Beneficios de un programa ambulatorio de ejercicio multicomponente unido a la valoración geriátrica integral para pacientes mayores de la comunidad con fragilidad física

Abstract

Introduction and objective

The greatest challenge in healthcare is maintaining the functional capacity of the elderly through prevention and reversal programs for situations of physical fragility before crossing the threshold of disability. The aim of this study is to describe the functional evolution of frail and pre-frail elderly people in the community, after a multifactorial intervention based on comprehensive geriatric assessment followed by an outpatient multicomponent exercise program.

Patients and methods

Longitudinal observational study, from May 27, 2021 to January 15, 2023, which included patients with physical frailty (Short Physical Performance Battery [SPPB] < 10) from the Frailty and Fall Prevention Clinic, to carry out an outpatient multicomponent exercise program for 12 weeks, supervised by a multidisciplinary team made up of geriatrics, physiotherapy and specialized nursing. The degree of frailty was assessed using the SPPB (10-12 points: robust, 7-9 points: pre-frail, 4-6 points: frail, 0-3 points: disability). The outcome variables were the pre- and post-intervention difference in SPPB, gait speed, grip strength and quality of life (EuroQoL EQ-5D), compared by Student's T test for paired samples.

Results

A total of 46 patients were included (82.3 years±5.47; 73.91% women). Before the intervention, 39.13% of the patients were categorized as frail and 60.87% as pre-frail. After the intervention, a gain of 3.56 points in the SPPB was achieved (P<.001), being 85.37% of the patients categorized as robust, 14.63% as pre-frail, and none of them as frail. Furthermore, the gait speed improved 0.38m/s (P<.001); the grip strength increased 2.84 kg in women (P<.05) and 3.91 kg in men (P<.05); and the EuroQoL score raised 29.15 points (P<.001).

Conclusion

Multicomponent exercise on an outpatient basis, combined with comprehensive geriatric assessment performed in a geriatric department by a multidisciplinary team, contributes to the reversal of frailty.