title: Physiological improvements and health benefits during an exercise-based comprehensive rehabilitation program in medically complex patients.
abstract: OBJECTIVE
  To determine the effects of an exercise-based comprehensive rehabilitation program on the physiological, health, and cost benefit in medically complex patients.
  
  
  METHODS
  Case series
  
  
  METHODS
  Comprehensive rehabilitation centers.
  
  
  METHODS
  Elderly chronically ill men (n = 39, age = 75.3 +/- 1.4) and women (n = 74, age = 76.5 +/- 0.9 years).
  
  
  METHODS
  Patients participated in individualized physical therapy with therapeutic exercises (stretching, strengthening, endurance, balance, sitting and standing dynamic exercises) three times/week for three months under the supervision of a physician.
  
  
  METHODS
  Upper (back) and lower (leg flexors) extremity strength, aerobic power as measured by metabolic equivalents (METS) at 80% of age predicted maximal heart rate (APMHR), physical functioning and mental health as assessed by the Short Form-36 (SF-36) questionnaire, and medical events (falls, physician visits, and hospitalizations) questionnaire was collected at baseline and after three months of the program.
  
  
  RESULTS
  Strength measures improved by approximately 30% (P < 0.05) as well as aerobic power improved by approximately 25% (P < 0.05) over the three-month period. There were significant improvements in two of the SF-36 Physical Component Scales: Physical Functioning (P < 0.05) and Role Physical (P < 0.05); plus, there were significant improvements in all four of the Mental Component Scales: Vitality (P < 0.05), Social Functioning (P < 0.05), Role Emotional (P < 0.05), and Mental Health (P < 0.05). There were significant reductions in fall rate (P < 0.05), physician visits (P < 0.05), and hospitalizations (P < 0.05).
  
  
  CONCLUSIONS
  Patients improve physical capacity, which result in improvements in health status with concurrent reductions in healthcare utilization during a comprehensive rehabilitation program.
authors.affiliation: Dept. of Integrative Physiology, University of Colorado at Boulder, Boulder, CO 80309, USA.
authors.forename: Taro P
authors.initials: TP
authors.lastname: Smith
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Kennedy
authors.forename: Marci
authors.initials: M
authors.lastname: Smith
authors.forename: Sander
authors.initials: S
authors.lastname: Orent
authors.forename: Monika
authors.initials: M
authors.lastname: Fleshner
mesh_terms: D000368:Aged / Q000502:physiology* / Q000523:psychology; D002908:Chronic Disease; D015444:Exercise; D005081:Exercise Therapy / Q000191:economics / Q000379:methods; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D053580:Muscle Strength; D010809:Physical Fitness; D011795:Surveys and Questionnaires; D016896:Treatment Outcome