In:
Gerontology, S. Karger AG, Vol. 63, No. 6 ( 2017), p. 495-506
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Post-ward geriatric rehabilitation programs have hardly been developed and validated, which leaves a substantial gap in rehabilitative care in older adults and hinders full exploitation of maintained, but often unrecognized rehabilitation potentials. Geriatric rehabilitation patients with cognitive impairment represent a highly vulnerable population which is often affected by a lack of an ongoing support at the intersection between ward-based and post-ward rehabilitation. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To determine the effect of a standardized home-based training program in geriatric patients with cognitive impairment following ward-based rehabilitation. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A randomized controlled, single-blinded intervention trial (RCT) with wait list control design was used. Geriatric patients ( 〈 i 〉 n 〈 /i 〉 = 34; age: 81.9 ± 5.7 years) with cognitive impairment (MMSE: 18.8 ± 4.7), identified by predefined in- and exclusion criteria, were consecutively recruited from a geriatric rehab ward. Patients in the intervention group (IG, 〈 i 〉 n 〈 /i 〉 = 17) performed a 6-week strength and functional home training. The control group (CG, 〈 i 〉 n 〈 /i 〉 = 17) started an identical training 6 weeks later with an initial usual care period during the intervention for the IG. Functional performance (Short Physical Performance Battery; SPPB), clinically relevant functional deficits (Performance Oriented Assessment; POMA), and physical activity (Assessment of Physical Activity For Older Persons questionnaire; APAFOP) represented primary outcome measurements complemented by additional secondary outcome parameters. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The IG significantly increased functional performances in SPPB (total score: 〈 i 〉 p 〈 /i 〉 = 0.012; chair rise: 〈 i 〉 p 〈 /i 〉 = 0.007, balance: 〈 i 〉 p 〈 /i 〉 = 0.066), reduced gait and balance deficits in POMA (total score: 〈 i 〉 p 〈 /i 〉 = 0.006; balance: 〈 i 〉 p 〈 /i 〉 = 0.034; gait: 〈 i 〉 p 〈 /i 〉 = 0.019), and increased physical activity (APAFOP; 〈 i 〉 p 〈 /i 〉 = 0.05) compared to the CG. Effect sizes showed medium to large effects for significant parameters (eta 〈 sup 〉 2 〈 /sup 〉 = 0.14-0.45). Training benefits and adherence were more pronounced following the immediate onset of post-ward training compared to a delayed start (eta 〈 sup 〉 2 〈 /sup 〉 = 0.06-0.23). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Results of this pilot study show that a feasible and easy to handle, home-based rehabilitation program increased functional performance and physical activity in a vulnerable, multimorbid patient group with cognitive impairment, in particular when the post-ward training onset was not postponed.
Type of Medium:
Online Resource
ISSN:
0304-324X
,
1423-0003
Language:
English
Publisher:
S. Karger AG
Publication Date:
2017
detail.hit.zdb_id:
1482689-6
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