Factors associated with improved walking in older people during hospital rehabilitation: secondary analysis of a randomized controlled trial

Catherine M. Said, Jennifer L. McGinley, Cassandra Szoeke, Barbara Workman, Keith D. Hill, Joanne E. Wittwer, Michael Woodward, Danny Liew, Leonid Churilov, Julie Bernhardt, Meg E. Morris

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Older people are often admitted for rehabilitation to improve walking, yet not everyone improves. The aim of this study was to determine key factors associated with a positive response to hospital-based rehabilitation in older people. Methods: This was a secondary data analysis from a multisite randomized controlled trial. Older people (n= 198, median age 80.9 years, IQR 76.6- 87.2) who were admitted to geriatric rehabilitation wards with a goal to improve walking were recruited. Participants were randomized to receive additional daily physical therapy focused on mobility (n = 99), or additional social activities (n = 99). Self-selected gait speed was measured on admission and discharge. Four participants withdrew. People who changed gait speed ≥0.1 m/s were classified as ‘responders’ (n = 130); those that changed <0.1m/s were classified as ‘non-responders’ (n = 64). Multivariable logistic regression explored the association of six pre-selected participant factors (age, baseline ambulation status, frailty, co-morbidities, cognition, depression) and two therapy factors (daily supervised upright activity time, rehabilitation days) and response. Results: Responding to rehabilitation was associated with the number of days in rehabilitation (OR 1.04; 95% CI 1.00 to 1.08; p =.039) and higher Mini Mental State Examination scores (OR 1.07, 95% CI 1.00 – 1.14; p =.048). No other factors were found to have association with responding to rehabilitation. Conclusion: In older people with complex health problems or multi-morbidities, better cognition and a longer stay in rehabilitation were associated with a positive improvement in walking speed. Further research to explore who best responds to hospital-based rehabilitation and what interventions improve rehabilitation outcomes is warranted. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12613000884707; ClinicalTrials.gov Identifier NCT01910740.

Original languageEnglish
Article number90
Number of pages8
JournalBMC Geriatrics
Volume21
Issue number1
DOIs
Publication statusPublished - 31 Jan 2021

Keywords

  • Aged
  • Aged, 80 and over
  • Exercise therapy
  • Hospitalization
  • Mobility limitation
  • Rehabilitation

Cite this