Effects of a home-based rehabilitation program in community-dwelling older people after discharge from hospital : a subgroup analysis of a randomized controlled trial
Turunen, K. M., Aaltonen-Määttä, L., Portegijs, E., Rantalainen, T., Keikkala, S., Kinnunen, M.-L., Sipilä, S., & Nikander, R. (2021). Effects of a home-based rehabilitation program in community-dwelling older people after discharge from hospital : a subgroup analysis of a randomized controlled trial. Clinical rehabilitation, 35(9), 1257-1265. https://doi.org/10.1177/02692155211001672
Published inClinical rehabilitation
© 2021 the Authors
Objective: To examine whether pre-admission community mobility explains the effects of a rehabilitation program on physical performance and activity in older adults recently discharged from hospital. Design: A secondary analysis of a randomized controlled trial. Setting: Home and community. Participants: Community-dwelling adults aged ⩾60 years recovering from a lower limb or back injury, surgery or other disorder who were randomized to a rehabilitation (n = 59) or standard care control (n = 58) group. They were further classified into subgroups that were not planned a priori: (1) mild, (2) moderate, or (3) severe pre-admission restrictions in community mobility. Interventions: The 6-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counselling, and standard care. Measurements: Physical performance was measured with the Short Physical Performance Battery and physical activity with accelerometers and self-reports. Data were analysed by generalized estimating equation models with the interactions of intervention, time, and subgroup. Results: Rehabilitation improved physical performance more in the intervention (n = 30) than in the control group (n = 28) among participants with moderate mobility restriction: score of the Short Physical Performance Battery was 4.4 ± 2.3 and 4.2 ± 2.2 at baseline, and 7.3 ± 2.6 and 5.8 ± 2.9 at 6 months in the intervention and control group, respectively (mean difference 1.6 points, 95% Confidence Interval 0.2 to 3.1). Rehabilitation did not increase accelerometer-based physical activity in the aforementioned subgroup and did not benefit those with either mild or severe mobility restrictions. Conclusions: Pre-admission mobility may determine the response to the largely counselling-based rehabilitation program. ...
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- Liikuntatieteiden tiedekunta 
Additional information about fundingThis study was supported by the Finnish Ministry of Social Affairs and Health, National Institute for Health and Welfare (THL) (Grant Number 201510222); the Social Insurance Institution of Finland (Kela), Dnro 113/331/2014; the Ministry of Social Affairs and Health for the Kuopio University Hospital Catchment Area (Grant Number 108(13.01.02/2015)); and the Finnish Association of Physiotherapists.
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