A randomized controlled trial of exercise to improve outcomes of acute hospitalization in older adults

OBJECTIVE: Older adults hospitalized for nondisabling diagnoses can lose fu nctional ability. Lack of exercise or physical activity during the acute il lness and recovery may be contributory. This study evaluated whether increa sed exercise in hospital and afterward would shorten length of stay and imp rove physical function at 1 month. DESIGN: A randomized controlled trial. SETTING: A 700-bed community-based hospital with academic and teaching prog rams. PARTICIPANTS: Three hundred patients (mean age 78.2 years +/- 5.6) with non disabling medical and surgical diagnoses who were admitted to an acute care hospital between December 1990 and April 1992. All patients had an expecte d 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, se lf-administered, at home. MEASUREMENTS: The primary outcome was hospital length of stay. Secondary ou tcomes at 1 month postdischarge included measures of physical function and other general health indicators. RESULTS: There was no significant difference in length of stay between trea tment and control groups controlling for baseline characteristics and diagn oses. The intervention was associated with better function in instrumental activities of daily living (beta = .433 (95% CI, 0.044-0.842)) at 1 month b ut no change in perceived general health status and other measures of physi cal function. CONCLUSIONS: An exercise program started during hospitalization and continu ed for 1 month did not shorten length of stay but did improve functional ou tcome at 1 month.