Rehabilitation Medicine, University of Potsdam, Potsdam, Germany.
Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
BMJ Open. 2023 May 18;13(5):e068722. doi: 10.1136/bmjopen-2022-068722.
Elderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evidence of the effects of MR on the independence and functional capacity of elderly patients hospitalised for age-related diseases in four main medical specialties beyond geriatrics.
The biomedical databases (PubMed, Cochrane Library, ICTRP Search Platform, ClinicalTrials) and additionally Google Scholar will be systematically searched for studies comparing centre-based MR with usual care in patients ≥75 years of age, hospitalised for common acute events due to age-related diseases (eg, joint replacement, stroke) in one of the specialties of orthopaedics, oncology, cardiology or neurology. MR is defined as exercise training and at least one additional component (eg, nutritional counselling), starting within 3 months after hospital discharge. Randomised controlled trials as well as prospective and retrospective controlled cohort studies will be included from inception and without language restriction. Studies investigating patients <75 years, other specialties (eg, geriatrics), rehabilitation definition or differently designed will be excluded. Care dependency after at least a 6-month follow-up is set as the primary outcome. Physical function, HRQL, ADL, rehospitalisation and mortality will be additionally considered. Data for each outcome will be summarised, stratified by specialty, study design and type of assessment. Furthermore, quality assessment of the included studies will be performed.
Ethical approval is not required. Findings will be published in a peer-reviewed journal and presented at national and/or international congresses.
因年龄相关疾病（如关节或心脏瓣膜置换手术）而住院治疗的老年患者在急性事件后，其功能健康状况往往明显下降。多组分康复（MR）被认为是恢复这些患者功能的合适方法。然而，其在改善与功能相关的结果（如护理依赖、日常生活活动（ADL）、身体功能和健康相关生活质量（HRQL））方面的疗效仍不清楚。我们概述了一项范围综述的研究框架，旨在绘制多组分康复对 4 个主要医学专科（除老年医学外）因年龄相关疾病而住院的老年患者的独立性和功能能力的影响的现有证据。
将系统地在生物医学数据库（PubMed、Cochrane 图书馆、ICTRP 搜索平台、ClinicalTrials）和另外的 Google Scholar 中搜索比较中心为基础的 MR 与因年龄相关疾病（如关节置换、中风）常见急性事件而住院的≥75 岁患者的常规护理的研究，这些患者来自于矫形外科、肿瘤学、心脏病学或神经病学中的一个专科。MR 被定义为运动训练和至少一个附加组成部分（如营养咨询），从出院后 3 个月内开始。将纳入从开始到现在且没有语言限制的随机对照试验以及前瞻性和回顾性对照队列研究。将排除研究患者<75 岁、其他专科（如老年医学）、康复定义或不同设计的研究。至少 6 个月随访后护理依赖是主要结局。身体功能、HRQL、ADL、再住院和死亡率也将被考虑。将对每个结局的数据进行总结，按专科、研究设计和评估类型进行分层。此外，还将对纳入研究的质量进行评估。
不需要伦理批准。研究结果将发表在同行评议的期刊上，并在国内和/或国际会议上展示。
