title: Identifying effective and feasible interventions to accelerate functional recovery from hospitalization in older adults: A randomized controlled pilot trial.
abstract: Hospitalization induces functional decline in older adults. Many geriatric patients fail to fully recover physical function after hospitalization, which increases the risk of frailty, disability, dependence, re-hospitalization, and mortality. There is a lack of evidence-based therapies that can be implemented following hospitalization to accelerate functional improvements. The aims of this Phase I clinical trial are to determine 1) the effect size and variability of targeted interventions in accelerating functional recovery from hospitalization and 2) the feasibility of implementing such interventions in community-dwelling older adults. Older patients (≥65years, n=100) will be recruited from a single site during hospitalization for an acute medical condition. Subjects will be randomized to one of five interventions initiated immediately upon discharge: 1. protein supplementation, 2. in-home rehabilitation plus placebo supplementation, 3. in-home rehabilitation plus protein supplementation, 4. single testosterone injection, or 5. isocaloric placebo supplementation. Testing will occur during hospitalization (baseline) and at 1 and 4weeks post-discharge. Each testing session will include measures of muscle strength, physical function/performance, body composition, and psychological function. Physical activity levels will be continuously monitored throughout study participation. Feasibility will be determined through collection of the number of eligible, contacted, and enrolled patients; intervention adherence and compliance; and reasons for declining enrollment and study withdrawal. This research will determine the feasibility of post-hospitalization strategies to improve physical function in older adults. These results will also provide a foundation for performing larger, multi-site clinical trials to improve physical function and reduce readmissions in geriatric patents.
authors.affiliation: Sealy Center on Aging, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0177, United States. Electronic address: rrdeer@utmb.edu.
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Deer
authors.affiliation: School of Nutrition and Health Promotion, Healthy Lifestyles Research Center, Arizona State University, Phoenix, AZ 85004, United States. Electronic address: jared.dickinson@asu.edu.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Dickinson
authors.affiliation: Sealy Center on Aging, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0177, United States; Dept. of Physical Therapy, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, United States. Electronic address: stfisher@utmb.edu.
authors.forename: Steve R
authors.initials: SR
authors.lastname: Fisher
authors.affiliation: Dept. of Preventive Medicine and Community Health, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, United States. Electronic address: hyju@utmb.edu.
authors.forename: Hyunsu
authors.initials: H
authors.lastname: Ju
authors.affiliation: Sealy Center on Aging, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0177, United States; Dept. of Internal Medicine, Division of Geriatrics, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, United States. Electronic address: evolpi@utmb.edu.
authors.forename: Elena
authors.initials: E
authors.lastname: Volpi
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease / Q000523:psychology / Q000534:rehabilitation*; D000368:Aged; D000369:Aged, 80 and over; D000728:Androgens / Q000627:therapeutic use*; D001823:Body Composition; D003863:Depression / Q000523:psychology / Q000534:rehabilitation; D004044:Dietary Proteins / Q000627:therapeutic use*; D019587:Dietary Supplements; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000523:psychology / Q000534:rehabilitation; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D053580:Muscle Strength; D010865:Pilot Projects; D004856:Postural Balance; D020127:Recovery of Function; D013739:Testosterone / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D004044:Dietary Proteins; D013739:Testosterone
keywords: Exercise; Geriatrics; Hospitalization; Physical function; Protein; Testosterone