Effects of standardized home training in patients with cognitive impairment following geriatric rehabilitation: A randomized controlled pilot study

Gerontology | August 18, 2017

Hauer K, et al. – This study investigated the impact of a standardized home–based training program in geriatric patients with cognitive impairment following ward–based rehabilitation. Findings showed an increment in functional performance and physical activity in a vulnerable, multimorbid patient group with cognitive impairment who participated in a feasible and easy to handle home–based rehabilitation program; these benefits were seen in particular when the post–ward training onset was not postponed.

Methods

  • Researchers performed a randomized controlled, single-blinded intervention trial (RCT) with wait list control design.  
  • They consecutively recruited 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, from a geriatric rehab ward.
  • They asked patients in the intervention group (IG, n = 17) to perform 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

  • Findings demonstrated that 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.
  • Data revealed that effect sizes showed medium to large effects for significant parameters (eta2 = 0.14-0.45).
  • Researchers noted that training benefits and adherence were more pronounced following the immediate onset of post-ward training compared to a delayed start (eta2 = 0.06-0.23).

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