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

Zelada 2009.

Study characteristics
Methods Design: quasi‐RCT
Baseline time point (T1): within 72 hours of admission
Outcome time point (T2): day of discharge
Participants Inclusion criteria: aged 65 years and admitted for an acute medical pathology to a geriatric care unit
Exclusion criteria: dependent in all basic ADL before admission; admitted to intensive care; transferred from other services; intubated patients; severe dementia; terminal cancer; severe aphasia; discharged in < 24 hours; admitted for specific procedures; patients from the internal medicine service to the geriatric care team for treatment
Exercise arm
  • n at baseline: 68

  • Age mean: 42 (SD 56) years

  • Women (n (%)): 42 (61.8%)


Control arm
  • n at baseline: 75

  • Age mean: 76.1 (SD 7.2) years

  • Women (n (%)): 42 (56%)

Interventions Exercise arm
  • TIDieR item 1: (brief name: provide the name or a phrase that describes the intervention): geriatric care unit.

  • TIDieR item 2: (why: describe any rationale, theory or goal of the elements essential to the intervention): it was hypothesised that the geriatric care unit could favour a reduction in the incidence of functional decline with a favourable impact on quality of life without an increase in care costs.

  • 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): based on protocol of Landefeld and colleagues 1995. Medical interventions included: geriatric assessment upon admission, evaluation of problems, early removal of endovenous and urinary catheters, prevention and early diagnosis of adverse events, early discharge planning and the co‐ordination of the continuity of treatment at an appropriate level. Multidisciplinary interventions included: functional evaluation, early rehabilitation, promotion of self‐care, neurosensory stimulation, orientation for the family or carer (or both). Nursing interventions included: incontinence management, prevention of pressure ulcers and promotion of self‐care. Furthermore, an interdisciplinary meeting was set up once per week (with the chief physician, resident, therapists and a social worker); daily information, education and active participation by family or carer.

  • 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): 1 geriatric physician, 1 medical resident of the speciality, general care nurses, a physiotherapist, an OT and a social worker (once per week).

  • 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): the geriatric unit contained 10 beds.

  • 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): as item 4.

  • 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): not specified.


Control arm
  • TIDieR item 1: usual care.

  • TIDieR item 2: not specified.

  • TIDieR item 3: not specified.

  • TIDieR item 4: routine medical care and nursing care, typical for an acute care unit – this was a different hospital unit as the comparison at the same time as the other site.

  • TIDieR item 5: internist physician, a medical resident to this speciality, general care nurses, access to PT and OT and a social worker by means of referral.

  • TIDieR item 6: face‐to‐face.

  • TIDieR item 7: acute medical unit.

  • 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 Katz ADL (score 0–6) at T2 (categorised scores only)
Length of hospital stay
Notes Intervention group was older (79.6 years in intervention vs 76.1 years in control), was more likely to be admitted with renal conditions (14.7% in intervention vs 6.7% in control) and less likely to have cardiovascular problems (9.9% in intervention vs 25.3% in control).

ADL: activities of daily living; AGW: acute geriatric ward; CAM: Confusion Assessment Method; CGA: comprehensive geriatric assessment; CI: confidence interval; CIRACT: Community In‐Reach and Care Transition; COPD: chronic obstructive pulmonary disease; EQ‐5D: EuroQol 5 Dimensions; EQ‐5D‐5L: EuroQol 5 Dimensions 5 Levels; IADL: Instrumental Activities of Daily Living; IQR: interquartile range; MDT: multidisciplinary team; n: number; NA: not applicable; OT: occupational therapy; PT: physiotherapy; RCT: randomised controlled trial; SD: standard deviation; T: time point (e.g. T1: time point 1); THB‐Rehab: traditional hospital‐based rehabilitation service; VAS: visual analogue scale.