The impact of mobility limitations on geriatric rehabilitation outcomes: Positive effects of resistance exercise training (RESORT)

IF 9.4 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2024-09-05 DOI:10.1002/jcsm.13557

Laure M. G. Verstraeten, Esmee M. Reijnierse, Thom Spoelstra, Carel G. M. Meskers, Andrea B. Maier

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引用次数: 0

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.

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行动不便对老年康复效果的影响：阻力运动训练（RESORT）的积极效果。

背景：恢复行走能力是老年康复的一个关键目标。本研究评估了一组老年康复住院患者入院时（入院前）的行走能力及相关临床特征；并对无行走能力的住院患者进行了渐进阻力运动训练（PRT）的可行性和有效性评估：方法：RESORT是一个老年康复住院病人的纵向观察队列，该队列中的住院病人在入院时被分为有独立行走能力和无独立行走能力（根据功能性行走分类（FAC）评分≤2来定义）的两类，并根据入院前的行走能力进行了进一步细分。根据（入院前）步行能力，比较入院时的临床特征、住院时间以及整个入院期间身体和功能表现的变化。在入院时无独立行走能力（入院前能行走）的住院患者子集中，对 PRT（n = 11）与常规护理（n = 11）的可行性（PRT 治疗的相对次数和辍学率）和有效性（短期体能测试、FAC、日常生活（工具性）活动（ADL/IADL）独立性的变化）进行了比较研究（LIFT-UP 研究）：在 710 名住院患者（中位年龄 83.5 岁；58.0% 为女性）中，52.2% 在入院时无法独立行走，7.6% 在入院前无法行走。与入院时和入院前都能独立行走的住院患者相比，入院时不能独立行走的住院患者住院时间更长，认知障碍、虚弱和营养不良风险评分的发生率更高，（I）ADL独立性的改善程度更低。在 LIFT-UP 项目中，与治疗方案（工作日两次）相比，PRT 治疗次数的相对中位数为 44 次中的 11 次。没有辍学者。与常规护理相比，PRT改善了FAC（P = 0.028）和ADL（P = 0.034）：结论：住院病人中无法独立行走的比例很高，这对老年康复期间的（I）ADL独立性产生了负面影响，这凸显了PRT等有针对性的干预措施的重要性，PRT可改善FAC和ADL。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.