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Improving the rehabilitation of older people after emergency hospital admission
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McKelvie, S., Hall, A. M., Richmond, H. R., Finnegan, Susanne and Lasserson, D. (2018) Improving the rehabilitation of older people after emergency hospital admission. Maturitas, 111 . pp. 20-30. doi:10.1016/j.maturitas.2018.02.011 ISSN 0378-5122.
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Official URL: http://dx.doi.org/10.1016/j.maturitas.2018.02.011
Abstract
Purpose
Older adults are at risk of functional decline during emergency hospital admissions. This review aims to understand which exercise-based interventions are effective in improving function for older adults who experience unplanned admissions.
Methods
Database searches identified randomised control trials (RCTs) comparing exercise-based interventions with usual hospital care. The primary outcome was functional status measured by activities of daily living (ADL) scores. Secondary outcomes were length of hospital stay (LOS), mortality and readmissions. Sub-group meta-analyses were conducted on interventions delivered in-hospital only compared with interventions provided both in hospital and after discharge.
Results
After reviewing 8365 studies, nine were eligible for inclusion. Seven were included in the meta-analysis. Participants from five countries had a mean age of 79 years (1602 participants). Usual care varied considerably and the interventions showed heterogeneity, with different combinations of strengthening, resistance, high-intensity or mobility exercises. There were limited descriptions of exercise intervention delivery and participant adherence. There is low-quality evidence supporting exercise interventions that have both in-hospital and post-discharge components (3 trials, SMD 0.56 (−0.02, 1.13)). Trials involving only in-hospital interventions were inconclusive for functional gains (5 trials, SMD −0.04 (−0.31, 0.22)).
Conclusions
Exercise-based rehabilitation for older patients after emergency hospitalisation improves functional ability if the intervention starts in hospital and continues after discharge. No conclusions can be made regarding the effective exercise ‘dose’ or content.
Item Type: | Journal Article | |||||||||
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Subjects: | R Medicine > RC Internal medicine | |||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Older people -- Hospital care , Hospitals -- Emergency services, Physical therapy | |||||||||
Journal or Publication Title: | Maturitas | |||||||||
Publisher: | Elsevier Ireland Ltd. | |||||||||
ISSN: | 0378-5122 | |||||||||
Official Date: | May 2018 | |||||||||
Dates: |
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Volume: | 111 | |||||||||
Page Range: | pp. 20-30 | |||||||||
DOI: | 10.1016/j.maturitas.2018.02.011 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Restricted or Subscription Access | |||||||||
Date of first compliant deposit: | 20 April 2018 | |||||||||
Date of first compliant Open Access: | 20 February 2019 | |||||||||
RIOXX Funder/Project Grant: |
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