Title
The effectiveness of functional task exercise and physical therapy as prevention of functional decline in community dwelling older people with complex
Author
Siemonsma, P.C.
Blom, J.W.
Hofstetter, H.
van Hespen, A.T.H.
Gussekloo, J.
Drewes, Y.M.
van Meeteren, N.L.U.
Publication year
2018
Abstract
Background: A physically active lifestyle in older people contributes to the preservation of good health. We assessed the influence of physiotherapy on daily functioning among community dwelling older people (75+) with complex health problems identified with screening, versus usual care. We also compared functional task exercise (FTE), with problems prioritized by older people, trained in the home environment, versus usual preventive physical therapy (PPT). Methods: Design: FTE and PPT were compared in a randomized controlled trial (RCT). Both interventions were compared with daily functioning in an observational study: control group. Setting/participants: Community-dwelling persons aged ≥75 years with daily activity limitations enlisted in 83 general practices (n = 155). Interventions: Both intervention groups (FTE, n = 76 and PPT, n = 79) received individual, 30 min treatments. The control group (n = 228) did not get any experimental intervention offered.Measurement: Groningen Activities of Daily Living Restriction Scale (GARS). Statisti analyses: Linear Mixed Model analysis, correcting for age, sex, baseline scores and clustering by physiotherapist were used to compare the different groups. Results: At baseline, 74% percent of the intervention trial group was female vs 79% in the control group. Median ages were 83.9 and 84.7 respectively. The median baseline GARS-score for the control group was 41.0 (25 and 75 percentile): 35.0; 48.0) and 40.0 (25 and 75 percentile: 32.3; 46.0) for the intervention group (FTE + PPT). The mean change over time was 3.3 (2.5; 4.1) for the control group. Mean difference in change over time between the intervention (FTE + PPT) and the control group was - 2.5 (- 4.3; - 0.6) (p = .009). Between FTE and PPT the difference in change was - 0.4 (95% CI: -2.3; 3.0, p = 0.795). Conclusion: An exercise intervention led by physiotherapists may slow down decline in self-reported daily functioning in older persons with daily activity limitations, identified by pro-active case finding.
Subject
ELSS - Earth, Life and Social Sciences
Life
Exercise
Functional training
Older people
Aged
Case finding
Controlled study
Daily life activity
Female
General practice
Home environment
Human
Human experiment
Intervention study
Major clinical study
Male
Netherlands
Observational study
Physiotherapist
Physiotherapy
Prevention
Randomized controlled trial
Registration
Statistical analysis
Very elderly
CH - Child Health
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http://resolver.tudelft.nl/uuid:17d361a4-300f-4e6a-a786-b663fb341c78
DOI
https://doi.org/10.1186/s12877-018-0859-3
TNO identifier
812902
Source
BMC Geriatrics, 18 (18)
Document type
article