Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

Scheerman, Kira; Raaijmakers, Kirsten; Otten, René; Meskers, Carel G.M.; Maier, Andrea B.

doi:10.1186/s12877-018-0965-2

Cited by 38 publications

(34 citation statements)

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“…The effect of early physical exercise interventions in acutely hospitalized older patients has already been examined in a number of previous systematic reviews [3, 8–13], reporting heterogeneous results across different outcomes and outcome categories such as hospital outcomes, adverse clinical events, or functional and mobility outcomes. A potential cause of this inconclusive evidence for the benefits of early physical exercise interventions has been addressed in one of these reviews, hypothesizing that the adaption level of the intervention to the capabilities of the patients might have played a critical role for the effectiveness of such interventions in acutely hospitalized older patients [13]. However, contrary to this hypothesis, patient-tailored physical exercise interventions were not found to be superior to those interventions that were not.…”

Section: Introductionmentioning

confidence: 99%

“…However, contrary to this hypothesis, patient-tailored physical exercise interventions were not found to be superior to those interventions that were not. Another potential cause for the still limited evidence might be the use of various outcome measures, which has been reported in most of the aforementioned reviews [3, 10, 11, 13]. However, none of these reviews specifically addressed the heterogeneity and the appropriateness of the outcome measures selected in the previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

et al. 2019

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Background Selecting appropriate outcome measures for vulnerable, multimorbid, older patients with acute and chronic impairments poses specific challenges, which may have caused inconsistent findings of previous intervention trials on early inpatient rehabilitation in acutely hospitalized older patients. The aim of this review was to describe primary outcome measures that have been used in randomized controlled trials (RCTs) on early rehabilitation in acutely hospitalized older patients, to analyze their matching, and to evaluate the effects of matching on the main findings of these RCTs. Methods A systematic literature search was conducted in PubMed, Cochrane CENTRAL, CINAHL, and PEDro databases. Additional studies were identified through reference and citation tracking. Inclusion criteria were: RCT, patients aged ≥65 years, admission to an acute hospital medical ward (but not to an intensive medical care unit), physical exercise intervention (also as part of multidisciplinary programs), and primary outcome measure during hospitalization. Two independent reviewers extracted the data, assessed the methodological quality, and analyzed the matching of primary outcome measures to the intervention, study sample, and setting. Main study findings were related to the results of the matching procedure. Results Twenty-eight articles reporting on 24 studies were included. A total of 33 different primary outcome measures were identified, which were grouped into six categories: functional status, mobility status, hospital outcomes, adverse clinical events, psychological status, and cognitive functioning. Outcome measures differed considerably within each category and showed a large heterogeneity in their matching to the intervention, study sample, and setting. Outcome measures that specifically matched the intervention contents were more likely to document intervention-induced benefits. Mobility instruments seemed to be the most sensitive outcome measures to reveal such benefits. Conclusions This review highlights that the selection of outcome measures has to be highly specific to the intervention contents as this is a key factor to reveal benefits attributable to early rehabilitation in acutely hospitalized older patients. Inappropriate selection of outcome measures may represent a major cause of inconsistent findings reported on the effectiveness of early rehabilitation in this setting. Trial registration PROSPERO CRD42017063978 . Electronic supplementary material The online version of this article (10.1186/s12877-019-1201-4) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

et al. 2019

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“…The results from our study are difficult to compare with other studies on physical activity interventions during hospitalization, 8 , 24 – 27 because these did not investigate multicomponent interventions including various eHealth elements/non-eHealth elements at the same time. However, studies that specifically evaluated the feasibility of single eHealth interventions, such as the study by Laver et al 19 on an interactive gaming program, showed that their use in a hospital setting was feasible.…”

Section: Discussionmentioning

confidence: 69%

“…A recent systematic review, concluding that the effect of physical activity interventions on physical performance in older patients during hospitalization was uncertain, included 15 trials. 8 The interventions used in those trials varied considerably and comprised (supervised) physical exercise program(s) with mobility, flexibility, strength, balance, walking and functional exercises, [9][10][11][12][13][14][15][16][17][18][19] proprioceptive neuromuscular facilitation, 20 electrical stimulation, 21 vibration training 22 and horse riding stimulation. 23 Four RCTs published afterwards [24][25][26][27] investigated one or more (supervised) physical exercise program(s) including mobility, flexibility, strength, balance, walking and functional exercises.…”

Section: Introductionmentioning

confidence: 99%

A multicomponent intervention to decrease sedentary time during hospitalization: a quasi-experimental pilot study

Conijn

Bodegom‐Vos

Volker³

et al. 2020

Clin Rehabil

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Objective: The aim of this study was to evaluate the feasibility and preliminary effects of a multicomponent intervention to decrease sedentary time during and shortly after hospitalization. Design: This is a quasi-experimental pilot study comparing outcomes in patients admitted before and after the implementation of the intervention. Setting: The study was conducted in a university hospital. Subjects: Participants were adult patients undergoing elective organ transplantation or vascular surgery. Interventions: In the control phase, patients received usual care, whereas in the intervention phase, patients also received a multicomponent intervention to decrease sedentary time. The intervention comprised eight elements: paper and digital information, an exercise movie, an activity planner, a pedometer and Fitbit Flex™, a personal activity coach and an individualized digital training program. Measures: Measures of feasiblity were the self-reported use of the intervention components (yes/no) and satisfaction (low–high = 0–10). Main outcome measure was the median % of sedentary time measured by an accelerometer worn during hospitalization and 7–14 days thereafter. Results: A total of 42 controls (mean age = 59 years, 62% male) and 52 intervention patients (58 years, 52%) were included. The exercise movie, paper information and Fitbit Flex were the three most frequently used components, with highest satisfaction scores for the fitbit, paper information, exercise movie and digital training. Median sedentary time decreased from 99.6% to 95.7% and 99.3% to 91.0% between Days 1 and 6 in patients admitted in the control and intervention phases, respectively. The difference at Day 6 reached statistical significance (difference = 41 min/day, P = 0.01). No differences were seen after discharge. Conclusion: Implementing a multicomponent intervention to reduce sedentary time appeared feasible and may be effective during but not directly after hospitalization.

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“…Multiple interventions targeting physical activity promotion in older hospitalized patients have been developed, but the results of such interventions were inconsistent (Scheerman, Raaijmakers, Otten, Meskers, & Maier, 2018). Implementation of interventions in clinical practice is challenging since it is affected by factors on organizational, professional, intervention and patient level (Chaudoir, Dugan, & Barr, 2013).…”

Section: Introductionmentioning

confidence: 99%

Tasks and responsibilities in physical activity promotion of older patients during hospitalization: A nurse perspective

et al. 2020

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Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

Cited by 38 publications

References 40 publications

Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

A multicomponent intervention to decrease sedentary time during hospitalization: a quasi-experimental pilot study

Tasks and responsibilities in physical activity promotion of older patients during hospitalization: A nurse perspective

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