Article
Functional task exercise and physical therapy as prevention of functional decline in community dwelling older people
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Published: | September 5, 2017 |
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Background: A physically active lifestyle in older people contributes to the preservation of good health.
Question: What is the effect of physiotherapy on daily functioning among community dwelling older people with complex health problems identified with screening, vs care as usual. In addition, we compare functional task exercise (FTE), (problems prioritized by older people, trained in own home environment), vs usual preventive physical therapy (PPT).
Method: Participants: Community-dwelling persons 75+ years with daily activity limitations, in 83 general practices (n=155). Both intervention groups (FTE, n=76; PPT, n=79) received individual, 30 minute treatments. An observational group (OG) (n=228) did not get any experimental intervention offered. Measurements: Groningen Activities for Daily Living Restriction Scale (GARS).
Results: At baseline, 74 percent of the intervention trial group was female vs 79% in the observational group (p=0.761). Median ages were 83.6 and 84.8 respectively (p=0.560). The median baseline GARS-score for the OG was 41.0 (Interquartile Range (IQR): 35.0; 48.0) and 40.0 (IQR: 32.3; 46.0) for the intervention group. The mean change over time was 3.3 (2.5; 4.1) for the OG. Differences in change over time between the intervention trial and the OG were statistically significant, with mean difference in change of GARS score of -2.5 (95%CI: -4.3; -0.6) (p= .009). No statistically significant difference was observed between FTE and PPT: difference in change was 0.4 (95% CI: -3.5; 2.8, p = 0.795).
Discussion: An exercise intervention led by physiotherapists may slow down decline in self-reported daily functioning in older persons with daily activity limitations, identified by pro-active case finding.