학술논문

Effectiveness of home-based exercise for improving physical activity, quality of life and function in older adults after hospitalisation: A systematic review and meta-analysis.
Document Type
Article
Source
Clinical Rehabilitation. Sep2022, Vol. 36 Issue 9, p1170-1185. 16p.
Subject
*MEDICAL databases
*CINAHL database
*META-analysis
*CONFIDENCE intervals
*MEDICAL information storage & retrieval systems
*PHYSICAL therapy
*HOME care services
*SYSTEMATIC reviews
*ACTIVITIES of daily living
*HEALTH outcome assessment
*PATIENT readmissions
*PHYSICAL activity
*QUALITY of life
*HOSPITAL care
*DESCRIPTIVE statistics
*QUALITY assurance
*CHI-squared test
*PATIENT care
*MEDLINE
*DATA analysis software
*ODDS ratio
*DATA analysis
*SENSITIVITY & specificity (Statistics)
*DISCHARGE planning
*OLD age
Language
ISSN
0269-2155
Abstract
Objective: To determine if home-based exercise programmes for older adults after hospitalisation are effective at improving physical activity, quality of life, activities of daily living (ADL) and mobility compared to no intervention, standard care or centre-based exercise. Methods: Databases were searched from inception to March 2022. Randomised controlled trials which included home-based exercise in older adults recently discharged from hospital were included. The primary outcome was physical activity. Secondary outcomes were quality of life, ADL performance, mobility, adverse events and hospital readmissions. Two reviewers independently selected relevant studies and extracted data. Quantitative synthesis with meta-analyses using a random-effects model and qualitative synthesis were performed. Results: Ten trials (PEDro score 6-8) were included. Three trials reported on physical activity but meta-analysis was not possible due to heterogeneity. Home-based exercise was more effective than no intervention at improving ADL performance (SMD 0.60, 95% CI 0.03 to 1.17); and standard care at improving quality of life (SMD 0.30, 95% CI 0.11 to 0.49) and mobility (SMD 0.23, 95% CI 0.00 to 0.45). Few and minor adverse events were associated with home-based exercise. Conclusion: Based on individual trials, home-based exercise has the potential to improve physical activity compared to no intervention or standard care. Meta-analyses indicate that home-based exercise is more effective than no intervention at improving activities of daily living performance, and standard care at improving mobility and quality of life. It is unclear if home-based exercise is more effective than centre-based exercise at improving these outcomes. [ABSTRACT FROM AUTHOR]