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

Exercise for acutely hospitalised older medical patients

Peter Hartley  1   2 , Jennifer L Keating  3 , Kimberley J Jeffs  4   5 , Melissa Jm Raymond  6   7 , Toby O Smith  8
Affiliations

Exercise for acutely hospitalised older medical patients

Peter Hartley et al. Cochrane Database Syst Rev. .

Abstract

Background: Approximately 30% of hospitalised older adults experience hospital-associated functional decline. Exercise interventions that promote in-hospital activity may prevent deconditioning and thereby maintain physical function during hospitalisation. This is an update of a Cochrane Review first published in 2007.

Objectives: To evaluate the benefits and harms of exercise interventions for acutely hospitalised older medical inpatients on functional ability, quality of life (QoL), participant global assessment of success and adverse events compared to usual care or a sham-control intervention.

Search methods: We used standard, extensive Cochrane search methods. The latest search date was May 2021.

Selection criteria: We included randomised or quasi-randomised controlled trials evaluating an in-hospital exercise intervention in people aged 65 years or older admitted to hospital with a general medical condition. We excluded people admitted for elective reasons or surgery.

Data collection and analysis: We used standard Cochrane methods. Our major outcomes were 1. independence with activities of daily living; 2. functional mobility; 3. new incidence of delirium during hospitalisation; 4. QoL; 5. number of falls during hospitalisation; 6. medical deterioration during hospitalisation and 7. participant global assessment of success. Our minor outcomes were 8. death during hospitalisation; 9. musculoskeletal injuries during hospitalisation; 10. hospital length of stay; 11. new institutionalisation at hospital discharge; 12. hospital readmission and 13. walking performance. We used GRADE to assess certainty of evidence for each major outcome. We categorised exercise interventions as: rehabilitation-related activities (interventions designed to increase physical activity or functional recovery, but did not follow a specified exercise protocol); structured exercise (interventions that included an exercise intervention protocol but did not include progressive resistance training); and progressive resistance exercise (interventions that included an element of progressive resistance training).

Main results: We included 24 studies (nine rehabilitation-related activity interventions, six structured exercise interventions and nine progressive resistance exercise interventions) with 7511 participants. All studies compared exercise interventions to usual care; two studies, in addition to usual care, used sham interventions. Mean ages ranged from 73 to 88 years, and 58% of participants were women. Several studies were at high risk of bias. The most common domain assessed at high risk of bias was measurement of the outcome, and five studies (21%) were at high risk of bias arising from the randomisation process. Exercise may have no clinically important effect on independence in activities of daily living at discharge from hospital compared to controls (16 studies, 5174 participants; low-certainty evidence). Five studies used the Barthel Index (scale: 0 to 100, higher scores representing greater independence). Mean scores at discharge in the control groups ranged from 42 to 96 points, and independence in activities of daily living was 1.8 points better (0.43 worse to 4.12 better) with exercise compared to controls. The minimally clinical important difference (MCID) is estimated to be 11 points. We are uncertain regarding the effect of exercise on functional mobility at discharge from the hospital compared to controls (8 studies, 2369 participants; very low-certainty evidence). Three studies used the Short Physical Performance Battery (SPPB) (scale: 0 to 12, higher scores representing better function) to measure functional mobility. Mean scores at discharge in the control groups ranged from 3.7 to 4.9 points on the SPPB, and the estimated effect of the exercise interventions was 0.78 points better (0.02 worse to 1.57 better). A change of 1 point on the SPPB represents an MCID. We are uncertain regarding the effect of exercise on the incidence of delirium during hospitalisation compared to controls (7 trials, 2088 participants; very low-certainty evidence). The incidence of delirium during hospitalisation was 88/1091 (81 per 1000) in the control group compared with 70/997 (73 per 1000; range 47 to 114) in the exercise group (RR 0.90, 95% CI 0.58 to 1.41). Exercise interventions may result in a small clinically unimportant improvement in QoL at discharge from the hospital compared to controls (4 studies, 875 participants; low-certainty evidence). Mean QoL on the EuroQol 5 Dimensions (EQ-5D) visual analogue scale (VAS) (scale: 0 to 100, higher scores representing better QoL) ranged between 48.9 and 64.7 in the control group at discharge from the hospital, and QoL was 6.04 points better (0.9 better to 11.18 better) with exercise. A change of 10 points on the EQ-5D VAS represents an MCID. No studies measured participant global assessment of success. Exercise interventions did not affect the risk of falls during hospitalisation (moderate-certainty evidence). The incidence of falls was 31/899 (34 per 1000) in the control group compared with 31/888 (34 per 1000; range 20 to 57) in the exercise group (RR 0.99, 95% CI 0.59 to 1.65). We are uncertain regarding the effect of exercise on the incidence of medical deterioration during hospitalisation (very low-certainty evidence). The incidence of medical deterioration in the control group was 101/1417 (71 per 1000) compared with 96/1313 (73 per 1000; range 44 to 120) in the exercise group (RR 1.02, 95% CI 0.62 to 1.68). Subgroup analyses by different intervention categories and by the use of a sham intervention were not meaningfully different from the main analyses.

Authors' conclusions: Exercise may make little difference to independence in activities of daily living or QoL, but probably does not result in more falls in older medical inpatients. We are uncertain about the effect of exercise on functional mobility, incidence of delirium and medical deterioration. Certainty of evidence was limited by risk of bias and inconsistency. Future primary research on the effect of exercise on acute hospitalisation could focus on more consistent and uniform reporting of participant's characteristics including their baseline level of functional ability, as well as exercise dose, intensity and adherence that may provide an insight into the reasons for the observed inconsistencies in findings.

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Conflict of interest statement

PH: none.

JK: none.

KJ: none.

MR: none.

TS: none.

Two review authors (JK, KJ) conducted included studies. They were not involved in the screening, data extraction or risk of bias assessments of their studies.

Figures

1
1
Study flow diagram
2
2
Funnel plot: independence with activities of daily living at discharge from hospital.
3
3
Funnel plot: medical deterioration during hospitalisation.
4
4
Funnel plot: mortality during hospitalisation.
5
5
Funnel plot: length of hospital stay.
6
6
Funnel plot: readmissions to hospital.
1.1
1.1. Analysis
Comparison 1: Major outcomes, Outcome 1: Functional ability: independence with activities of daily living at discharge from hospital
1.2
1.2. Analysis
Comparison 1: Major outcomes, Outcome 2: Functional ability: functional mobility at discharge from hospital
1.3
1.3. Analysis
Comparison 1: Major outcomes, Outcome 3: Functional ability: new incidence of delirium during hospitalisation
1.4
1.4. Analysis
Comparison 1: Major outcomes, Outcome 4: Quality of life at discharge from hospital
1.5
1.5. Analysis
Comparison 1: Major outcomes, Outcome 5: Falls during hospitalisation
1.6
1.6. Analysis
Comparison 1: Major outcomes, Outcome 6: Medical deterioration during hospitalisation
2.1
2.1. Analysis
Comparison 2: Minor outcomes, Outcome 1: Death during hospitalisation
2.2
2.2. Analysis
Comparison 2: Minor outcomes, Outcome 2: Hospital length of stay (days)
2.3
2.3. Analysis
Comparison 2: Minor outcomes, Outcome 3: New institutionalisation at hospital discharge
2.4
2.4. Analysis
Comparison 2: Minor outcomes, Outcome 4: Hospital readmission
2.5
2.5. Analysis
Comparison 2: Minor outcomes, Outcome 5: Walking performance at discharge from hospital
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References

References to studies included in this review

Abizanda 2011 {published data only}
    1. Abizanda P, Leon M, Dominguez-Martin L, Lozano-Berrio V, Romero L, Luengo C, et al. Effects of a short-term occupational therapy intervention in an acute geriatric unit. A randomized clinical trial. Maturitas 2011;69(3):273-8. - PubMed
Asplund 2000 {published data only}
    1. Asplund K, Gustafson Y, Jacobsson C, Bucht G, Wahlin A, Peterson J, et al. Geriatric-based versus general wards for older acute medical patients: a randomized comparison of outcomes and use of resources. Journal of the American Geriatrics Society 2000;48:1381-8. - PubMed
Blanc‐Bisson 2008 {published data only}
    1. Blanc-Bisson C, Dechamps A, Gouspillou G, Dehail P, Bourdel-Marchasson I. A randomized controlled trial on early physiotherapy intervention versus usual care in acute care unit for elderly: potential benefits in light of dietary intakes. Journal of Nutrition, Health and Aging 2008;12(6):395-9. - PubMed
Brown 2016 {published data only}
    1. Brown CJ, Foley KT, Lowman JD, MacLennan PA, Razjouyan J, Najafi B, et al. Comparison of posthospitalization function and community mobility in hospital mobility program and usual care patients a randomized clinical trial. JAMA Internal Medicine 2016;176(7):921-7. - PubMed
Counsell 2000 {published data only}
    1. Counsell SR, Holder CM, Liebenauer LL, Palmer RM, Fortinsky RH, Kresevic DM, et al. Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. Journal of the American Geriatrics Society 2000;48(12):1572-81. - PubMed
Courtney 2009 {published data only}
    1. Courtney M, Edwards H, Chang A, Parker A, Finlayson K, Hamilton K. Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. Journal of the American Geriatrics Society 2009;57(3):395-402. - PubMed
    1. Courtney MD, Edwards HE, Chang AM, Parker AW, Finlayson K, Bradbury C, et al. Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission: a randomized controlled trial. Journal of Evaluation in Clinical Practice 2012;18(1):128-34. - PubMed
    1. Graves N, Courtney M, Edwards H, Chang A, Parker A, Finlayson K. Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients. PLOS One 2009;4(10):e7455. - PMC - PubMed
de Morton 2007 {published data only}
    1. Morton NA, Keating JL, Berlowitz DJ, Jackson B, Lim WK. Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial. Australian Journal of Physiotherapy 2007;53(2):105-11. - PubMed
Ekerstad 2017 {published data only}
    1. Åhlund K, Bäck M, Öberg B, Ekerstad N. Effects of comprehensive geriatric assessment on physical fitness in an acute medical setting for frail elderly patients. Clinical Interventions in Aging 2017;12:1929-39. - PMC - PubMed
    1. Ekerstad N, Ivanoff SD, Landahl S, Ostberg G, Johansson M, Andersson D, et al. Acute care of severely frail elderly patients in a CGA-unit is associated with less functional decline than conventional acute care. Clinical Interventions in Aging 2017;12:1239-49. - PMC - PubMed
    1. Ekerstad N, Karlson BW, Dahlin Ivanoff S, Landahl S, Andersson D, Heintz E, et al. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care? Clinical Interventions in Aging 2017;12:1-9. - PMC - PubMed
Fretwell 1990 {published data only}
    1. Fretwell MD, Raymond PM, McGarvey ST, Owens N, Traines M, Silliman RA, et al. The Senior Care Study. A controlled trial of a consultative/unit-based geriatric assessment program in acute care. Journal of the American Geriatrics Society 1990;38(10):1073-81. - PubMed
Gazineo 2021 {published and unpublished data}
    1. Gazineo D, Godino L, Decaro R, Calogero P, Pinto D, Chiari P, et al. Assisted walking program on walking ability in in-hospital geriatric patients: a randomized trial. Journal of the American Geriatrics Society 2021;69(3):637-43. - PubMed
Hu 2020 {published data only}
    1. Hu F-W, Huang Y-T, Lin H-S, Chen C-H, Chen M-J, Chang C-M. Effectiveness of a simplified reablement program to minimize functional decline in hospitalized older patients. Geriatrics & Gerontology International 2020;20(5):436-42. - PubMed
Jeffs 2013 {published and unpublished data}
    1. Jeffs KJ, Berlowitz DJ, Grant S, Lawlor V, Graco M, De Morton NA, et al. An enhanced exercise and cognitive programme does not appear to reduce incident delirium in hospitalised patients: a randomised controlled trial. BMJ Open 2013;3(6):e002569. - PMC - PubMed
Jones 2006 {published data only}
    1. Jones CT, Lowe AJ, MacGregor L, Brand CA, Tweddle N, Russell DM. A randomised controlled trial of an exercise intervention to reduce functional decline and health service utilisation in the hospitalised elderly. Australasian Journal on Ageing 2006;25(3):126-33.
Killey 2006 {published data only (unpublished sought but not used)}
    1. Killey B, Watt E. The effect of extra walking on the mobility, independence and exercise self-efficacy of elderly hospital in-patients: a pilot study. Contemporary Nurse 2006;22(1):120-33. - PubMed
Landefeld 1995 {published data only}
    1. Covinsky KE, King JT, Quinn LM, Siddique R, Palmer R, Kresevic DM, et al. Do acute care for elders units increase hospital costs? A cost analysis using the hospital perspective. Journal of the American Geriatrics Society 1997;45(6):729-34. - PubMed
    1. Landefeld CS, Palmer RM, Kresevic DM, Fortinsky RH, Kowal J. A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill older patients. New England Journal of Medicine 1995;332(20):1338-44. - PubMed
Martinez‐Velilla 2019 {published and unpublished data}
    1. Anonymous. Correction: effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: a randomized clinical trial (JAMA Internal Medicine (2018) DOI: 10.1001/jamainternmed.2018.4869). JAMA Internal Medicine 2019;179(1):127. - PMC - PubMed
    1. Martínez-Velilla N, Sáez de Asteasu L, Ramírez-Vélez R, Zambom-Ferraresi F, García-Hermoso A, Izquierdo M. Recovery of the decline in activities of daily living after hospitalization through an individualized exercise programme: secondary analysis of a randomized clinical trial. Journals of Gerontology: Series A 2021;76(8):1519–23. - PubMed
    1. Martinez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F, Lopez Saez de Asteasu M, Lucia A, Galbete A, et al. Effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: a randomized clinical trial. JAMA Internal Medicine 2019;179(1):28-36. - PMC - PubMed
    1. Martinez-Velilla N, Valenzuela PL, Saez de Asteasu ML, Zambom-Ferraresi F, Ramirez-Velez R, Garcia-Hermoso A, et al. Effects of a tailored exercise intervention in acutely hospitalized diabetic oldest old adults: an ancillary analysis. Journal of Clinical Endocrinology and Metabolism 2020;106(2):e899-906. - PubMed
    1. Sáez de Asteasu ML, Martinez-Velilla N, Zambom-Ferraresi F, Casas-Herrero A, Cadore EL, Galbete A, et al. Assessing the impact of physical exercise on cognitive function in older medical patients during acute hospitalization: secondary analysis of a randomized trial. PLOS Medicine 2019;16(7):e1002852. - PMC - PubMed
McCullagh 2020 {published and unpublished data}
    1. McCullagh R, O'Connell E, O'Meara S, Dahly D, O'Reilly E, O'Connor K, et al. Augmented exercise in hospital improves physical performance and reduces negative post hospitalization events: a randomized controlled trial. BMC Geriatrics 2020;20(1):46. - PMC - PubMed
McGowan 2018a {published data only}
    1. McGowan T, Ong T, Kumar A, Lunt E, Sahota O. The effect of chair-based pedal exercises for older people admitted to an acute hospital compared to standard care: a feasibility study. Age and Ageing 2018;47(3):483-6. - PubMed
Mudge 2008 {published data only}
    1. Mudge AM, Giebel AJ, Cutler AJ. Exercising body and mind: an integrated approach to functional independence in hospitalized older people. Journal of the American Geriatrics Society 2008;56(4):630-5. - PubMed
Ortiz‐Alonso 2020 {published data only}
    1. Ortiz-Alonso J, Bustamante-Ara N, Valenzuela PL, Vidan-Astiz M, Rodriguez-Romo G, Mayordomo-Cava J, et al. Effect of a simple exercise program on hospitalization-associated disability in older patients: a randomized controlled trial. Journal of the American Medical Directors Association 2020;21(4):531-7.e1. - PubMed
    1. Valenzuela PL, Ortiz-Alonso J, Bustamante-Ara N, Vidán MT, Rodríguez-Romo G, Mayordomo-Cava J, et al. Individual responsiveness to physical exercise intervention in acutely hospitalized older adults. Journal of Clinical Medicine 2020;9(3):797. - PMC - PubMed
Pedersen 2019 {published and unpublished data}
    1. Pedersen MM, Petersen J, Beyer N, Larsen Helle G-J, Jensen PS, Andersen O, et al, STAND-Cph Collaborative Group. A randomized controlled trial of the effect of supervised progressive cross-continuum strength training and protein supplementation in older medical patients: the STAND-Cph trial. Trials 2019;20(1):655. - PMC - PubMed
Sahota 2017 {published data only}
    1. Sahota O, Pulikottil-Jacob R, Marshall F, Montgomery A, Tan W, Sach T, et al. The Community In-reach Rehabilitation and Care Transition (CIRACT) clinical and cost-effectiveness randomisation controlled trial in older people admitted to hospital as an acute medical emergency. Age and Ageing 2017;46(1):26-32. - PMC - PubMed
Slaets 1997 {published data only (unpublished sought but not used)}
    1. Slaets JP, Kauffmann RH, Duivenvoorden HJ, Pelemans W, Schudel WJ. A randomized trial of geriatric liaison intervention in elderly medical inpatients. Psychosomatic Medicine 1997;59(6):585-91. - PubMed
Zelada 2009 {published data only (unpublished sought but not used)}
    1. Zelada MA, Salinas R, Baztan JJ. Reduction of functional deterioration during hospitalization in an acute geriatric unit. Archives of Gerontology and Geriatrics 2009;48(1):35-9. - PubMed

References to studies excluded from this review

Ahn 2018 {published data only}
    1. Ahn JY, Song JE, Ann HW, Jeon Y, Ahn MY, Jung IY, et al. Effects of early exercise rehabilitation on functional recovery in patients with severe sepsis. Yonsei Medical Journal 2018;59(7):843-51. - PMC - PubMed
Barnes 2012 {published data only}
    1. Barnes DE, Palmer RM, Kresevic DM, Fortinsky RH, Kowal J, Chren M-M, et al. Acute care for elders units produced shorter hospital stays at lower cost while maintaining patients' functional status. Health Affairs 2012;31(6):1227-36. - PMC - PubMed
Braun 2019 {published data only}
    1. Braun T, Gruneberg C, Susmilch K, Wiessmeier M, Schwenk I, Eggert S, et al. An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial. BMC Geriatrics 2019;19(1):240. - PMC - PubMed
Brown 2006 {published data only}
    1. Brown CJ, Peel C, Bamman MM, Allman RM. Exercise program implementation proves not feasible during acute care hospitalization. Journal of Rehabilitation Research and Development 2006;43(7):939-46. - PubMed
Bruun 2020 {published data only}
    1. Bruun IH, Maribo T, Norgaard B, Schiottz-Christensen B, Jessen MG, Mogensen CB. The effect of systematic functional assessment and immediate rehabilitation on physical performance in acutely admitted older adults with reduced functional performance: a randomised clinical trial. BMJ Open 2020;42(1):53-62. - PubMed
Buhl 2016 {published data only}
    1. Buhl SF, Andersen AL, Andersen JR, Andersen O, Jensen JE, Rasmussen AM, et al. The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients – a randomized controlled trial. Clinical Nutrition 2016;35(1):59-66. - PubMed
Collard 1985 {published data only}
    1. Collard AF, Bachman SS, Beatrice DF. Acute care delivery for the geriatric patient: an innovative approach. QRB – Quality Review Bulletin 1985;11(6):180-5. - PubMed
Cumming 2008 {published data only}
    1. Cumming RG, Sherrington C, Lord SR, Simpson JM, Vogler C, Cameron ID, et al. Cluster randomised trial of a targeted multifactorial intervention to prevent falls among older people in hospital. BMJ (Clinical Research Ed.) 2008;336(7647):758-60. - PMC - PubMed
DRKS00011262 {published data only}
    1. DRKS00011262. Feasibility and effectiveness of an augmented prescribed exercise programme (APEP) on mobility in older medical patients in the acute setting – a randomised pilot study. www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DR... (first received 27 October 2016).
Fleck 2012 {published data only}
    1. Fleck SJ, Bustamante-Ara N, Ortiz J, Vidán M-T, Lucia A, Serra-Rexach JA. Activity in GEriatric acute CARe (AGECAR): rationale, design and methods. BMC Geriatrics 2012;12(1):28. - PMC - PubMed
Fleiner 2017 {published data only}
    1. Fleiner T, Dauth H, Gersie M, Zijlstra W, Haussermann P. Structured physical exercise improves neuropsychiatric symptoms in acute dementia care: a hospital-based RCT. Alzheimer's Research & Therapy 2017;9(1):68. - PMC - PubMed
Gade 2019 {published data only}
    1. Gade J, Beck AM, Andersen HE, Christensen B, Ronholt F, Klausen TW, et al. Protein supplementation combined with low-intensity resistance training in geriatric medical patients during and after hospitalization: a randomized, double-blind, multicenter trial. British Journal of Nutrition 2019;112(9):1006-20. - PubMed
Greening 2014 {published data only}
    1. Greening NJ, Williams JE, Hussain SF, Harvey-Dunstan TC, Bankart MJ, Chaplin EJ, et al. An early rehabilitation intervention to enhance recovery during hospital admission for an exacerbation of chronic respiratory disease: randomised controlled trial. BMJ 2014;349:g4315. - PMC - PubMed
Haines 2004 {published data only}
    1. Haines TP, Bennell KL, Osborne RH, Hill KD. Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. BMJ 2004;328(7441):676-9. - PMC - PubMed
Haines 2007 {published data only}
    1. Haines TP, Hill KD, Bennell KL, Osborne RH. Additional exercise for older subacute hospital inpatients to prevent falls: benefits and barriers to implementation and evaluation. Clinical Rehabilitation 2007;21(8):742-53. - PubMed
Hamilton 2018 {published data only}
    1. Hamilton AC, Stilphen M, Hu B, Jacqueline F, Hartley J, Rothberg M. Dedicated ambulator-assisted physical activity to improve hospital outcome measures in elderly medical inpatients: a randomized controlled trial. Hospital Medicine 2018:Abstract 124.
Hamilton 2019 {published data only}
    1. Hamilton AC, Lee N, Stilphen M, Hu B, Schramm S, Frost F, et al. Increasing mobility via in-hospital ambulation protocol delivered by mobility technicians: a pilot randomized controlled trial. Journal of Hospital Medicine 2019;14(5):272-7. - PubMed
Harris 1991 {published data only}
    1. Harris RD, Henschke PJ, Popplewell PY, Radford AJ, Bond MJ, Turnbull RJ, et al. A randomised study of outcomes in a defined group of acutely ill elderly patients managed in a geriatric assessment unit or a general medical unit. Australian and New Zealand Journal of Medicine 1991;21(2):230-4. - PubMed
Hegerova 2015 {published data only}
    1. Hegerova P, Dedkova Z, Sobotka L. Early nutritional support and physiotherapy improved long-term self-sufficiency in acutely ill older patients. Nutrition 2015;31(1):166-70. - PubMed
Heim 2017 {published data only}
    1. Heim N, Stel HF, Ettema RG, Mast RC, Inouye SK, Schuurmans MJ. HELP! Problems in executing a pragmatic, randomized, stepped wedge trial on the Hospital Elder Life Program to prevent delirium in older patients. Trials 2017;18(1):220. - PMC - PubMed
Hochstetter 2005 {published data only}
    1. Hochstetter JK, Lewis J, Soares-Smith L. An investigation into the immediate impact of breathlessness management on the breathless patient: randomised controlled trial. Physiotherapy 2005;91(3):178-85.
José 2016 {published data only}
    1. José A, Dal Corso S. Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial. Journal of Physiotherapy 2016;62(2):96-102. - PubMed
JPRN‐UMIN000019551 {published data only}
    1. JPRN-UMIN000019551. Effects of acute phase intensive electrical muscle stimulation in frail elderly patients with acute decompensated heart failure: the ACTIVE-EMS Randomized Controlled Trial. trialsearch.who.int/Trial2.aspx?TrialID=JPRN-UMIN000019551 (first received 28 October 2015).
JPRN‐UMIN000030036 {published data only}
    1. JPRN-UMIN000030036. Effects of movement velocity training of upper limbs on the mobility in frail elderly. trialsearch.who.int/Trial2.aspx?TrialID=JPRN-UMIN000030036 (first received 27 November 2017).
Kim 2013 {published data only}
    1. Kim S, Yuk G-C, Gak H. Effects of the horse riding simulator and ball exercises on balance of the elderly. Journal of Physical Therapy Science 2013;25(11):1425-8. - PMC - PubMed
Kirk 2018 {published data only}
    1. Kirk JW, Bodilsen AC, Tjornhoj-Thomsen T, Pedersen MM, Bandholm T, Husted RS, et al. A tailored strategy for designing the Walk-Copenhagen (WALK-Cph) intervention to increase mobility in hospitalised older medical patients: a protocol for the qualitative part of the WALK-Cph project. BMJ Open 2018;8(3):e020272. - PMC - PubMed
Latham 2001 {published data only}
    1. Latham NK, Stretton C, Ronald M. Progressive resistance strength training in hospitalised older people: a preliminary investigation. Journal of Physiotherapy 2001;29(2):41-8.
Lopez‐Lopez 2019 {published data only}
    1. Lopez-Lopez L, Torres-Sanchez I, Rodriguez-Torres J, Cabrera-Martos I, Ortiz-Rubio A, Valenza MC. Does adding an integrated physical therapy and neuromuscular electrical stimulation therapy to standard rehabilitation improve functional outcome in elderly patients with pneumonia? A randomised controlled trial. Clinical Rehabilitation 2019;33(11):1757-66. - PubMed
Mallery 2003 {published data only}
    1. Mallery LH, MacDonald EA, Hubley-Kozey CL, Earl ME, Rockwood K, MacKnight C. The feasibility of performing resistance exercise with acutely ill hospitalized older adults. BMC Geriatrics 2003;3(3):1-8. - PMC - PubMed
Martinez‐Velilla 2017 {published data only}
    1. Martinez-Velilla N, Casas-Herrero A, Lopez Saez De Asteasu M, Zambon Ferraresi F, Gutierrez-Valencia M, Amu Ruiz F, et al. Can we modify the functional and cognitive trajectory in a hospital with exercise? A randomized clinical trial. European Geriatric Medicine 2017;8(Suppl 1):S146.
McGowan 2018b {published data only}
    1. McGowan T, Ong T, Kumar A, Lunt E, Sahota O. The effect of chair-based pedal exercises for older people admitted to hospital: a feasibility study. Age and Ageing 2018;47(Suppl 2):ii9–ii11. - PubMed
Mills 2019 {published data only (unpublished sought but not used)}
    1. Mills LG, Roberson M, Dalton T. Evaluating the effect of mobilizing geriatric inpatients on length of stay. Journal of the American Geriatrics Society 2019;67(Suppl 1):S293.
Mudge 2007 {published data only}
    1. Mudge A, Cutler A, Geibel A. Exercising body and mind: an integrated approach to functional independence in acutely hospitalised older people. Internal Medicine Journal 2007;37(Suppl 3):A73. - PubMed
Mudge 2019 {published data only}
    1. Mudge AM, McRae P, Barnett A, Inouye S. Reducing hospital associated complications in older people: results from the cherish cluster randomised controlled study. Journal of the American Geriatrics Society 2019;67(Suppl 1):S142. - PMC - PubMed
Mundy 2003 {published data only}
    1. Mundy LM, Leet TL, Darst K, Schnitzler MA, Dunagan WC. Early mobilization of patients hospitalized with community-acquired pneumonia. Chest 2003;124(3):883-9. - PubMed
NCT00038155 {published data only}
    1. NCT00038155. Rehabilitation for older adults from acute medical conditions. clinicaltrials.gov/ct2/show/NCT00038155 (first received 30 May 2002).
NCT01483456 {published data only}
    1. NCT01483456. Impact of multidisciplinary program on falls in elderly inpatients. clinicaltrials.gov/ct2/show/NCT01483456 (first received 1 December 2011).
NCT02062541 {published data only}
    1. NCT02062541. Effect of functional assessment and immediate rehabilitation of ED admitted elderly with reduced functional performance. www.clinicaltrials.gov/ct2/show/NCT02062541 (first received 13 February 2014).
NCT03558841 {published data only}
    1. NCT03558841. Effect of lyra gait training on the mobility of geriatric rehabilitation inpatients. clinicaltrials.gov/ct2/show/NCT03558841 (first received 15 June 2018).
NCT04565626 {published data only}
    1. NCT04565626. Impact of additional unsupervised peddle bike physiotherapy on acutely hospitalized medicine inpatients. clinicaltrials.gov/ct2/show/NCT04565626 (first received 25 September 2020).
Netz 1994 {published data only}
    1. Netz Y, Yaretzki A, Salganik I, Jacob T, Finkeltov B, Argov E. The effect of supervised physical activity on cognitive and affective state of geriatric and psychogeriatric in-patients. Clinical Gerontologist 1994;15(1):47-56.
Neumeier 2017 {published data only}
    1. Neumeier A, Nordon-Craft A, Malone D, Schenkman M, Clark B, Moss M. Prolonged acute care and post-acute care admission and recovery of physical function in survivors of acute respiratory failure: a secondary analysis of a randomized controlled trial. Critical Care 2017;21(1):190. - PMC - PubMed
O'Shaughnessy 2019 {published data only}
    1. O'Shaughnessy I, White S, Smalle E, Cassarino M, Robinson K, Quinn R, et al. Optimising early assessment and intervention by health and social care professions in the ED: preliminary findings from the OPTIMEND RCT. Age and Ageing 2019;48(Suppl 3):iii1–iii16.
Peel 2016 {published data only}
    1. Peel NM, Paul SK, Cameron ID, Crotty M, Kurrle SE, Gray LC. Promoting activity in geriatric rehabilitation: a randomized controlled trial of accelerometry. PLOS One 2016;11(8):e0160906. - PMC - PubMed
Peyrusqué 2021 {published data only}
    1. Peyrusqué E, Kergoat M-J, Bolduc A, Buckinx F, Law C, Veillette N, et al. Maintenance of Autonomy Through exerCise in Hospital setting (MATCH): a feasibility study. Journal of the American Medical Directors Association 2021;22(4):873-5. - PubMed
Pires 2020 {published data only}
    1. Pires PR, Trombert V, Poncet A, Kizlik J, Gold G, Ehret G, et al. Feasibility and safety of high-intensity interval training for the rehabilitation of geriatric inpatients (HIITERGY): a pilot randomized study. BMC Geriatrics 2020;20(1):197. - PMC - PubMed
Pitkala 2006 {published data only}
    1. Pitkala KH, Laurila JV, Strandberg TE, Tilvis RS. Multicomponent geriatric intervention for elderly inpatients with delirium: a randomized, controlled trial. Journals of Gerontology: Series A 2006;61(2):176-81. - PubMed
Raymond 2017 {published data only}
    1. Raymond MJ, Jeffs KJ, Winter A, Soh S-E, Hunter P, Holland AE. The effects of a high-intensity functional exercise group on clinical outcomes in hospitalised older adults: an assessor-blinded, randomised controlled trial. Age and Ageing 2017;46(2):208-14. - PubMed
Rodrigues 2019 {published data only}
    1. Rodrigues C, Mendonça D, Martins MM. Effects of a nursing care program on functional outcomes in older acute medical in-patients: protocol for a randomized controlled trial. Porto Biomedical Journal 2019;4(2):e24. - PMC - PubMed
Rubenstein 1984 {published data only}
    1. Rubenstein LZ, Josephson KR, Wieland GD, English PA, Sayre JA, Kane RL. Effectiveness of a geriatric evaluation unit. A randomized clinical trial. New England Journal of Medicine 1984;311(26):1664-70. - PubMed
Sáez de Asteasu 2021b {published data only}
    1. Sáez de Asteasu ML, Martínez-Velilla N, Zambom-Ferraresi F, Ramírez-Vélez R, García-Hermoso A, Cadore EL, et al. Exercise effects on brain and muscle function in acutely hospitalized older patients assessed by functional near-infrared spectroscopy. Journal of the American Medical Directors Association 2021;22(4):875-6. - PubMed
Said 2012 {published data only}
    1. Said CM, Morris ME, Woodward M, Churilov L, Bernhardt J. Enhancing physical activity in older adults receiving hospital based rehabilitation: a phase II feasibility study. BMC Geriatrics 2012;12:26. - PMC - PubMed
Saltvedt 2002 {published data only}
    1. Saltvedt I, Mo ES, Fayers P, Kaasa S, Sletvold O. Reduced mortality in treating acutely sick, frail older patients in a geriatric evaluation and management unit. A prospective randomized trial. Journal of the American Geriatrics Society 2002;50(5):792-8. - PubMed
Saltvedt 2004 {published data only}
    1. Saltvedt I, Saltnes T, Opdahl Mo ES, Fayers P, Kaasa S, Sletvold O. Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study. Aging Clinical and Experimental Research 2004;16(4):300-6. - PubMed
Saltvedt 2006 {published data only}
    1. Saltvedt I, Jordhoy M, Mo ES, Fayers P, Kaasa S, Sletvold O. Randomised trial of in-hospital geriatric intervention: impact on function and morale. Gerontology 2006;52(4):223-30. - PubMed
Schwenk 2014 {published data only}
    1. Schwenk M, Dutzi I, Englert S, Micol W, Najafi B, Mohler J, et al. An intensive exercise program improves motor performances in patients with dementia: translational model of geriatric rehabilitation. Journal of Alzheimer's Disease 2014;39(3):487-98. - PubMed
Seo 2019 {published data only}
    1. Seo K-H, Sin D, Ju EP, Lim J-Y. Effects of whole body vibration training using side-alternating vibration platform with tilt table in hospitalized older adults with sarcopenia: a randomized controlled pilot study. Age and Ageing 2019;48(S4):iv18–iv27.
Siebens 2000 {published data only}
    1. Siebens H, Aronow H, Edwards D, Ghasemi Z. A randomized controlled trial of exercise to improve outcomes of acute hospitalization in older adults. Journal of the American Geriatrics Society 2000;48(12):1545-52. - PubMed
Steadman 2003 {published data only}
    1. Steadman J, Donaldson N, Kalra L. A randomized controlled trial of an enhanced balance training program to improve mobility and reduce falls in elderly patients. Journal of the American Geriatrics Society 2003;51(6):847-52. - PubMed
Steunenberg 2016 {published data only}
    1. Steunenberg B, Mast R, Strijbos MJ, Inouye SK, Schuurmans MJ. How trained volunteers can improve the quality of hospital care for older patients. A qualitative evaluation within the Hospital Elder Life Program (HELP). Geriatric Nursing 2016;37(6):458-63. - PubMed
Sullivan 2007 {published data only}
    1. Sullivan DH, Roberson PK, Smith ES, Price JA, Bopp MM. Effects of muscle strength training and megestrol acetate on strength, muscle mass, and function in frail older people. Journal of the American Geriatrics Society 2007;55(1):20-8. - PubMed
Tibaek 2014 {published data only}
    1. Tibaek S, Andersen CW, Pedersen SF, Rudolf KS. Does progressive resistance strength training as additional training have any measured effect in older hospitalised patients? A single-blinded randomized controlled trial. Clinical Rehabilitation 2014;28(4):319-28. - PubMed
Timonen 2002 {published data only}
    1. Timonen L, Rantanen T, Timonen TE, Sulkava R. Effects of a group-based exercise program on the mood state of frail older women after discharge from hospital. International Journal of Geriatric Psychiatry 2002;17(12):1106-11. - PubMed
Timonen 2006 {published data only}
    1. Timonen L, Rantanen T, Makinen E, Timonen TE, Tormakangas T, Sulkava R. Effects of a group-based exercise program on functional abilities in frail older women after hospital discharge. Aging Clinical and Experimental Research 2006;18(1):50-6. - PubMed
Treacy 2015a {published data only}
    1. Treacy D, Schurr K, Lloyd B, Sherrington C. Additional standing balance circuit classes during inpatient rehabilitation improved balance outcomes: an assessor-blinded randomised controlled trial. Physiotherapy 2015;44(4):580-6. - PubMed
Treacy 2015b {published data only}
    1. Treacy D, Schurr K, Lloyd B, Sherrington C. Additional standing balance circuit classes during inpatient rehabilitation improved balance outcomes: an assessor blinded randomised controlled trial. Age and Ageing 2015;101(Suppl 1):eS1533-4. - PubMed
Trombetti 2013 {published data only}
    1. Trombetti A, Hars M, Herrmann F, Rizzoli R, Ferrari S. Effect of a multifactorial fall-and-fracture risk assessment and management program on gait and balance performances and disability in hospitalized older adults: a controlled study. Osteoporosis International 2013;24(3):867-76. - PubMed
Vidan 2009 {published data only}
    1. Vidan MT, Sanchez E, Alonso M, Montero B, Ortiz J, Serra JA. An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients. Journal of the American Geriatrics Society 2009;57(11):2029-36. - PubMed
Weatherall 2004 {published data only}
    1. Weatherall M. A targeted falls prevention programme plus usual care significantly reduces falls in elderly people during hospital stays. Evidence-Based Healthcare and Public Health 2004;8(5):273-5.
Yoo 2013 {published data only}
    1. Yoo JW, Nakagawa S, Kim S. Delirium and transition to a nursing home of hospitalized older adults: a controlled trial of assessing the interdisciplinary team-based "geriatric" care and care coordination by non-geriatrics specialist physicians. Geriatrics & Gerontology International 2013;13(2):342-50. - PubMed

References to studies awaiting assessment

Kojaie‐Bidgoli 2021 {published data only}
    1. Kojaie-Bidgoli A, Sharifi F, Maghsoud F, Alizadeh-Khoei M, Jafari F, Sadeghi F. The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: a double-blind randomized control trial. BMC Geriatrics 2021;21(1):599. [PMID: ] - PMC - PubMed

References to ongoing studies

NCT03604640 {published data only}
    1. NCT03604640. Physical training and health education in hospitalized elderly. clinicaltrials.gov/ct2/show/NCT03604640 (first received 27 July 2018).
NCT04600453 {published data only}
    1. NCT04600453. Prevention of functional and cognitive impairment through a multicomponent exercise program. clinicaltrials.gov/ct2/show/NCT04600453 (first received 23 October 2020).

Additional references

Clegg 2013
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013;381(9868):752-62. - PMC - PubMed
Cole 2015
    1. Cole MG, Bailey R, Bonnycastle M, McCusker J, Fung S, Ciampi A, et al. Partial and no recovery from delirium in older hospitalized adults: frequency and baseline risk factors. Journal of the American Geriatrics Society 2015;63(11):2340-8. - PubMed
Covidence [Computer program]
    1. Covidence. Melbourne, Australia: Veritas Health Innovation, accessed 20 May 2021. Available at covidence.org.
Covinsky 2011
    1. Covinsky KE, Pierluissi E, Johnston CB. Hospitalization-associated disability: "she was probably able to ambulate, but I'm not sure". JAMA 2011;306(16):1782-93. - PubMed
Davydow 2013
    1. Davydow DS, Hough CL, Levine DA, Langa KM, Iwashyna TJ. Functional disability, cognitive impairment, and depression after hospitalization for pneumonia. American Journal of Medicine 2013;126(7):615-24.e5. - PMC - PubMed
Deeks 2022
    1. Deeks JJ, Higgins JP, Altman DG. Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
de Morton 2007b
    1. Morton NA, Jones CT, Keating JL, Berlowitz DJ, Lachlan DJ, MacGregor L, et al. The effect of exercise on outcomes for hospitalised older acute medical patients: an individual patient data meta-analysis. Age and Ageing 2007;36(2):219-22. [PMID: ] - PubMed
Falvey 2015
    1. Falvey JR, Mangione KK, Stevens-Lapsley JE. Rethinking hospital-associated deconditioning: proposed paradigm shift. Physical Therapy and Rehabilitation Journal 2015;95(9):1307-15. - PMC - PubMed
Fortinsky 1999
    1. Fortinsky RH, Covinsky K, Palmer RM, Landefeld CS. Effects of functional status changes before and during hospitalization on nursing home admission of older adults. Journals of Gerontology. Series A 1999;54(10):M521-6. - PubMed
Gill 2015
    1. Gill TM, Gahbauer EA, Han L, Allore HG. The role of intervening hospital admissions on trajectories of disability in the last year of life: prospective cohort study of older people. BMJ 2015;350:h2361. - PMC - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Hamilton (ON): McMaster University (developed by Evidence Prime), accessed 3 March 2021. Available at gradepro.org.
Guyatt 2011
    1. Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso-Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence – imprecision. Journal of Clinical Epidemiology 2011;64(12):1283-93. - PubMed
Hartley 2021
    1. Hartley P, Romero-Ortuno R, Wellwood I, Deaton C. Changes in muscle strength and physical function in older patients during and after hospitalisation: a prospective repeated-measures cohort study. Age and Ageing 2021;50(1):153-60. - PubMed
Heyn 2004
    1. Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Archives of Physical Medicine and Rehabilitation 2004;85(10):1694-704. - PubMed
Higgins 2022a
    1. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook. [PMID: ] - PubMed
Higgins 2022b
    1. Higgins JP, Li T, Deeks JJ. Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
Hoffmann 2014
    1. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: Template for Intervention Description and Replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. [DOI: 10.1136/bmj.g1687] [PMID: ] - DOI - PubMed
Hoyer 2014
    1. Hoyer EH, Needham DM, Atanelov L, Knox B, Friedman M, Brotman DJ. Association of impaired functional status at hospital discharge and subsequent rehospitalization. Journal of Hospital Medicine 2014;9(5):277-82. - PMC - PubMed
Inouye 2003
    1. Inouye SK, Bogardus ST Jr, Williams CS, Leo-Summers L, Agostini JV. The role of adherence on the effectiveness of nonpharmacologic interventions: evidence from the Delirium Prevention Trial. Archives of Internal Medicine 2003;163(8):958-64. - PubMed
Kanach 2018
    1. Kanach FA, Pastva AM, Hall KS, Pavon JM, Morey MC. Effects of structured exercise interventions for older adults hospitalized with acute medical illness: a systematic review. Journal of Aging and Physical Activity 2018;26(2):284-303. - PMC - PubMed
Kortebein 2008
    1. Kortebein P, Symons TB, Ferrando A, Paddon-Jones D, Ronsen O, Protas E, et al. Functional impact of 10 days of bed rest in healthy older adults. Journals of Gerontology. Series A 2008;63(10):1076-81. - PubMed
Kortebein 2009
    1. Kortebein Patrick. Rehabilitation for hospital-associated deconditioning. American Journal of Physical Medicine & Rehabilitation 2009;88(1):66-77. - PubMed
Kosse 2013
    1. Kosse NM, Dutmer AL, Dasenbrock L, Bauer JM, Lamoth CJ. Effectiveness and feasibility of early physical rehabilitation programs for geriatric hospitalized patients: a systematic review. BMC Geriatrics 2013;13:107. - PMC - PubMed
Lafont 2011
    1. Lafont C, Gérard S, Voisin T, Pahor M, Vellas B, The members of I A G G / A M P A Task Force. Reducing "iatrogenic disability" in the hospitalized frail elderly. Journal of Nutrition, Health and Aging 2011;15(8):645-60. - PubMed
Liu 2009
    1. Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No: CD002759. [DOI: 10.1002/14651858.CD002759] - DOI - PMC - PubMed
Loyd 2020
    1. Loyd C, Markland AD, Zhang Y, Fowler M, Harper S, Wright NC, et al. Prevalence of hospital-associated disability in older adults: a meta-analysis. Journal of the American Medical Directors Association 2020;21(4):455-61.e5. - PMC - PubMed
Lyons 2019
    1. Lyons A, Romero-Ortuno R, Hartley P. Functional mobility trajectories of hospitalized older adults admitted to acute geriatric wards: a retrospective observational study in an English university hospital. Geriatrics & Gerontology International 2019;19(4):305-10. - PubMed
Martínez‐Velilla 2016
    1. Martínez-Velilla N, Cadore EL, Casas-Herrero Á, Idoate-Saralegui F, Izquierdo M. Physical activity and early rehabilitation in hospitalized elderly medical patients: systematic review of randomized clinical trials. Journal of Nutrition, Health & Aging 2016;20(7):738-51. - PubMed
McCusker 2001
    1. McCusker J, Cole M, Dendukuri N, Belzile É, Primeau F. Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. Canadian Medical Association Journal 2001;165(5):575. - PMC - PubMed
Norman 2003
    1. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Medical Care 2003;41(5):582-92. - PubMed
Page 2022
    1. Page MJ, Higgins JP, Sterne JA. Chapter 13: Assessing risk of bias due to missing results in a synthesis. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane 2022. Available from www.training.cochrane.org/handbook.
Perera 2006
    1. Perera S, Mody SH, Woodman RC, Studenski SA. Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society 2006;54(5):743-9. - PubMed
R [Computer program]
    1. R: A language and environment for statistical computing. Version 3.4.2. Vienna, Austria: R Foundation for Statistical Computing, 2017. Available at www.R-project.org. [URL: www.R-project.org/]
Review Manager Web [Computer program]
    1. Review Manager Web (RevMan Web). Version 4.12.0. The Cochrane Collaboration, 2022. Available at revman.cochrane.org.
Reynolds 2021
    1. Reynolds CD, Brazier KV, Burgess EA, Golla JA, Le J, Parks BA, et al. Effects of unstructured mobility programs in older hospitalized general medicine patients: a systematic review and meta-analysis. Journal of the American Medical Directors Association 2021;S1525-8610(20):31057-4. - PubMed
Schünemann 2022a
    1. Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing 'Summary of findings' tables and grading the certainty of the evidence. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
Schünemann 2022b
    1. Schünemann HJ, Vist GE, Higgins JP, Santesso N, Deeks JJ, Glasziou P, et al. Chapter 15: Interpreting results and drawing conclusions. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
Sourdet 2015
    1. Sourdet S, Lafont C, Rolland Y, Nourhashemi F, Andrieu S, Vellas B. Preventable iatrogenic disability in elderly patients during hospitalization. Journal of the American Medical Directors Association 2015;16(8):674-81. - PubMed
Tonkikh 2016
    1. Tonkikh O, Shadmi E, Flaks-Manov N, Hoshen M, Balicer RD, Zisberg A. Functional status before and during acute hospitalization and readmission risk identification. Journal of Hospital Medicine 2016;11(9):636-41. - PubMed
Valenzuela 2020
    1. Valenzuela PL, Morales JS, Castillo-García A, Mayordomo-Cava J, García-Hermoso A, Izquierdo M, et al. Effects of exercise interventions on the functional status of acutely hospitalised older adults: a systematic review and meta-analysis. Ageing Research Reviews 2020;61:101076. - PubMed
Viechtbauer 2010
    1. Viechtbauer W. Conducting meta-analyses in R with the metafor package. Journal of Statistical Software 2010;36(3):1-48. [DOI: 10.18637/jss.v036.i03] - DOI
Welch 2018
    1. Welch C, Hassan-Smith ZK, Greig CA, Lord JM, Jackson TA. Acute sarcopenia secondary to hospitalisation – an emerging condition affecting older adults. Aging and Disease 2018;9(1):151-64. - PMC - PubMed
WHO 2020
    1. World Health Organization. WHO guidelines on physical activity and sedentary behaviour. www.who.int/publications/i/item/9789240015128 (last accessed prior to 17 October 2022).
Zisberg 2015
    1. Zisberg A, Shadmi E, Gur-Yaish N, Tonkikh O, Sinoff G. Hospital-associated functional decline: the role of hospitalization processes beyond individual risk factors. Journal of the American Geriatrics Society 2015;63(1):55-62. - PubMed

References to other published versions of this review

de Morton 2006
    1. Morton NA, Keating JL, Jeffs K. Exercise for acutely hospitalised older medical patients. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No: CD005955. [DOI: 10.1002/14651858.CD005955] - DOI - PMC - PubMed
de Morton 2007a
    1. Morton N, Keating JL, Jeffs K. Exercise for acutely hospitalised older medical patients. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No: CD005955. [DOI: 10.1002/14651858.CD005955.pub2] [PMID: ] - DOI - PMC - PubMed

Publication types