Preservation of functional capacity and lower-limb mechanical power during acute hospitalisation: effects of a low-cost multicomponent exercise programme in older adults-a randomised controlled trial

BACKGROUND: Hospitalised older adults are at increased risk of hospitalisation-associated disability. OBJECTIVE: to investigate the effects of an in-hospital exercise program on functional and cognitive outcomes in older adults admitted to an Acute Care for the Elderly (ACE) unit. METHODS: This randomised controlled trial included acutely hospitalised older adults (≥70 years) randomised to an exercise intervention based on VIVIFRAIL program [intervention group (IG)] or usual care [control group (CG)]. Exercise intervention included resistance/power training, balance and gait exercises. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes included handgrip strength, gait speed, balance, timed-up-and-go, sit-to-stand (STS) time and relative STS power, global cognitive function using Mini Mental State Examination (MMSE), executive function and depressive symptoms. Assessments were performed at ACE unit admission and discharge. Analyses followed the intention-to-treat principle using generalised estimating equations. RESULTS: Forty-seven participants (83.1 ± 5.1 years, 33% women) were randomised into the groups and performed 4 ± 2 exercise sessions across the hospitalisation period. Significant time × group interactions were found for SPPB, STS time, maximal and mean relative STS power, balance and MMSE, favouring IG compared to CG. Between-groups mean differences at discharge were observed for SPPB [3.18 points, 95% CI (1.3, 5.1)], STS time [-11.3 s, (-20.6, -1.9)], maximal relative STS power [1.45 W/Kg, (0.3, 2.5)], mean relative STS power [0.70 W/Kg, (0.2, 1.2)] and MMSE [2.16 points, (0.6, 3.7)] favouring IG compared to CG. CONCLUSION: Multicomponent exercise may attenuate physical and cognitive declines during acute hospitalisation. These findings support the implementation of structured exercise programmes during hospitalisation. (Registration number: NCT06682598).