Physiotherapy dosage in hospitalized older adults
The incidence of hospitalization in older adults is high, especially for those with multimorbidity, including frailty and cognitive impairment. Physical activity interventions (PAIs) are often applied in this population during hospitalization. However, knowledge about the effectiveness and dose-response of PAIs in older adults with multimorbidity remains incomplete.
This study observed PAI frequency and duration data for a representative sample (n=75) of hospitalized older adults. Subsequently, they determined the impact of PAIs on clinical and hospital parameters, and the influence of frailty and cognition on these outcome parameters.
PAI dosing was consistent in this sample, commencing after a median of 2 days, with a median of 0.4 PAIs per day. All clinical parameters (balance confidence, ADL indepence, handgrip strength and preferred gait speed) showed significant improvement during hospitalization episodes.
In the unimpaired subgroup, there were significant associations between time to first PAI or total PAI duration and clinical parameters. However, for subgroups with frailty or cognitive impairment, no statistically significant associations between PAI frequency and duration and clinical parameters were observed.
Clinical changes during hospitalization are positively affected by increased PAI duration. However, more favourable responses occur if patients are not frail or cognitively impaired. Therefore, it is desirable to use a more personalized rehabilitation approach based on patient characteristics.
> From: Jones et al., J Eval Clin Pract (2017) (Epub ahead of print). All rights reserved to John Wiley & Sons, Ltd. Click here for the online summary.