0.06 m.∙s−1 (0.06-0.16) −3 (−6 to −1) .01). Physical intervention remained consistent within subgroups. several moderate large associations amount of change observed, most unimpaired subgroups. Conclusions PAI consistent. However, while during hospital episodes positive, more favourable responses occur if nonfrail/cognitively-unimpaired. Therefore, deliver personalized rehabilitation approach, adaptation dose based patient presentation desirable.