de Morton Natalie A, Keating Jennifer L, Berlowitz David J, Jackson Bruce, Lim Wen K
Monash University, Frankston, VIC 3199, Australia.
Aust J Physiother. 2007;53(2):105-11. doi: 10.1016/s0004-9514(07)70043-0.
What are the effects of additional exercise on hospital and patient outcomes for acutely-hospitalised older medical patients?
Controlled clinical trial.
236 Patients aged 65 or older admitted to an acute care hospital with a medical illness between October 2002 and July 2003.
The experimental group received usual care plus an individually tailored exercise program administered twice daily from hospital admission to discharge. The control group received usual care only.
The primary outcome was discharge destination. Secondary outcomes were measures of activity limitation (Barthel Index, Timed Up and Go, Functional Ambulation Classification), length of stay, and adverse events.
There was no significant effect of the additional exercise program on any outcome. There were no significant differences between groups for the proportion of the patients discharged to home (RR 0.99, 95% CI 0.86 to 1.14) or inpatient rehabilitation (RR 0.76, 95% CI 0.30 to 1.51) or for measures of activity limitation at hospital discharge. A one day difference in length of stay was identified between groups but this difference was not significant (p = 0.45). There were no significant differences between groups for adverse events: 28-day readmission (RR 1.10, 95% CI 0.65 to 1.86), patient mortality (RR 1.15, 95% CI 0.16 to 8.0), intensive care admission (RR 0.16, 95% CI 0.01 to 3.13) and falls (RR 0.69, 95% CI 0.17 to 2.81).
Additional physiotherapy intervention during hospitalisation did not significantly improve hospital or patient outcomes.
额外的运动对急性住院的老年内科患者的医院结局和患者结局有何影响？
对照临床试验。
2002年10月至2003年7月期间因内科疾病入住一家急性护理医院的236名65岁及以上的患者。
实验组接受常规护理加一项从入院到出院每天实施两次的个性化运动计划。对照组仅接受常规护理。
主要结局是出院去向。次要结局是活动受限的测量指标（巴氏指数、起立行走试验、功能性步行分类）、住院时间和不良事件。
额外的运动计划对任何结局均无显著影响。两组之间在出院回家的患者比例（相对风险0.99，95%置信区间0.86至1.14）、入住 inpatient rehabilitation（相对风险0.76，95%置信区间0.30至1.51）或出院时活动受限的测量指标方面均无显著差异。两组之间确定了住院时间有一天的差异，但这种差异不显著（p = 0.45）。两组在不良事件方面无显著差异：28天再入院（相对风险1.10，95%置信区间0.65至1.86）、患者死亡率（相对风险1.15，95%置信区间0.16至8.0）、重症监护病房入住率（相对风险0.16，95%置信区间0.01至3.13）和跌倒（相对风险0.69，95%置信区间0.17至2.81）。
住院期间额外的物理治疗干预并未显著改善医院结局或患者结局。
