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|Title:||A systematic scoping review of physical activity to minimise functional decline in older general medicine patients receiving 24-hour acute care.|
|Epworth Authors:||Ley, Lenore|
Recommended Physical Activities
Patients Functional Outcomes
Centre for Quality and Patient Safety Research, Epworth HealthCare Partnership
Epworth/Deakin Centre for Clinical Nursing Research, Melbourne, Victoria, Australia.
|Conference:||Epworth HealthCare Research Week 2018|
|Conference Location:||Epworth Research Institute, Victoria, Australia|
|Abstract:||Background. Quality 24-hour care of older patients involves balancing activities to minimise functional decline with rest to aid recovery. However, there is limited guidance regarding the most effective type and dose of activity to minimise functional decline during acute care. Methods. We conducted a systematic scoping review of current literature (2003 – 2017) to identify recommended physical activity to reduce functional decline in hospitalized general medicine patients aged 65 years and over according to their physical capability on admission. The strength of evidence supporting activity interventions were graded according to NHMRC recommendations. Results. Included reports (n=15) were randomised (n=3) and non-randomised (n=3) trials, before-after studies (n=3) and prospective cohort studies (n=6). Studies tested the efficacy of individual walking (n=10) and exercise (n=5) interventions on patients’ functional outcomes. No studies evaluated the optimal dose of physical activity according to physical capability on admission. Overall, walking interventions significantly reduced functional decline among elders capable (Grade D – poor) and not capable (Grade C – satisfactory) of independent ambulation, and among samples with mixed physical capability (Grade B – good). Graduated exercise programs had no significant effect on the functional status of elders capable of independent ambulation, but significantly reduced functional decline among samples of elders with mixed physical capability (Grade B – good). Discussion. Insufficient evidence limits prescription of the optimal dose of physical activity required to minimise functional decline in hospitalised elders. However, research supported the value of promoting ambulation for hospitalised elders, irrespective of physical capability, and suggested the possible value of graduated exercise in mitigating the functional decline of dependent elders.|
|Affiliated Organisations:||Deakin University, Geelong. School of Nursing and Midwifery, Victoria|
|Type of Clinical Study or Trial:||Systematic Reviews|
|Appears in Collections:||Rehabilitation|
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