Effect of 12-Month Supervised, Home-Based Physical Exercise on Functioning Among Persons With Signs of Frailty: A Randomized Controlled Trial.


Journal

Archives of physical medicine and rehabilitation
ISSN: 1532-821X
Titre abrégé: Arch Phys Med Rehabil
Pays: United States
ID NLM: 2985158R

Informations de publication

Date de publication:
12 2021
Historique:
received: 02 02 2021
revised: 24 06 2021
accepted: 29 06 2021
pubmed: 21 7 2021
medline: 15 12 2021
entrez: 20 7 2021
Statut: ppublish

Résumé

To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty. A randomized controlled trial with a 1:1 allocation. Home-based. Home-dwelling persons aged 65 years or older meeting at least 1 frailty phenotype criteria (N=300). The mean age of the participants was 82.2±6.3 years, 75% were women, 61% met 1-2 frailty criteria, and 39% met ≥3 criteria. A 12-month, individually tailored, progressive, and physiotherapist-supervised physical exercise twice a week (n=150) vs usual care (n=149). FIM, Short Physical Performance Battery (SPPB), handgrip strength, instrumental activities of daily living (IADL), and self-reported falls and physical activity (other than intervention). Assessed 4 times at home over 12 months. FIM deteriorated in both groups over 12 months, -4.1 points (95% confidence interval [CI], -5.6 to -2.5) in the exercise group and -6.9 (95% CI, -8.4 to -2.3) in the usual care group (group P=.014, time P<.001, interaction P=.56). The mean improvement in SPPB was significantly greater in the exercise group (1.6 [95% CI, 1.3-2.0]) than in the usual care group (0.01 [95% CI, -0.3 to 0.3]) (group P<.001, time P=.11, interaction P=.027). The exercise group reported significantly fewer falls per person-year than the usual care group (incidence rate ratio, 0.47 [95% CI, 0.40-0.55]; P<.001). There was no significant difference between the groups over 12 months in terms of handgrip strength, IADL function, or self-reported physical activity. One year of physical exercise improved physical performance and decreased the number of falls among people with signs of frailty. FIM differed between the groups at 12 months, but exercise did not prevent deterioration of FIM, IADL, or handgrip strength.

Identifiants

pubmed: 34283997
pii: S0003-9993(21)00508-6
doi: 10.1016/j.apmr.2021.06.017
pii:
doi:

Types de publication

Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2283-2290

Informations de copyright

Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Sara Suikkanen (S)

South Karelia Social and Health Care District, Rehabilitation, Lappeenranta; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä. Electronic address: sara.a.suikkanen@jyu.fi.

Paula Soukkio (P)

South Karelia Social and Health Care District, Rehabilitation, Lappeenranta; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä.

Eeva Aartolahti (E)

Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä.

Sanna Kääriä (S)

Raatimiehet Oy, Lappeenranta.

Hannu Kautiainen (H)

Department of General Practice, University of Helsinki, Helsinki; Unit of Primary Health Care Helsinki University Hospital, Helsinki.

Markku T Hupli (MT)

South Karelia Social and Health Care District, Rehabilitation, Lappeenranta.

Kaisu Pitkälä (K)

Department of General Practice, University of Helsinki, Helsinki; Unit of Primary Health Care Helsinki University Hospital, Helsinki.

Sarianna Sipilä (S)

Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä; Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.

Katriina Kukkonen-Harjula (K)

South Karelia Social and Health Care District, Rehabilitation, Lappeenranta.

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Classifications MeSH