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Changes in muscle strength and physical function in older patients during and after hospitalisation : A prospective repeated-measures cohort study
Hartley, Peter Romero-Ortuno, Roman Wellwood, Ian Deaton, Christi
Hartley, Peter
Romero-Ortuno, Roman
Wellwood, Ian
Deaton, Christi
Abstract
Aim
to investigate changes in knee-extension strength and physical function in older adults during and after acute hospital admission, and the contributions of illness severity, frailty and sedentary activity to changes in knee-extension strength.
Methods
prospective repeated-measures cohort study on a sample of participants aged ≥75 recruited within 24 hours of acute hospital admission. Knee-extension, grip strength and functional mobility (de Morton Mobility Index, DEMMI) were measured at recruitment, day 7 (or discharge if earlier), and at follow-up 4–6 weeks later. During the first 7 days, continuous measurement of physical activity and daily measurements of muscle strength were taken. Participants recalled the functional ability they had 2-weeks before admission and self-reported it at follow-up (Barthel Index, BI).
Results
sixty-five of 70 participants (median age 84 years) had at least one repeated measure of muscle strength in hospital. Knee-extension strength declined during hospitalisation by 11% (P < 0.001), but did not change post-hospitalisation (P = 0.458). Grip strength did not change during hospitalisation (P = 0.665) or from discharge to follow-up (P = 0.508). General functional ability (BI) deteriorated between 2 weeks before admission and follow-up (P < 0.001). Functional mobility (DEMMI) improved during hospitalisation (P < 0.001), but did not change post-hospitalisation (P = 0.508). A repeated-measures mixed model showed that greater loss in knee-extension strength during hospitalisation was associated with increased sedentary time, frailty and baseline strength and lower baseline inflammatory levels.
Conclusions
our observations add to a growing body of evidence on potential risk factors for hospital-associated deconditioning.
Keywords
hospital, deconditioning, activity, frailty, strength, older people
Date
2021
Type
Journal article
Journal
Age and Ageing
Book
Volume
50
Issue
1
Page Range
153-160
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
Faculty of Health Sciences
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Source URL
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Open Access Status
License
All rights reserved
File Access
Controlled