Sarcopenia, malnutrition and cognition affect physiotherapy frequency during geriatric rehabilitation: RESORT cohort - 03/02/23

Doi : 10.1016/j.rehab.2023.101735

Laure M.G. Verstraeten ^a, Federica Sacchi ^a, Janneke P. van Wijngaarden ^b, Carel G.M. Meskers ^c, Andrea B. Maier ^a,^d,^e,^f,^⁎
^a Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
^b Danone Nutricia Research, Uppsalalaan 12, 3584 CT, Utrecht, The Netherlands
^c Department of Rehabilitation Medicine, Amsterdam University Medical Centre, Amsterdam Movement Sciences, Amsterdam, The Netherlands
^d Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
^e Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
^f Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.

^⁎Corresponding author. Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. Telephone number: +31629444246.Department of Human Movement Sciences@AgeAmsterdamFaculty of Behavioural and Movement SciencesAmsterdam Movement SciencesVrije UniversiteitAmsterdam, van der Boechorststraat 7Amsterdam1081 BTThe Netherlands

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Highlights

•	There is a large variation in physiotherapy frequency in geriatric rehabilitation
•	Median physiotherapy frequency is 5 sessions per week of approximately 30 min
•	Individuals with the poorest health characteristics receive less physiotherapy

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Abstract

Background

Physiotherapy (PT) is important to optimize functional recovery in geriatric rehabilitation. The dose of PT received by inpatients during geriatric rehabilitation and the determinants of dose are unknown.

Objectives

Describe PT dose in terms of total number of sessions, frequency, duration and type of sessions, and inpatient characteristics determining the frequency of PT in geriatric rehabilitation.

Methods

The observational, longitudinal REStORing health of acutely unwell adulTs (RESORT) cohort consists of geriatric inpatients undergoing rehabilitation including PT (Melbourne, Australia). Ordinal regression was used to assess the determinants of PT frequency (total number of sessions divided by length of stay in weeks). Malnutrition, frailty and sarcopenia were diagnosed according to the Global Leadership Initiative on Malnutrition criteria, Clinical Frailty Scale and revised definition of the European Working Group on Sarcopenia in Older People respectively.

Results

Of the 1890 participants, 1799, median (quartile 1; quartile 3) age 83.4 (77.6; 88.4) years, 56% females received PT and were admitted for at least 5 days. Median total number of PT sessions was 15 (8; 24); median frequency was 5.2 sessions per week (3.0; 7.7); and duration was 27 (22; 34) minutes per session. Higher disease burden, cognitive impairment, delirium, higher anxiety and depression scores, malnutrition, frailty and sarcopenia were associated with a lower PT frequency. Older age, female sex, musculoskeletal reason for admission, greater independence in (instrumental) activities of daily living and handgrip strength were associated with a higher PT frequency.