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An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial
BACKGROUND: There is inconclusive evidence for the effectiveness of additional exercise in older hospital patients. The aims of this study were (1) to assess the feasibility of an augmented prescribed exercise program (APEP) in older acute medical patients and (2) to measure the potential effects of...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716827/ https://www.ncbi.nlm.nih.gov/pubmed/31470815 http://dx.doi.org/10.1186/s12877-019-1246-4 |
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author | Braun, Tobias Grüneberg, Christian Süßmilch, Kirsten Wiessmeier, Max Schwenk, Isabel Eggert, Sarah Machleit-Ebner, Annika Harras, Irene Thiel, Christian |
author_facet | Braun, Tobias Grüneberg, Christian Süßmilch, Kirsten Wiessmeier, Max Schwenk, Isabel Eggert, Sarah Machleit-Ebner, Annika Harras, Irene Thiel, Christian |
author_sort | Braun, Tobias |
collection | PubMed |
description | BACKGROUND: There is inconclusive evidence for the effectiveness of additional exercise in older hospital patients. The aims of this study were (1) to assess the feasibility of an augmented prescribed exercise program (APEP) in older acute medical patients and (2) to measure the potential effects of APEP on mobility capacity in order to assess the feasibility of a large full-scale study. METHODS: We conducted a single-center, prospective, parallel-group, single-blinded, randomized (1:1) controlled pilot and feasibility trial. Participants were recruited from acute geriatric wards of a general hospital. Key inclusion criteria were: age ≥ 65 years and walking ability. Key exclusion criteria were severe cognitive impairment and medical restriction for physical exercise interventions. Both groups received usual care, including physiotherapy. Intervention group participants were scheduled for additional exercise sessions (20–30 min, 4-5x/week). Feasibility of the trial design was assessed along pre-defined criteria for process, resources and management. Feasibility of the APEP intervention was analyzed by means of adherence, compliance and safety. Outcomes were measured at baseline and prior to hospital discharge. The primary outcome was mobility capacity (de Morton Mobility Index; DEMMI). Secondary outcomes were walking ability, physical endurance, fear of falling, frailty and length of stay. RESULTS: Thirty-five participants were recruited (recruitment rate 20.3%). We lost 7 participants to follow-up (retention rate: 80%). Intervention group participants (n = 17) each participated in 5.3 ± 2.2 additional exercise sessions (mean duration: 23.2 ± 4.0 min; mean adherence rate 78% ± 26%). No severe adverse events occurred during study assessments or APEP sessions. There were no statistically significant differences in mean change scores in any outcome measure. A sample of 124 participants would be required to detect a difference of 4 DEMMI points (ES = 0.45) with a power of 80%. CONCLUSIONS: This small feasibility RCT indicates that an APEP intervention may be safe and feasible in older acute medical patients. APEP may possibly induce small to moderate effects on mobility, but the clinical relevance of these effects may be limited. These results inform the planning of a larger-scale phase III study. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00011262). Registered 27 October 2016. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1246-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6716827 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67168272019-09-04 An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial Braun, Tobias Grüneberg, Christian Süßmilch, Kirsten Wiessmeier, Max Schwenk, Isabel Eggert, Sarah Machleit-Ebner, Annika Harras, Irene Thiel, Christian BMC Geriatr Research Article BACKGROUND: There is inconclusive evidence for the effectiveness of additional exercise in older hospital patients. The aims of this study were (1) to assess the feasibility of an augmented prescribed exercise program (APEP) in older acute medical patients and (2) to measure the potential effects of APEP on mobility capacity in order to assess the feasibility of a large full-scale study. METHODS: We conducted a single-center, prospective, parallel-group, single-blinded, randomized (1:1) controlled pilot and feasibility trial. Participants were recruited from acute geriatric wards of a general hospital. Key inclusion criteria were: age ≥ 65 years and walking ability. Key exclusion criteria were severe cognitive impairment and medical restriction for physical exercise interventions. Both groups received usual care, including physiotherapy. Intervention group participants were scheduled for additional exercise sessions (20–30 min, 4-5x/week). Feasibility of the trial design was assessed along pre-defined criteria for process, resources and management. Feasibility of the APEP intervention was analyzed by means of adherence, compliance and safety. Outcomes were measured at baseline and prior to hospital discharge. The primary outcome was mobility capacity (de Morton Mobility Index; DEMMI). Secondary outcomes were walking ability, physical endurance, fear of falling, frailty and length of stay. RESULTS: Thirty-five participants were recruited (recruitment rate 20.3%). We lost 7 participants to follow-up (retention rate: 80%). Intervention group participants (n = 17) each participated in 5.3 ± 2.2 additional exercise sessions (mean duration: 23.2 ± 4.0 min; mean adherence rate 78% ± 26%). No severe adverse events occurred during study assessments or APEP sessions. There were no statistically significant differences in mean change scores in any outcome measure. A sample of 124 participants would be required to detect a difference of 4 DEMMI points (ES = 0.45) with a power of 80%. CONCLUSIONS: This small feasibility RCT indicates that an APEP intervention may be safe and feasible in older acute medical patients. APEP may possibly induce small to moderate effects on mobility, but the clinical relevance of these effects may be limited. These results inform the planning of a larger-scale phase III study. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00011262). Registered 27 October 2016. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1246-4) contains supplementary material, which is available to authorized users. BioMed Central 2019-08-30 /pmc/articles/PMC6716827/ /pubmed/31470815 http://dx.doi.org/10.1186/s12877-019-1246-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Braun, Tobias Grüneberg, Christian Süßmilch, Kirsten Wiessmeier, Max Schwenk, Isabel Eggert, Sarah Machleit-Ebner, Annika Harras, Irene Thiel, Christian An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
title | An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
title_full | An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
title_fullStr | An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
title_full_unstemmed | An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
title_short | An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
title_sort | augmented prescribed exercise program (apep) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716827/ https://www.ncbi.nlm.nih.gov/pubmed/31470815 http://dx.doi.org/10.1186/s12877-019-1246-4 |
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