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Table 2 Setting and study characteristics physical functioning

From: Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review

Study Population & Setting Intervention Time of assessment  
     (I)ADL Physical Performance Mortality (%) LOS (days) Discharge ICF (%)
Multidisciplinary care with an exercise component       
Asplund 2000 [17] Intervention (n=190) Multidisciplinary team, with physical and occupational therapy. Discharge planning and early rehabilitation. T0 Admission BI ≥ 19 points NA T1 4.2 5.9* T1 11.6
Mean age 80.9 years T1 Discharge T0 52% T2 11.1   T2 11.6
58% female, AGU, UH T2 3 months post-discharge T2 44%
  Control (n=223) General medical unit care   BI ≥ 19 points   T1 2.7 7.3* T1 19.3
Mean age 81.0 years T0 44% T2 7.6   T2 18.4
63% female, MU, UH T2 43%
Counsell 2000 [19] Intervention (n=767) † Multidisciplinary team, with daily assessment of physical functioning and protocols to improve self-care and mobility. Early discharge planning. T0 2 weeks pre-admission ADL decline PPME score T1 2.7 6.1 T1 12.9
Mean age 80 years T1 Discharge T1 30% T1 5.6* T2 9.0 T2 10.3
60% female, CH T2 1 months post-discharge T2 27% T3 15.9 T3 8.9
T3 3 months post-discharge T3 26% T4 22.6 T4 7.5
T4 6 months post-discharge T4 22% T5 31.4 T5 6.7
T5 1 year post-discharge T5 25%
  Control (n=764) † Usual physician and nursing staff care   ADL decline PPME score T1 3.7 6.3 T1 15.6
Mean age 79 years T1 34% T1 5.0* T2 11.3 T2 10.1
61% female, CH T2 29%
T3 26% T3 17.4 T3 7.2
T4 30%
T5 30% T4 22.5 T4 8.0
T5 29.2 T5 7.3
Landefeld 1995 [24] Intervention (n=327) Multidisciplinary program, with daily assessment of physical functioning and protocols to improve self-care and mobility T0 Admission ADL score: NA T1 7.3 7.3 T1 5.8*
Mean age 80.2 years T1 Discharge T0 3.0 T2 20.8   T2 13.1*
68% female, MU, CH T2 3 months post-discharge T1 3.6*
T2 4.0
IADL score:
T0 2.8
T1 3.3*
T2 3.9
  Control (n=324) Usual care services provided by physicians and nurses   ADL score:   T1 7.4 8.3 T1 11.7*
Mean age 80.1 years T0 3.0 T2 19.8 T2 18.8*
65% female, MU, CH
T2 3.8
IADL score:
T0 2.8
T2 3.8
Saltvedt 2002 [26, 27] Intervention (n=127) † Interdisciplinary program to prevent complications, with early mobilization, rehabilitation and discharge planning T0 Admission ADL dependence NA T1 11.8* 15* NA
Mean age 81.8 years T1 3 months post-discharge T1 21%   T3 26.8*
81% female, GU, UH T2 6 months post-discharge T2 13%
T3 1 year post-discharge T3 25%
IADL dependence
T1 46%
T2 44%
T3 45%
  Control (n=127) † Usual care   ADL dependence   T1 27.6* 7*  
Mean age 82.4 years T1 12% T2 33.9*
84% female, MU, UH T2 13%
T3 23%
IADL dependence
T1 39%
T2 40%
T3 44%
Slaets 1997 [29] Intervention (n=140) Multidisciplinary program added to the usual care. Geriatrician, physiotherapist and liaison nurse obtained optimal ADL and mobility in 2 hours training a day. T0 Admission Improved ADL Improved mobility NA 19.7* T2 18*
Mean age 82.5 years T1 Discharge T1 61%* T1 48%*
67% female , MU, CH T2 1 year post-discharge
  Control (n=97) Usual care: services provided by physicians and nurses.   Improved ADL Improved mobility   24.8* T2 27*
Mean age 83.2 years T1 46%* T1 44%*
75% female, MU, CH
Usual care programs with an exercise intervention       
Abinzanda 2011 [16] Intervention (n=198) Conventional treatment plus occupational therapy: 5 days per week, 30 - 45 min a day T0 Admission 55.6% improved ≥ 10 BI points NA T1 7.6 9.1 NA
Mean age 83.7 years T1 Discharge
56.6% female, AGU, UH
  Control (n=202) Conventional treatment: medical treatment, nursing care, physical therapy, and social assistance according with the usual practice of the unit.   36.7% improved ≥ 10 BI points   T1 11.9 8.7  
Mean age 83.3 years
56.9% female, AGU, UH
Blanc-Bisson 2008 [18] Intervention (n=38) Usual care plus early intensive physical therapy program: start day 1-2, strength training twice a day half an hour, 5 days a week until T1 T0 Admission Mean Katz index NA T1 5.3 T1 12.6 NA
Mean age 85.5 years T1 Clinical stability T0 6.7 T2 7.9
66% female, AGU, UH T2 1 month after clinical stability T1 5.3
T2 4.5
  Control (n=38) Usual care: transferred to arm-chair asap. Start day 3-6 walking 3 times a week with human help or without assistance. Physical therapy at home for 1 month   Mean Katz index   T1 5.3 T1 12.6  
Mean age 85.4 years T0 6.0 T1 5.3
79% female, AGU, UH T1 4.7
T2 3.0
Courtney 2009 [20, 21] Intervention (n=64) † Individual exercise program and nursing visits, performed daily or several times a week. The intervention continued at home with home visits and regular telephone follow-up by a nurse. T0 Admission ADL: Mean score WIQ distance* T1 1.6 4.6 NA
Mean age 78.1 years T1 4 weeks post-discharge index of ADL* T0 23.54 T2 3.1
62% female, MU, CH T2 12 weeks post-discharge T0 0.36 T1 53.62 T3 3.1
T3 24 weeks post-discharge T1 0.07 T2 54.83
T2 0.18 T3 62.89
T3 0.16 WIQ speed*
IADL: Mean IADL scale* T0 16.21
T0 2.16 T1 41.30
T1 1.47 T2 44.62
T2 1.27 T3 48.56
T3 1.13 WIQ stairs*
T0 27.70
T1 46.73
T2 51.23
T3 57.20
  Control (n=64) † Routine care, discharge planning and rehabilitation advice. If necessary, in-home follow-up.   ADL: Mean score index of ADL* WIQ distance* T1 4.7 4.7  
Mean age 79.4 years T0 0.35 T0 20.22 T2 4.7
63% female, MU, CH T1 0.69 T1 28.90 T3 4.7
T2 0.75 T2 21.59
T3 1.27 T3 19.93
IADL: Mean IADL scale* WIQ speed*
T0 2.62 T0 14.43
T1 3.29 T1 22.09
T2 3.56 T2 17.89
T3 4.33 T3 16.58
WIQ stairs*
T0 24.12
T1 26.06
T2 24.40
T3 22.18
De Morton 2007 [22] Intervention (n=110) † Usual care plus an individual exercise program. Twice daily, 5 days a week, for 20-30 minutes. T0 Admission Mean BI: Mean TUG (s): T1 1.8 5.0 T1 18.2
Mean age 78 years T1 Discharge T0 66 T0 35
54% female, MU, ACH T1 79 T1 36
Mean FAC:
T0 4.0
T1 4.8
  Control (n=126) † Usual care: daily medical assessment, 24 hour nursing assistance, and allied health service on referral from medical, nursing or other allied health staff.   Mean BI: Mean TUG (s): T1 1.6 6.0 T1 20.6
Mean age 80 years T0 68 T0 30
56% female, MU, ACH T1 75 T1 26
Mean FAC:
T0 3.9
T1 4.7
Jones 2006 [23] Intervention (n=80) † Usual care plus an individual exercise program Twice daily for approximately 30 minutes. T0 Admission T1 Discharge Mean change mBI: 11 points Mean change TUG: 5.4 sec* T1 5.0 9 T1 32.5
Mean age 81.9 years
54% female, MU, ACH
  Control (n=80) † Usual care: medical, nursing and allied health intervention and discharge planning consistent with the patient’s diagnosis and resources available on the acute general medical wards.   Mean change mBI: 9 points Mean change TUG: 1.2 sec* T1 2.5 11 T1 51.3
Mean age 82.9 years
61% female, MU, ACH
Laver 2012 [14] Intervention (n=22) Individual interactive video game program (Wii Fit) 25 min/day, 5 days/week supervised by a physiotherapist T0 Admission IADL TUG T1 0 12.3 NA
Mean age 85.2 years T1 Discharge T0 181 T0 38
86% female GU, ACH T1 205 T1 28
  Control (n=22) Conventional physiotherapy, matching the patients abilities and treatment needs 25 min/day, 5 days/week   IADL TUG T1 0 14.95 NA
Mean age 84.6 years T0 141 T0 35
73% female GU, ACH T1 190 T1 29
Nikolaus 1999 [25] Intervention with follow-up (n=181) † In-hospital and post-discharge follow-up treatment by an interdisciplinary team. Physical or occupational therapy twice a week up to twice a day for 30 min T0 Admission Mean BI score: NA T2 18.2 33.5* T1 4.4*
Mean age 81.4 years T1 Discharge T0 71.0 T2 16.6
Female 73.4%, GU, UH T2 1 year post-discharge T1 91.8
T2 81.2
Mean LB score:
T1 5.7
T2 5.6*
  Intervention without follow-up (n=179) † In-hospital treatment by an interdisciplinary team, followed by usual care at home   Mean score BI:   T2 16.8 40.7* T1 7.3*
Mean age 81.4 years T0 71.0 T2 18.4
Female 73.4%, GU, UH T1 92.6
T2 82.3
Mean LB score:
T1 5.5
T2 4.1*
  Control (n=185) † Usual care in hospital   Mean score BI:   T2 17.3 42.7* T1 8.1*
Mean age 81.4 years T0 71.0 T2 22.7
Female 73.4%, GU, UH T1 91.1
T2 80.9
Mean LB score:
T1 5.5
T2 4.3
Siebens 2000 [28] Intervention (n=149) † Hospital-based exercise program twice a day. Encouragement to continue the program at home T0 2 weeks pre-admission Mean number of independent IADL Independent walking T1 6.7 12.0 NA
Mean age 78.2 years T1 1 month post-discharge T0 5.3 T0 59.7%
62% female, ACH T1 5.1* T1 64.2%
  Control (n=151) † Usual care   Mean number of IADL independence Independent walking T1 6.6 10.5  
Mean age 78.5 years T0 5.3 T0 50.3%
59% female, ACH T1 4.6* T1 65.5%
  1. † = included only community dwelling old adults; ADL= Activities of Daily Living; IADL= Instrumental Activities of Daily Living; ICF=Intramural Care Facility; AGU=Acute Geriatric Unit; GU=Geriatric Unit; MU=Medical Unit; UH=University Hospital; CH=City Hospital; ACH=Acute Care Hospital; * = significant (p > 0.05); PPME=Physical Performance and Mobility Examination; WIQ=Walking Impairment Questionnaire; TUG=Timed Up and Go; FAC=Functional ambulation classification; NA=not available.