Schulz R, Knauf W, Püllen R
Zentrum für Internistische und Geriatrische Medizin (ZIGM), Asklepios Paulinen Klinik Wiesbaden, Geisenheimerstr. 10, 65197, Wiesbaden, Deutschland.
Z Gerontol Geriatr. 2014 Feb;47(2):147-52. doi: 10.1007/s00391-013-0494-8.
Mobile geriatric rehabilitation is an outpatient rehabilitative treatment in which a multidisciplinary team treats elderly patients at home. This kind of treatment has been performed in rare cases in Germany but there are no data available on the effectiveness in patients with severe cognitive and functional impairment.
In a retrospective study design the data of all patients who had participated in mobile geriatric rehabilitation between 1 September 2009 and 23 May 2011 were evaluated. Before treatment a comprehensive geriatric assessment was performed and after treatment an assessment of mobility and activities of daily living (ADL). After 6 months a random sample of 20 patients were contacted by telephone to check the ADL.
A total of 87 patients were treated between 1 September 2009 and 23 May 2011. The median age was 83 years and 56 % of the patients lived in nursing homes. Only 24 % of the patients had MMSE scores > 23 points, 77 patients completed the treatment with an assessment and in these patients the ADL could be improved significantly (Barthel index at the beginning 36.2 points and on completion 50.9 points, p < 0.001). The Barthel index 6 months after treatment was only 1.25 points lower compared to the assessment at the end of the treatment. Significant improvement after therapy could also be demonstrated in the mobility assessment (timed up and go test, Tinetti mobility score and Esslinger transfer scale).
The results of this non-randomized and non-blinded trial indicated the efficacy of mobile geriatric rehabilitation. In functionally and cognitively impaired elderly patients ADL and mobility can be improved. These effects seem to persist for at least for 6 months.
移动老年康复是一种门诊康复治疗，由多学科团队在家中为老年患者提供治疗。这种治疗在德国很少实施，且尚无关于严重认知和功能障碍患者疗效的数据。
采用回顾性研究设计，对2009年9月1日至2011年5月23日期间参加移动老年康复治疗的所有患者的数据进行评估。治疗前进行全面的老年评估，治疗后评估活动能力和日常生活活动（ADL）。6个月后，通过电话联系20名患者的随机样本以检查ADL。
2009年9月1日至2011年5月23日期间共治疗了87名患者。中位年龄为83岁，56%的患者住在养老院。只有24%的患者MMSE评分>23分，77名患者完成了评估治疗，这些患者的ADL有显著改善（开始时Barthel指数为36.2分，结束时为50.9分，p<0.001）。治疗后6个月的Barthel指数与治疗结束时的评估相比仅低1.25分。在活动能力评估（计时起立行走测试、Tinetti活动能力评分和Esslinger转移量表）中也显示出治疗后有显著改善。
这项非随机、非盲法试验的结果表明移动老年康复具有疗效。在功能和认知受损的老年患者中，ADL和活动能力可以得到改善。这些效果似乎至少持续6个月。
