Effects of a home-based rehabilitation program in community-dwelling older people after discharge from hospital : a subgroup analysis of a randomized controlled trial
Year of publication
2021
Authors
Turunen, Katri Maria; Aaltonen-Määttä, Laura; Portegijs, Erja; Rantalainen, Timo; Keikkala, Sirkka; Kinnunen, Marja-Liisa; Sipilä, Sarianna; Nikander, Riku
Abstract
Objective: To examine whether pre-admission community mobility explains the effects of a rehabilitation program on physical performance and activity in older adults recently discharged from hospital. Design: A secondary analysis of a randomized controlled trial. Setting: Home and community. Participants: Community-dwelling adults aged ⩾60 years recovering from a lower limb or back injury, surgery or other disorder who were randomized to a rehabilitation (n = 59) or standard care control (n = 58) group. They were further classified into subgroups that were not planned a priori: (1) mild, (2) moderate, or (3) severe pre-admission restrictions in community mobility. Interventions: The 6-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counselling, and standard care. Measurements: Physical performance was measured with the Short Physical Performance Battery and physical activity with accelerometers and self-reports. Data were analysed by generalized estimating equation models with the interactions of intervention, time, and subgroup. Results: Rehabilitation improved physical performance more in the intervention (n = 30) than in the control group (n = 28) among participants with moderate mobility restriction: score of the Short Physical Performance Battery was 4.4 ± 2.3 and 4.2 ± 2.2 at baseline, and 7.3 ± 2.6 and 5.8 ± 2.9 at 6 months in the intervention and control group, respectively (mean difference 1.6 points, 95% Confidence Interval 0.2 to 3.1). Rehabilitation did not increase accelerometer-based physical activity in the aforementioned subgroup and did not benefit those with either mild or severe mobility restrictions. Conclusions: Pre-admission mobility may determine the response to the largely counselling-based rehabilitation program.
Show moreOrganizations and authors
University of Eastern Finland
Kinnunen Marja-Liisa
Publication type
Publication format
Article
Parent publication type
Journal
Article type
Original article
Audience
ScientificPeer-reviewed
Peer-ReviewedMINEDU's publication type classification code
A1 Journal article (refereed), original researchPublication channel information
Journal
Volume
35
Issue
9
Pages
1257-1265
ISSN
Publication forum
Publication forum level
2
Open access
Open access in the publisher’s service
Yes
Open access of publication channel
Partially open publication channel
Self-archived
Yes
Other information
Fields of science
Health care science; Public health care science, environmental and occupational health; Sport and fitness sciences
Keywords
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Internationality of the publisher
International
Language
English
International co-publication
No
Co-publication with a company
Yes
DOI
10.1177/02692155211001672
The publication is included in the Ministry of Education and Culture’s Publication data collection
Yes