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Home training with and without additional group training in physically frail old people living at home: effect on health-related quality of life and ambulation [with consumer summary] |
Helbostad JL, Sletvold O, Moe-Nilssen R |
Clinical Rehabilitation 2004 Aug;18(5):498-508 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To test the effect of two exercise regimes on health-related quality of life (HRQoL) and ambulatory capacity. DESIGN: Randomized controlled trial. SUBJECTS: Seventy-seven community-dwelling physically frail people over 75 years of age (mean 81, SD 4.5). INTERVENTIONS: Home training (HT, N = 38) comprised twice daily functional balance and strength exercises and three group meetings. Combined training (CT, N = 39) included group training twice weekly and the same home exercises. Interventions lasted 12 weeks. Physiotherapists ran both programmes. Home exercises were recorded daily. MAIN MEASURES: HRQoL was assessed by SF-36, and ambulatory capacity by walking speed and frequency and duration of outdoor walks. RESULTS: Following intervention, CT improved the SF-36 mental health index significantly more than HT (p = 0.01). The SF-36 physical health index (p = 0.002) and walking speed (p = 0.02) demonstrated improvements, but no group differences. Six months after cessation of intervention there was still overall improvements on the mental health index (p = 0.032), borderline overall improvements on the physical health index (p = 0.057), higher weekly number of outdoor walks for the CT group than for the HT group (p = 0.027) and an improved habitual walking speed in the CT group only (p = 0.022). CONCLUSIONS: HT improved HRQoL and walking speed, but additional group training gave larger benefits on mental health. Group training away from home may be beneficial for mental health and ambulatory capacity.
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