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Supervised progressive cross-continuum strength training compared with usual care in older medical patients: study protocol for a randomized controlled trial (the STAND-Cph trial).
- Source :
- Trials; 4/1/2016, Vol. 17, p1-16, 16p, 3 Diagrams, 3 Charts
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Hospitalization in older adults is characterized by physical inactivity and a risk of losing function and independence. Systematic strength training can improve muscle strength and functional performance in older adults. Few studies have examined the effect of a program initiated during hospitalization and continued after discharge. We conducted a feasibility study prior to this trial and found a progression model for loaded sit-to-stands feasible in older medical patients. This study aims to determine whether a simple supervised strength training program for the lower extremities (based on the model), combined with post-training protein supplementation initiated during hospitalization and continued at home for 4 weeks, is superior to usual care on change in mobility 4 weeks after discharge in older medical patients.<bold>Methods: </bold>Eighty older medical patients (65 years or older) acutely admitted from their own homes will be included in this randomized, controlled, parallel-group, investigator-blinded, superiority trial. After baseline assessments patients will be randomized to (1) intervention: progressive strength training during hospitalization and after discharge (home-based), or (2) control: usual care. Shortly after discharge, 4 weeks after discharge (primary end point) and 6 months after discharge patients will be assessed in their own homes. The intervention encompasses strength training consisting of two lower extremity exercises (sit-to-stand and heel raise) daily during hospitalization and three times per week for 4 weeks after discharge. Both exercises follow pre-defined models for progression and will be performed for three sets of 8-12 repetitions maximum in each training session. Thereafter, the patient will be asked to consume a protein supplement given orally containing 18 g milk-based protein. The primary outcome will be change in the de Morton Mobility Index score from baseline to 4 weeks after discharge. Secondary outcomes will be 24-h mobility level, isometric knee extension strength, the 30-sec sit-to-stand test, habitual gait speed, hand-grip strength, and Activities of Daily Living.<bold>Discussion: </bold>We chose to investigate the effect of a minimal time-consuming treatment approach, i.e. two well-performed strength training exercises combined with protein supplementation, to facilitate implementation in a busy clinical care setting, given a positive trial outcome.<bold>Trial Registration: </bold>ClinicalTrials.gov: NCT01964482 . [ABSTRACT FROM AUTHOR]
- Subjects :
- HOSPITAL care of older people
OLDER patients
RANDOMIZED controlled trials
CLINICAL trials
MEDICAL research
MEDICAL care
AGE distribution
GERIATRIC assessment
COMBINED modality therapy
COMPARATIVE studies
ELEMENTAL diet
HOSPITAL patients
RESEARCH methodology
MEDICAL cooperation
RESEARCH protocols
MILK proteins
MUSCLE strength
RESEARCH
TIME
ACTIVITIES of daily living
SYMPTOMS
EVALUATION research
DISCHARGE planning
TREATMENT effectiveness
NUTRITIONAL status
RESISTANCE training
Subjects
Details
- Language :
- English
- ISSN :
- 17456215
- Volume :
- 17
- Database :
- Complementary Index
- Journal :
- Trials
- Publication Type :
- Academic Journal
- Accession number :
- 114208886
- Full Text :
- https://doi.org/10.1186/s13063-016-1309-1