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. 2022 Nov 10;2022(11):CD005955. doi: 10.1002/14651858.CD005955.pub3

Asplund 2000.

Study characteristics
Methods Design: RCT
Baseline time point (T1): admission to hospital
Outcome time point (T2): discharge from hospital
Follow‐up time point (T3): 3 months after discharge
Participants Inclusion criteria: aged > 70 years; acutely admitted to University Hospital of Umeå for medical ailments
Exclusion criteria: required treatment in specialised units, such as the intensive care unit, coronary care unit or acute stroke unit; or required treatment in 1 of the designated subspecialities such as in a renal care unit
Exercise arm

  • n at baseline: 190

  • Age mean: 80.9 (95% CI 80.1 to 81.9) years

  • Women (n (%)): 111 (58)

  • Barthel Index (0–20) on admission: 0–14 points: 16%; 15–19 points: 32%; 20 points: 52%

  • Confusion on admission – CAM (n (%)): 86 (47)


Control arm

  • n at baseline: 223

  • Age mean: 81.0 (95% CI 80.3 to 81.8) years

  • Women (n (%)): 140 (63)

  • Barthel Index (0–20) on admission: 0–14 points: 15%; 15–19 points: 41%; 20 points: 44%

  • Confusion on admission – CAM (n (%)): 113 (53)
Interventions Exercise arm

  • TIDieR item 1: (brief name: provide the name or a phrase that describes the intervention): AGW.

  • TIDieR item 2: (why: describe any rationale, theory or goal of the elements essential to the intervention): 1. When compared with participants admitted to general medical wards, global outcome at 3 months after admission is improved in participants acutely admitted to a dedicated geriatric medical unit. 2. Acute care in a dedicated geriatric unit reduces resource consumption without compromising participant outcome at 3 months.

  • TIDieR item 3: (what (materials): describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training of intervention providers): not specified.

  • TIDieR item 4: (what (procedures): describe each of the procedures, activities or processes (or a combination) used in the intervention, including any enabling or support activities): the geriatric approach followed the principles outlined by the Nordic Working Group on geriatric assessment and rehabilitation. Staffing of the ward was designed to optimise the conditions for treatment, nursing, early rehabilitation and planning of care for older, acutely ill patients. Care covered by both internists and geriatricians. MDT included nursing staff, physiotherapists, OTs and dietician (no social workers). Most participants assessed by physiotherapists and OTs. Early rehabilitation, interdisciplinary teamwork and 'intense' discharge planning.

  • TIDieR item 5: (who provided: for each category of intervention provider (e.g. psychologist, nursing assistant), describe their expertise, background and any specific training given): the staff were recruited from geriatric, medical and surgical departments. There was a 1‐week education period for the staff with emphasis on the principles of interdisciplinary and geriatric working forms and on ethical issues. This was followed by a 3‐week run‐in period of the AGW before the beginning of randomisation.

  • TIDieR item 6: (how: describe the modes of delivery (such as face‐to‐face or by some other mechanism, such as Internet or telephone) of the intervention and whether it was provided individually or in a group): face‐to‐face.

  • TIDieR item 7: (where: describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features): AGW consisted of 11 beds and shared facilities with a surgical ward.

  • TIDieR item 8: (when and how much: describe the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule, and their duration, intensity or dose): not specified.

  • TIDieR item 9: (tailoring: if the intervention was planned to be personalised, titrated or adapted, then describe what, why, when and how): not specified.

  • TIDieR item 10: (modifications: if the intervention was modified during the course of the study, describe the changes (what, why, when and how)): not specified.

  • TIDieR item 11: (how well (planned): if intervention adherence or fidelity was assessed, describe how and by whom, and if any strategies were used to maintain or improve fidelity, describe them): not specified.

  • TIDieR item 12: (how well (actual): if intervention adherence or fidelity was assessed, describe the extent to which the intervention was delivered as planned): fidelity to the intervention not described other than 4 participants refused to participate after first consenting.


Control arm

  • TIDieR item 1: medical ward.

  • TIDieR item 2: NA.

  • TIDieR item 3: NA.

  • TIDieR item 4: wards were covered by internists only (no geriatricians). Physiotherapists, OT and dietitian not routinely available. Only occasional assessment by physiotherapists or OT. Dedicated part‐time social worker.

  • TIDieR item 5: as item 4.

  • TIDieR item 6: face‐to‐face.

  • TIDieR item 7: 2 medical wards, 30 beds on each ward.

  • TIDieR item 8: not specified.

  • TIDieR item 9: not specified.

  • TIDieR item 10: not specified.

  • TIDieR item 11: not specified.

  • TIDieR item 12: not specified.
Outcomes Barthel Index (categorised scores only) at T2 and T3
Mini‐Mental State Examination at T3
Incidence of delirium during hospitalisation
Length of hospital stay
Adverse events (mortality during hospitalisation)
New institutionalisation at discharge from hospital
Readmission to an acute hospital during first 3 months after discharge
Notes