Koiwa Yudai, Koyama Shingo, Takahashi Yuma, Kawamura Kohei, Kunieda Yota, Ase Hiroyuki, Matsubara Tomomi, Miyazaki Tadashi, Wada Futoshi, Takakura Tomokazu
Department of Rehabilitation Medicine, Juntendo University Juntendo Tokyo Koto Geriatric Medical Center, Japan.
Faculty of Health Science, Tsukuba University of Technology, Japan.
Phys Ther Res. 2024;27(2):84-91. doi: 10.1298/ptr.E10283. Epub 2024 May 24.
The aim of this study was to examine the relationship between the frequency and duration of physical therapy (PT) and the development of hospitalization-associated disability (HAD) in hospitalized geriatric patients with heart failure (HF).
This single-center, retrospective, observational study included hospitalized patients with HF aged 65 years or older who had received PT. Data regarding demographics, comorbidities, laboratory findings, medications, rehabilitation, and activities of daily living (ADLs) status were collected from electronic medical records. Based on the average frequency and duration of PT, patients were divided into three groups: Group 1, ≥3 days/week and ≥120 minutes/week; Group 2, ≥3 days/week and <120 minutes/week; and Group 3, <3 days/week and <120 minutes/week. Logistic regression analysis was performed to identify the association between the average frequency and duration of weekly PT and the incidence of HAD.
In all, 105 patients (mean age, 84.8 years; proportion of women, 59%) were enrolled in the study, and 43 (41.0%) patients exhibited HAD at discharge. In the multivariate logistic regression analysis, Group 2 (odds ratio [OR], 3.66) and Group 3 (OR, 6.71) had a significantly elevated risk of developing HAD using Group 1 as the reference, even after adjusting for age, ADLs before admission, cognitive function, and severity of HF.
This study showed that a lower frequency and shorter duration of PT are associated with developing HAD in hospitalized geriatric patients with HF. However, further prospective studies are required to confirm these findings.
本研究旨在探讨住院老年心力衰竭(HF)患者物理治疗(PT)的频率和时长与住院相关残疾(HAD)发生之间的关系。
这项单中心、回顾性、观察性研究纳入了65岁及以上接受过PT的住院HF患者。从电子病历中收集有关人口统计学、合并症、实验室检查结果、用药情况、康复情况及日常生活活动(ADL)状态的数据。根据PT的平均频率和时长,将患者分为三组:第1组,每周≥3天且每周≥120分钟;第2组,每周≥3天且每周<120分钟;第3组,每周<3天且每周<120分钟。进行逻辑回归分析以确定每周PT的平均频率和时长与HAD发生率之间的关联。
共有105例患者(平均年龄84.8岁;女性比例59%)纳入本研究,43例(41.0%)患者出院时出现HAD。在多因素逻辑回归分析中,以第1组为参照,第2组(比值比[OR],3.66)和第3组(OR,6.71)发生HAD的风险显著升高,即使在调整年龄、入院前ADL、认知功能和HF严重程度后亦是如此。
本研究表明,住院老年HF患者PT频率较低和时长较短与发生HAD相关。然而,需要进一步的前瞻性研究来证实这些发现。