Montreal health-care professionals develop 27 daily exercises for patients to stay in shape once they return home and avoid falls.
Seniors make up 18 per cent of Canada’s population yet account for 42 per cent of hospitalizations. Hospital stays can have serious impacts, such as decreased mobility, a greater risk of falling, and readmission to hospital, which become obstacles to seniors remaining independent and staying at home. To reduce these risks, a team of researchers has come up with a simple approach: to prescribe daily exercises that patients can do at home once they get out of the hospital.
Studies of these exercise prescriptions have shown that they are indeed effective, as nearly 8 out of 10 seniors liked or enjoyed the exercise program, which helped prevent falls over a period of 12 weeks. What’s more, 8 out of 10 seniors found the program useful and easy to do.
The study was conducted at the Institut universitaire de gériatrie de Montréal (IUGM) of the CIUSSS du Centre-Sud-de-l’Île-de-Montréal (CCSMTL) by Dr. Mylène Aubertin-Leheudre, a professor in the Department of Physical Activity Sciences at Université du Québec à Montréal (UQAM), and Dr. Marie-Jeanne Kergoat, head of the Department of Geriatrics of the CCSMTL and a professor in the Faculty of Medicine at Université de Montréal.
Three simple tests
Physical activity has been proven to help prevent loss of muscle mass and strength. It also reinforces balance and confidence in one's mobility and self-care skills. However, after a hospital stay, many seniors become sedentary, which in turn decreases their mobility and ability to get around on their own.
To make it easier to prescribe physical activity, Aubertin-Leheudre’s research team developed a decision-support tool based on research data. Using three simple criteria (cardiomuscular fitness, balance and cognitive health, combined with the presence or not of a family caregiver), health-care professionals put each senior on one of 27 exercise programs to do every day after discharge from hospital.
These exercises had to be simple and safe to perform, as they would be done by seniors in fragile health who would not be supervised by a professional. Since the only "equipment" they'd need would be a chair and kitchen counter, the exercises were highly accessible.
Simple, easy and effective
Aubertin-Leheudre’s main goal was to provide a simple, safe and effective approach to post-hospitalization exercise. “For health professionals to adopt the project, the program had to be seen as fast, easy and safe for patients," she said. "The patients also had to be confident about the effectiveness of the program and their abilities to perform the exercises safely on their own. The results were positive for both health professionals and patients."
Indeed, after 12 weeks the seniors were able to increase their walking speed, with no increase in the number of falls. Overall, 76 per cent of participants expressed appreciation for the program, and 82 per cent said they were “satisfied” or “very satisfied.” Furthermore, 88 per cent of the health professionals found the program “useful” or “very useful” and most said that the program was easy and quick to use.
Next: broader deployment
Thanks to strong support from the CIUSSS du Centre-Sud-de-l’Île-de-Montréal, the project is already attracting interest from other institutions.
“We now want to launch this program at the IUGM and two other institutions," said Aubertin-Leheudre. "This will allow us to test the program on senior populations with other profiles and with other types of health-care teams while evaluating the program’s cost effectiveness.
"I believe that this approach will greatly reduce hospital readmissions among seniors, but we need to validate this hypothesis with concrete results. In the long run, all seniors in Quebec should enjoy the benefits of this program."
About the study
Livia P. Carvalho, Marie-Jeanne Kergoat, Aline Boldu and Mylène Aubertin-Leheudre, "A Systematic Approach for Prescribing Posthospitalization Home-Based Physical Activity for Mobility in Older Adults: The PATH Study", Journal of the American Medical Directors Association (JAMDA), March 11 2019.