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Managing Mobility Outcomes in Vulnerable Seniors (MMOVeS): a randomized controlled pilot study [with consumer summary]
Figueiredo S, Morais JA, Mayo N
Clinical Rehabilitation 2017 Dec;31(12):1604-1615
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; 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 estimate feasibility and potential for efficacy of an individualized, exercise-focused, self-management program (ie, Managing Mobility Outcomes In Vulnerable Seniors (MMOVeS)), in comparison to exercise information in improving mobility after six months among seniors recently discharged from hospital. DESIGN: Randomized pilot study. SETTING: Two McGill University-teaching hospitals. SUBJECTS: Community dwelling seniors, aged 70 years and older, recently discharged from either participating hospitals. INTERVENTIONS: The physiotherapy-facilitated intervention consisted of (1) evaluation of mobility capacity, (2) setting short- and long-term goals, (3) delineation of an exercise treatment plan, (4) an educational booklet to enhance mobility self-management skills, and (5) six monthly telephone calls. Control group received a booklet with information on exercises targeting mobility limitations in seniors. MAIN MEASURES: Mobility, pain, and health status were assessed at baseline and at six months using multiple indicators drawn from Disabilities of the Arm, Shoulder, and Hand (DASH) Score, Lower Extremity Functional Scale (LEFS) and Short-Form (SF)-36. RESULTS: In all, 26 people were randomized to the intervention (mean age 81 +/- 8; 39% women), and 23 were randomized to the control (mean age 79 +/- 7; 33% women). The odds ratio for the mobility outcomes combined was 3.08 and the 95% confidence interval excluded 1 (1.65 to 5.77). The odds ratio for pain and health perception favored the MMOVeS group, but the 95% confidence interval included the null value. CONCLUSIONS: This feasibility study highlights the potential for efficacy of an individualized, exercise-focused, self-management program in comparison to exercise information in improving mobility outcome for seniors. Furthermore, a home-program combining self-management skills and exercise taught with minimal supervision prove to be feasible. Finally, data from this study can be used to estimate sample size for a confirmatory trial.

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