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Factors associated with improved walking in older people during hospital rehabilitation : Secondary analysis of a randomized controlled trial
Said, Catherine M. McGinley, Jennifer L. Szoeke, Cassandra Workman, Barbara Hill, Keith D. Wittwer, Joanne E. Woodward, Michael Liew, Danny Churilov, Leonid Bernhardt, Julie
Said, Catherine M.
McGinley, Jennifer L.
Szoeke, Cassandra
Workman, Barbara
Hill, Keith D.
Wittwer, Joanne E.
Woodward, Michael
Liew, Danny
Churilov, Leonid
Bernhardt, Julie
Abstract
Background
Older people are often admitted for rehabilitation to improve walking, yet not everyone improves. The aim of this study was to determine key factors associated with a positive response to hospital-based rehabilitation in older people.
Methods
This was a secondary data analysis from a multisite randomized controlled trial. Older people (n= 198, median age 80.9 years, IQR 76.6- 87.2) who were admitted to geriatric rehabilitation wards with a goal to improve walking were recruited. Participants were randomized to receive additional daily physical therapy focused on mobility (n = 99), or additional social activities (n = 99). Self-selected gait speed was measured on admission and discharge. Four participants withdrew. People who changed gait speed ≥0.1 m/s were classified as ‘responders’ (n = 130); those that changed <0.1m/s were classified as ‘non-responders’ (n = 64). Multivariable logistic regression explored the association of six pre-selected participant factors (age, baseline ambulation status, frailty, co-morbidities, cognition, depression) and two therapy factors (daily supervised upright activity time, rehabilitation days) and response.
Results
Responding to rehabilitation was associated with the number of days in rehabilitation (OR 1.04; 95% CI 1.00 to 1.08; p = .039) and higher Mini Mental State Examination scores (OR 1.07, 95% CI 1.00 – 1.14; p = .048). No other factors were found to have association with responding to rehabilitation.
Conclusion
In older people with complex health problems or multi-morbidities, better cognition and a longer stay in rehabilitation were associated with a positive improvement in walking speed. Further research to explore who best responds to hospital-based rehabilitation and what interventions improve rehabilitation outcomes is warranted.
Keywords
mobility limitation, rehabilitation, exercise therapy, hospitalization, aged, aged, 80 and over
Date
2021
Type
Journal article
Journal
BMC Geriatrics
Book
Volume
21
Issue
Page Range
1-8
Article Number
Article 90
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open