A prehabilitation program for the prevention of functional decline: effect on higher-level physical function.
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.
Gill
Thomas M
TM
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
Baker
Dorothy I
DI
Gottschalk
Margaret
M
Peduzzi
Peter N
PN
Allore
Heather
H
Van Ness
Peter H
PH
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