Karlsen Anders, Loeb Mads Rohde, Andersen Kristine Bramsen, Joergensen Katrine Jeong, Scheel Frederik Ulrik, Turtumoeygard Ida Fanny, Perez Alberto Luis Rodrigues, Kjaer Michael, Beyer Nina
From the Department of Geriatrics, Bispebjerg Hospital, Denmark (AK, MRL, KBA, KJJ, FUS, IFT, ALRP); Department of Physical and Occupational Therapy, Bispebjerg Hospital, University of Copenhagen, Denmark (NB); Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Denmark (AK, MRL, KBA, KJJ, FUS, IFT, MK, NB); Center for Healthy Aging, University of Copenhagen, Denmark (AK, MK, NB); and Department of Biomedical Sciences, University of Copenhagen, Denmark (AK).
Am J Phys Med Rehabil. 2017 May;96(5):e78-e84. doi: 10.1097/PHM.0000000000000671.
The aim of this work was to evaluate the time course of changes in strength and functional performance in elderly hospitalized medical patients.
This was a prospective observational study in elderly medical patients of age 65 years or older at a geriatric department.Measurements were obtained on days 2 to 4, day 5 to 8, and days 9 to 13. Functional performance was measured with De Morton Mobility Index (DEMMI) test and a 30-second chair stand test (30-s CST). Muscular strength was measured with handgrip strength. Activity level was determined with accelerometry (ActivPAL).
Results in DEMMI and 30-s CST gradually improved (P < 0.05), whereas handgrip strength remained unchanged (P > 0.05). Larger functional improvements were observed in patients with "high" compared to "low" and "moderate" activity level (P < 0.05). Changes in DEMMI score correlated with changes in 30-s CST (P < 0.05); however, changes in DEMMI score and 30-s CST were more likely to occur in patients with a low versus high functional level, respectively.
Functional performance of the lower extremities in geriatric patients improves moderately over the time of a hospital stay of less than 14 days, with larger improvements in patients with high activity level. The DEMMI test and the 30-s CST seem to be complementary to each other when evaluating functional changes in a geriatric hospital population.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) describe changes in mobility and muscle strength of geriatric patients during a hospital stay of less than 14 days, (2) understand the significance of physical activity during hospital admission in geriatric patients, and (3) discuss the potential limitations of measures for assessing mobility and lower extremity strength status and change during a hospital admission.
Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在评估老年住院内科患者力量和功能表现的变化时间进程。
这是一项针对老年科65岁及以上老年内科患者的前瞻性观察性研究。在第2至4天、第5至8天和第9至13天进行测量。功能表现通过德莫顿移动指数（DEMMI）测试和30秒坐立试验（30-s CST）进行测量。肌肉力量通过握力进行测量。活动水平通过加速度计（ActivPAL）确定。
DEMMI和30-s CST的结果逐渐改善（P < 0.05），而握力保持不变（P > 0.05）。与“低”和“中等”活动水平的患者相比，“高”活动水平的患者功能改善更大（P < 0.05）。DEMMI评分的变化与30-s CST的变化相关（P < 0.05）；然而，DEMMI评分和30-s CST的变化分别更可能发生在功能水平低和高的患者中。
老年患者下肢的功能表现在住院时间少于14天的过程中适度改善，活动水平高的患者改善更大。在评估老年住院人群的功能变化时，DEMMI测试和30-s CST似乎相互补充。
高级。认证：学术物理医学与康复医师协会经继续医学教育认证委员会认可，可为医生提供继续医学教育。学术物理医学与康复医师协会将此活动指定为最多1.5个美国医学协会医师认可奖第1类学分™。医生应仅根据其参与活动的程度申请学分。
