Eva Peyrusqué, Marie-Jeanne Kergoat, Ali Filali-Mouhim, Nathalie Veillette, Raquel Fonseca, Marie-Josée Sirois, Mylène Aubertin-Leheudre
{"title":"实用运动干预试点研究对预防住院老年人功能和体能下降的效果。","authors":"Eva Peyrusqué, Marie-Jeanne Kergoat, Ali Filali-Mouhim, Nathalie Veillette, Raquel Fonseca, Marie-Josée Sirois, Mylène Aubertin-Leheudre","doi":"10.1249/MSS.0000000000003687","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Although physical activity (PA) has the potential to prevent iatrogenic disability, it is rarely integrated into usual care. We evaluated whether MATCH, a pragmatic unsupervised exercise intervention, could help prevent physical and functional decline in hospitalized older adults.</p><p><strong>Methods: </strong>A quasi-randomized trial (ClinicalTrials #NCT04078334) was conducted involving 100 hospitalized patients, who were allocated to either the usual care + MATCH group (MG; n = 62) or the usual care only group (CG; n = 38). MATCH is an unsupervised PA program guided by a decision tree (3 exercises/session; 3x/day). Outcomes were assessed at admission and discharge: 1) primary outcome: functional capacities (Short Physical Performance Battery (SPPB)); 2) secondary outcomes: handgrip strength, walking speed, functional mobility (3-metre Timed-Up-and-Go (TUG)), leg muscle power (30-second chair-test), need for home care support, and functional autonomy in both instrumental and basic activities of daily living (ADL).</p><p><strong>Results: </strong>At admission, groups were similar, except for nutritional status (p = 0.047). There were no significant differences between groups for the primary outcome (SPPB: MG:+1.5 ± 1.9 vs. CG:+1.0 ± 1.4/12pts, p = 0.25). However, the MG showed greater improvements in handgrip strength (MG:+1.7 ± 3.9 vs. CG:-0.15 ± 3.0 kg, p = 0.02) and had a lower need for home care support at discharge (MG:44.3% vs. CG:65.8%, p = 0.041). A higher proportion of MG participants improved to being at no risk of falling (TUG<14 sec), achieved good functional capacity (SPPB ≥10/12: +6.6%), increased leg muscle power (Women:<2.1/Men:<2.6(W/kgBW): -15.1%), and improved walking speed (<0.6 m/s: -30.6%) compared to the CG. Clinically meaningful improvements in ADL (+82.7%) were observed only in the MG.</p><p><strong>Conclusions: </strong>Combining usual care with the MATCH intervention appears more effective that usual care alone in preventing physical and functional decline and reducing the need for home care support at discharge. Larger-scale efficacy studies are needed to confirm these promising results.</p>","PeriodicalId":18426,"journal":{"name":"Medicine and Science in Sports and Exercise","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of a Pragmatic Exercise Intervention Pilot Study on Preventing Functional and Physical Decline in Hospitalized Older Adults.\",\"authors\":\"Eva Peyrusqué, Marie-Jeanne Kergoat, Ali Filali-Mouhim, Nathalie Veillette, Raquel Fonseca, Marie-Josée Sirois, Mylène Aubertin-Leheudre\",\"doi\":\"10.1249/MSS.0000000000003687\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Although physical activity (PA) has the potential to prevent iatrogenic disability, it is rarely integrated into usual care. We evaluated whether MATCH, a pragmatic unsupervised exercise intervention, could help prevent physical and functional decline in hospitalized older adults.</p><p><strong>Methods: </strong>A quasi-randomized trial (ClinicalTrials #NCT04078334) was conducted involving 100 hospitalized patients, who were allocated to either the usual care + MATCH group (MG; n = 62) or the usual care only group (CG; n = 38). MATCH is an unsupervised PA program guided by a decision tree (3 exercises/session; 3x/day). 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引用次数: 0
摘要
目的:虽然体育活动(PA)具有预防医源性残疾的潜力,但它很少被纳入日常护理。我们评估了MATCH,一种实用的无监督运动干预,是否有助于预防住院老年人的身体和功能下降。方法:对100例住院患者进行准随机试验(ClinicalTrials #NCT04078334),将患者分为常规护理+ MATCH组(MG组;n = 62)或常规护理组(CG;N = 38)。MATCH是一个由决策树指导的无监督PA程序(3个练习/次;3 x /天)。在入院和出院时评估结局:1)主要结局:功能能力(短物理性能电池(SPPB));2)次要结果:握力、步行速度、功能活动能力(3米计时-起身-走(TUG))、腿部肌肉力量(30秒椅子测试)、家庭护理支持需求、日常生活工具和基本活动(ADL)的功能自主。结果:入院时,各组除营养状况外无显著差异(p = 0.047)。各组间主要结局无显著差异(SPPB: MG:+1.5±1.9 vs CG:+1.0±1.4/12,p = 0.25)。然而,MG组在握力方面表现出更大的改善(MG:+1.7±3.9 vs. CG:-0.15±3.0 kg, p = 0.02),并且出院时对家庭护理支持的需求更低(MG:44.3% vs. CG:65.8%, p = 0.041)。更高比例的MG参与者改善到没有跌倒的风险。结论:在预防身体和功能衰退以及减少出院时对家庭护理支持的需求方面,常规护理与MATCH干预相结合似乎比单独的常规护理更有效。需要更大规模的疗效研究来证实这些有希望的结果。
Effect of a Pragmatic Exercise Intervention Pilot Study on Preventing Functional and Physical Decline in Hospitalized Older Adults.
Purpose: Although physical activity (PA) has the potential to prevent iatrogenic disability, it is rarely integrated into usual care. We evaluated whether MATCH, a pragmatic unsupervised exercise intervention, could help prevent physical and functional decline in hospitalized older adults.
Methods: A quasi-randomized trial (ClinicalTrials #NCT04078334) was conducted involving 100 hospitalized patients, who were allocated to either the usual care + MATCH group (MG; n = 62) or the usual care only group (CG; n = 38). MATCH is an unsupervised PA program guided by a decision tree (3 exercises/session; 3x/day). Outcomes were assessed at admission and discharge: 1) primary outcome: functional capacities (Short Physical Performance Battery (SPPB)); 2) secondary outcomes: handgrip strength, walking speed, functional mobility (3-metre Timed-Up-and-Go (TUG)), leg muscle power (30-second chair-test), need for home care support, and functional autonomy in both instrumental and basic activities of daily living (ADL).
Results: At admission, groups were similar, except for nutritional status (p = 0.047). There were no significant differences between groups for the primary outcome (SPPB: MG:+1.5 ± 1.9 vs. CG:+1.0 ± 1.4/12pts, p = 0.25). However, the MG showed greater improvements in handgrip strength (MG:+1.7 ± 3.9 vs. CG:-0.15 ± 3.0 kg, p = 0.02) and had a lower need for home care support at discharge (MG:44.3% vs. CG:65.8%, p = 0.041). A higher proportion of MG participants improved to being at no risk of falling (TUG<14 sec), achieved good functional capacity (SPPB ≥10/12: +6.6%), increased leg muscle power (Women:<2.1/Men:<2.6(W/kgBW): -15.1%), and improved walking speed (<0.6 m/s: -30.6%) compared to the CG. Clinically meaningful improvements in ADL (+82.7%) were observed only in the MG.
Conclusions: Combining usual care with the MATCH intervention appears more effective that usual care alone in preventing physical and functional decline and reducing the need for home care support at discharge. Larger-scale efficacy studies are needed to confirm these promising results.
期刊介绍:
Medicine & Science in Sports & Exercise® features original investigations, clinical studies, and comprehensive reviews on current topics in sports medicine and exercise science. With this leading multidisciplinary journal, exercise physiologists, physiatrists, physical therapists, team physicians, and athletic trainers get a vital exchange of information from basic and applied science, medicine, education, and allied health fields.