Summary of findings 2. Summary of findings table ‐ Rehabilitation‐related activity interventions compared to usual care with or without sham interventions for acutely hospitalised older medical patients.

Rehabilitation‐related activity interventions compared to usual care with or without sham interventions for acutely hospitalised older medical patients
Patient or population: acutely hospitalised older medical patients Setting: acute hospital wards Intervention: rehabilitation‐related activities Comparison: usual care ± sham interventions
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with usual care ± sham interventions	Risk with rehabilitation‐related activities
Functional ability: independence with activities of daily living at discharge from hospital assessed with: Barthel Index (higher scores = independence) Scale from: 0 to 100	The mean functional ability: independence with activities of daily living at discharge from hospital was 42 points on the Barthel Indexa	MD 0 points on the Barthel Index (0.12 lower to 0.13 higher)b	‐	2838 (4 RCTs)	⊕⊕⊝⊝ Lowc,d	Rehabilitation‐related activities may result in little to no difference in independence with activities of daily living at discharge from hospital (standardised mean difference (SMD) 0.00, 95% CI −0.12 to 0.13). A change of 11 points on the Barthel Index is thought to represent a minimally clinically important difference (MCID).
Functional ability: functional mobility at discharge from hospital assessed with: Physical Performance and Mobility Examination (higher scores = greater function)	The mean functional ability: functional mobility at discharge from hospital was 5 points on the Physical Performance and Mobility Examination	MD 0.14 points on the Physical Performance and Mobility Examination higher (0.01 higher to 0.27 higher)	‐	975 (1 study)	‐	Included only 1 study categorised as delivering a rehabilitation‐related activity intervention. The effect of rehabilitation‐related activities on functional mobility at discharge from hospital was very uncertain.
Incidence of new delirium during hospitalisation	107 per 1000	92 per 1000 (32 to 267)	RR 0.86 (0.30 to 2.50)	732 (2 RCTs)	⊕⊝⊝⊝ Very lowe,f,g	The evidence was very uncertain with regard to the effect of rehabilitation‐related activity interventions on incidence of delirium during hospitalisation.
Falls during hospitalisation	24 per 1000	32 per 1000 (7 to 140)	RR 1.33 (0.30 to 5.84)	250 (1 study)	‐	Only 1 study categorised as delivering a rehabilitation‐related activity intervention was included. The effect of rehabilitation‐related activities on falls during hospitalisation was very uncertain.
Quality of life at discharge from hospital assessed with: EuroQol 5 Dimensions (EQ‐5D) visual analogue scale (VAS) (higher scores = better quality of life) Scale from: 0 to 100	The mean quality of life at discharge from hospital was 48.9 points on the EQ‐5D VAS	MD 2.2 points on the EQ‐5D VAS higher (1.9 lower to 6.3 higher)	‐	350 (1 study)	‐	Only 1 study reported a quality‐of‐life outcome at hospital discharge. The effect of rehabilitation‐related activities on the incidence of delirium during hospitalisation was very uncertain.
Medical deterioration during hospitalisation	107 per 1000	92 per 1000 (32 to 267)	RR 0.86 (0.30 to 2.50)	732 (2 RCTs)	⊕⊝⊝⊝ Very lowh,i,j	The evidence was very uncertain with regard to the effect of rehabilitation‐related activity interventions on incidence of medical deterioration during hospitalisation.
Participant global assessment of success	Not pooled	Not pooled	Not pooled	(0 studies)	‐	No studies reported participant global assessment of success.
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; OR: odds ratio; RR: risk ratio
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_423062461138566957.

^a Based on the one study that measured activities of daily living using a Barthel Index (range of possible scores 0–100).
^b SMD was re‐expressed as the MD, by multiplying the SMD and associated 95% CIs by the estimated standard deviation (SD) of measurements in the intervention group at discharge. This estimate of the SD was obtained by calculating a weighted mean of measurements taken across all intervention groups of all studies that used the instrument.
^c Risk of bias: 3/4 studies were at high risk of bias. Downgraded one level. 
^d Inconsistency: I² = 40%, 95% prediction interval (PI) for the SMD: −0.11 to 0.22 demonstrating significant uncertainty. Downgraded one level. 
^e Risk of bias: 1/2 studies were at high risk of bias. Downgraded one level. 
^f Inconsistency: I² = 63%, 95% PI for the RR: 0.17 to 4.40, demonstrating significant uncertainty. Downgraded one level. 
^g Imprecision: due to only 67 events, a control event rate of approximately 11% an optimal information size (OIS) is unlikely to have been met (Guyatt and colleagues, 2011). The CIs included no effect, appreciable benefit and appreciable harm (i.e. an RR < 0.75 and > 1.25). Downgraded one level. 
^h Risk of bias: 1/2 studies were at high risk of bias. Downgraded one level. 
ⁱ Inconsistency: I² = 63%, 95% PI for the RR: 0.17 to 4.40, demonstrating significant uncertainty. Downgraded one level. 
^j Imprecision: due to only 67 events, a control event rate of approximately 11% an OIS is unlikely to have been met (Guyatt and colleagues, 2011). The CIs included no effect, appreciable benefit and appreciable harm (i.e. an RR < 0.75 and > 1.25). Downgraded one level.