Martinez-Velilla N, et al. - Researchers investigated whether functional and cognitive impairment associated with the acute hospitalization of older adults be reversed by implementing an innovative multicomponent exercise intervention. Participants included 370 very elderly patients undergoing acute-care hospitalization. They observed reversal of the functional decline associated with acute hospitalization in very elderly patients after implementation of the exercise intervention.

Methods

• This trial was performed in an acute care unit in a tertiary public hospital in Navarra, Spain, from February 1, 2015, to August 30, 2017.
• Participants were randomly assigned to an in-hospital exercise intervention that included individualized moderate-intensity resistance, balance, and walking exercises (two daily sessions) or control (usual-care) intervention, which included physical rehabilitation when needed.
• Using the Barthel Index of independence and the Short Physical Performance Battery (SPPB), they evaluated change in functional capacity from baseline to hospital discharge (primary end point).
• They also assessed the changes in cognitive and mood status, quality of life, handgrip strength, incident delirium, length of stay, falls, transfer after discharge, and readmission rate and mortality at 3 months after discharge (secondary end points).

Results

• Mean (SD) age of patients was 87.3 (4.9) years, and 56.5% of patients were women.
• Eight days median hospital stay was noted in both groups.
• For intervention, median duration was 5 days; there was a mean of five morning and four evening sessions per patient.
• According to findings, the intervention did not result in adverse effects.
• The benefits of the exercise intervention program were remarkable vs usual care.
• At discharge, a mean increase of 2.2 points and 6.9 points on the SPPB scale and on the Barthel Index, respectively, was demonstrated by the exercise vs usual-care group.
• The usual-care group was found to have hospitalization-related impairment in functional capacity, whereas the exercise intervention reversed this trend.
• An improvement in the SPPB score, which was attributed to the intervention, was also noted.
• At the cognitive level, significant intervention benefits of 1.8 points were reported over the usual-care group.