Factors associated with improved walking in older people during hospital rehabilitation: secondary analysis of a randomized controlled trial

Background Older people are often admitted for rehabilitation to improve walking, yet not everyone improves. The aim of this study was to determine key factors associated with a positive response to hospital-based rehabilitation in older people. Methods This was a secondary data analysis from a mult...

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Bibliographic Details
Published in:BMC geriatrics Vol. 21; no. 1; pp. 90 - 8
Main Authors: Said, Catherine M, McGinley, Jennifer L, Szoeke, Cassandra, Workman, Barbara, Hill, Keith D., Wittwer, Joanne E, Woodward, Michael, Liew, Danny, Churilov, Leonid, Bernhardt, Julie, Morris, Meg E
Format: Journal Article
Language:English
Published: London BioMed Central 31.01.2021
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Activities of Daily Living
Age
Aged
Aged patients
Aged, 80 and over
Aging
Australia
Care and treatment
Clinical trials
Cognition
Cognition & reasoning
Exercise
Exercise therapy
Frailty
Gait
Geriatrics
Geriatrics/Gerontology
Health aspects
Hospitalization
Hospitals
Humans
Intervention
Medicine
Medicine & Public Health
Mobility limitation
Morbidity
Older people
Patient outcomes
Physical functioning
physical health and activity
Physical therapy
Physical Therapy Modalities
Rehabilitation
Rehabilitation services
Research Article
Responsible persons
Treatment Outcome
Walking
Australia
Aged, 80 and over
Hospitalization
Aged
Rehabilitation
Mobility limitation
Exercise therapy
ISSN:1471-2318, 1471-2318
Online Access:Get full text
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Summary:Background Older people are often admitted for rehabilitation to improve walking, yet not everyone improves. The aim of this study was to determine key factors associated with a positive response to hospital-based rehabilitation in older people. Methods This was a secondary data analysis from a multisite randomized controlled trial. Older people (n= 198, median age 80.9 years, IQR 76.6- 87.2) who were admitted to geriatric rehabilitation wards with a goal to improve walking were recruited. Participants were randomized to receive additional daily physical therapy focused on mobility (n = 99), or additional social activities (n = 99). Self-selected gait speed was measured on admission and discharge. Four participants withdrew. People who changed gait speed ≥0.1 m/s were classified as ‘responders’ (n = 130); those that changed <0.1m/s were classified as ‘non-responders’ (n = 64). Multivariable logistic regression explored the association of six pre-selected participant factors (age, baseline ambulation status, frailty, co-morbidities, cognition, depression) and two therapy factors (daily supervised upright activity time, rehabilitation days) and response. Results Responding to rehabilitation was associated with the number of days in rehabilitation (OR 1.04; 95% CI 1.00 to 1.08; p = .039) and higher Mini Mental State Examination scores (OR 1.07, 95% CI 1.00 – 1.14; p = .048). No other factors were found to have association with responding to rehabilitation. Conclusion In older people with complex health problems or multi-morbidities, better cognition and a longer stay in rehabilitation were associated with a positive improvement in walking speed. Further research to explore who best responds to hospital-based rehabilitation and what interventions improve rehabilitation outcomes is warranted. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000884707; ClinicalTrials.gov Identifier NCT01910740 .
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ISSN:1471-2318
1471-2318
DOI:10.1186/s12877-021-02016-0