Department of Health Sciences, 7788Macquarie University, Sydney, Australia.
Department of Mathematics and Statistics, 7788Macquarie University, Sydney, Australia.
Clin Rehabil. 2022 Sep;36(9):1170-1185. doi: 10.1177/02692155221095936. Epub 2022 May 6.
To determine if home-based exercise programmes for older adults after hospitalisation are effective at improving physical activity, quality of life, activities of daily living (ADL) and mobility compared to no intervention, standard care or centre-based exercise.
Databases were searched from inception to March 2022. Randomised controlled trials which included home-based exercise in older adults recently discharged from hospital were included. The primary outcome was physical activity. Secondary outcomes were quality of life, ADL performance, mobility, adverse events and hospital readmissions. Two reviewers independently selected relevant studies and extracted data. Quantitative synthesis with meta-analyses using a random-effects model and qualitative synthesis were performed.
Ten trials (PEDro score 6-8) were included. Three trials reported on physical activity but meta-analysis was not possible due to heterogeneity. Home-based exercise was more effective than no intervention at improving ADL performance (SMD 0.60, 95% CI 0.03 to 1.17); and standard care at improving quality of life (SMD 0.30, 95% CI 0.11 to 0.49) and mobility (SMD 0.23, 95% CI 0.00 to 0.45). Few and minor adverse events were associated with home-based exercise.
Based on individual trials, home-based exercise has the potential to improve physical activity compared to no intervention or standard care. Meta-analyses indicate that home-based exercise is more effective than no intervention at improving activities of daily living performance, and standard care at improving mobility and quality of life. It is unclear if home-based exercise is more effective than centre-based exercise at improving these outcomes.
确定与无干预、标准护理或基于中心的运动相比，针对出院后老年人的家庭为基础的运动方案在提高身体活动、生活质量、日常生活活动（ADL）和活动能力方面是否有效。
从创建到 2022 年 3 月对数据库进行了搜索。纳入了包括最近从医院出院的老年人进行家庭为基础的运动的随机对照试验。主要结果是身体活动。次要结果是生活质量、ADL 表现、活动能力、不良事件和医院再入院。两位评审员独立选择相关研究并提取数据。使用随机效应模型进行定量综合分析和荟萃分析以及定性综合分析。
纳入了 10 项试验（PEDro 评分为 6-8）。有 3 项试验报告了身体活动情况，但由于异质性，无法进行荟萃分析。与无干预相比，家庭为基础的运动在改善 ADL 表现方面更有效（SMD 0.60，95%CI 0.03 至 1.17）；与标准护理相比，在改善生活质量（SMD 0.30，95%CI 0.11 至 0.49）和活动能力（SMD 0.23，95%CI 0.00 至 0.45）方面更有效。家庭为基础的运动与少数轻微的不良事件相关。
基于单独的试验，家庭为基础的运动与无干预或标准护理相比，有改善身体活动的潜力。荟萃分析表明，与无干预相比，家庭为基础的运动在改善日常生活活动表现方面更有效，与标准护理相比，在改善活动能力和生活质量方面更有效。尚不清楚家庭为基础的运动在改善这些结果方面是否比基于中心的运动更有效。
