. 2019 Jul 9;19:189. doi: 10.1186/s12877-019-1201-4

Table 2.

Characteristics of the included studies

Study Country	Sample	Intervention	Outcome measures during hospitalization* (category: outcome measure) *primary outcome measure in bold	Time point of measurement (primary outcome)	Main findings
Abizanda 2011 [32] Spain	n = 400 Mean age, 84 yrs. Females: n = 227 (57%); Patients with acute medical illness (stroke, cardiopulmonary pathologies, or other diagnoses)	Intervention: - Additional occupational therapy by special trained therapists (daily 45-min sessions, 5 days/week) - Day 1: physical, functional, cognitive social and emotional assessment; preparation of individual therapeutic plan - Day 2 until discharge: cognitive exercises, ADL training (mobility in bed, sitting and standing, chair to bed transfers, wheelchair to bed/toilet transfers, dressing, bathing, personal hygiene, toilet use) - Day of discharge: a second 30-min session in addition to the regular 45-min daily intervention; instruction for relatives or caregivers; recommendations for ADL at home Control: Conventional treatment with usual physiotherapy	FCT: Barthel Index (improvement of ≥10 pt. from admission to discharge) COG: CAM	Admission Discharge	Between-group differences at discharge: - Improvement in Barthel Index of ≥10 pt. from admission to discharge: n.s. (total sample, stroke/cardiopulmonary patients), ↑ (others) - Absolute improvement in Barthel Index: n.s. (total sample, stroke patients, others), ↑ (cardiopulmonary patients) Feasibility: - Missing data: Barthel Index = 0% (admission), 6% (discharge)
Blanc-Bisson 2008 [33] France	n = 76 Mean age: 85 yrs. Females: n = 55 (72%); Patients with acute medical illness	Intervention: - Additional early physiotherapy (start: day 1 or 2, 2 times/day for 30 min, 5 days/week), - Focus on leg extension exercises in the upright position - Nutritional supplements Control: - Walking with/without technical assistance or human help (start: day 3 to 6, 3 times/week until discharge) - Nutritional supplements - Physical therapy at home for 1 month	MOB: Handgrip strength (handheld dynamometry) FCT: Katz ADL Index BPN: Body weight, energy intake, protein intake, calf and arm circumferences, triceps skin fold, biochemical measures (serum albumin, C-reactive protein)	Admission Clinical stable condition	Changes from admission to clinical stable situation in total sample (time effect): - Katz ADL Index: ↓ Feasibility: - Missing data: Katz ADL Index = 0%
Brown 2016 [34] USA	n = 100 Mean age: 74 yrs. Females: n = 3 (3%) Patients with acute medical illness	Intervention: - Additional mobility protocol: Starting with basic transfers with progress to ambulation if tolerated (2 times/day, 15–20 min, 7 days/week) - Patients were encouraged to walk at each session - Physical activity behavioral strategy: goal setting, diary and interview to increase times out of bed Control: Usual care (physical therapy had to be ordered by physicians)	FCT: Modified Katz ADL Index HU: LOS, physical therapy ordered during hospitalization ACE: Falls	Admission Discharge	Between-group differences at discharge: - Modified Katz ADL Index: n.s. Changes during hospitalization in total sample: - Katz ADL Index: n.s. Group × time interaction during hospitalization: - Katz ADL Index: n.s. Feasibility: - Katz ADL Index: mean admission score in both groups was within the best 15% of the rating scale → ceiling effect
Czyzewski 2013 [35] Poland	n = 34 Mean age: 76 yrs. Females: n = 14 (41%); Patients with major abdominal surgery	Intervention: - Usual care with a modified exercise component based on the Proprioceptive Neuromuscular Facilitation concept (30 min/day) Control: Usual care (30 min/day)	MOB: 10MWT, TUG FCT: Lawton IADL scale MOB: UCLA scale, PPSA BPN: Forced ventilation capacity, first-second forced expiratory volume, maximal expiratory flow (spirometry) HU: LOS	3 days prior surgery 4 days after surgery	Within-group changes from 3 days prior surgery to 4 days after surgery: - 10MWT, TUG: ↓ in both groups - Lawton IADL scale, UCLA, PPSA: NA Between-group differences 4 days after surgery: - PPSA: ↑ - 10MWT, TUG: NA Feasibility: - Lawton IADL scale: mean admission score of the sample was within the best 15% of the rating scale → ceiling effect - Missing data (3 days prior & 4 days after surgery): 10MWT, TUG = 9%, SAP = 0%, UCLA, IADL: NA
Eyres 2005 [36] Australia	n = 15 Mean age: 80 yrs. Females: n = 9 (60%); Patients with acute medical illness	Intervention: - Daily additional occupational therapy - Self-care program (ADL), IADL training (e.g., cooking, laundry, café visits), community mobility (e.g., walking outdoors) Control: Usual care	FCT: FIM PSY: Self-Efficacy Gauge, Life Satisfaction Index HU: LOS, use of allied health services, use of community services, discharge destination	Admission Discharge	Within-group comparisons over time: - FIM ↑ (IG, CG) - Self-Efficacy Gauge: n.s. (IG, CG) - Life Satisfaction Index: n.s. (IG, CG) Feasibility: - Missing data: FIM, Self-Efficacy Gauge, Life Satisfaction Index = 0%
Hagsten 2004 [37] Sweden	n = 100 Mean age: 80 yrs. Females: n = 80 (80%); Patients with hip fracture	Intervention: - Additional occupational therapy (40–60 min, 5 days/week) - Self-care, independence at home (transfers, bathroom visits, morning activities, dressing), use of aids - Home visits - Instruction of a physiotherapist CG: Usual care from nursing staff, instruction of a physiotherapist	FCT: Modified Klein-Bell ADL Scale (75 items of 4 areas: dressing, toilet visits, mobility, bathing/hygiene); mDRI with visual analogize scales for ADL, indoor IADL, and outdoor IADL PSY: Study-specific mDRI items on fear of performing (I)ADL and for pain level during (I)ADL performance	Discharge	Between-group differences at discharge: - Modified Klein-Bell ADL scale: dressing ↑, toilet visits ↑, hygiene ↑, mobility: n.s. mDRI: ADL, indoor/outdoor IADLs, fear, pain: n.s. Feasibility: - Missing data: Klein-Bell ADL scale, mDRI = 0%
He 2015 [38] China	n = 101 Mean age: 71 yrs. Females: n = 11 (12%) Patient with acute COPD exacerbation	Intervention: - Patient education (physical activity behavior intervention): benefits and importance of daily exercise, pacing and energy-conservation technique to manage ADL - Stretching, endurance & strength training (endurance lower limb: walking with treadmill; upper limb: shoulder flexion and abduction with light weight; strength training: free weights or body weights) - breathing exercise: relaxation, breathing control, pursed-lip breathing, pacing during exercise - 30 min 2 times/day Control: Usual care	MOB: 6MWT DS: mMRC dyspnea grade, ADL-Dyspnea scale, CRQ-SAS, CAT Borg dyspnea scale, Bode index BPN: Resting/exercise oxygen saturation (spirometry, arterial blood gas analysis)	Admission Discharge	Within-group differences from admission to discharge: - 6MWT: ↑ (IG), n.s. (CG) - mMRC dyspnea grade: ↑ (IG), n.s. (CG) - ADL-Dyspnea scale: ↑ (IG), n.s. (CG) - CRQ-SAS: ↑ (IG), n.s. (CG) - CAT: ↑ in both groups Feasibility: NA
Jeffs 2013 [39] Australia	n = 649 Mean age: 79 yrs. Females: n = 340 (52%) Patients with acute medical illness	Intervention: - Graded physical activity and orientation program twice daily in addition to usual care - Physical activity program: progressive, variable resistance training against gravity, body or light weight (progression whenever a patient could perform 10 repetitions), - Cognitive exercise program: Orientation, (7 questions for improving orientation [day, month, year, date, ward, bed number, name of primary nurse]); - 2 times/day, 5 days/week, 20–30 min until discharge + self-training on weekends Control: Usual care (including: 24 h nursing care, daily medical assessment, allied health referral)	COG: Number of delirious patients, severity/duration of delirium (CAM) HU: Discharge destination, LOS	Admission Every 48 h until discharge	Between-group differences - Number of delirious patients: n.s. Feasibility: - No delirium in 94% of patients → rare event
Jones 2006 [40] Australia	n = 160 Mean age: 82 yrs. Females: n = 92 (58%) Patients with acute medical illness	Intervention: - Additional exercise program (2 times/day, 30 min) - Strengthening and mobility exercises (e.g., sit-to-stand transfer) specifically designed to be carried out in a hospital setting Control: Usual care with standard physiotherapy	FCT: Barthel Index MOB: TUG HU: Discharge destination, LOS ACE: Falls, mortality, deterioration in medical status	Admission Discharge	Between-group differences at discharge: - Barthel Index: n.s. Multivariable regression analyses: - Barthel Index: low admission Barthel Index & IG assignment = independent predictors of improving Barthel Index Feasibility: - Missing data: Barthel Index = 0%
Kimmel 2016 [41] Australia	n = 92 Mean age: 81 yrs. Females n = 59 (64%) Patients with hip fracture	Intervention: - Two additional physiotherapy sessions aimed to improve the functional advances achieved during the usual physiotherapy session (3 times/day, 7 days/week) Control: Usual care (physiotherapy: 1 time/day, 7 days/week)	MOB: mILOAS, TUG HU: LOS, Discharge destination, opioid equivalence score ACE: Postoperative complications PSY: Self-developed pain scale	Day 5	Between-group differences at post-operative Day 5: - mILOAS: n.s. Between-group differences controlled for confounding factors: - mILOAS: ↑ Feasibility: - Missing data: mILOA = 0%
Nikolaus 1999 [42] Germany	n = 545 Mean age, 81 yrs. Females: n = 400 (73%); Patients with acute medical illness	Intervention 1:Comprehensive geriatric assessment and interdisciplinary intervention in the hospital and at home, physical and occupational therapy (washing, eating, dressing, walking) twice a week up to twice a day for 30 min Intervention 2: Comprehensive geriatric assessment with recommendation in the hospital and usual care at home Control: Assessment of ADL and cognition and usual care in the hospital and at home	FCT: Barthel Index, Lawton IADL scale HU: Discharge destination, LOS	Admission Discharge	Between-group differences at discharge: - Barthel Index, Lawton IADL scale: n.s. Feasibility: - Barthel Index, Lawton IADL scale: mean discharge scores in both groups within the best 15% of the rating scale → ceiling effect - Missing data: Barthel Index, Lawton IADL scale = 0% (discharge)
Oldmeadow 2006 [43] Australia	n = 60 Mean age: 79 yrs. Females: n = 43 (68%) Patient with hip fracture	Intervention: - First walk at day 1 or 2 (early mobilization) (7 days/week) Control: Usual care (first walk at day 3 or 4) (7 days/week)	MOB: mILOAS items: Transfer from supine to sitting, transfer from sitting to standing (independent vs. assisted), ambulation (walking distance), step negotiation (independent vs. failed/unable) HU: Discharge destination, LOS	Day 7	Between-group differences at post-surgery day 7: - mILOAS: transfer item: ↑, walking distance: ↑, step negotiation: n.s. Feasibility at day 7: - mILOAS step negotiation item: > 15% (23%) of total sample with worst possible score → floor effect, 21% missing data - mILOAS transfer item = 15% missing data
Siebens et al., 2000 [44] USA	n = 300 Mean age: 78 yrs. Females: n = 182 (61%); Patients with acute medical illness	Intervention: - Hospital-based exercise program (twice a day) - Flexibility and strengthening exercises - Walking program (60 to 80% max. Heart rate, 5 min to 30 min) Control: Usual care	HU: LOS ACE: Mortality	Discharge	Between-group differences at discharge: - LOS: n.s. Feasibility: - Missing data: LOS = 0%
Torres-Sanchez 2017 [45] Spain	n = 58 Mean age: 74 yrs. Females: n = 16 (28%); Patients with acute exacerbation of COPD	Intervention: - Additional individually-adapted endurance training on a pedal exerciser - Cycling time, velocity, and resistance were adapted to patient and increased every day Control: Usual care (no supervised or progressive exercise)	MOB: Lower limb strength (handheld dynamometer), balance (OLS), exercise capacity (30CST), physical activity/number of steps (SenseWear Armband)	Admission Discharge	Group × time interaction: - Lower-limb strength: ↑ - Balance: ↑ - Exercise capacity: ↑ Between-group differences at discharge: - Lower-limb strength: ↑ - Balance (OLS): ↑ - Exercise capacity (30STS): n.s. Feasibility: - Missing data: Lower-limb strength, balance (OLS), exercise capacity (30CST) = 0%
Asplund 2000 [46] Sweden	n = 444 Mean age: 81 yrs. Females: n = 251 (61%) Patients with acute medical illness	Intervention: - Multidisciplinary teamwork (internist, geriatrician, nurses, nurse aids, physiotherapist, occupational therapist, social worker, dietician) - Assessment by physiotherapist and occupational therapist - Early start of rehabilitation - Discharge planning Control: General medical unit care	ACE: Mortality HU: LOS, discharge destination, hospital costs	Admission Discharge	Between-group differences at discharge: - Mortality: n.s. Feasibility: - Missing data: mortality = 3% 97% survivals → mortality = rare event
Barnes 2012 [47] USA	n = 1632 Mean age: 81 yrs. Females: n = 1094 (67%) Patient with acute medical illness	Intervention: - Prepared environment (e.g., carpeting, handrails, uncluttered hallways) - Patient-centered care (daily assessment by nurse of physical, cognitive and psychosocial function - Protocols to improve of ADL (bathing/dressing, mobility/transferring, toileting, feeding), nutrition, skin care, falls, cognition, mood etc., daily team rounds by physiotherapist, nurse, social worker, nutritionist) - Planning for discharge - Medical care review (daily by medical director) - Protocols to minimize adverse effects (e.g., urinary catheterization) Control: Usual care	HU: LOS, hospital costs, process-of-care measures (physical therapy consults, orders for bed rest, use of physical restraints, documentation of discharge planning, discharge destination) FCT: Katz ADL Index (bathing, dressing, toileting, transferring, eating), Lawton IADL scale (shopping, cooking, performing household chores, using transportation, managing money, managing medication, and using the telephone) MOB: 5-items hierarchical mobility scale ACE: Mortality	Admission Discharge	Between-group differences at discharge: - LOS: ↓ - Hospital costs: ↓ - Feasibility: - Missing data: LOS, hospital costs = NA
Counsell 2000 [48] USA	n = 1531 Mean age: 80 yrs. Females: n = 926 (61%) Patients with acute medical illness	Intervention: - Prepared environment (e.g., carpeting, handrails, uncluttered hallways) - Patient-centered care (daily assessment by nurse of physical, cognitive and psychosocial function - Protocols to improve of ADL (bathing/dressing, mobility/transferring, toileting, feeding) nutrition, skin care, falls, cognition, mood etc., daily team rounds by physiotherapist, nurse, social worker, nutritionist) - Planning for discharge - Medical care review (daily by medical director) - Protocols to minimize adverse effects Control: Usual care	FCT: Modified Katz ADL Index (bathing, dressing, toileting, transferring, eating), modified Lawton IADL scale (shopping, cooking, performing household chores, using transportation, managing money, managing medication, and using the telephone) MOB: PPME, 5-items hierarchical mobility scale HU: Process-of-care measures (nursing care plans, time from admission to initiation of discharge planning, social work consultation, orders for bed rest, physical therapy consults, use of urinary catheters, and application of physical restraints, inappropriate medications), LOS, hospital costs, discharge destination PSY: Caregiver satisfaction ACE: Mortality	Admission Discharge	Between-group differences at discharge: - Mortality: n.s.; Modified Katz ADL Index: n.s. Feasibility: - Missing data: Katz ADL Index = NA (admission & discharge)
Huusko 2000 [49] Finland	n = 260 Mean age: 80 yrs. Females: n = 184 (72%) Patients with hip fracture No dementia (MMSE 24–30): n = 99 (41%) Suspected severe dementia (MMSE 0–11): n = 28 (12%) Suspected moderate dementia (MMSE 12–17): n = 36 (15%) Suspected mild dementia (MMSE 18–23): n = 77 (32%)	Intervention: - Multidisciplinary teamwork (geriatrician, general practitioner, nurses, social worker, neuropsychologist, occupational therapist, physiotherapist) - Geriatric team assessment - Physiotherapy (2times/day), ADL training by nurses - Weekly meetings by physiotherapists and nurses - Discharge plan Control: Discharged to local hospitals	HU: LOS	Discharge	Between-group differences at discharge: - LOS: severe dementia (MMSE score: 0–11 pt): n.s.; moderate dementia (MMSE score: 12–17 pt): ↓; mild dementia (MMSE score: 18–23 pt) ↓; normal (MMSE score: 24–30): n.s. Feasibility: - Missing data: LOS = 0%
Landefeld 1995 [50] USA	n = 651 Mean age: 80 yrs. Females: n = 435 (67%) Patients with acute medical illness	Intervention: - Prepared environment (e.g., carpeting, handrails, uncluttered hallways) - Patient-centered care (daily assessment by nurse of physical, cognitive and psychosocial function - Protocols to improve of ADL (bathing/dressing, mobility/transferring, toileting, feeding) nutrition, skin care, falls, cognition, mood etc., daily team rounds by physiotherapist, nurse, social worker, nutritionist) - Planning for discharge - Medical care review (daily by medical director) - Protocols to minimize adverse effects (e.g., urinary catheterization) Control: Usual care	FCT: Modified Katz ADL Index (bathing, dressing, toileting, transferring, eating), Lawton IADL scale MOB: Walking ability HU: Discharge destination, LOS, hospital costs PSY: GDS, overall health status COG: MMSE	Admission Discharge	Between-group differences at discharge: - Katz ADL Index: ↑ Multivariable regression analyses controlled for confounding baseline patient characteristics: IG assignment = significant independent predictor of an increase in the number of independently performed ADLs Feasibility: - Katz ADL Index: > 15% of participants reaching a score within the best 15% of the instrument’s rating scale → ceiling effect - Missing data: Katz ADL Index: 0% (admission & discharge)
Naglie 2002 [51] Canada	n = 279 Mean age 84 yrs. Females n = 223 (80%); Patients with hip fracture	Intervention: - Multidisciplinary teamwork (physiotherapist, occupational therapist, nurse, social worker) - Special education of staff - Prevention of complications (e.g., delirium, urinary problems, malnutrition) - Physiotherapy: early full weight bearing, ADL training, (2 times/day for 5 day/week) - Discharge plan, pre-discharge home visits - 2 times/week meeting for monitoring treatment plan Control: Usual care	HU: Discharge destination, LOS	Admission Discharge	Between-group differences at discharge: - Discharge destination: ↑ (in community-dwellers, relative’s/retirement home residents), n.s. (in nursing home residents) Feasibility: - Missing data: Discharge destination: 0%
Pitkälä 2008 [52] Finland	n = 174 Mean age: 83 yrs. Females: n = 128 (74%) Patients with delirium	Intervention: - Comprehensive geriatric assessment (physical examination, cognition, nutrition, screening of depression, review of medication) - Administering antipsychotics for hyperactive/psychotic symptoms - Cholinesterase inhibitors - Orientation (calendars, clocks) - Physiotherapy - Nutritional supplements - Comprehensive discharge planning (e.g., occupational home visits) Control: Usual care	PSY: 15D HRQOL questionnaire, self-developed subjective health scale	Admission Discharge	Between-group differences at discharge: - HRQOL: ↑ - Self-developed subjective health sale: ↑ Feasibility: - Missing data: 15D questionnaire: 9%; self-developed subjective health sale: NA (admission & discharge)
Prestmo 2015 [30] Taraldsen 2014 [31] Norway	n = 397 Mean age: 83 yrs. Females: n = 293 (73%) Patients with hip fracture	Intervention: - Multidisciplinary teamwork (geriatricians, nurses, physiotherapists, occupational therapists, with special competence in geriatrics) - Comprehensive geriatric assessment (somatic and mental health, function, social situation) - Interdisciplinary team meetings - Adequate nutrition, - Individual rehabilitation plan based on cognition and motivation - Early mobilization, functioning in ADL, weight-bearing exercise program - Early discharge planning Control: Usual care (standard orthopedic care)	MOB: SPPB, PA (activPAL: time spent in upright, number of upright events), Cumulated Ambulation Score HU: LOS, discharge destination, hospital costs	Day 4 after surgery (activePAL) Day 5 after surgery (SPPB)	Between-group differences at day 4 (activePAL) and 5 (SPPB): - SPPB: ↑ - Time spent in upright: ↑ Feasibility: - Missing data: SPPB = 13% (5 days after surgery) - activPAL: > 15% missing data
Siebens et al., 2000 [44] USA	n = 300 Mean age: 78 yrs. Females: n = 182 (61%); Patients with acute medical illness	Intervention: - Hospital-based exercise program (twice a day) - Flexibility and strengthening exercises - Walking program (60 to 80% max. Heart rate, 5 min to 30 min) Control: Usual care	HU: LOS ACE: Mortality	Discharge	Between-group differences at discharge: - LOS: n.s. Feasibility: - Missing data: LOS = 0%
Stenvall 2007a,b, 2012 [27–29] Lundström 2007 [26] Sweden	Total sample: n = 199 Mean age: 82 yrs. Females: n = 148 (74%) Patients with hip fracture	Intervention: - Multidisciplinary teamwork (nurses, physiotherapists, occupational therapists, dietician, geriatrician) - Staff education in prevention of postoperative complication - Individual care planning (all team members assessed each patient as soon as possible, planning of process and goals twice a week) - Prevention and treatment of complications (falls, delirium etc.) - Pain treatment (contained assessment of underlying causes) - Saturation (oxygen-enriched air during first two postoperative days) - Nutrition (protein-enriched meals during the first four days) - Mobilization: (ADL training with focus on fall risk factors, high-intensity weight-bearing exercises) Control: Usual care (no corresponding team work)	ACE: Falls, fallers, and time lapse to first fall after admission; AIS, postoperative complications (urinary tract infections, decubitus ulcer, sleeping disturbances, mortality) MOB: COVS walking item FCT: ADL staircase (Katz ADL Index with IADL items) HU: Discharge destination, LOS COG: Number of delirious days (OBS scale), MMSE PSY: GDS BPN: Nutritional problems assessed by care/nursing staff	Discharge	Between-group differences at discharge: - Falls: ↓ - Fallers: ↓ - AIS: minor or moderate injuries:↓, serious injuries: n.s. - COVS walking item: n.s. - ADL staircase: NA (Katz ADL Index: n.s., IADL: NA) - Discharge destination: n.s. - Number of delirious days: ↓ - MMSE: n.s. - GDS: n.s. Feasibility: - Falls: 81% = non-fallers → rare event - AIS: not assessable in 81%; 42% of fallers with an AIS score of 0 pt. → floor effect - GDS: missing data at discharge in 20% - ADL staircase: > 15% of patients reaching a score within the best 15% of the best possible score → ceiling effect
Subsample: n = 64 (32%) Mean age: 82 yrs. Females: n = 47 (73%) Patients with hip fracture & dementia Mean MMSE score: 8.6 (IG), 6.9 (CG)	ACE: Postoperative complications (pneumonia, urinary tract infection, decubital ulcers, new fracture, falls, fallers, fall incidence rate, mortality) COG: Number of delirious days (OBS scale) BPN: Nutritional problems assessed by care/nursing staff MOB: COVS walking item FCT: ADL staircase (Katz ADL Index with IADL items)	Between-group differences at discharge: - Postoperative complications: total: NA; urinary tract infection: ↓; fallers: ↓; Fall incidence rate: ↓; mortality, pneumonia, decubital ulcers, new fracture: n.s. - Number of delirious days: ↓ - COVS walking item: n.s. - ADL staircase: NA (Katz ADL Index: n.s., IADL: NA)
Vidan 2005 [53] Spain	n = 319 Mean age: 82 yrs. Females: n = 260 (82%) Patients with hip fracture	Intervention: - Multidisciplinary teamwork (geriatrician, rehabilitation specialist, and specific social worker) - Geriatric assessment (medical, psychosocial problems and functional capability) - Interdisciplinary meeting to elaborate a comprehensive therapeutic plan (weekly repeated) - Daily visits by geriatrician - Rehabilitation specialist planned physiotherapy (schedule, intensity and duration) - Social worker assessed the social environment Control: Usual care	HU: LOS ACE: Mortality, postoperative complications COG: CAM	Admission Discharge	Admission to discharge: - LOS: n.s. - Mortality: ↓ - Postoperative complications: ↓ Feasibility: - LOS: 0% (admission to discharge) - Mortality: 97% survivals → rare event - Postoperative complications: 47% of patients without complications (admission to discharge) → rare events

Study
Country

Sample

Intervention

Outcome measures during hospitalization*
(category: outcome measure)
*primary outcome measure in bold

Time point of measurement (primary outcome)

Main findings

Abizanda 2011 [32]

Spain

n = 400

Mean age, 84 yrs.

Females: n = 227 (57%);

Patients with acute medical illness (stroke, cardiopulmonary pathologies, or other diagnoses)

Intervention:

- Additional occupational therapy by special trained therapists (daily 45-min sessions, 5 days/week)

- Day 1: physical, functional, cognitive social and emotional assessment; preparation of individual therapeutic plan

- Day 2 until discharge: cognitive exercises, ADL training (mobility in bed, sitting and standing, chair to bed transfers, wheelchair to bed/toilet transfers, dressing, bathing, personal hygiene, toilet use)

- Day of discharge: a second 30-min session in addition to the regular 45-min daily intervention; instruction for relatives or caregivers; recommendations for ADL at home

Control: Conventional treatment with usual physiotherapy

FCT: Barthel Index (improvement of ≥10 pt. from admission to discharge)

COG: CAM

Admission

Discharge

Between-group differences at discharge:

- Improvement in Barthel Index of ≥10 pt. from admission to discharge: n.s. (total sample, stroke/cardiopulmonary patients), ↑ (others)

- Absolute improvement in Barthel Index: n.s. (total sample, stroke patients, others), ↑ (cardiopulmonary patients)

Feasibility:

- Missing data: Barthel Index = 0% (admission), 6% (discharge)

Blanc-Bisson 2008 [33]

France

n = 76

Mean age: 85 yrs.

Females: n = 55 (72%);

Patients with acute medical illness

Intervention:

- Additional early physiotherapy (start: day 1 or 2, 2 times/day for 30 min, 5 days/week),

- Focus on leg extension exercises in the upright position

- Nutritional supplements

Control:

- Walking with/without technical assistance or human help (start: day 3 to 6, 3 times/week until discharge)

- Nutritional supplements

- Physical therapy at home for 1 month

MOB: Handgrip strength (handheld dynamometry)

FCT: Katz ADL Index

BPN: Body weight, energy intake, protein intake, calf and arm circumferences, triceps skin fold, biochemical measures (serum albumin, C-reactive protein)

Admission

Clinical stable condition

Changes from admission to clinical stable situation in total sample (time effect):

- Katz ADL Index: ↓

Feasibility:

- Missing data: Katz ADL Index = 0%

Brown 2016 [34]

USA

n = 100

Mean age: 74 yrs.

Females: n = 3 (3%)

Patients with acute medical illness

Intervention:

- Additional mobility protocol: Starting with basic transfers with progress to ambulation if tolerated (2 times/day, 15–20 min, 7 days/week)

- Patients were encouraged to walk at each session

- Physical activity behavioral strategy: goal setting, diary and interview to increase times out of bed

Control: Usual care (physical therapy had to be ordered by physicians)

FCT: Modified Katz ADL Index

HU: LOS, physical therapy ordered during hospitalization

ACE: Falls

Admission

Discharge

Between-group differences at discharge:

- Modified Katz ADL Index: n.s.

Changes during hospitalization in total sample:

- Katz ADL Index: n.s.

Group × time interaction during hospitalization:

- Katz ADL Index: n.s.

Feasibility:

- Katz ADL Index: mean admission score in both groups was within the best 15% of the rating scale → ceiling effect

Czyzewski 2013 [35]

Poland

n = 34

Mean age: 76 yrs.

Females: n = 14 (41%);

Patients with major abdominal surgery

Intervention:

- Usual care with a modified exercise component based on the Proprioceptive Neuromuscular Facilitation concept (30 min/day)

Control: Usual care (30 min/day)

MOB: 10MWT, TUG

FCT: Lawton IADL scale

MOB: UCLA scale, PPSA

BPN: Forced ventilation capacity, first-second forced expiratory volume, maximal expiratory flow (spirometry)

HU: LOS

3 days prior surgery

4 days after surgery

Within-group changes from 3 days prior surgery to 4 days after surgery:

- 10MWT, TUG: ↓ in both groups

- Lawton IADL scale, UCLA, PPSA: NA

Between-group differences 4 days after surgery:

- PPSA: ↑

- 10MWT, TUG: NA

Feasibility:

- Lawton IADL scale: mean admission score of the sample was within the best 15% of the rating scale → ceiling effect

- Missing data (3 days prior & 4 days after surgery): 10MWT, TUG = 9%, SAP = 0%, UCLA, IADL: NA

Eyres 2005 [36]

Australia

n = 15

Mean age: 80 yrs.

Females: n = 9 (60%);

Patients with acute medical illness

Intervention:

- Daily additional occupational therapy

- Self-care program (ADL), IADL training (e.g., cooking, laundry, café visits), community mobility (e.g., walking outdoors)

Control: Usual care

FCT: FIM

PSY: Self-Efficacy Gauge, Life Satisfaction Index

HU: LOS, use of allied health services, use of community services, discharge destination

Admission

Discharge

Within-group comparisons over time:

- FIM ↑ (IG, CG)

- Self-Efficacy Gauge: n.s. (IG, CG)

- Life Satisfaction Index: n.s. (IG, CG)

Feasibility:

- Missing data: FIM, Self-Efficacy Gauge, Life Satisfaction Index = 0%

Hagsten 2004 [37]

Sweden

n = 100

Mean age: 80 yrs.

Females: n = 80 (80%);

Patients with hip fracture

Intervention:

- Additional occupational therapy (40–60 min, 5 days/week)

- Self-care, independence at home (transfers, bathroom visits, morning activities, dressing), use of aids

- Home visits

- Instruction of a physiotherapist

CG: Usual care from nursing staff, instruction of a physiotherapist

FCT: Modified Klein-Bell ADL Scale (75 items of 4 areas: dressing, toilet visits, mobility, bathing/hygiene); mDRI with visual analogize scales for ADL, indoor IADL, and outdoor IADL

PSY: Study-specific mDRI items on fear of performing (I)ADL and for pain level during (I)ADL performance

Discharge

Between-group differences at discharge:

- Modified Klein-Bell ADL scale: dressing ↑, toilet visits ↑, hygiene ↑, mobility: n.s.

mDRI: ADL, indoor/outdoor IADLs, fear, pain: n.s.

Feasibility:

- Missing data: Klein-Bell ADL scale, mDRI = 0%

He 2015 [38]

China

n = 101

Mean age: 71 yrs.

Females: n = 11 (12%)

Patient with acute

COPD exacerbation

Intervention:

- Patient education (physical activity behavior intervention): benefits and importance of daily exercise, pacing and energy-conservation technique to manage ADL

- Stretching, endurance & strength training (endurance lower limb: walking with treadmill; upper limb: shoulder flexion and abduction with light weight; strength training: free weights or body weights)

- breathing exercise: relaxation, breathing control, pursed-lip breathing, pacing during exercise

- 30 min 2 times/day

Control: Usual care

MOB: 6MWT

DS: mMRC dyspnea grade, ADL-Dyspnea scale, CRQ-SAS, CAT Borg dyspnea scale, Bode index

BPN: Resting/exercise oxygen saturation (spirometry, arterial blood gas analysis)

Admission

Discharge

Within-group differences from admission to discharge:

- 6MWT: ↑ (IG), n.s. (CG)

- mMRC dyspnea grade: ↑ (IG), n.s. (CG)

- ADL-Dyspnea scale: ↑ (IG), n.s. (CG)

- CRQ-SAS: ↑ (IG), n.s. (CG)

- CAT: ↑ in both groups

Feasibility: NA

Jeffs 2013 [39]

Australia

n = 649

Mean age: 79 yrs.

Females: n = 340 (52%)

Patients with acute medical illness

Intervention:

- Graded physical activity and orientation program twice daily in addition to usual care

- Physical activity program: progressive, variable resistance training against gravity, body or light weight (progression whenever a patient could perform 10 repetitions),

- Cognitive exercise program: Orientation, (7 questions for improving orientation [day, month, year, date, ward, bed number, name of primary nurse]);

- 2 times/day, 5 days/week, 20–30 min until discharge + self-training on weekends

Control: Usual care (including: 24 h nursing care, daily medical assessment, allied health referral)

COG: Number of delirious patients, severity/duration of delirium (CAM)

HU: Discharge destination, LOS

Admission

Every 48 h until discharge

Between-group differences

- Number of delirious patients: n.s.

Feasibility:

- No delirium in 94% of patients → rare event

Jones 2006 [40]

Australia

n = 160

Mean age: 82 yrs.

Females: n = 92 (58%)

Patients with acute medical illness

Intervention:

- Additional exercise program (2 times/day, 30 min)

- Strengthening and mobility exercises (e.g., sit-to-stand transfer) specifically designed to be carried out in a hospital setting

Control: Usual care with standard physiotherapy

FCT: Barthel Index

MOB: TUG

HU: Discharge destination, LOS

ACE: Falls, mortality, deterioration in medical status

Admission

Discharge

Between-group differences at discharge:

- Barthel Index: n.s.

Multivariable regression analyses:

- Barthel Index: low admission Barthel Index & IG assignment = independent predictors of improving Barthel Index

Feasibility:

- Missing data: Barthel Index = 0%

Kimmel 2016 [41]

Australia

n = 92

Mean age: 81 yrs.

Females n = 59 (64%)

Patients with hip fracture

Intervention:

- Two additional physiotherapy sessions aimed to improve the functional advances achieved during the usual physiotherapy session (3 times/day, 7 days/week)

Control: Usual care (physiotherapy: 1 time/day, 7 days/week)

MOB: mILOAS, TUG

HU: LOS, Discharge destination, opioid equivalence score

ACE: Postoperative complications

PSY: Self-developed pain scale

Day 5

Between-group differences at post-operative Day 5:

- mILOAS: n.s.

Between-group differences controlled for confounding factors:

- mILOAS: ↑

Feasibility:

- Missing data: mILOA = 0%

Nikolaus 1999 [42]

Germany

n = 545

Mean age, 81 yrs.

Females: n = 400 (73%);

Patients with acute medical illness

Intervention 1:Comprehensive geriatric assessment and interdisciplinary intervention in the hospital and at home, physical and occupational therapy (washing, eating, dressing, walking) twice a week up to twice a day for 30 min

Intervention 2: Comprehensive geriatric assessment with recommendation in the hospital and usual care at home

Control: Assessment of ADL and cognition and usual care in the hospital and at home

FCT: Barthel Index, Lawton IADL scale

HU: Discharge destination, LOS

Admission

Discharge

Between-group differences at discharge:

- Barthel Index, Lawton IADL scale: n.s.

Feasibility:

- Barthel Index, Lawton IADL scale: mean discharge scores in both groups within the best 15% of the rating scale → ceiling effect

- Missing data: Barthel Index, Lawton IADL scale = 0% (discharge)

Oldmeadow 2006 [43]

Australia

n = 60

Mean age: 79 yrs.

Females: n = 43 (68%)

Patient with hip fracture

Intervention:

- First walk at day 1 or 2 (early mobilization) (7 days/week)

Control: Usual care (first walk at day 3 or 4) (7 days/week)

MOB: mILOAS items: Transfer from supine to sitting, transfer from sitting to standing (independent vs. assisted), ambulation (walking distance), step negotiation (independent vs. failed/unable)

HU: Discharge destination, LOS

Day 7

Between-group differences at post-surgery day 7:

- mILOAS: transfer item: ↑, walking distance: ↑, step negotiation: n.s.

Feasibility at day 7:

- mILOAS step negotiation item: > 15% (23%) of total sample with worst possible score → floor effect, 21% missing data

- mILOAS transfer item = 15% missing data

Siebens et al., 2000 [44]

USA

n = 300

Mean age: 78 yrs.

Females: n = 182 (61%);

Patients with acute medical illness

Intervention:

- Hospital-based exercise program (twice a day)

- Flexibility and strengthening exercises

- Walking program (60 to 80% max. Heart rate, 5 min to 30 min)

Control: Usual care

HU: LOS

ACE: Mortality

Discharge

Between-group differences at discharge:

- LOS: n.s.

Feasibility:

- Missing data: LOS = 0%

Torres-Sanchez 2017 [45]

Spain

n = 58

Mean age: 74 yrs.

Females: n = 16 (28%);

Patients with acute exacerbation of COPD

Intervention:

- Additional individually-adapted endurance training on a pedal exerciser

- Cycling time, velocity, and resistance were adapted to patient and increased every day

Control: Usual care (no supervised or progressive exercise)

MOB: Lower limb strength (handheld dynamometer), balance (OLS), exercise capacity (30CST), physical activity/number of steps (SenseWear Armband)

Admission

Discharge

Group × time interaction:

- Lower-limb strength: ↑

- Balance: ↑

- Exercise capacity: ↑

Between-group differences at discharge:

- Lower-limb strength: ↑

- Balance (OLS): ↑

- Exercise capacity (30STS): n.s.

Feasibility:

- Missing data: Lower-limb strength, balance (OLS), exercise capacity (30CST) = 0%

Asplund 2000 [46]

Sweden

n = 444

Mean age: 81 yrs.

Females: n = 251 (61%)

Patients with acute medical illness

Intervention:

- Multidisciplinary teamwork (internist, geriatrician, nurses, nurse aids, physiotherapist, occupational therapist, social worker, dietician)

- Assessment by physiotherapist and occupational therapist

- Early start of rehabilitation

- Discharge planning

Control: General medical unit care

ACE: Mortality

HU: LOS, discharge destination, hospital costs

Admission

Discharge

Between-group differences at discharge:

- Mortality: n.s.

Feasibility:

- Missing data: mortality = 3%

97% survivals → mortality = rare event

Barnes 2012 [47]

USA

n = 1632

Mean age: 81 yrs.

Females: n = 1094 (67%)

Patient with acute medical illness

Intervention:

- Prepared environment (e.g., carpeting, handrails, uncluttered hallways)

- Patient-centered care (daily assessment by nurse of physical, cognitive and psychosocial function

- Protocols to improve of ADL (bathing/dressing, mobility/transferring, toileting, feeding), nutrition, skin care, falls, cognition, mood etc., daily team rounds by physiotherapist, nurse, social worker, nutritionist)

- Planning for discharge

- Medical care review (daily by medical director)

- Protocols to minimize adverse effects (e.g., urinary catheterization)

Control: Usual care

HU: LOS, hospital costs, process-of-care measures (physical therapy consults, orders for bed rest, use of physical restraints, documentation of discharge planning, discharge destination)

FCT: Katz ADL Index (bathing, dressing, toileting, transferring, eating), Lawton IADL scale (shopping, cooking, performing household chores, using transportation, managing money, managing medication, and using the telephone)

MOB: 5-items hierarchical mobility scale

ACE: Mortality

Admission

Discharge

Between-group differences at discharge:

- LOS: ↓

- Hospital costs: ↓

- Feasibility:

- Missing data: LOS, hospital costs = NA

Counsell 2000 [48]

USA

n = 1531

Mean age: 80 yrs.

Females: n = 926 (61%)

Patients with acute medical illness

Intervention:

- Prepared environment (e.g., carpeting, handrails, uncluttered hallways)

- Patient-centered care (daily assessment by nurse of physical, cognitive and psychosocial function

- Protocols to improve of ADL (bathing/dressing, mobility/transferring, toileting, feeding) nutrition, skin care, falls, cognition, mood etc., daily team rounds by physiotherapist, nurse, social worker, nutritionist)

- Planning for discharge

- Medical care review (daily by medical director)

- Protocols to minimize adverse effects

Control: Usual care

FCT: Modified Katz ADL Index (bathing, dressing, toileting, transferring, eating), modified Lawton IADL scale (shopping, cooking, performing household chores, using transportation, managing money, managing medication, and using the telephone)

MOB: PPME, 5-items hierarchical mobility scale

HU: Process-of-care measures (nursing care plans, time from admission to initiation of discharge planning, social work consultation, orders for bed rest, physical therapy consults, use of urinary catheters, and application of physical restraints, inappropriate medications), LOS, hospital costs, discharge destination

PSY: Caregiver satisfaction

ACE: Mortality

Admission

Discharge

Between-group differences at discharge:

- Mortality: n.s.; Modified Katz ADL Index: n.s.

Feasibility:

- Missing data: Katz ADL Index = NA (admission & discharge)

Huusko 2000 [49]

Finland

n = 260

Mean age: 80 yrs.

Females: n = 184 (72%)

Patients with hip fracture

No dementia (MMSE 24–30): n = 99 (41%)

Suspected severe dementia (MMSE 0–11): n = 28 (12%)

Suspected moderate dementia (MMSE 12–17): n = 36 (15%)

Suspected mild dementia (MMSE 18–23): n = 77 (32%)

Intervention:

- Multidisciplinary teamwork (geriatrician, general practitioner, nurses, social worker, neuropsychologist, occupational therapist, physiotherapist)

- Geriatric team assessment

- Physiotherapy (2times/day), ADL training by nurses

- Weekly meetings by physiotherapists and nurses

- Discharge plan

Control: Discharged to local hospitals

HU: LOS

Discharge

Between-group differences at discharge:

- LOS: severe dementia (MMSE score: 0–11 pt): n.s.; moderate dementia (MMSE score: 12–17 pt): ↓; mild dementia (MMSE score: 18–23 pt) ↓; normal (MMSE score: 24–30): n.s.

Feasibility:

- Missing data: LOS = 0%

Landefeld 1995 [50]

USA

n = 651

Mean age: 80 yrs.

Females: n = 435 (67%)

Patients with acute medical illness

Intervention:

- Prepared environment (e.g., carpeting, handrails, uncluttered hallways)

- Patient-centered care (daily assessment by nurse of physical, cognitive and psychosocial function

- Planning for discharge

- Medical care review (daily by medical director)

- Protocols to minimize adverse effects (e.g., urinary catheterization)

Control: Usual care

FCT: Modified Katz ADL Index (bathing, dressing, toileting, transferring, eating), Lawton IADL scale

MOB: Walking ability

HU: Discharge destination, LOS, hospital costs

PSY: GDS, overall health status

COG: MMSE

Admission

Discharge

Between-group differences at discharge:

- Katz ADL Index: ↑

Multivariable regression analyses controlled for confounding baseline patient characteristics: IG assignment = significant independent predictor of an increase in the number of independently performed ADLs

Feasibility:

- Katz ADL Index: > 15% of participants reaching a score within the best 15% of the instrument’s rating scale → ceiling effect

- Missing data: Katz ADL Index: 0% (admission & discharge)

Naglie 2002 [51]

Canada

n = 279

Mean age 84 yrs.

Females n = 223 (80%);

Patients with hip fracture

Intervention:

- Multidisciplinary teamwork (physiotherapist, occupational therapist, nurse, social worker)

- Special education of staff

- Prevention of complications (e.g., delirium, urinary problems, malnutrition)

- Physiotherapy: early full weight bearing, ADL training, (2 times/day for 5 day/week)

- Discharge plan, pre-discharge home visits

- 2 times/week meeting for monitoring treatment plan

Control: Usual care

HU: Discharge destination, LOS

Admission

Discharge

Between-group differences at discharge:

- Discharge destination: ↑ (in community-dwellers, relative’s/retirement home residents), n.s. (in nursing home residents)

Feasibility:

- Missing data: Discharge destination: 0%

Pitkälä 2008 [52]

Finland

n = 174

Mean age: 83 yrs.

Females: n = 128 (74%)

Patients with delirium

Intervention:

- Comprehensive geriatric assessment (physical examination, cognition, nutrition, screening of depression, review of medication)

- Administering antipsychotics for hyperactive/psychotic symptoms

- Cholinesterase inhibitors

- Orientation (calendars, clocks)

- Physiotherapy

- Nutritional supplements

- Comprehensive discharge planning (e.g., occupational home visits)

Control: Usual care

PSY: 15D HRQOL questionnaire, self-developed subjective health scale

Admission

Discharge

Between-group differences at discharge:

- HRQOL: ↑

- Self-developed subjective health sale: ↑

Feasibility:

- Missing data: 15D questionnaire: 9%; self-developed subjective health sale: NA (admission & discharge)

Prestmo 2015 [30]

Taraldsen 2014 [31]

Norway

n = 397

Mean age: 83 yrs.

Females: n = 293 (73%)

Patients with hip fracture

Intervention:

- Multidisciplinary teamwork (geriatricians, nurses, physiotherapists, occupational therapists, with special competence in geriatrics)

- Comprehensive geriatric assessment (somatic and mental health, function, social situation)

- Interdisciplinary team meetings

- Adequate nutrition,

- Individual rehabilitation plan based on cognition and motivation

- Early mobilization, functioning in ADL, weight-bearing exercise program

- Early discharge planning

Control: Usual care (standard orthopedic care)

MOB: SPPB, PA (activPAL: time spent in upright, number of upright events), Cumulated Ambulation Score

HU: LOS, discharge destination, hospital costs

Day 4 after surgery (activePAL)

Day 5 after surgery (SPPB)

Between-group differences at day 4 (activePAL) and 5 (SPPB):

- SPPB: ↑

- Time spent in upright: ↑

Feasibility:

- Missing data: SPPB = 13% (5 days after surgery)

- activPAL: > 15% missing data

Siebens et al., 2000 [44]

USA

n = 300

Mean age: 78 yrs.

Females: n = 182 (61%);

Patients with acute medical illness

Intervention:

- Hospital-based exercise program (twice a day)

- Flexibility and strengthening exercises

- Walking program (60 to 80% max. Heart rate, 5 min to 30 min)

Control: Usual care

HU: LOS

ACE: Mortality

Discharge

Between-group differences at discharge:

- LOS: n.s.

Feasibility:

- Missing data: LOS = 0%

Stenvall 2007a,b, 2012 [27–29]

Lundström 2007 [26]

Sweden

Total sample:

n = 199

Mean age: 82 yrs.

Females: n = 148 (74%)

Patients with hip fracture

Intervention:

- Multidisciplinary teamwork (nurses, physiotherapists, occupational therapists, dietician, geriatrician)

- Staff education in prevention of postoperative complication

- Individual care planning (all team members assessed each patient as soon as possible, planning of process and goals twice a week)

- Prevention and treatment of complications (falls, delirium etc.)

- Pain treatment (contained assessment of underlying causes)

- Saturation (oxygen-enriched air during first two postoperative days)

- Nutrition (protein-enriched meals during the first four days)

- Mobilization: (ADL training with focus on fall risk factors, high-intensity weight-bearing exercises)

Control: Usual care (no corresponding team work)

ACE: Falls, fallers, and time lapse to first fall after admission; AIS, postoperative complications (urinary tract infections, decubitus ulcer, sleeping disturbances, mortality)

MOB: COVS walking item

FCT: ADL staircase (Katz ADL Index with IADL items)

HU: Discharge destination, LOS

COG: Number of delirious days (OBS scale), MMSE

PSY: GDS

BPN: Nutritional problems assessed by care/nursing staff

Discharge

Between-group differences at discharge:

- Falls: ↓

- Fallers: ↓

- AIS: minor or moderate injuries:↓, serious injuries: n.s.

- COVS walking item: n.s.

- ADL staircase: NA (Katz ADL Index: n.s., IADL: NA)

- Discharge destination: n.s.

- Number of delirious days: ↓

- MMSE: n.s.

- GDS: n.s.

Feasibility:

- Falls: 81% = non-fallers → rare event

- AIS: not assessable in 81%; 42% of fallers with an AIS score of 0 pt. → floor effect

- GDS: missing data at discharge in 20%

- ADL staircase: > 15% of patients reaching a score within the best 15% of the best possible score → ceiling effect

Subsample:

n = 64 (32%)

Mean age: 82 yrs.

Females: n = 47 (73%)

Patients with hip fracture & dementia

Mean MMSE score: 8.6 (IG), 6.9 (CG)

ACE: Postoperative complications (pneumonia, urinary tract infection, decubital ulcers, new fracture, falls, fallers, fall incidence rate, mortality)

COG: Number of delirious days (OBS scale)

BPN: Nutritional problems assessed by care/nursing staff

MOB: COVS walking item

FCT: ADL staircase (Katz ADL Index with IADL items)

Between-group differences at discharge:

- Postoperative complications: total: NA; urinary tract infection: ↓; fallers: ↓; Fall incidence rate: ↓; mortality, pneumonia, decubital ulcers, new fracture: n.s.

- Number of delirious days: ↓

- COVS walking item: n.s.

- ADL staircase: NA (Katz ADL Index: n.s., IADL: NA)

Vidan 2005 [53]

Spain

n = 319

Mean age: 82 yrs.

Females: n = 260 (82%)

Patients with hip fracture

Intervention:

- Multidisciplinary teamwork (geriatrician, rehabilitation specialist, and specific social worker)

- Geriatric assessment (medical, psychosocial problems and functional capability)

- Interdisciplinary meeting to elaborate a comprehensive therapeutic plan (weekly repeated)

- Daily visits by geriatrician

- Rehabilitation specialist planned physiotherapy (schedule, intensity and duration)

- Social worker assessed the social environment

Control: Usual care

HU: LOS

ACE: Mortality, postoperative complications

COG: CAM

Admission

Discharge

Admission to discharge:

- LOS: n.s.

- Mortality: ↓

- Postoperative complications: ↓

Feasibility:

- LOS: 0% (admission to discharge)

- Mortality: 97% survivals → rare event

- Postoperative complications:

47% of patients without complications (admission to discharge) → rare events

10MWT 10-Meter Walking Test, 30CST 30-Seconds Chair Stand Test, 6MWT 6-Minute Walk Test, ACE Adverse clinical events, ADL Activities of daily living; AIS, Abbreviated Injury Scale, BPN Body constitution, physiological or nutritional status, CAM Confusion Assessment Method, CAM Confusion Assessment Method, CAT COPD Assessment Test, CG Control group, COG Cognitive functioning, COPD Chronic obstructive pulmonary disease, COVS Clinical Outcome Variables Scale, CRQ-SAS Chronic Respiratory Questionnaire Self-Administered Standardized, DSM-IV Diagnostic and Statistical Manual of Mental Disorders, FCT Functional status, FIM Functional Independence Measure, GDS Geriatric Depression Scale, HRQOL Health-related quality of life, HU Hospital outcomes, IADL Instrumental activities of daily living, IG Intervention group, LOS Length of stay, mDRI modified Disability Rating Index, mILOAS Modified Iowa level of Assistance, mMRC modified Medical Research Council, MMSE Mini-Mental State Examination, n.s not significant (p > 0.05), NA Not available, OLS One Leg Stance, PPAS Postoperative patient activity scale, PPME Physical Performance and Mobility Examination, PSY Psychological status, SPPB Short Physical Performance Battery, TUG Timed Up and Go, UCLA scale University of California, Los Angeles Activity scale; ↑, significant increase (p ≤ 0.05); ↓, significant decrease (p ≤ 0.05)