TY - JOUR AU - Sherrington Catherine AU - O'Rourke S. AU - Barraclough E. AU - Clemson L. AU - Vogler C. AU - Dean C. AU - Ramsay E. AU - Lord S. AU - Howard K. AU - Cumming R. AU - Herbert R. AU - Close J. AU - Heller G. AB -

BACKGROUND: Home exercise can prevent falls in the general older community but its impact in people recently discharged from hospital is not known. The study aimed to investigate the effects of a home-based exercise program on falls and mobility among people recently discharged from hospital. METHODS AND FINDINGS: This randomised controlled trial (ACTRN12607000563460) was conducted among 340 older people. Intervention group participants (n = 171) were asked to exercise at home for 15-20 minutes up to 6 times weekly for 12 months. The control group (n = 169) received usual care. Primary outcomes were rate of falls (assessed over 12 months using monthly calendars), performance-based mobility (Lower Extremity Summary Performance Score, range 0-3, at baseline and 12 months, assessor unaware of group allocation) and self-reported ease of mobility task performance (range 0-40, assessed with 12 monthly questionaries). Participants had an average age of 81.2 years (SD 8.0) and 70% had fallen in the past year. Complete primary outcome data were obtained for at least 92% of randomised participants. Participants in the intervention group reported more falls than the control group (177 falls versus 123 falls) during the 12-month study period and this difference was statistically significant (incidence rate ratio 1.43, 95% CI 1.07 to 1.93, p = 0.017). At 12-months, performance-based mobility had improved significantly more in the intervention group than in the control group (between-group difference adjusted for baseline performance 0.13, 95% CI 0.04 to 0.21, p = 0.004). Self-reported ease in undertaking mobility tasks over the 12-month period was not significantly different between the groups (0.49, 95% CI -0.91 to 1.90, p = 0.488). CONCLUSIONS: An individualised home exercise prescription significantly improved performance-based mobility but significantly increased the rate of falls in older people recently discharged from hospital. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12607000563460.

AD - The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia; Department of Aged Care and Rehabilitation, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Randwick, New South Wales, Australia.
School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Department of Health Professions, Faculty of Human Sciences, Macquarie University, Macquarie Park, NSW, Australia.
Department of Statistics, Macquarie University, Macquarie Park, New South Wales, Australia.
Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia. AN - 25180702 BT - PLoS One C2 - PMC4152130 DP - NLM ET - 2014/09/03 LA - eng LB - MSK M1 - 9 N1 - Sherrington, Catherine
Lord, Stephen R
Vogler, Constance M
Close, Jacqueline C T
Howard, Kirsten
Dean, Catherine M
Heller, Gillian Z
Clemson, Lindy
O'Rourke, Sandra D
Ramsay, Elisabeth
Barraclough, Elizabeth
Herbert, Robert D
Cumming, Robert G
United States
PLoS One. 2014 Sep 2;9(9):e104412. doi: 10.1371/journal.pone.0104412. eCollection 2014. N2 -

BACKGROUND: Home exercise can prevent falls in the general older community but its impact in people recently discharged from hospital is not known. The study aimed to investigate the effects of a home-based exercise program on falls and mobility among people recently discharged from hospital. METHODS AND FINDINGS: This randomised controlled trial (ACTRN12607000563460) was conducted among 340 older people. Intervention group participants (n = 171) were asked to exercise at home for 15-20 minutes up to 6 times weekly for 12 months. The control group (n = 169) received usual care. Primary outcomes were rate of falls (assessed over 12 months using monthly calendars), performance-based mobility (Lower Extremity Summary Performance Score, range 0-3, at baseline and 12 months, assessor unaware of group allocation) and self-reported ease of mobility task performance (range 0-40, assessed with 12 monthly questionaries). Participants had an average age of 81.2 years (SD 8.0) and 70% had fallen in the past year. Complete primary outcome data were obtained for at least 92% of randomised participants. Participants in the intervention group reported more falls than the control group (177 falls versus 123 falls) during the 12-month study period and this difference was statistically significant (incidence rate ratio 1.43, 95% CI 1.07 to 1.93, p = 0.017). At 12-months, performance-based mobility had improved significantly more in the intervention group than in the control group (between-group difference adjusted for baseline performance 0.13, 95% CI 0.04 to 0.21, p = 0.004). Self-reported ease in undertaking mobility tasks over the 12-month period was not significantly different between the groups (0.49, 95% CI -0.91 to 1.90, p = 0.488). CONCLUSIONS: An individualised home exercise prescription significantly improved performance-based mobility but significantly increased the rate of falls in older people recently discharged from hospital. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12607000563460.

PY - 2014 SN - 1932-6203 (Electronic)
1932-6203 (Linking) EP - e104412 T2 - PLoS One TI - A post-hospital home exercise program improved mobility but increased falls in older people: a randomised controlled trial VL - 9 ER -