Exercise and Nutrition Intervention for Frail Older Patients
Study Details
Study Description
Brief Summary
The objective of this study is to evaluate the effect of a person-centered training and nutrition intervention six month after discharge in acutely admitted frail old medical patients on physical function. Secondly, to evaluate the effect on frailty, quality of life, health literacy, nutrition, readmissions, death and consumption of home care costs.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
Evidence on how to improve physical function and avoid unnecessary readmissions for frail hospitalized older medical patients is not established as yet. In Denmark, the few studies performed have not succeeded in showing a significant difference in physical function or quality of life, due to sector barriers, low compliance and uni-dimensional interventions and none of the studies addressed readmissions and or described a patient-centered approach.
This research project will address this serious individual and societal challenge by testing and evaluating a person-centered complex intervention with emphasis on the patients´ own focus and goals. To increase the probability of developing a successful intervention with the patient in focus we have completed two qualitative studies with patients and health professionals. The primary results from these studies indicate that the pedagogical approach of the involved healthcare professional is important for establishing a good relation. Patients had a desire of being more active, but after four week only a minority had their own expectations fulfilled. Furthermore, the patients expressed that social relations had the potential of increasing adherence to training sessions. Furthermore, a citizen's panel has been established, and possible elements important for the intervention were discussed on behalf of their own experiences with the healthcare system. The results of these qualitative studies and the latest evidence contributed to the development of the current intervention study.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Intervention (A) Intervention focusing on strength training and nutritional optimization. |
Other: 1. Goalsetting conversation before start of training. 2. Strength training two times a week for 15 weeks. 3. Three conversations with dietician. 4. Focus on social relations.
Focus on high intensity strength training and nutrition intervention with focus on energy and protein intake.
|
Active Comparator: Control (B) Usual care. Physiotherapy (type of training decided by the physiotherapist) without nutritional intervention. |
Other: Standard training
Training as usual when discharged with a rehabilitation plan.
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Outcome Measures
Primary Outcome Measures
- Short Physical Performance Battery (SPPB) [26 weeks]
A group of measures that combines the results of the gait speed, chair stand and balance tests
Secondary Outcome Measures
- Timed Up and Go [26 weeks]
A simple test used to assess a person's mobility and requires both static and dynamic balance.
- Timed Up and Go [15 weeks]
A simple test used to assess a person's mobility and requires both static and dynamic balance.
- Grip strength [26 weeks]
Measures the muscular strength or the maximum force generated using a hand held dynamometer
- Grip strength [15 weeks]
Measures the muscular strength or the maximum force generated using a hand held dynamometer
- Tilburg Frailty Indicator [26 weeks]
The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people
- Tilburg Frailty Indicator [15 weeks]
The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people
- Clinical Frailty Scale (CFS) [26 weeks]
The Clinical Frailty Scale (CFS) is a judgement-based frailty tool that evaluates specific domains including comorbidity, function, and cognition to generate a frailty score ranging from 1 (very fit) to 9 (terminally ill)
- Clinical Frailty Scale (CFS) [15 weeks]
The Clinical Frailty Scale (CFS) is a judgement-based frailty tool that evaluates specific domains including comorbidity, function, and cognition to generate a frailty score ranging from 1 (very fit) to 9 (terminally ill)
- EQ5D-5L [26 weeks]
A descriptive system which comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
- EQ5D-5L [15 weeks]
A descriptive system which comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
- Body mass, body fat mass and body muscle mass [26 weeks]
Inbody270 measurement. I scale measuring mass, fat mass and muscle mass at the same time. Measured in kg.
- Body mass, body fat mass and body muscle mass [15 weeks]
Inbody270 measurement. I scale measuring mass, fat mass and muscle mass at the same time. Measured in kg.
- Admission [26 weeks.]
Number of admissions
- Admission [15 weeks.]
Number of admissions
- Home care [26 weeks.]
Hours of home care
- Home care [15 weeks.]
Hours of home care
- Other healthcare services [26 weeks.]
ex. Occupational therapy or psychologist
- Short Physical Performance Battery (SPPB) [15 weeks]
A group of measures that combines the results of the gait speed, chair stand and balance tests
- Height [Baseline]
Measured in cm
Eligibility Criteria
Criteria
Inclusion Criteria:
-
65+ years old
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Acutely admitted with a medical focus at Aalborg University Hospital, South.
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Living in Aalborg Municipality (except 9230 Svenstrup, 9240 Nibe, 9293 Kongerslev, 9381 Sulsted, and 9382 Tylstrup)
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Able to walk (assistance is ok) before admission.
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Speak and understand Danish.
Exclusion Criteria:
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Discharged with rehabilitatinplan for physiotherapy within the last 30 days.
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Dementia or other cognitive impairments.
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Terminal ill.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Aalborg Municipality | Aalborg | Denmark |
Sponsors and Collaborators
- Aalborg University Hospital
Investigators
- Principal Investigator: Laurine Nilsson, PhD stud., Aalborg University Hospital
- Study Chair: Jane Andreasen, Assoc. prof., Aalborg University Hospital and Aalborg Municipality
- Study Chair: Mette Holst, Aalborg University Hospital and Aalborg University
- Study Chair: Morten Villumsen, Aarhus Municipality
Study Documents (Full-Text)
None provided.More Information
Publications
- Andreasen J, Aadahl M, Sorensen EE, Eriksen HH, Lund H, Overvad K. Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study. Arch Gerontol Geriatr. 2018 May-Jun;76:65-72. doi: 10.1016/j.archger.2018.01.013. Epub 2018 Feb 13.
- Baert V, Gorus E, Mets T, Geerts C, Bautmans I. Motivators and barriers for physical activity in the oldest old: a systematic review. Ageing Res Rev. 2011 Sep;10(4):464-74. doi: 10.1016/j.arr.2011.04.001. Epub 2011 May 5.
- Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M; Medical Research Council Guidance. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008 Sep 29;337:a1655. doi: 10.1136/bmj.a1655.
- Dedeyne L, Deschodt M, Verschueren S, Tournoy J, Gielen E. Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv Aging. 2017 May 24;12:873-896. doi: 10.2147/CIA.S130794. eCollection 2017.
- Nilsson L, Holst M, Villumsen M, Andreasen J. Maintenance of own health after acute hospitalization - older people's experiences and perspectives on physical activity and nutrition. Physiother Theory Pract. 2022 Oct 3:1-10. doi: 10.1080/09593985.2022.2122912. Online ahead of print.
- Rasmussen RL, Holst M, Nielsen L, Villumsen M, Andreasen J. The perspectives of health professionals in Denmark on physical exercise and nutritional interventions for acutely admitted frail older people during and after hospitalisation. Health Soc Care Community. 2020 Nov;28(6):2140-2149. doi: 10.1111/hsc.13025. Epub 2020 Jun 1.
- Rossi PG, Carnavale BF, Farche ACS, Ansai JH, de Andrade LP, Takahashi ACM. Effects of physical exercise on the cognition of older adults with frailty syndrome: A systematic review and meta-analysis of randomized trials. Arch Gerontol Geriatr. 2021 Mar-Apr;93:104322. doi: 10.1016/j.archger.2020.104322. Epub 2020 Dec 10.
- 2021-215