A randomised controlled trial to measure the effects of an augmented prescribed exercise program on mobility, quality of life and healthcare utilisation for frail hospilised older medical in-patients

Older people can become less physically independent following a hospital stay. Up to one third become newly dependant on walking aids and others remain more dependent in the long-term, affecting physical and psychological health and increasing the burden on carers and healthcare. Although many factors can influence this deterioration, low physical activity levels in hospital may be of particular importance. The hospital environment does not encourage physical activity, which may lead to muscle weakness and decline. Therefore, by simply assisting exercise in the hospital, this functional decline might be prevented. Results from a pilot study completed in the Mercy Hospital Cork showed that a dedicated exercise programme completed by older patients was associated with improved physical function and well-being and a shorter hospital stay. Based on these exciting, preliminary results, we would like to complete a larger study which will provide more definitive evidence on the effectiveness of a specific exercise programme for older inpatients, and importantly, its effect on the least active group. The research will be divided into two studies. In the first study, we will measure physical activity in a sample of the older adult in-patients. From this, the less active patients will be identified. In the second study, we will measure the effects of additional exercise on this type of patient. A strengthening, balance and endurance program will be designed for each patient, supervised and assisted twice daily. The effects on the patients' levels of independent activity, mobility and well-being will be measured at discharge and after three months. We will also assess the cost and value for money of this intervention. This simple intervention has the potential to improve patients' health, reduce their need for support and healthcare and change the way physiotherapy is delivered in the hospital to the older adult.

Award Date: 25 April 2013
Award Value: €171,976
Principal Investigator: Ms Ruth McCullagh
Host Institution: University College Cork
Scheme: Research Training Fellowships for Health Professionals