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Exercise Intervention and Hospital-Associated Disability: A Nonrandomized Controlled Clinical Trial
Carlos Rodriguez-Lopez1,2, Jennifer Mayordomo-Cava1,2, Teresa Zarralanga-Lasobras2
1Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain.
JAMA Network Open
|February 8, 2024
Summary
Inpatient exercise and health education interventions did not significantly reduce hospital-associated disability (HAD) based on the Katz Index. However, the intervention showed benefits in secondary outcomes, suggesting potential value for older hospitalized patients.
Area of Science:
- Geriatrics
- Rehabilitation Medicine
- Clinical Trials
Background:
- Hospital-associated disability (HAD) is a significant concern for older adults, impacting their post-discharge health.
- The effectiveness of inpatient exercise interventions in preventing HAD and improving long-term outcomes remains unclear.
Purpose of the Study:
- To investigate the association between a combined exercise and health education program and the incidence of hospital-associated disability (HAD) in older adults.
- To evaluate the impact of the intervention on secondary outcomes, including functional capacity and physical performance, at discharge and 3 months post-discharge.
Main Methods:
- A single-center, open-label, nonrandomized controlled trial involving 260 patients aged 75 years and older.
- The intervention group received usual care plus a supervised multicomponent exercise program and health education, while the control group received usual care.
- HAD incidence was assessed using the Katz Index and Barthel Index, with secondary outcomes including ambulatory capacity, physical performance, falls, readmissions, and mortality.
Main Results:
- No statistically significant difference in HAD incidence was found between groups using the Katz Index at discharge or 3-month follow-up.
- The intervention group showed a significantly lower HAD incidence when measured by the Barthel Index at both discharge and follow-up.
- The intervention was associated with a reduced decline in ambulatory capacity and improved physical performance at discharge.
Conclusions:
- While the primary outcome (HAD incidence via Katz Index) was not significantly improved, the intervention demonstrated positive effects on secondary measures.
- These findings suggest that in-hospital exercise and health education programs may offer clinical benefits for older hospitalized patients.
- Further research may be warranted to explore the optimal components and delivery of such interventions.
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