Randomized controlled trial of the effect of additional functional exercise during slow-stream rehabilitation in a regional center
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Objective To evaluate whether adding functional exercise training to standard physiotherapy during residential slow-stream rehabilitation (SSR) improves discharge outcomes and functional ability. Design Randomized controlled trial. Setting A regional hospital. Participants Older people (N=60) admitted to SSR. Intervention All participants received standard physiotherapy. An individualized functional incidental training (FIT) program was implemented for intervention participants consisting of 4 extra episodes of functional exercise daily for the period of SSR. Research assistants visited twice weekly to practice and progress FIT programs. Main Outcome Measures Outcome measures included discharge destination, participant-expected discharge destination, and functional tests of the Berg Balance Scale (BBS), de Morton Mobility Index (DEMMI), and 5 times sit-to-stand test (FTSTS) at admission and discharge. Results Fifty-two participants completed the study. At baseline, the SSR group achieved higher scores on the BBS, DEMMI, and FTSTS. There was no significant difference in discharge destination between groups (P=.305). The difference in functional change between groups from admission to discharge on the BBS, DEMMI, and FTSTS was not significant. Participant-expected discharge destination was significantly associated with eventual discharge destination (?12=8.40, P=.004). Conclusions Adding FIT to standard physiotherapy did not improve discharge outcomes and did ot have a statistically significant effect on function, but may have a small effect on balance. Patient expected and actual discharge destinations were associated.
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