Effects of exercise interventions on the functional status of acutely hospitalised older adults: A systematic review and meta-analysis

Valenzuela, Pedro L.; Morales, Javier S.; Castillo‐García, Adrián; Mayordomo-Cava, Jennifer; García-Hermoso, António; Izquierdo, Mikel; Rexach, José Antonio Serra; Lucía, Alejandro

doi:10.1016/j.arr.2020.101076

Cited by 71 publications

(66 citation statements)

References 45 publications

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“…Physical exercise improves both physical and cognitive performance in older individuals and multicomponent exercise interventions, including resistance, balance, and walking exercises performed during acute hospitalization increase muscle strength, functional capacity, and ability to complete basic daily living activities [7,8]. Physical exercise also benefits executive function and memory and can reduce the risk of developing dementia [9].…”

Section: Introductionmentioning

confidence: 99%

Determinants of participation in a post-hospitalization physical exercise program for older adults

et al. 2020

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Background Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients. Methods A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model. Results Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07–1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69–0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08–0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. Conclusions This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000093189, (date: January 22, 2019, retrospectively registered).

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Section: Introductionmentioning

confidence: 99%

Determinants of participation in a post-hospitalization physical exercise program for older adults

et al. 2020

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“…The key to a good recovery is an exercise program adjusted to the ability of the patient to perform it. As has been shown by Izquierdo and his colleagues, these programs should be started in hospital and continued following hospital ( 35 – 37 ). The ViviFrail exercise program is ideally adapted to doing this.…”

Section: Rehabilitationmentioning

confidence: 92%

COVID-19 — The Long Road to Recovery

Morley

2020

J Nutr Health Aging

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“…The key to a good recovery is an exercise program adjusted to the ability of the patient to perform it. As has been shown by Izquierdo and his colleagues, these programs should be started in hospital and continued following hospital (35)(36)(37). The ViviFrail exercise program is ideally adapted to doing this.…”

Section: Rehabilitationmentioning

confidence: 99%

COVID-19 — The Long Road to Recovery

Morley

2020

J Nutr Health Aging

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Seems like it's been a long journey in the past two months of recovery. I'm making progress and starting to walk independently with a cane. A little at a time but getting there."-Carol Todecheene COVID-19 is a pandemic viral disease that has spread throughout the world in 2020 (1, 2). Nearly half of the persons with COVID-19 are asymptomatic. Older persons, persons with comorbidity and diabetes mellitus are particularly at risk of developing COVID-19. Severe cases of COVID-19 cause a viral pneumonia. In addition, COVID-19 can affect almost any organ in the body, as it enters cells through the angiotensin converting enzyme (ACE) 2 receptor (3). A subset of persons with COVID-19 appear to have a prolonged recovery period. This has been termed "long Covid" (4). The concept of a viral disease leading to a post viral syndrome usually with chronic fatigue, is well recognized (5). In one study where patients were followed after having one of three viral diseases (Epstein Barr virus, Coxiella burnetti or Ross fever virus), 12% were found to have a specific syndrome for 6 or more months. Acute recurrences of the illness occurred in the first 3 months and chronic fluctuating symptoms included fatigue, cognitive disturbances, dysphoria, anxiety and pains in the muscles. This syndrome has also been termed myalgic encephalomyelitis (6). After having had COVID-19, the Boston Red Sox pitcher, Eduardo Rodriguez was fatigued when throwing the ball and an MRI showed that he had myocarditis that will prevent him from pitching this year. There is now good evidence that the corona virus can invade myocardial cells and cause destruction of heart muscle (7). As is shown in Figure 1, myocarditis is not the only long-term side effect of COVID-19. These symptoms of "long Covid" include: fatigue, cough, dyspnea, loss of taste and smell, muscle weakness, muscle and joint pain, headache, confusion, conjunctivitis, chest pain, decreased mobility and falls (8, 9). It is important to recognize that persons who have severe pneumonia due to COVID-19 might take 6 months or longer to return their breathing to normal and that this is associated with decreased mobility. Elevated D-dimer levels are prognostic of poor lung function at 3 months (10).

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Effects of exercise interventions on the functional status of acutely hospitalised older adults: A systematic review and meta-analysis

Cited by 71 publications

References 45 publications

Determinants of participation in a post-hospitalization physical exercise program for older adults

Determinants of participation in a post-hospitalization physical exercise program for older adults

COVID-19 — The Long Road to Recovery

COVID-19 — The Long Road to Recovery

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