TY - JOUR

T1 - Improved Functional Performance in Geriatric Patients During Hospital Stay

AU - Karlsen, Anders

AU - Loeb, Mads Rohde

AU - Andersen, Kristine Bramsen

AU - Joergensen, Katrine Jeong

AU - Scheel, Frederik Ulrik

AU - Turtumoeygard, Ida Fanny

AU - Perez, Alberto Luis Rodrigues

AU - Kjaer, Michael

AU - Beyer, Nina

PY - 2017

Y1 - 2017

N2 - OBJECTIVE: The aim of this work was to evaluate the time course of changes in strength and functional performance in elderly hospitalized medical patients.DESIGN: This was a prospective observational study in elderly medical patients of age 65 years or older at a geriatric department.Measurements were obtained on days 2 to 4, day 5 to 8, and days 9 to 13. Functional performance was measured with De Morton Mobility Index (DEMMI) test and a 30-second chair stand test (30-s CST). Muscular strength was measured with handgrip strength. Activity level was determined with accelerometry (ActivPAL).RESULTS: Results in DEMMI and 30-s CST gradually improved (P < 0.05), whereas handgrip strength remained unchanged (P > 0.05). Larger functional improvements were observed in patients with "high" compared to "low" and "moderate" activity level (P < 0.05). Changes in DEMMI score correlated with changes in 30-s CST (P < 0.05); however, changes in DEMMI score and 30-s CST were more likely to occur in patients with a low versus high functional level, respectively.CONCLUSIONS: Functional performance of the lower extremities in geriatric patients improves moderately over the time of a hospital stay of less than 14 days, with larger improvements in patients with high activity level. The DEMMI test and the 30-s CST seem to be complementary to each other when evaluating functional changes in a geriatric hospital population.TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) describe changes in mobility and muscle strength of geriatric patients during a hospital stay of less than 14 days, (2) understand the significance of physical activity during hospital admission in geriatric patients, and (3) discuss the potential limitations of measures for assessing mobility and lower extremity strength status and change during a hospital admission.LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AB - OBJECTIVE: The aim of this work was to evaluate the time course of changes in strength and functional performance in elderly hospitalized medical patients.DESIGN: This was a prospective observational study in elderly medical patients of age 65 years or older at a geriatric department.Measurements were obtained on days 2 to 4, day 5 to 8, and days 9 to 13. Functional performance was measured with De Morton Mobility Index (DEMMI) test and a 30-second chair stand test (30-s CST). Muscular strength was measured with handgrip strength. Activity level was determined with accelerometry (ActivPAL).RESULTS: Results in DEMMI and 30-s CST gradually improved (P < 0.05), whereas handgrip strength remained unchanged (P > 0.05). Larger functional improvements were observed in patients with "high" compared to "low" and "moderate" activity level (P < 0.05). Changes in DEMMI score correlated with changes in 30-s CST (P < 0.05); however, changes in DEMMI score and 30-s CST were more likely to occur in patients with a low versus high functional level, respectively.CONCLUSIONS: Functional performance of the lower extremities in geriatric patients improves moderately over the time of a hospital stay of less than 14 days, with larger improvements in patients with high activity level. The DEMMI test and the 30-s CST seem to be complementary to each other when evaluating functional changes in a geriatric hospital population.TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) describe changes in mobility and muscle strength of geriatric patients during a hospital stay of less than 14 days, (2) understand the significance of physical activity during hospital admission in geriatric patients, and (3) discuss the potential limitations of measures for assessing mobility and lower extremity strength status and change during a hospital admission.LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

KW - Accelerometry/instrumentation

KW - Aged

KW - Aged, 80 and over

KW - Denmark

KW - Exercise

KW - Female

KW - Hand Strength

KW - Hospitalization

KW - Humans

KW - Male

KW - Mobility Limitation

KW - Prospective Studies

U2 - 10.1097/PHM.0000000000000671

DO - 10.1097/PHM.0000000000000671

M3 - Journal article

C2 - 28045706

VL - 96

SP - e78-e84

JO - American Journal of Physical Medicine and Rehabilitation

JF - American Journal of Physical Medicine and Rehabilitation

SN - 0894-9115

IS - 5

ER -