Institute of Physiotherapy, OsloMet - Oslo Metropolitan University (OsloMet), PO Box 4, St. Olavs Plass, 0130, Oslo, Norway.
Diakonhjemmet Hospital, PO Box 23, Vinderen, 0319, Oslo, Norway.
BMC Geriatr. 2020 Nov 11;20(1):464. doi: 10.1186/s12877-020-01829-9.
Many older people suffer from mobility limitations and reduced health-related quality of life (HRQOL) after discharge from hospital. A consensus regarding the most effective exercise-program to optimize physical function and HRQOL after discharge is lacking. This study investigates the effects of a group-based multicomponent high intensity exercise program on physical function and HRQOL in older adults with or at risk of mobility disability after discharge from hospital.
This single blinded parallel group randomised controlled trial recruited eighty-nine home dwelling older people (65-89 years) while inpatient at medical wards at a general hospital in Oslo, Norway. Baseline testing was conducted median 49 (25 percentile, 75 percentile) (26, 116) days after discharge, before randomisation to an intervention group or a control group. The intervention group performed a group-based exercise program led by a physiotherapist twice a week for 4 months. Both groups were instructed in a home-based exercise program and were encouraged to exercise according to World Health Organisation's recommendations for physical activity in older people. The primary outcome, physical performance, was measured by the Short Physical Performance Battery (SPPB). Secondary outcomes were 6-min walk test (6MWT), Berg Balance Scale (BBS), grip strength, Body Mass Index (BMI), and HRQOL (the Short-Form 36 Health Survey (SF-36)). Data were analysed according to the intention-to-treat principle. Between-group differences were assessed using independent samples t-test.
The groups were comparable at baseline. Intention-to-treat analysis showed that the intervention group improved their functional capacity (6MWT) and the physical component summary of SF-36 significantly compared to the control group. No further between group differences in change from baseline to 4 months follow-up were found.
A high intensity multicomponent exercise program significantly improved functional capacity and physical HRQOL in older adults with or at risk of mobility disability after discharge from hospital. The study suggests that this population can benefit from systematic group exercise after hospital-initial rehabilitation has ended.
ClinicalTrials.gov . NCT02905383 . September 19, 2016.
许多老年人在出院后会出现行动能力受限和健康相关生活质量（HRQOL）下降的情况。目前，对于哪种运动方案最能有效改善出院后老年人的身体机能和 HRQOL 尚未达成共识。本研究旨在调查基于小组的多成分高强度运动方案对出院后有或有移动障碍风险的老年人身体机能和 HRQOL 的影响。
本单盲平行组随机对照试验在挪威奥斯陆一家综合医院的内科病房招募了 89 名居家的老年人（65-89 岁）。在出院后中位数 49（25 分位，75 分位）（26，116）天进行基线测试，然后将其随机分配到干预组或对照组。干预组由一名物理治疗师每周两次进行基于小组的运动方案，为期 4 个月。两组均接受了家庭运动方案的指导，并按照世界卫生组织（WHO）对老年人身体活动的建议进行运动。主要结局指标为身体表现，采用简短身体表现电池（SPPB）进行测量。次要结局指标为 6 分钟步行测试（6MWT）、伯格平衡量表（BBS）、握力、体重指数（BMI）和 HRQOL（简短 36 健康调查（SF-36））。数据分析采用意向治疗原则。使用独立样本 t 检验评估组间差异。
两组在基线时具有可比性。意向治疗分析表明，与对照组相比，干预组的功能能力（6MWT）和 SF-36 的身体成分综合评分显著提高。在 4 个月随访时，未发现两组间进一步的变化差异。
高强度多成分运动方案可显著改善出院后有或有移动障碍风险的老年人的功能能力和身体 HRQOL。本研究表明，在医院初始康复结束后，该人群可以从系统的小组运动中受益。
ClinicalTrials.gov。NCT02905383。2016 年 9 月 19 日。
