The content of physical fitness training and the changes in physical fitness and functioning in orthopedic geriatric rehabilitation: an explorative observational study.

Abstract

This explorative study investigates the content of physical fitness training and changes in physical fitness and functioning in the current practice of orthopedic geriatric rehabilitation (GR) in the Netherlands. The content of physical fitness training was analyzed in 48 patients from 11 orthopedic GR wards, comparing it to general guidelines for older adults. Endurance, muscle strength, and functioning were measured at admission and discharge. Correlations between training volume and change in endurance, knee-extensor muscle strength, and physical functioning were assessed. Training characteristics varied substantially among individuals. Compared to guidelines, endurance time and intensity were low, and muscle strength training volume was low to moderate. Significant improvements (17.7-41.4%) in muscle strength and all measures of physical functioning were observed. Pain highly affected endurance outcomes in the majority of the patients. Patients not limited by pain showed no change in endurance. Only resistance training volume of the affected leg moderately correlated with change in muscle strength. Physical fitness training content varied and was generally low in intensity compared to guidelines. Its relation to fitness and functioning was limited. Future efforts should focus on improving training strategies and developing a valid measure of endurance.