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Improved Functional Performance in Geriatric Patients During Hospital Stay

Karlsen, Anders MSc; Loeb, Mads Rohde BS; Andersen, Kristine Bramsen BS; Joergensen, Katrine Jeong BS; Scheel, Frederik Ulrik BS; Turtumoeygard, Ida Fanny BS; Perez, Alberto Luis Rodrigues MD, DrM, Sci; Kjaer, Michael MD, DrM, Sci; Beyer, Nina PT, PhD

American Journal of Physical Medicine & Rehabilitation: May 2017 - Volume 96 - Issue 5 - p e78–e84
doi: 10.1097/PHM.0000000000000671
Original Research Articles CME Article . 2017 Series . Number 6

Objective: The aim of this work was to evaluate the time course of changes in strength and functional performance in elderly hospitalized medical patients.

Design: This was a prospective observational study in elderly medical patients of age 65 years or older at a geriatric department.

Measurements were obtained on days 2 to 4, day 5 to 8, and days 9 to 13. Functional performance was measured with De Morton Mobility Index (DEMMI) test and a 30-second chair stand test (30-s CST). Muscular strength was measured with handgrip strength. Activity level was determined with accelerometry (ActivPAL).

Results: Results in DEMMI and 30-s CST gradually improved (P < 0.05), whereas handgrip strength remained unchanged (P > 0.05). Larger functional improvements were observed in patients with “high” compared to “low” and “moderate” activity level (P < 0.05). Changes in DEMMI score correlated with changes in 30-s CST (P < 0.05); however, changes in DEMMI score and 30-s CST were more likely to occur in patients with a low versus high functional level, respectively.

Conclusions: Functional performance of the lower extremities in geriatric patients improves moderately over the time of a hospital stay of less than 14 days, with larger improvements in patients with high activity level. The DEMMI test and the 30-s CST seem to be complementary to each other when evaluating functional changes in a geriatric hospital population.

To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives: Upon completion of this article, the reader should be able to (1) describe changes in mobility and muscle strength of geriatric patients during a hospital stay of less than 14 days, (2) understand the significance of physical activity during hospital admission in geriatric patients, and (3) discuss the potential limitations of measures for assessing mobility and lower extremity strength status and change during a hospital admission.

Level: Advanced

Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

From the Department of Geriatrics, Bispebjerg Hospital, Denmark (AK, MRL, KBA, KJJ, FUS, IFT, ALRP); Department of Physical and Occupational Therapy, Bispebjerg Hospital, University of Copenhagen, Denmark (NB); Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Denmark (AK, MRL, KBA, KJJ, FUS, IFT, MK, NB); Center for Healthy Aging, University of Copenhagen, Denmark (AK, MK, NB); and Department of Biomedical Sciences, University of Copenhagen, Denmark (AK).

All correspondence and requests for reprints should be addressed to: Anders Karlsen, MSc, Department of Geriatrics and Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Bldg 3 (2nd Floor), Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.

The authors declare no competing interests. The authors also declare no financial benefits from the study.

No funding, grants, or equipment was provided for the project from any source.

Accepted in abstract form for the European Union Geriatric Medicine Society conference in Lisbon 2016, Portugal.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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