1 School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada.
2 Division of Geriatric Medicine, McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada.
Clin Rehabil. 2017 Dec;31(12):1604-1615. doi: 10.1177/0269215517705941. Epub 2017 May 1.
To estimate feasibility and potential for efficacy of an individualized, exercise-focused, self-management program (i.e. Managing Mobility Outcomes In Vulnerable Seniors ( MMOVeS)), in comparison to exercise information in improving mobility after six months among seniors recently discharged from hospital.
Randomized pilot study.
Two McGill University-teaching hospitals.
Community dwelling seniors, aged 70 years and older, recently discharged from either participating hospitals.
The physiotherapy-facilitated intervention consisted of (1) evaluation of mobility capacity, (2) setting short- and long-term goals, (3) delineation of an exercise treatment plan, (4) an educational booklet to enhance mobility self-management skills, and (5) six monthly telephone calls. Control group received a booklet with information on exercises targeting mobility limitations in seniors.
Mobility, pain, and health status were assessed at baseline and at six months using multiple indicators drawn from Disabilities of the Arm, Shoulder, and Hand (DASH) Score, Lower Extremity Functional Scale (LEFS) and Short-Form (SF)-36.
In all, 26 people were randomized to the intervention (mean age: 81 ± 8; 39% women), and 23 were randomized to the control (mean age: 79 ± 7; 33% women). The odds ratio for the mobility outcomes combined was 3.08 and the 95% confidence interval excluded 1 (1.65-5.77). The odds ratio for pain and health perception favored the MMOVeS group, but the 95% confidence interval included the null value.
This feasibility study highlights the potential for efficacy of an individualized, exercise-focused, self-management program in comparison to exercise information in improving mobility outcome for seniors. Furthermore, a home-program combining self-management skills and exercise taught with minimal supervision prove to be feasible. Finally, data from this study can be used to estimate sample size for a confirmatory trial.
评估一项个体化、以运动为重点、自我管理的方案（即管理易损老年人的活动能力方案，MMOVeS）的可行性和潜在疗效，与仅提供运动信息相比，该方案在改善最近从医院出院的老年人 6 个月后的活动能力方面的效果。
随机试验研究。
两所麦吉尔大学教学医院。
社区居住的老年人，年龄在 70 岁及以上，最近从参与的医院出院。
由物理治疗师实施的干预措施包括：（1）评估活动能力，（2）设定短期和长期目标，（3）制定运动治疗计划，（4）制作一本增强活动能力自我管理技能的教育手册，以及（5）每 6 个月打一次电话。对照组收到一本针对老年人活动能力受限的运动信息手册。
采用上肢、肩和手功能障碍（DASH）评分、下肢功能量表（LEFS）和简明健康调查问卷（SF-36）中的多项指标，在基线和 6 个月时评估活动能力、疼痛和健康状况。
共有 26 人被随机分配到干预组（平均年龄：81±8 岁，39%为女性），23 人被随机分配到对照组（平均年龄：79±7 岁，33%为女性）。在综合活动能力结果中，移动能力的比值比为 3.08，95%置信区间排除了 1（1.65-5.77）。疼痛和健康感知的比值比有利于 MMOVeS 组，但 95%置信区间包含了零值。
这项可行性研究强调了与仅提供运动信息相比，个体化、以运动为重点、自我管理方案在改善老年人活动能力方面的潜在疗效。此外，一个结合自我管理技能和运动的家庭方案，在最少监督的情况下进行教学，被证明是可行的。最后，这项研究的数据可用于估计验证性试验的样本量。
