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dc.contributor.authorSuikkanen, Sara A.
dc.contributor.authorSoukkio, Paula K.
dc.contributor.authorAartolahti, Eeva M.
dc.contributor.authorKautiainen, Hannu
dc.contributor.authorKääriä, Sanna M.
dc.contributor.authorHupli, Markku T.
dc.contributor.authorSipilä, Sarianna
dc.contributor.authorPitkälä, Kaisu H.
dc.contributor.authorKukkonen-Harjula, Katriina T.
dc.date.accessioned2021-04-06T08:22:00Z
dc.date.available2021-04-06T08:22:00Z
dc.date.issued2021
dc.identifier.citationSuikkanen, S. A., Soukkio, P. K., Aartolahti, E. M., Kautiainen, H., Kääriä, S. M., Hupli, M. T., Sipilä, S., Pitkälä, K. H., & Kukkonen-Harjula, K. T. (2021). Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons : Randomized Controlled Trial. <i>Journal of the American Medical Directors Association</i>, <i>22</i>(4), 773-779. <a href="https://doi.org/10.1016/j.jamda.2020.06.005" target="_blank">https://doi.org/10.1016/j.jamda.2020.06.005</a>
dc.identifier.otherCONVID_41630263
dc.identifier.urihttps://jyx.jyu.fi/handle/123456789/74951
dc.description.abstractObjectives Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre-frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored. Design Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization. Setting and Participants A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: ≥65 years, meeting at least 1 of the frailty phenotype criteria, Mini-Mental State Examination score ≥17. Methods Primary outcome, days spent at home over 24 months, was calculated deducting days in inpatient care, in nursing homes, and days after death. HRQoL was assessed (15D questionnaire) at baseline and at 3, 6, and 12 months. Utilization data were retrieved from medical records. Results The participants' mean age was 82.5 (SD 6.3), 75% were women, 61% were pre-frail and 39% frail. After 24 months, there was no difference between groups in days spent at home [incidence rate ratio 1.03; 95% confidence interval (CI) 0.98–1.09]. After 12 months, the costs per person-year were 1.60-fold in the exercise group (95% CI 1.23–1.98), and after 24 months, 1.23-fold (95% CI 0.95–1.50) versus usual care. Over 12 months, the exercise group gained 0.04 quality-adjusted life-years and maintained the baseline 15D level, while the score in the usual care group deteriorated (P for group <.001, time 0.002, interaction 0.004). Conclusions and Implications Physical exercise did not increase the number of days spent at home. Exercise prevented deterioration of HRQoL, and in the frail subgroup, all intervention costs were compensated with decreased utilization of other health care and social services over 24 months.en
dc.format.mimetypeapplication/pdf
dc.languageeng
dc.language.isoeng
dc.publisherElsevier BV
dc.relation.ispartofseriesJournal of the American Medical Directors Association
dc.rightsCC BY-NC-ND 4.0
dc.subject.otherfrailty
dc.subject.otherexercise cost-effectiveness
dc.subject.otherutilization of social and healthcare services
dc.titleEffects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons : Randomized Controlled Trial
dc.typearticle
dc.identifier.urnURN:NBN:fi:jyu-202104062277
dc.contributor.laitosLiikuntatieteellinen tiedekuntafi
dc.contributor.laitosFaculty of Sport and Health Sciencesen
dc.contributor.oppiaineGerontologia ja kansanterveysfi
dc.contributor.oppiaineFysioterapiafi
dc.contributor.oppiaineGerontology and Public Healthen
dc.contributor.oppiainePhysiotherapyen
dc.type.urihttp://purl.org/eprint/type/JournalArticle
dc.description.reviewstatuspeerReviewed
dc.format.pagerange773-779
dc.relation.issn1525-8610
dc.relation.numberinseries4
dc.relation.volume22
dc.type.versionacceptedVersion
dc.rights.copyright© 2021 Elsevier
dc.rights.accesslevelopenAccessfi
dc.subject.ysososiaalipalvelut
dc.subject.ysolaitoshoito
dc.subject.ysokotihoito
dc.subject.ysoikääntyneet
dc.subject.ysoliikunta
dc.subject.ysoterveyspalvelut
dc.subject.ysovanhukset
dc.subject.ysokustannustehokkuus
dc.subject.ysofyysinen aktiivisuus
dc.format.contentfulltext
jyx.subject.urihttp://www.yso.fi/onto/yso/p1307
jyx.subject.urihttp://www.yso.fi/onto/yso/p1308
jyx.subject.urihttp://www.yso.fi/onto/yso/p5513
jyx.subject.urihttp://www.yso.fi/onto/yso/p2433
jyx.subject.urihttp://www.yso.fi/onto/yso/p916
jyx.subject.urihttp://www.yso.fi/onto/yso/p3307
jyx.subject.urihttp://www.yso.fi/onto/yso/p2434
jyx.subject.urihttp://www.yso.fi/onto/yso/p20596
jyx.subject.urihttp://www.yso.fi/onto/yso/p23102
dc.rights.urlhttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.relation.doi10.1016/j.jamda.2020.06.005
jyx.fundinginformationThis work was supported by South Karelia Social and Health Care District (Eksote, grant register number 1236/00.01.05.01/2013); the Social Insurance Institution of Finland (SII, register number 94/331/2013); and State Research Funding for Academic Health Research (Ministry of Social Affairs and Health, Finland). The funders had no role in the design, or in collection, analysis, and interpretation of the data, or in writing the manuscript.


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