BACKGROUND: Post-ward geriatric rehabilitation programs have hardly been developed and validated, which leaves a substantial gap in rehabilitative care in older adults and hinders full exploitation of maintained, but often unrecognized rehabilitation potentials. Geriatric rehabilitation patients with cognitive impairment represent a highly vulnerable population which is often affected by a lack of an ongoing support at the intersection between ward-based and post-ward rehabilitation. OBJECTIVE: To determine the effect of a standardized home-based training program in geriatric patients with cognitive impairment following ward-based rehabilitation. METHODS: A randomized controlled, single-blinded intervention trial (RCT) with wait list control design was used. Geriatric patients (n = 34; age 81.9 +/- 5.7 years) with cognitive impairment (MMSE 18.8 +/- 4.7), identified by predefined in- and exclusion criteria, were consecutively recruited from a geriatric rehab ward. Patients in the intervention group (IG, n = 17) performed a 6-week strength and functional home training. The control group (CG, n = 17) started an identical training 6 weeks later with an initial usual care period during the intervention for the IG. Functional performance (Short Physical Performance Battery; SPPB), clinically relevant functional deficits (Performance Oriented Assessment; POMA), and physical activity (Assessment of Physical Activity For Older Persons questionnaire; APAFOP) represented primary outcome measurements complemented by additional secondary outcome parameters. RESULTS: The IG significantly increased functional performances in SPPB (total score p = 0.012; chair rise p = 0.007, balance p = 0.066), reduced gait and balance deficits in POMA (total score p = 0.006; balance p = 0.034; gait p = 0.019), and increased physical activity (APAFOP; p = 0.05) compared to the CG. Effect sizes showed medium to large effects for significant parameters (Eta2 = 0.14 to 0.45). Training benefits and adherence were more pronounced following the immediate onset of post-ward training compared to a delayed start (Eta2 = 0.06 to 0.23). CONCLUSION: Results of this pilot study show that a feasible and easy to handle, home-based rehabilitation program increased functional performance and physical activity in a vulnerable, multimorbid patient group with cognitive impairment, in particular when the post-ward training onset was not postponed.

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