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May increase likelihood of being discharged home (Hospital Associated Deconditioning Evidence)

Evidence Summary

One Cochrane review has looked at exercise interventions, including when part of multidisciplinary interventions, in acutely admitted medical patients have shown a reduction in length of stay (LOS) in the intervention group compared to control [1].  Exercise interventions included walking, strength and balance training, education or a mixture of activities. In addition to exercise interventions, multidisciplinary interventions included geriatric wards, discharge planning and/or occupational therapy. Included RCTs were from Western Europe, US, Australasia and China.  The Cochrane review, which included meta-analysis, found the chances of being discharged to pre-admission residence / home was increased in the multicomponent intervention group (RR 1.08; 95% CI 1.03 to 1.14; 4 studies; 1675 participants).  When looking at exercise interventions alone the discharge destination was uncertain (RR 1.15; 95% CI 0.8 to 1.66; 2 studies, 380 participants)

Quality of Evidence

B- evidence from meta-analysis but uncertainty in evidence in exercise interventions alone

Strength of Recommendation

1 – Exercise interventions as part of multicomponent interventions of benefit, but effect of exercise alone unclear, risk of physical activity is low

Conclusion

Exercise interventions, as part of a multi-component intervention, may increase the proportion of patients discharged back to their preadmission residence / home. The effect of exercise interventions alone on discharge destination is uncertain.  Exercise interventions can be recommended to most people, in most circumstances, to try and increase chances of being discharged to their usual residence, but there is some uncertainty in the supporting evidence base.

References

1         De Morton NA, Keating JL, Jeffs K. Exercise for acutely hospitalised older medical patients. Cochrane Database Syst Rev Published Online First: 2007. doi:10.1002/14651858.CD005955.pub

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