Abstract
BACKGROUND: Regaining walking ability is a key target in geriatric rehabilitation. This study evaluated the prevalence of walking ability at (pre-)admission and related clinical characteristics in a cohort of geriatric rehabilitation inpatients; in inpatients without walking ability, feasibility and effectiveness of progressive resistance exercise training (PRT) were assessed.
METHODS: Inpatients within RESORT, an observational, longitudinal cohort of geriatric rehabilitation inpatients, were stratified in those with and without ability to walk independently (defined by Functional Ambulation Classification (FAC) score ≤ 2) at admission; further subdivision was performed by pre-admission walking ability. Clinical characteristics at admission, length of stay, and changes in physical and functional performance throughout admission were compared depending on (pre-)admission walking ability. Feasibility (relative number of PRT sessions given and dropout rate) and effectiveness [change in Short Physical Performance Battery, FAC, independence in (instrumental) activities of daily living (ADL/IADL)] of PRT (n = 11) in a subset of inpatients without ability to walk independently at admission (able to walk pre-admission) were investigated compared with usual care (n = 11) (LIFT-UP study).
RESULTS: Out of 710 inpatients (median age 83.5 years; 58.0% female), 52.2% were not able to walk independently at admission, and 7.6% were not able to walk pre-admission. Inpatients who were not able to walk independently at admission, had a longer length of stay, higher prevalence of cognitive impairment and frailty and malnutrition risk scores, and a lower improvement in independence in (I)ADL compared with inpatients who were able to walk at both admission and pre-admission. In LIFT-UP, the relative median number of PRT sessions given compared with the protocol (twice per weekday) was 11 out of 44. There were no dropouts. PRT improved FAC (P = 0.028) and ADL (P = 0.034) compared with usual care.
CONCLUSIONS: High prevalence of inpatients who are not able to walk independently and its negative impact on independence in (I)ADL during geriatric rehabilitation highlights the importance of tailored interventions such as PRT, which resulted in improvement in FAC and ADL.
| Original language | English |
|---|---|
| Pages (from-to) | 2094-2103 |
| Journal | Journal of Cachexia, Sarcopenia and Muscle |
| Volume | 15 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2024 |
Funding
This work was supported by an unrestricted grant of the University of Melbourne received by Prof. Andrea B. Maier and the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH). This work is also part of a collaboration project co-funded by the PPP Allowance made available by Health~Holland (grant number TKI-LSHM19069-H049), Top Sector Life Sciences & Health, to stimulate public-private partnerships, and Top Sector Agri & Food (grant number LWV19287). The collaboration project also includes an in-cash and in-kind contribution from Danone Nutricia Research. The authors thank the multidisciplinary team of the Royal Melbourne Hospital involved in the RESORT cohort for their clinical work and data collection, especially Anthony Kamleh and the physiotherapy team at Royal Park Campus for their work on LIFT-UP. The authors of this manuscript certify that they comply with the ethical guidelines for authorship and publishing of the Journal of Cachexia, Sarcopenia and Muscle. This work was supported by an unrestricted grant of the University of Melbourne received by Prof. Andrea B. Maier and the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH). This work is also part of a collaboration project co\u2010funded by the PPP Allowance made available by Health~Holland (grant number TKI\u2010LSHM19069\u2010H049), Top Sector Life Sciences & Health, to stimulate public\u2010private partnerships, and Top Sector Agri & Food (grant number LWV19287). The collaboration project also includes an in\u2010cash and in\u2010kind contribution from Danone Nutricia Research.
| Funders | Funder number |
|---|---|
| University of Melbourne | |
| Nutricia Research | |
| Medical Research Future Fund | |
| Royal Melbourne Hospital | |
| Melbourne Academic Centre for Health | |
| Health~Holland | TKI‐LSHM19069‐H049 |
| Top Sector Agri and Food | LWV19287 |