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| A prehabilitation program for the prevention of functional decline: effect on higher-level physical function |
| Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, van Ness PH |
| Archives of Physical Medicine and Rehabilitation 2004 Jul;85(7):1043-1049 |
| clinical trial |
| 6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; 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: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To determine whether a home-based physical therapy (PT) program prevented decline in several higher-level measures of physical function among physically frail, community-living older persons. DESIGN: Randomized controlled trial. SETTING: General community. PARTICIPANTS: Persons (N = 188) who were physically frail and aged 75 years or older. INTERVENTION: A home-based PT program (ie, prehabilitation) that focused primarily on improving underlying impairments in physical capabilities. MAIN OUTCOME MEASURES: Self-reported instrumental activities of daily living (IADLs); mobility, as determined by a modified version of the Performance Oriented Mobility Assessment; timed rapid gait and timed chair stands; and integrated physical performance, as determined by a modified version of the Physical Performance Test, were assessed at baseline, 7 months, and 12 months. RESULTS: As compared with participants in the educational control group, participants in the intervention group had reductions in IADL disability of 17.7% at 7 months (p = 0.036) and 12.0% at 12 months (p = 0.143) and had gains, ranging from 7.2% to 15.6%, in mobility and integrated physical performance at 7 and 12 months. CONCLUSIONS: Our home-based prehabilitation program offered modest but consistent benefits for the prevention of decline in several higher-level measures of physical function.
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