Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review A controlled trial of a nursing-centered intervention in hospitalized elderly medical patients: the Yale Geriatric Care Program. Enhancing physical function in HIV-infected older adults: A randomized controlled clinical trial. Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. Enhancing physical activity in older adults receiving hospital based rehabilitation: a phase II feasibility study Evaluating the effects of increasing physical activity to optimize rehabilitation outcomes in hospitalized older adults (MOVE Trial): study protocol for a randomized controlled trial Randomized Controlled Trial of Screening, Risk Modification, and Physical Therapy to Prevent Falls Among the Elderly Recently Discharged From the Emergency Department to the Community: The Steps to Avoid Falls in the Elderly Study. Effects of an Exercise Intervention in Frail Older Patients with Chronic Obstructive Pulmonary Disease Hospitalized due to an Exacerbation: A Randomized Controlled Trial Physician-based physical activity counseling for middle-aged and older adults: A randomized trial Implementation and effectiveness of a community-based health promotion program for older adults. A randomized controlled trial of exercise to improve outcomes of acute hospitalization in older adults. Cluster randomized controlled trial of a multilevel physical activity intervention for older adults Effectiveness of a video-based exercise programme to reduce falls and improve health-related quality of life among older adults discharged from hospital: a pilot randomized controlled trial Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission: a randomized controlled trial. Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study. Changing physician practice of physical activity counseling Interventions to reduce the incidence of falls in older adult patients in acute care hospitals: a systematic review
Background To counteract decline in physical performance and physical activity in older patients during hospitalization , multiple physical interventions were developed . However , it is unknown whether these are effective in this particular population . This systematic review aim ed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization . Methods The systematic search included PubMed , EMBASE , Cinahl , the Trials data base of The Cochrane Library and SPORTd iscus from inception to 22 November 2017 . Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on  physical performance or physical activity  was evaluated during hospitalization . Results Fifteen r and omized controlled trials met the inclusion criteria . Overall , the effect of physical interventions on physical performance was inconsistent . Patient tailored interventions , i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not . Physical activity as outcome measure was not addressed . Reporting of intensity of the interventions and adherence were frequently lacking . Conclusions Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain . Further research on the efficacy of the intervention is needed , comparing types of intervention with detailed reporting of frequency , intensity and duration OBJECTIVE To test the effectiveness of a nursing-centered intervention to prevent functional decline among hospitalized elderly medical patients . DESIGN Prospect i ve cohort study with stratified and matched cohort analyses . SETTING General medicine wards of a university teaching hospital . PATIENTS Two hundred sixteen patients aged > or = 70 years ( 85 intervention and 131 control patients ) . INTERVENTION The intervention included identification and surveillance of frail older patients , twice-weekly rounds of the Geriatric Care Team , and a nursing-centered educational program . MAIN OUTCOME MEASURE Functional decline , defined as a net decline in five activities of daily living ( ADLs ) . RESULTS In stratified analyses , the intervention result ed in a beneficial effect with a relative risk of 0.82 ( 95 % confidence interval [ CI ] 0.54 to 1.24 ) in patients ( n = 106 ) with one of four geriatric target conditions at baseline ( eg , delirium , functional impairment , incontinence , and pressure sores ) . The intervention had no effect in patients without target conditions at baseline ( n = 110 ) ; thus , this subgroup was excluded from further analyses . When patients were matched on number of target conditions and risk for functional decline at baseline ( n = 66 ) , the intervention result ed in a significant beneficial effect , with a reduction in functional decline from 64 % in controls to 41 % in the intervention group , for a relative risk of 0.64 ( 95 % CI , 0.43 to 0.96 ) . The intervention group had significantly less decline in ADL score and in individual ADLs than control subjects . Specific interventions aim ed at maximizing function , such as physical therapy , were received more often by intervention patients ; however , the beneficial effects of the intervention were achieved without increasing per-day hospital costs . CONCLUSIONS The intervention appears effective to decrease functional decline in targeted elderly hospitalized medical patients OBJECTIVE HIV-infected older adults ( HOA ) are at risk of functional decline . Interventions promoting physical activity that can attenuate functional decline and are easily translated into the HOA community are of high priority . We conducted a r and omized , controlled clinical trial to evaluate whether a physical activity counseling intervention based on self-determination theory ( SDT ) improves physical function , autonomous motivation , depression and the quality of life ( QOL ) in HOA . METHOD In total , 67 community-dwelling HOA with mild-to-moderate functional limitations were r and omized to 1 of 2 groups : a physical activity counseling group or the usual care control group . We used SDT to guide the development of the experimental intervention . Outcome measures that were collected at baseline and final study visits included a battery of physical function tests , levels of physical activity , autonomous motivation , depression , and QOL . RESULTS The study participants were similar in their demographic and clinical characteristics in both the treatment and control groups . Overall physical performance , gait speed , measures of endurance and strength , and levels of physical activity improved in the treatment group compared to the control group ( p < .05 ) . Measures of autonomous regulation such as identified regulation , and measures of depression and QOL improved significantly in the treatment group compared with the control group ( p < .05 ) . Across the groups , improvement in intrinsic regulation and QOL correlated with an improvement in physical function ( p < .05 ) . CONCLUSION Our findings suggest that a physical activity counseling program grounded in SDT can improve physical function , autonomous motivation , depression , and QOL in HOA with functional limitations . ( PsycINFO Data base OBJECTIVES To compare the effect of high-intensity aerobic interval exercise ( HIA ) with home-based exercise ( HB ) in older adults with chronic disease soon after discharge from the hospital . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Community-dwelling older adults aged 70 to 92 ( N = 115 ) were recruited while in the hospital . After discharge , they were r and omized to HIA group ( n = 59 ) or HB ( n = 56 ) . INTERVENTION High-intensity aerobic interval exercise ( HIA ) consisted of endurance , strength , and balance exercises . The HB consisted of low-intensity exercises and telephone follow-up from a physical therapist . MEASUREMENTS Health-related quality of life ( HRQOL ) was assessed using the Medical Outcomes Study 36-item Short Form Survey , physical fitness was measured using the Senior Fitness Test , and physical activity was assessed using the Physical Activity Scale for the Elderly . RESULTS Intention-to-treat analysis showed that both groups improved their HRQOL and physical activity after 3 months . Improvements on the Senior Fitness Test ( chair st and , arm curl and 6-minute walk ( 6MWT ) ) were significantly greater in the HIA group than the HB group . The mean difference was 25.9 m on the 6MWT ( P = .001 , effect size d = 0.2 ) , 1.3 per 30 seconds on the chair st and s mean ( P = .001 , effect size d = 0.3 ) , and 1.6 per 30 seconds on the arm curl ( P = .001 , effect size d = 0.4 ) . CONCLUSION High-intensity aerobic interval exercise ( HIA ) participants significantly improved their physical fitness . Both groups increased their HRQOL and physical activity . The findings suggest that exercise therapy should be incorporated as a part of the treatment for older people at risk for functional decline Background Older adults receiving inpatient rehabilitation have low activity levels and poor mobility outcomes . Increased physical activity may improve mobility . The objective of this Phase II study was to evaluate the feasibility of a r and omized controlled trial ( RCT ) of enhanced physical activity in older adults receiving rehabilitation . Methods Patients admitted to aged care rehabilitation with reduced mobility were r and omized to receive usual care or usual care plus additional physical activity  , which was delivered by a physiotherapist or physiotherapy assistant . The feasibility and safety of the proposed RCT protocol was evaluated . The primary clinical outcome was mobility , which was assessed on hospital admission and discharge by an assessor blinded to group assignment . To determine the most appropriate measure of mobility , three measures were trialled ; the Timed Up and Go , the Elderly Mobility Scale and the de Morton Mobility Index . Results The protocol was feasible . Thirty-four percent of people admitted to the ward were recruited , with 47 participants r and omised to a control ( n = 25 ) or intervention group ( n = 22 ) . The rates of adverse events ( death , falls and readmission to an acute service ) did not differ between the groups . Usual care therapists remained blind to group allocation , with no change in usual practice . Physical activity targets were met on weekdays but not weekends and the intervention was acceptable to participants . The de Morton Mobility Index was the most appropriate measure of mobility . Conclusions The proposed RCT of enhanced physical activity in older adults receiving rehabilitation was feasible . A larger multi-centre RCT to establish whether this intervention is cost effective and improves mobility is warranted . Trial registration The trial was registered with the ANZTCR ( ACTRN12608000427370 ) Background Older adults who have received inpatient rehabilitation often have significant mobility disability at discharge . Physical activity levels in rehabilitation are also low . It is hypothesized that providing increased physical activity to older people receiving hospital-based rehabilitation  will lead to better mobility outcomes at discharge . Methods / Design A single blind , parallel-group , multisite r and omized controlled trial with blinded assessment of outcome and intention-to-treat analysis . The cost effectiveness of the intervention will also be examined . Older people ( age > 60 years ) undergoing inpatient rehabilitation to improve mobility will be recruited from geriatric rehabilitation units at two Australian hospitals . A computer-generated blocked stratified r and omization sequence will be used to assign 198 participants in a 1:1 ratio to either an ‘ enhanced physical activity ’ ( intervention ) group or a ‘ usual care plus ’ ( control ) group for the duration of their inpatient stay . Participants will receive usual care and either spend time each week performing additional physical activities such as st and ing or walking ( intervention group ) or performing an equal amount of social activities that have minimal impact on mobility such as card and board games ( control group ) . Self-selected gait speed will be measured using a 6-meter walk test at discharge ( primary outcome ) and 6 months follow-up ( secondary outcome ) . The study is powered to detect a 0.1 m/sec increase in self-selected gait speed in the intervention group at discharge . Additional measures of mobility ( Timed Up and Go , De Morton Mobility Index ) , function ( Functional Independence Measure ) and quality of life will be obtained as secondary outcomes at discharge and tertiary outcomes at 6 months follow-up . The trial commenced recruitment on 28 January 2014 . Discussion This study will evaluate the efficacy and cost effectiveness of increasing physical activity in older people during inpatient rehabilitation . These results will assist in the development of evidence d-based rehabilitation programs for this population .Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12613000884707 ( Date of registration 08 August 2013 ) ; Clinical Trials.gov Identifier NCT01910740 ( Date of registration 22 July 2013 ) OBJECTIVE To evaluate the effectiveness of a multifactorial , tailored program of physical therapy to reduce the occurrence of falls among a heterogeneous group of high-risk elderly Singaporeans recently discharged from the emergency department ( ED ) . DESIGN R and omized controlled trial . SETTING Communities . PARTICIPANTS Adults ( N=354 ) aged ≥65 years who were seen in the ED for a fall or fall-related injuries and discharged home . INTERVENTIONS The intervention primarily consisted of a tailored program of physical therapy focused on progressive training in strength , balance , and gait for a period of 3 months . Participants in the intervention group also received screening and follow-up for vision , polypharmacy , and environmental hazards . Participants in the control group received usual care prescribed by a physician and educational material s on falls prevention . MAIN OUTCOME MEASURES The primary outcome measure was experiencing at least 1 fall during the 9-month study period ( a 3-mo active intervention phase and a 6-mo maintenance phase ) . Secondary outcome measures were the occurrence of at least 1 injurious fall during the study period and a change in the Short Physical Performance Battery ( SPPB ) score . Participants were assessed both after 3 and 9 months . RESULTS During the 9-month study period , 37.8 % of the control group and 30.5 % of the intervention group fell at least once , which was not statistically significantly different ( odds ratio [OR]=.72 ; 95 % confidence interval [ CI ] , .46 - 1.12 ; P=.146 ) . The intervention group had statistically significantly fewer individuals with injurious falls ( OR=.56 ; 95 % CI , .32-.98 ; P=.041 ) and less deterioration in physical performance , reflected by a mean difference of 0.6 in SPPB scores ( P=.029 ) . Multivariate analyses indicated a strong interaction effect between the intervention and the presence of 2 or more major comorbidities ; after accounting for this effect , the intervention program reduced the number of people experiencing at least 1 fall ( OR=.34 ; 95 % CI , .17-.67 ; P=.002 ) . CONCLUSIONS We observed that in this heterogeneous population , the proportion of participants experiencing at least 1 fall during the study period was not statistically significantly lower in the intervention group compared with the control group . Secondary analyses strongly suggest that individuals with 2 or more major comorbidities do not benefit from a tailored physical therapy program ; however , individuals with less comorbidity may substantially benefit ABSTRACT The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease ( COPD ) during hospitalization due to an acute exacerbation . This study was a r and omized , single-blind clinical trial . Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD ( AE COPD ) were included in this study . All patients received st and ard medical and pharmacological care . Patients assigned to the intervention group also received an exercise intervention . The main outcome measures were balance , muscle strength , and exercise capacity . Significant between-group differences were found in muscle strength ( p = 0.028 ) and balance ( p = 0.013 ) after the intervention . All the variables improved significantly ( p < 0.05 ) in the exercise intervention group . In the intervention group , the mean difference in muscle strength between baseline and discharge was 10.47 N. Balance also improved , showing a mean difference of 7.56 seconds on the right leg and 6.57 seconds on the left leg . Exercise capacity improved as well , with a difference of 4.97 st and s between baseline and discharge . All the variables showed impairment in the control group . In conclusion , an exercise intervention using a pedal exerciser during the hospital stay of frail elderly patients with an AE COPD improves muscle strength , balance , and exercise capacity Sedentary behavior among older adults increases risk for chronic diseases . Physicians in a primary care setting can play an important role in promoting physical activity adoption among their older patients . The Physically Active for Life ( PAL ) project was a r and omized , controlled trial comparing the efficacy of brief physician-delivered physical activity counseling to usual care on self-reported physical activity levels . The physical activity counseling was based on the Transtheoretical Model of Change and social learning theory . Twenty-four community-based primary care medical practice s were recruited into the study ; 12 were r and omized to the Intervention condition and 12 to the Control condition . Physicians in the Intervention practice s received training in the delivery of brief physical activity counseling . Subjects in the Intervention practice s ( n=181 ) received brief activity counseling matched to their stage of motivational readiness for physical activity , a patient manual , a follow-up appointment with their physician to discuss activity counseling , and newsletter mailings . Subjects in the Control practice s ( n=174 ) received st and ard care .  Measures of motivational readiness for physical activity and the Physical Activity Scale for the Elderly ( PASE ) were administered to subjects in both conditions at baseline , 6 weeks following their initial appointment , and at 8 months . Results showed that at the 6-week follow-up , subjects in the Intervention condition were more likely to be in more advanced stages of motivational readiness for physical activity than subjects in the Control condition . This effect was not maintained at the 8 month follow-up and the intervention did not produce significant changes in PASE scores . Results suggest that more intensive , sustained interventions may be necessary to promote the adoption of physical activity among sedentary , middle-aged , and older adults in primary care medical practice BACKGROUND Because preventing functional decline in older adults is a national priority and senior centers have been identified as potentially important venues for health-promotion activities , a trial of a multicomponent disability prevention program was conducted at a senior center . METHODS One hundred older adults were recruited for a 6-month r and omized clinical trial . All members of the experimental group received an exercise intervention , nutrition counseling , and a home safety assessment . Smoking and alcohol interventions were delivered to at-risk subjects . Outcome variables included the Medical Outcomes Study Short Form ( SF-36 ) health survey , the CES-Depression scale , bed days , and restricted-activity days . RESULTS A single study announcement result ed in a response sufficient to recruit 100 subjects . The exercise program was well received : 85 % of intervention subjects completed the 6-month program and adherence was excellent , with over 90 % attendance at exercise classes . After 6 months the intervention group had significantly better scores on 7 of 8 SF-36 subscales and fewer depressive symptoms than controls . CONCLUSIONS Senior centers may be excellent sites for community-based health promotion interventions : participation and adherence rates may be acceptable , interventions can be design ed that are feasible in this setting , and these interventions appear to affect health status positively . The study program improved physical and psychosocial functioning and is a promising model for preventing functional decline through activities based at senior centers OBJECTIVE Older adults hospitalized for nondisabling diagnoses can lose functional ability . Lack of exercise or physical activity during the acute illness and recovery may be contributory . This study evaluated whether increased exercise in hospital and afterward would shorten length of stay and improve physical function at 1 month . DESIGN A r and omized controlled trial . SETTING A 700-bed community-based hospital with academic and teaching programs . PARTICIPANTS Three hundred patients ( mean age 78.2 years + /- 5.6 ) with nondisabling medical and surgical diagnoses who were admitted to an acute care hospital between December 1990 and April 1992 . All patients had an expected length of stay 5 or more days , were ambulatory before admission , and were not expected to die within 12 months . INTERVENTION A hospital-based general exercise program was administered to intervention patients along with encouragement to continue the program , self-administered , at home . MEASUREMENTS The primary outcome was hospital length of stay . Secondary outcomes at 1 month post-discharge included measures of physical function and other general health indicators . RESULTS There was no significant difference in length of stay between treatment and control groups controlling for baseline characteristics and diagnoses . The intervention was associated with better function in instrumental activities of daily living ( beta = .433 ( 95 % CI , 0.044 - 0.842 ) ) at 1 month but no change in perceived general health status and other measures of physical function . CONCLUSIONS An exercise program started during hospitalization and continued for 1 month did not shorten length of stay but did improve functional outcome at 1 month Background Older adults are the least active population group . Interventions in residential setting s may support a multi-level approach to behavior change . Methods In a cluster r and omized control trial , 11 San Diego retirement communities were assigned to a physical activity ( PA ) intervention or a healthy aging attention control condition .  Participants were 307 adults over 65 years old . The multilevel PA intervention was delivered with the assistance of peer leaders , who were trained older adult from the retirement communities . Intervention components included individual counseling & self-monitoring with pedometers , group education sessions , group walks , community advocacy and pedestrian community change projects . Intervention condition by time interactions were tested using generalized mixed effects regressions . The primary outcomes was accelerometer measured physical activity . Secondary outcomes were blood pressure and objective ly measured physical functioning . Results Over 70 % of the sample were 80 years or older .  PA  significantly increased in the intervention condition ( 56 min of moderate-vigorous PA per week ; 119 min of light PA ) compared with the control condition and remained significantly higher across the 12 month study . Men and participants under 84 years old benefited most from the intervention . There was a significant decrease in systolic ( p < .007 ) and diastolic ( p < .02 ) blood pressure at 6 months . Physical functioning improved but the changes were not statistically significant . Conclusions Intervention fidelity was high demonstrating feasibility . Changes in PA and blood pressure achieved were comparable to other studies with much younger participants . Men , in particular , avoided a year-long decline in PA.Trial registration clincialtrials.gov Identifier : NCT01155011 Objective : Falls , loss of health-related quality of life and physical capacity , reduced participation in activities of daily living , and increased fear of falling are all potential outcomes for older adults discharged from hospital . A low-cost video based exercise programme may address this . Design : This study was a r and omized controlled trial with blinded outcomes assessment and a six-month follow-up . Subjects and setting : Participants were older adults ( > 65 years ) using a mobility aid discharged from a tertiary hospital in Brisbane , Australia , without referral for community-based rehabilitation services . Intervention : A digital video disk-based programme encompassing six exercise types each with six levels of difficulty . A home visit from a project physiotherapist was conducted to ensure patient safety . Control group patients received usual care . Main measures : Falls , health-related quality of life , participation in activities of daily living , physical capacity and fear of falling . Results : Study participants ( n = 53 , 19 intervention , 34 control ) experienced decreasing health-related quality of life , several falls ( 72 ) , and lower levels of participation in activities of daily living over the six-month follow-up . The intervention group did not differ significantly from the control group in terms of the outcomes examined , though a non-significant reduction in the rate of falls was observed . Intervention group participants complied with the exercise programme well during the first two weeks following discharge from hospital but then reduced their compliance levels thereafter . Conclusions : The intervention may be beneficial for reducing the rate of falls in this patient population though further research with a larger sample size is indicated OBJECTIVE During hospitalization older people often experience functional decline which impacts on their future independence . The objective of this study was to evaluate a multifaceted transitional care intervention including home-based exercise strategies for at-risk older people on functional status , independence in activities of daily living ( ADLs ) and walking ability . METHODS A r and omized controlled trial was undertaken in a metropolitan hospital in Australia with 128 patients ( 64 intervention , 64 control ) aged over 65 years with an acute medical admission and at least one risk factor for hospital readmission . The intervention group received an individually tailored programme for exercise and follow-up care which was commenced in hospital and included regular visits in hospital by a physiotherapist and a registered nurse , a home visit following discharge and regular telephone follow-up for 24 weeks following discharge . The programme was design ed to improve health-promoting behaviours , strength , stability , endurance and mobility . Data were collected at baseline , then 4 , 12 and 24 weeks following discharge using the Index of ADL , Instrumental Activities of Daily Living ( IADL ) and the Walking Impairment Question naire ( WIQ ; modified ) . RESULTS Significant improvements were found in the intervention group in IADL scores ( P < 0.001 ) , ADL scores ( P < 0.001 ) and WIQ scale scores ( P < 0.001 ) in comparison to the control group . The greatest improvements were found in the first 4 weeks following discharge . CONCLUSIONS Early introduction of a transitional model of care incorporating a tailored exercise programme and regular telephone follow-up for hospitalized at-risk older adults can improve independence and functional ability Reduction in muscle mass and physical function depends on a variety of interacting factors : age , physical activity level , nutritional state and the type and impact of disease . The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength , balance , mobility , ambulation and activities of daily living ( ADL ) in institutionalized elderly people aged 65 and over with multiple diagnoses . Baseline assessment s consisted of strength , balance , mobility/ambulation , and ADL .  Twenty-one subjects were included in the intervention program . A control group ( 21 subjects ) was first matched in pairs according to gender , age , ADL and mobility , and then by balance , ambulation and strength . The intervention program was individualized and included strength , mobility , balance and endurance training . Follow-up measures were conducted directly after the intervention and 10 weeks later . After drop-out , 20 subjects in the intervention group and 15 subjects in the control group remained for analyses . Balance and mobility improved significantly in the intervention group while declining in the control group . This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses We conducted a prospect i ve controlled trial to determine whether an educational intervention could improve resident physician  self-efficacy and counseling behaviors for physical activity and increase their patients ’ reported activity levels .  Forty-eight internal medicine residents who practice d at a Department of Veterans Affairs hospital received either two workshops on physical activity counseling or no intervention . All residents completed question naires before and 3 months after the workshops . The 21 intervention physicians reported increased self-efficacy for counseling and increased frequency of counseling compared with the 27 control physicians . Approximately 10 patients of each resident were included in the study and surveyed before and 6 months after the intervention . Of 560 patients , 465 ( 83 % ) returned both question naires . Following the intervention , there were no significant differences between patients of intervention and control physicians on any outcome measures . We conclude that educational interventions can improve physicians ’ reported self-efficacy of physical activity counseling but may not increase patient physical activity levels . Alternative approaches that emphasize overcoming the substantial barriers to exercise in chronically ill out patients clearly will be improtant for facilitating changes in physical activity Background Falls can have a considerable impact on a patients ' well being , they can result in serious physical and emotional injury , poor quality of life and increased length of hospital stay . Most of the current literature recommends a comprehensive approach to fall prevention that addresses a wide variety of risk factors and involves the use of risk assessment . Objective The objective of this review was to present the best available evidence for the effectiveness of interventions design ed to reduce the incidence of falls in older adult patients in acute care hospitals . Inclusion Criteria Types of Studies Only r and omised controlled trials ( RCTs ) assessing the effectiveness of risk assessment or other interventions that aim ed to minimise the number of falls were included . Types of Participants Participants were older adult in patients ( defined as aged 65 years or over ) in acute care hospitals . Types of Interventions This review focused on interventions design ed to assess the risk of falling or those used to minimise the risk of falling in older adult hospital patients . These interventions were compared to either st and ard practice , which included any method or technique already in place at the facility , or no intervention . Types of Outcome measures The primary outcome was the number of patient falls during hospitalisation . Search Strategy A search for published and unpublished literature from 1998 to 2008 published in the English language was conducted using all major electronic data bases . A three‐step search strategy was developed using MeSH terminology and keywords to ensure that all material relevant to the review was captured . Assessment of Quality The method ological quality of included studies was assessed by two review ers , who appraised each study independently , using st and ardised Joanna Briggs Institute ( JBI ) critical appraisal tools Data Collection and Analysis Data was extracted from the studies that were identified as meeting the criteria for method ological quality using the st and ard JBI data extraction tools . Due to the heterogeneity of population s and interventions , meta‐analyses were not possible and results are presented in narrative form . Results and Conclusions Seven studies were included in the review . The evidence on interventions for reducing the number of falls in older adults during their stay in an acute health care facility is sparse . There is some evidence to suggest that certain multifactorial interventions are more effective than others and that increasing patient education or targeting fall risk factors may be of benefit . Further high quality research is needed in order to ascertain effective fall prevention strategies in acute care facilities . Implication s for Practice There are some evidence to suggest that implementing the following interventions in acute hospitals may be effective in reducing the amount of falls of older adult in patients : ˙ a multidisciplinary multifactorial intervention program consisting of a falls risk alert card , an exercise program , an education program and the use of hip protectors after approximately 45 days ˙ a one‐on‐one patient education package entailing information on risk factors and preventative strategies for falls as well as goal setting ˙ a targeted falls risk factor reduction intervention that includes a falls risk factor screen , recommended interventions encompassing local advice and a summary of the evidence There is some evidence to suggest that implementing a multidisciplinary multifactorial intervention that consists of systematic assessment and treatment of fall risk factors , as well as active management of postoperative complications can reduce the amount of falls in patients with femoral neck fracture following surgery . Implication s for Research Better design ed RCTs that distinguish subgroups of population s ( for example people with or without cognitive impairment ) and that targets interventions at specific groups is required . Further research that focuses on individual intervention components that are part of larger multifactorial interventions are also warranted
Overall , the effect of physical interventions on physical performance was inconsistent .
Patient tailored interventions , i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not .
Conclusions Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain .
Background To counteract decline in physical performance and physical activity in older patients during hospitalization , multiple physical interventions were developed .
However , it is unknown whether these are effective in this particular population .
This systematic review aim ed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization .