Effects of Physical Activity in Prevention of Functional Decline of Post-Hospitalization Elderly

Monday, 30 July 2012

ChiaoWen Chang, RN, BSN
Institute of Nursing, National Cheng Kung University, Tainan City, Taiwan
Chia-Ming Chang, MD
Department of Internal Medicine; Institute of Gerontology, National Cheng Kung University Hospital, Tainan, Taiwan
Ching-Huey Chen, PhD, RN
Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan

Learning Objective 1: The learner will be able to knowing which kinds of simply physical activity can improve the physical ability of hospitalized elderly.

Learning Objective 2: The learner will be able to knowing the nursing procedure of prevent functional decline of the hospitalized elderly.


For many older adults, hospitalization can lead to functional decline because of medical diseases or activity restriction.Previous researches found that at least 30% hospitalized older adults experienced functional decline and this even influenced about 70% elders in Taiwan.Following post-hospitalization elders for 3 months, less than 75% of them could regain their previous physical function.The aim of this study were trying to find a nursing procedure to prevent functional decline of the elderly and describe the effects of physical activity intervention after 1 month post-hospitalization. 


A randomized controlled trial was conducted on 33 hospitalized elderly patients who were admitted to four medical units at a medical center in Taiwan.Participants were patients aged ≥ 65 years without conscious disturbance and patients who can stand independently, with or without aids.Exclusion criteria were patients with length of stay < 72 hours, patients who were too ill to participate, those with terminal diseases, and any reasons resulting in physical activity restriction.The intervention group performed a physical activity through daily nursing care for 30 minutes a day, with supervision and assistance.Physical activities included walking or in bed-bicycle ergometer during hospitalization period. Both groups received weekly phone calls to follow their daily physical activity.Changes in physical function were measured by the Modified Barthel Index (MBI) and Timed Up and Go Test (TUG) within 48 hours after admission, 48 hours before discharge, and one month after discharge.


One month after discharge, with every 20 seconds cutoff point, the intervention group had greater improvement in TUG than the control group (P = 0.015 < 0.05).The MBI did not differ between two groups. 


It is feasible to consider that elderly patients are likely to benefit from physical activity through nursing process to maintain functional abilities one month after discharge.