An international expert consensus statement regarding a post-discharge exercise intervention program for acutely hospitalized older adults

Abstract

Aim: Currently there is no consensus on what constitutes an optimal exercise intervention for acutely hospitalized older adults post-discharge. This study aimed to develop a consensus statement on i) recommended measurement tools and ii) what constitutes a targeted exercise intervention to prevent functional decline, for acutely hospitalized older adults post-discharge. Methods: A Delphi consensus study was performed. A scoping review was conducted to formulate statements, based on articles with focus on measurement tools and interventions for acutely hospitalized older adults. Out of the scoping review, 5 themes emerged. Statements were ranked by an international expert panel. Panelists were included based on field of expertise and clinical experience; consisting of physiotherapists and healthcare professionals with 0 to 20 years of experience working in the field. Ranking of statements occurred on a 9-point Likert-Scale. Results were presented as median score on Likert-Scale and semi-interquartile range (SIQR). Consensus was reached in case SIQR≤0.5. Results: The Delphi process was performed in three rounds, input of 15 panelists was analyzed, with a response rate of respectively 93.3%, 93.3% and 80%. Consensus was reached in 91.4% of the ranked items. Out of the process 21 essential measurement tools emerged. Essential patient information consists of 5 personal factors; and 16 items regarding discharge information. For an optimal exercise intervention, teamwork personalized to the patient has been found essential by the panel. An exercise intervention contains different physical interventions for each phase of recovery. Conclusion: This consensus statement establishes a set of essential measurements and a tailored exercise intervention based on the principles of frequency, intensity time and type (FITT-criteria)1. An intervention consists of a tailor-made, interdisciplinary intervention program, applied to the different stages of disease and recovery; focusing on physical factors in relation to nutritional and behavioral factors of the acutely hospitalized older adult post-discharge. Clinical Relevance: These statements are proposed as starting-points for a tailored-made exercise intervention for acutely hospitalized older adults post-discharge.