Randomized controlled trial of the effect of additional functional exercise during slow-stream rehabilitation in a regional center.

Abstract

To evaluate whether adding functional exercise training to standard physiotherapy during residential slow-stream rehabilitation (SSR) improves discharge outcomes and functional ability. Randomized controlled trial. A regional hospital. Older people (N=60) admitted to SSR. 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. 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. 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 (χ1(2)=8.40, P=.004). Adding FIT to standard physiotherapy did not improve discharge outcomes and did not have a statistically significant effect on function, but may have a small effect on balance. Patient expected and actual discharge destinations were associated.