Factors Affecting Engagement of Older Adults in Exercise Following Hospitalization

Naseri, Chiara, Haines, Terry P., Morris, Meg E., Mcphail, Steven M., Etherton-Beer, Christopher, Shorr, Ronald, Flicker, Leon, Waldron, Nicolas, Bulsara, Max, and Hill, Anne-Marie (2022) Factors Affecting Engagement of Older Adults in Exercise Following Hospitalization. Journal of Geriatric Physical Therapy, 45 (4). pp. 197-206.

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Background and Purpose: Exercise interventions can improve physical recovery and reduce falls in older adults following hospitalization. The aim of the study was to identify factors associated with exercise engagement after hospital discharge.

Methods: This study was a secondary analysis of data collected as part of a randomized controlled trial. Participants were 60 years and older, discharged from 3 rehabilitation hospitals in Australia, and followed for 6 months after discharge. The primary outcome was level of engagement in exercise after discharge, measured using setting, type, frequency, and time. A secondary outcome was self-efficacy for exercise at 6-month follow-up. Data were gathered at baseline in hospital and at 6 months after discharge by telephone using structured surveys. Associations between exercise and participant characteristics were evaluated using logistic regression models.

Results and Discussion: Participants' (n = 292) mean age was 78 (SD 8) years and 63% were female. There were 146 (50%) who exercised after hospitalization for a median (interquartile range) time of 60 (60-75) minutes per week. Characteristics that were significantly associated with post-discharge engagement in exercise were having higher levels of functional ability at discharge (adjusted odds ratio [AOR] 1.2, 95% CI 1.0, 1.4), living with a partner (AOR 2.9, 95% CI 1.7, 4.9), and engagement in exercise prior to hospital admission (AOR 1.7, 95% CI 1.0, 2.8). The mean self-efficacy for exercise score at 6 months post-discharge was 58.5/90 (SD 24.5). Characteristics that were significantly predictive of a higher mean self-efficacy score at 6 months after hospitalization were having a college or university education (adjusted beta-coefficient [Adj beta] 11.5, 95% CI 3.8, 19.0), exercise prior to hospital admission (Adj beta 12.3, 95% CI 5.1, 19.5), living with a partner at discharge (Adj beta 14.5, 95% CI 7.1, 21.9), and higher functional ability at discharge (Adj beta 4.0, 95% CI 1.9, 6.1).

Conclusion: Older adults have low levels of engagement in exercise that might impact their recovery after hospitalization. During exercise prescription, clinicians should prioritize older adults who live alone, who have lower functional ability, and no previous habit of exercising.

Item ID: 76694
Item Type: Article (Research - C1)
ISSN: 2152-0895
Keywords: exercise, falls, hospital, patient discharge, physiotherapy
Copyright Information: © 2022 APTA Geriatrics, An Academy of the American Physical Therapy Association.
Date Deposited: 02 Nov 2022 09:02
FoR Codes: 42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420106 Physiotherapy @ 80%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320210 Geriatrics and gerontology @ 20%
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