Oxford University Press
Physical Therapy
,  volume 104 ,  issue 12

Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Hospitalization: Randomized Clinical Trial

Alexander Garbin 1, 2, 3
, 
Jason R. Falvey 2, 3, 4, 5
, 
Ethan Cumbler 6, 7
, 
Danielle Derlein 2, 3
, 
Deborah Currier 2, 3
, 
Amy Nordon-Craft 2, 3
, 
Robert Will 2, 3
, 
Maegan Olivos 2, 3
, 
Jeri E. Forster 8, 9, 10
, 
Kathleen K Mangione 11, 12
, 
Jennifer E. Stevens-Lapsley 1, 2, 3
1
 
Eastern Colorado VA Health Care System, Geriatric Research Education and Clinical Center (GRECC) , Aurora, CO ,
2
 
Physical Therapy Program , Department of Physical Medicine and Rehabilitation, , Aurora, CO , | 
3
 
4
 
Department of Physical Therapy and Rehabilitation Science , Department of Epidemiology and Public Health, , Baltimore, MD , | 
5
 
6
 
7
 
8
 
VA Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center , Aurora, CO , | 
9
 
Department of Physical Medicine and Rehabilitation , Anschutz School of Medicine, , Aurora, CO , | 
10
 
11
 
Department of Physical Therapy , College of Health Sciences, , Glenside, PA , | 
12
 
Publication type: Journal Article
Publication date: 2024-12-20
Oxford University Press
scimago Q1
wos Q1
SJR: 1.233
CiteScore: 7.3
Impact factor: 3.3
ISSN: 00319023, 15386724
DOI:  10.1093/ptj/pzae169
PubMed ID:  39704300
Abstract
Objectives

Reduced physical function following hospitalization places older adults at risk of adverse health events. Many older adults receive home health physical therapy to reverse their deconditioning; however, optimal approaches to improve physical function are currently not known. This study aimed to evaluate the effectiveness of a home health care approach comprised of high-intensity exercise, enhanced care transition, and protein supplementation.

Methods

Eligible participants included adults aged 65 years or older referred to home health care following hospitalization. Two hundred older adults who are medically complex were enrolled and were randomized 1:1 to (1) a high-intensity progressive, multi-component (PMC) intervention or (2) enhanced usual care (UC) comparison group. All participants received 12 visits over 60 days. The primary study outcome was change in the Short Physical Performance Battery (SPPB) from baseline to 60 days. Secondary outcomes included gait speed (usual, fast), modified Physical Performance Test, grip strength, Fatigue Severity Scale, Falls Efficacy Scale-International, physical activity (step count), and adverse events (falls, emergency department visits, hospitalizations). All outcomes were collected at baseline, then 30, 60, 90, and 180 days post baseline.

Results

There was no difference in 60-day SPPB change between groups with both groups experiencing significant improvements (PMC = 1.53 [95% CI: 1.00–2.05]; enhanced UC = 1.39 [95% CI = 0.89–1.88]). Differences were also not observed in secondary measures or adverse events at any time point.

Conclusion

An intervention consisting of high-intensity exercise, enhanced care transition, and protein supplementation was not associated with greater functional improvement at 60 days compared to enhanced UC in older adults receiving home health physical therapy.

Impact

The findings of this study demonstrate that a high-intensity progressive, multi-component intervention results in similar physical functional changes as an enhanced UC intervention in older adults who are medically complex and receiving home health care following hospital-associated deconditioning.

Found 
Found 

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GOST Copy
Garbin A. et al. Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Hospitalization: Randomized Clinical Trial // Physical Therapy. 2024. Vol. 104. No. 12.
GOST all authors (up to 50) Copy
Garbin A., Falvey J. R., Cumbler E., Derlein D., Currier D., Nordon-Craft A., Will R., Olivos M., Forster J. E., Mangione K. K., Stevens-Lapsley J. E. Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Hospitalization: Randomized Clinical Trial // Physical Therapy. 2024. Vol. 104. No. 12.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1093/ptj/pzae169
UR - https://academic.oup.com/ptj/article/doi/10.1093/ptj/pzae169/7929385
TI - Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Hospitalization: Randomized Clinical Trial
T2 - Physical Therapy
AU - Garbin, Alexander
AU - Falvey, Jason R.
AU - Cumbler, Ethan
AU - Derlein, Danielle
AU - Currier, Deborah
AU - Nordon-Craft, Amy
AU - Will, Robert
AU - Olivos, Maegan
AU - Forster, Jeri E.
AU - Mangione, Kathleen K
AU - Stevens-Lapsley, Jennifer E.
PY - 2024
DA - 2024/12/20
PB - Oxford University Press
IS - 12
VL - 104
PMID - 39704300
SN - 0031-9023
SN - 1538-6724
ER -
BibTex
Cite this
BibTex (up to 50 authors) Copy
@article{2024_Garbin,
author = {Alexander Garbin and Jason R. Falvey and Ethan Cumbler and Danielle Derlein and Deborah Currier and Amy Nordon-Craft and Robert Will and Maegan Olivos and Jeri E. Forster and Kathleen K Mangione and Jennifer E. Stevens-Lapsley},
title = {Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Hospitalization: Randomized Clinical Trial},
journal = {Physical Therapy},
year = {2024},
volume = {104},
publisher = {Oxford University Press},
month = {dec},
url = {https://academic.oup.com/ptj/article/doi/10.1093/ptj/pzae169/7929385},
number = {12},
doi = {10.1093/ptj/pzae169}
}