Impact of an individual personalised rehabilitation program on mobility performance in older-old people

Aging Clin Exp Res. 2021 Oct;33(10):2821-2830. doi: 10.1007/s40520-021-01812-3. Epub 2021 Feb 24.

Abstract

Background: Studies have shown benefits of exercise interventions on preferred and fast gait speed in healthy older adults, but the impact of a personalised rehabilitation program targeting a large cohort of non-disabled older-old adults has rarely been examined.

Aims: The purpose was to determine whether personalised intervention-related improvements in gait and mobility performance in older-old adults were dependent on cognitive status and/or history of falls.

Methods: Based on a pre-post design, 483 older-old persons (mean age: 83.3 ± 5.1 years) were followed during a personalised rehabilitation program over a period of 7 weeks, with twice-weekly sessions (45 min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), static postural sway, Timed Up and Go test, Five Times Sit to Stand test, the ability to rise from the floor, and handgrip strength test were assessed.

Results: Using a pre-post analysis of covariance, a significant increase in preferred gait speed (+ 20.1%), fast gait speed (+ 15.8%), and dual-task speed while counting (+ 13.4%) was observed after the rehabilitation, regardless of the baseline cognitive status and fall history. Similar improvements in TUG and maximal handgrip force were observed, with a significant reduction of performance time (-19.5%) or an increase of handgrip strength (+ 6.2%).

Discussion: Results suggest the effectiveness of personalised intervention to improve a battery of physical performance measures in older-old adults, even for the frailest participants.

Conclusion: Implementing a personalised intervention for targeting the high-risk older-old adults in priority is critical regarding the clinically meaningful change in gait speed.

Keywords: Gait speed; Improvement; Individual rehabilitation program; Older-old adults.

MeSH terms

  • Accidental Falls / prevention & control
  • Aged
  • Aged, 80 and over
  • Exercise Therapy
  • Gait
  • Hand Strength*
  • Humans
  • Postural Balance*
  • Time and Motion Studies