Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial.
OBJECTIVE
What are the effects of additional exercise on hospital and patient outcomes for acutely-hospitalised older medical patients?


METHODS
Controlled clinical trial.


METHODS
236 Patients aged 65 or older admitted to an acute care hospital with a medical illness between October 2002 and July 2003.


METHODS
The experimental group received usual care plus an individually tailored exercise program administered twice daily from hospital admission to discharge. The control group received usual care only.


METHODS
The primary outcome was discharge destination. Secondary outcomes were measures of activity limitation (Barthel Index, Timed Up and Go, Functional Ambulation Classification), length of stay, and adverse events.


RESULTS
There was no significant effect of the additional exercise program on any outcome. There were no significant differences between groups for the proportion of the patients discharged to home (RR 0.99, 95% CI 0.86 to 1.14) or inpatient rehabilitation (RR 0.76, 95% CI 0.30 to 1.51) or for measures of activity limitation at hospital discharge. A one day difference in length of stay was identified between groups but this difference was not significant (p = 0.45). There were no significant differences between groups for adverse events: 28-day readmission (RR 1.10, 95% CI 0.65 to 1.86), patient mortality (RR 1.15, 95% CI 0.16 to 8.0), intensive care admission (RR 0.16, 95% CI 0.01 to 3.13) and falls (RR 0.69, 95% CI 0.17 to 2.81).


CONCLUSIONS
Additional physiotherapy intervention during hospitalisation did not significantly improve hospital or patient outcomes.
de Morton
Natalie A
NA
Monash University, Frankston, VIC 3199, Australia. natalie.demorton@med.monash.edu.au
Keating
Jennifer L
JL
Berlowitz
David J
DJ
Jackson
Bruce
B
Lim
Wen K
WK
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D018709:Statistics, Nonparametric; D016896:Treatment Outcome