Progressive Resistance Training in a Post-Acute, Older, Inpatient Population
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Many older adults are at risk of functional decline following an acute hospital admission. Many of these older adults are pre-sarcopenic or sarcopenic and are extremely vulnerable to a further deterioration of function and dependence in Activities of Daily Living ability. Progressive Resistance Training (PRT) is an intervention that involves exercising a muscle against a load that is progressively increased as the muscle strengthens. PRT has been shown to successfully target both functional decline and sarcopenia in older adults. However, the majority of this research has been performed with a healthy older community-dwelling population.
Aims and Objectives
The aim of this study was to evaluate the feasibility of using PRT in an older, postacute, inpatient population and to explore the perceptions and experiences of physiotherapists in the use of PRT in this population.
This was a mixed-methods research design. A randomised controlled feasibility study recruited appropriate older inpatients undergoing postacute rehabilitation. Feasibility measures examined were safety, recruitment, outcome measurement, adherence and retention rates and satisfaction. A range of clinical measures were used to capture changes in body structure and function, activity and participation. Assessments were performed on admission to the study and six weeks later.
The study employed a qualitative description design using semi-structured interviews with thirteen Physiotherapists from three hospitals. An interview schedule was developed, interviews were recorded and later transcribed. Key themes emerged from analysing the data using thematic analysis.
Feasibility study - there were no serious adverse events, adherence rates were 63% and retention rates were 82%. Clinical measures – there were no significant differences between the two groups.
Qualitative study – Physiotherapists do not routinely use PRT with this population due to concerns of injury and reduced motivation for this intervention. Prescription and progression are usually subjective.
This study demonstrated that PRT is safe to use with this population. It also demonstrates that physiotherapists do not routinely use PRT as a rehabilitation intervention for this population.