Thursday, November 22, 2018

Personalised Physical Exercise Program Reverses Functional Decline in Adults Aged Older Than 75 Years

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Personalised Physical Exercise Program Reverses Functional Decline in Adults Aged Older Than 75 Years


An individualised, multicomponent exercise program proved safe and effective to reverse the functional decline associated with acute hospitalisation in very elderly patients, according to a study published in JAMA Internal Medicine.
Nicolás Martínez-Velilla, MD, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain, and colleagues assessed the effects of an innovative multicomponent exercise intervention on the functional status of 370 very elderly patients undergoing acute-care hospitalisation.
Patients were randomised to an exercise or control (usual-care) intervention. The control group received usual-care hospital care, which included physical rehabilitation when needed. The in-hospital intervention included individualised moderate-intensity resistance, balance, and walking exercises (2 daily sessions).
The primary endpoint was change in functional capacity from baseline to hospital discharge, assessed with the Barthel Index of independence and the Short Physical Performance Battery (SPPB).
Secondary endpoints were changes in cognitive and mood status, quality of life, handgrip strength, incident delirium, length of stay, falls, transfer after discharge, readmission rate, and mortality at 3 months after discharge.
The exercise intervention program provided significant benefits over usual care. At discharge, the exercise group showed a mean increase of 2.2 points on the Short Physical Performance Battery (SPPB) scale and 6.9 points on the Barthel Index over the usual-care group.
Hospitalisation led to an impairment in functional capacity (mean change from baseline to discharge in the Barthel Index of -5.0 points in the usual-care group, whereas the exercise intervention reversed this trend (1.9 points).
The intervention also improved the SPPB score (2.4 points vs 0.5 points in controls). Significant intervention benefits were also found at the cognitive level of 1.8 points over the usual-care group.
“Our study shows that intervention involving, innovative, personalised multicomponent physical exercise that includes moderate intensity endurance training over a very short period of time, has a significant benefit on routine care, and may help to reverse the functional and cognitive deterioration associated with the hospitalisation of the elderly,” said Dr. Martínez-Velilla.
Reference: http://dx.doi.org/10.1001/jamainternmed.2018.4869
SOURCE: Elhuyar Fundazioa

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