Physical exercises improve the physical capacity of older individuals during hospitalization
estudo longitudinal
DOI:
https://doi.org/10.15448/2357-9641.2023.1.45138Keywords:
Functional Status, Hospitalization, Physical Exercise, elderly person healthAbstract
Objective: to investigate whether physical exercises improve the physical capacity of older individuals during hospitalization. Methods: the sample consisted of 67 older person with a median age of 73 (range 60 - 90) years, hospitalized in an inpatient unit due to acute health conditions (20.9% due to renal/urinary causes, 19.4% due to metabolic causes, and 17.9% due to respiratory conditions) who participated in a physiotherapy program of physical exercises based on the literature. The program aimed to improve balance, walking training, and strengthen lower limb muscles. Participants were assessed using clinical tests, including the Short Physical Performance Battery (SPPB), handgrip strength (HGS), and the Medical Research Council (MRC) manual muscle strength test, administered in two assessments conducted before and after the intervention. Wilcoxon test (=0.05) was used for comparisons. Results: the median length of hospital stay was 6 (3 - 19) days, and the median number of interventions was 3 (1 - 8) sessions. Statistical differences between pre- and post-interventions were found in SPPB scores (4 [2 - 5] vs. 5 [3 - 4]), direct HGS (18 [9.60 - 35.4] vs. 20 [10 - 36.6] kgf), left HGS (17.2 [5.30 - 29.7] vs. 18 [7.20 - 32.0] kgf), and MRC score (48 [40 - 60] vs. 56 [44 - 60]). Conclusion: physical exercises with an emphasis on balance training, walking training, and lower limb strengthening improve the physical capacity of older individuals during hospitalization.
Downloads
References
Viveiro LAP de, Almeida AS de, Meira DM, Lavoura PH, Carmo CM do, Silva JM da, et al. Declínio de atividades instrumentais de vida diária associado à perda de força de preensão palmar em idosos internados em enfermaria geriátrica. Rev Bras Geriatr e Gerontol. 2014;17(2):235-42. https://doi.org/10.1590/S1809-98232014000200002. DOI: https://doi.org/10.1590/S1809-98232014000200002
Covinsky KE, Pierluissi E, Johnston CB. Hospitalization-associated disability “She was probably able to ambulate, but i’m not sure”. JAMA – J Am Med Assoc. 2011;306(16):1782-93. https://doi.org/10.1001/jama.2011.1556. DOI: https://doi.org/10.1001/jama.2011.1556
Sáez de Asteasu ML, Martínez-Velilla N, Zambom- -Ferraresi F, Ramírez-Vélez R, García-Hermoso A, Cadore EL, et al. Changes in muscle power after usual care or early structured exercise intervention in acutely hospitalized older adults. J Cachexia Sarcopenia Muscle. 2020;11(4):997-1006. https://doi.org/10.1002/jcsm.12564. DOI: https://doi.org/10.1002/jcsm.12564
Verlaan S, Van Ancum JM, Pierik VD, Van Wijngaarden JP, Scheerman K, Meskers CGM, et al. Muscle Measures and Nutritional Status at Hospital Admission Predict Survival and Independent Living of Older Patients - the EMPOWER Study. J frailty aging. 2017;6(3):161-6. https://doi.org/10.14283/jfa.2017.23.
Mattison et al. Hospital management of older adults [Internet]. Boston: UpToDate. 2021 [cited 2022 Oct 20]. Available from: https://www.uptodate.com/contents/hospital-management-of-older-adults
Morey, Miriam C. Physical activity and exercise in older adult [Internet]. Durham: UpToDate. 2019 2021 [cited 2022 Oct 20]. Available from: https://www.uptodate.com/contents/physical-activity-and-exercise-in-older-adults.
Hoenig AH, Cary M. Visão geral da reabilitação geriátrica: componentes e configurações do programa para reabilitação [Internet]. Durham: UpToDate. 2020 [cited 2022 Oct 22]. Available from: https://www.uptodate.com/contents/overview-of-geriatric-rehabilitation-patient-assessment-and-common-indications-for-rehabilitation.
Sáez de Asteasu ML, Martínez-Velilla N, Zambom- -Ferraresi F, Casas-Herrero Á, Lucía A, Galbete A, et al. Physical exercise improves function in acutely hospitalized older patients: secondary analysis of a randomized clinical trial. J Am Med Dir Assoc. 2019;20(7):866-73. https://doi.org/10.1016/j.jamda.2019.04.001. DOI: https://doi.org/10.1016/j.jamda.2019.04.001
Takeuchi I. et al. Effects of branched-chain amino acids and vitamin D supplementation on physical function, muscle mass and strength, and nutritional status in sarcopenic older adults undergoing hospital-based rehabilitation: A multicenter randomized controlled trial. Geriatr Gerontol Int. 2018;19(1):12-17. DOI: https://doi.org/10.1111/ggi.13547
Sullivan DH. et al. Progressive resistance muscle strength training of hospitalized frail elderly. Am J Phys Med Rehabil. 2001;80(7):503-9. DOI: https://doi.org/10.1097/00002060-200107000-00007
Torres-Sánchez I. et al. Effects of an exercise intervention in frail older patients with chronic obstructive pulmonary disease hospitalized due to an exacerbation: a randomized controlled trial. COPD. 2016;14(1):37-42. DOI: https://doi.org/10.1080/15412555.2016.1209476
Momosaki R. et al. Effect of early rehabilitation by physical therapists on in-hospital mortality after aspiration pneumonia in the elderly. Arch Phys Med Rehabil. 2015;96(2):205-9. DOI: https://doi.org/10.1016/j.apmr.2014.09.014
Lærum-Onsager E. et al. Effect of nutritional and physical exercise intervention on hospital readmission for patients aged 65 or older: a systematic review and meta-analysis of randomized controlled trials. Int J Behav Nutr Phys Act. 2021;18(1):1-14. DOI: https://doi.org/10.1186/s12966-021-01123-w
Glans M. et al. Risk factors for hospital readmission in older adults within 30 days of discharge–a comparative retrospective study. BMC geriatrics. 2020;20(1):1-12. DOI: https://doi.org/10.1186/s12877-020-01867-3
Pedersen MK, Meyer G, Uhrenfeldt L. Risk factors for acute care hospital readmission in older persons in Western countries: a systematic review. JBI Database System Rev Implement Rep. 2017;15(2):454-85. DOI: https://doi.org/10.11124/JBISRIR-2016-003267
Hoyer EH, Needham DM, Miller J, Deutschendorf A, Friedman MP, Brotman DJ. Functional status impairment is associated with unplanned readmissions [Internet]. Arch Phys Med Rehabil. 2013;94(10):1951-8. DOI: https://doi.org/10.1016/j.apmr.2013.05.028
Ottenbacher KJ, Karmarkar A, Graham JE, Kuo Y, Deutsch A, Reistetter TA., et al. Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service medicare patients [Internet]. JAMA. 2014;311(6):604-14. DOI: https://doi.org/10.1001/jama.2014.8
Martínez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F, Sáez De Asteasu ML, Lucia A, Galbete A, et al. Effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: a randomized clinical trial. JAMA Intern Med.2019;179(1):28- 36. https://doi.org/10.1001/jamainternmed.2018.4869. DOI: https://doi.org/10.1001/jamainternmed.2018.4869
Boumer TC, Faustino EC, Cania FD, Morais HQ, Borsato RMT, Coltro PH. Exercícios físicos para idosos frágeis e sarcopênicos hospitalizados: revisão de literatura. Residências em Saúde: Experiências, Pesquisa e Produção do Conhecimento para o SUS. 2021;37-48. https://doi.org/10.22533/at.ed.1702125065. DOI: https://doi.org/10.22533/at.ed.1702125065
Duarte YA de O, de Andrade CL, Lebrão ML. O índex de Katz na avaliação da funcionalidade dos idosos. Rev da Esc Enferm. 2007;41(2):317-25. https://doi.org/10.1590/S008062342007000200021. DOI: https://doi.org/10.1590/S0080-62342007000200021
Moraes EN de, do Carmo JA, de Moraes FL, Azevedo RS, Machado CJ, Montilla DER. Clinical-Functional Vulnerability Index-20 (IVCF-20): Rapid recognition of frail older adults. Rev Saude Publica. 2016;50:1-10. https://doi.org/10.1590/S1518-8787.2016050006963. DOI: https://doi.org/10.1590/s1518-8787.2016050006963
Cesari M, Landi F, Calvani R, et al. Rationale for a preliminary operational definition of physical frailty and sarcopenia in the SPRINTT trial. Aging Clin Exp Res. 2017;29(1):81-8. DOI: https://doi.org/10.1007/s40520-016-0716-1
Barbosa-Silva TG, Menezes AMB, Bielemann RM, Malmstrom TK, Gonzalez MC. Enhancing SARC-F: improving sarcopenia screening in the clinical practice. J Am Med Dir Assoc. 2016;17(12):1136-41. https://doi.org/10.1016/j.jamda.2016.08.004. DOI: https://doi.org/10.1016/j.jamda.2016.08.004
Cruz-Jentoft, Alfonso J. et al. Writing group for the european working group on sarcopenia in older people 2 (EWGSOP2), and the extended group for EWGSOP2. sarcopenia: revised european consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. DOI: https://doi.org/10.1093/ageing/afy169
Freitas EV, Py L. Tratado de geriatria e gerontologia. 5. ed. Rio de Janeiro. Guanabara Koogan; 2022. 2360 p.
Hermans G, Clerckx B, Vanhullebusch T, Segers J, Vanpee G, Robbeets C, et al. Interobserver agreement of medical research council sum score and handgrip strength in the intensive care unit. Muscle Nerve. 2012;45(1):18-25. https://doi.org/10.1002/mus.22219. DOI: https://doi.org/10.1002/mus.22219
Latronico N, Gosselink R. Abordagem dirigida para o diagnóstico de fraqueza muscular grave na unidade de terapia intensiva. Rev Bras Ter Intensiva. 2015;27(3):199- 201. https://doi.org/10.5935/0103-507X.20150036. DOI: https://doi.org/10.5935/0103-507X.20150036
Amaral JF, Mancini M, Júnior JMN. Comparison of three hand dynamometers in relation to the accuracy and precision of the measurements. Braz. J. Phys. Ther. 2012;16(June):216-24. https://doi.org/10.1590/S1413-35552012000300007. DOI: https://doi.org/10.1590/S1413-35552012000300007
Martins R, Assumpção MS, Schivinski CIS. Percepção de esforço e dispneia em pediatria: revisão das escalas de avaliação. Med (Ribeirao Preto Online). 2014;47(1):25. https://doi.org/10.11606/issn.2176-7262.v47i1p25-35. DOI: https://doi.org/10.11606/issn.2176-7262.v47i1p25-35
Rodríguez, Bárbara; Paris-Garcia, Federico. Influence of Dance Programmes on Gait Parameters and Physical Parameters of the Lower Body in Older People: A Systematic Review Int J Environ Res Public Health. 2022;19(3):1547. DOI: https://doi.org/10.3390/ijerph19031547
Lee P, Jackson E, Richardson C. Exercise prescriptions in older adults - american family physician. Am Fam Physician. 2017;95(7):425-32.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised european consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169. DOI: https://doi.org/10.1093/ageing/afz046
Pagotto, VI; Ferreira dos Santos, KI; Gomes Malaquias, SI; Bachion, MM; Silveira EA. Circunferência da panturrilha: validação clínica para avaliação de massa muscular em idosos. Rev Bras Enferm. 2018;71(2):343-50. https://doi.org/10.1590/0034-7167-2017-0121. DOI: https://doi.org/10.1590/0034-7167-2017-0121
Kwak Y, Kim Y. Quality of life and subjective health status according to handgrip strength in the elderly: a cross-sectional study. Aging Ment Health. 2019; 23(1):107-1. DOI: https://doi.org/10.1080/13607863.2017.1387766
Souza LA, Tavares DMS. Desempenho físico e força de preensão manual como preditores de qualidade de vida de idosos. Acta Fisiatr. 2021;28(3):149-55. DOI: https://doi.org/10.11606/issn.2317-0190.v28i3a185905
Valenzuela PL, Morales JS, Castillo-García A, Mayordomo-Cava J, García-Hermoso A, Izquierdo M, et al. Effects of exercise interventions on the functional status of acutely hospitalised older adults: asystematic review and meta-analysis. Ageing Res Rev. 2020;61(March):101076. https://doi.org/10.1016/j.arr.2020.101076. DOI: https://doi.org/10.1016/j.arr.2020.101076
Klinge, M. et al. Readmission of older acutely admitted medical patients after short-term admissions in Denmark: a nationwide cohort study. BMC geriatrics. 2020;20(1):1-10. DOI: https://doi.org/10.1186/s12877-020-01599-4
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 PAJAR - Pan American Journal of Aging Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
The submission of originals to PAJAR implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite PAJAR as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
