title: A prehabilitation program for the prevention of functional decline: effect on higher-level physical function.
abstract: OBJECTIVE
  To determine whether a home-based physical therapy (PT) program prevented decline in several higher-level measures of physical function among physically frail, community-living older persons.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  General community.
  
  
  METHODS
  Persons (N=188) who were physically frail and aged 75 years or older.
  
  
  METHODS
  A home-based PT program (ie, prehabilitation) that focused primarily on improving underlying impairments in physical capabilities.
  
  
  METHODS
  Self-reported instrumental activities of daily living (IADLs); mobility, as determined by a modified version of the Performance Oriented Mobility Assessment; timed rapid gait and timed chair stands; and integrated physical performance, as determined by a modified version of the Physical Performance Test, were assessed at baseline, 7 months, and 12 months.
  
  
  RESULTS
  As compared with participants in the educational control group, participants in the intervention group had reductions in IADL disability of 17.7% at 7 months (P=.036) and 12.0% at 12 months (P=.143) and had gains, ranging from 7.2% to 15.6%, in mobility and integrated physical performance at 7 and 12 months.
  
  
  CONCLUSIONS
  Our home-based prehabilitation program offered modest but consistent benefits for the prevention of decline in several higher-level measures of physical function.
authors.affiliation: Department of Internal Medicine, Adler Geriatric Assessment Center, Yale University School of Medicine, 20 York Street, 17B TMP, New Haven, CT 06504, USA. gill@ynhh.org
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Gill
authors.forename: Dorothy I
authors.initials: DI
authors.lastname: Baker
authors.forename: Margaret
authors.initials: M
authors.lastname: Gottschalk
authors.forename: Peter N
authors.initials: PN
authors.lastname: Peduzzi
authors.forename: Heather
authors.initials: H
authors.lastname: Allore
authors.forename: Peter H
authors.initials: PH
authors.lastname: Van Ness
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003237:Connecticut; D005260:Female; D016330:Frail Elderly; D005684:Gait; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities