| Participants |
Inclusion criteria: aged > 70 years; confined to bed or walking from bed to chair with human help, but independent for locomotion within 3 months; written consent from participants and surrogates
Exclusion criteria: any neuromuscular diseases affecting lower limbs, chronic respiratory impairment, severe heart failure (New York Heart Association class IV), peripheral vascular disease, palliative care, use of drugs known to impair muscle function. Owing to PT availability, admitted patients in a period that was incompatible to PT intervention the following day after admission were excluded. Thus, no more than 5/20 patients admitted from Sunday to Thursday were included per week
Exercise arm
Control arm
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| Interventions |
Exercise arm
TIDieR item 1: (brief name: provide the name or a phrase that describes the intervention): Acute Care for Elders programme (early and intense PT rehabilitation). TIDieR item 2: (why: describe any rationale, theory or goal of the elements essential to the intervention): it was hypothesised the exercise programme may improve ADL performance. The intervention focused on leg extension exercises because knee and hip extensors are essential to perform independent activities, such as walking, stair climbing, and rising from a chair. 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): for crural triceps: 10 repetitions of dynamic work against the foot of the bed, extended legs to push the body to the top of the bed. If the participant was too weak, exercise was performed against the hand of the physiotherapist. When the participant was able to stand, exercises of plantar flexors and extensors were performed in the upright position. For all the leg: extended leg, hip flexion at 45° in alternate for each leg, each repetition is maintained 3–5 seconds, 10 repetitions with 10‐second rest period between each. For the pelvis: knee flexed at 30°, moving pelvis to the left and to the right, 10 repetitions. 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): physiotherapists delivered the intervention, their experience/specific training was not specified. 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): acute care geriatric medicine ward and in PT room. 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): additional to usual care until participant deemed 'clinically stable'. Started on day 1 or 2 of hospitalisation. 30‐minute sessions. Twice per day, five days per week. TIDieR item 9: (tailoring: if the intervention was planned to be personalised, titrated or adapted, then describe what, why, when and how): some modification for crural triceps exercises based on ability (see item 4). 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): exercise was supervised. 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 not reported.
Control arm
TIDieR item 1: acute care geriatric medicine unit. TIDieR item 2: not specified. TIDieR item 3: not specified. TIDieR item 4: local policy indicated that participants should be transferred to armchair as soon as possible according to their general health status. From day 3 to 6, participants started to walk with human help with or without technical assistance in the PT room for 3 sessions per week until discharge. PT was continued at home for 1 month. TIDieR item 5: physiotherapists delivered the intervention, their experience/specific training was not specified. TIDieR item 6: face‐to‐face. TIDieR item 7: acute care geriatric medicine ward and in PT room. TIDieR item 8: from day 3 to 6, participants started to walk in the PT room for 3 sessions per week. After discharge PT was continued at home for 1 month. TIDieR item 9: as per item 4. Walking practice was with or without technical assistance. TIDieR item 10: not specified. TIDieR item 11: in‐hospital walking practice supervised. TIDieR item 12: not specified.
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