A randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) on length of stay, physical ability and quality of life in frail older medical patients in the acute setting

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dc.contributor.advisor Timmons, Suzanne en
dc.contributor.advisor Horgan, N. Frances en
dc.contributor.author McCullagh, Ruth
dc.date.accessioned 2018-08-27T08:36:04Z
dc.date.available 2018-08-27T08:36:04Z
dc.date.issued 2017
dc.date.submitted 2017
dc.identifier.citation McCullagh, R. 2017. A randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) on length of stay, physical ability and quality of life in frail older medical patients in the acute setting. PhD Thesis, University College Cork. en
dc.identifier.endpage 200 en
dc.identifier.uri http://hdl.handle.net/10468/6643
dc.description.abstract The aim of this thesis was to measure the effectiveness of additional exercises on length of stay, physical performance and quality of life for frail older medical inpatients. The thesis, in three phases (1) identified a suitable and accurate motion sensor to measure walking in hospital, (2) measured walking in hospital, and (3) measured the effectiveness of an augmented prescribed exercise programme (APEP) for frail older acute medical (RCT). Phase 1: A scholarly review identified two accelerometers and three pedometers showing potential, and a validation study (n=32), identified one of these as suitably accurate. Phase 2: The accelerometer was used to measure the association between walking (step-count) and (1) length of stay, (2) physical performance and (3) potential influencers of walking (n=154). More walking (50%) was associated with a 6% shorter hospital stay. Better physical performance on admission predicted 15% more walking, and assigned bed-rest and tethering treatments were associated with less walking (70% and 30% respectively). Phase 3: The effectiveness of the APEP was measured (n=190), using length of stay as the primary outcome measure. Twice-daily exercise sessions were delivered; strengthening/balance to the intervention group, stretching/relaxation to the control group. Many (35%) patients were transferred to sub-acute care. A 30% shorter length of stay (patients discharged directly home only), was detected, however, failed to reach significant significance (n=128), (HR 1.3 (CI 0.90-1.87) p=0.1). Improved physical performance at discharge (β 0.88 (CI 0.2-1.57) p=0.01), quality of life at follow-up (β 0.28 (CI 0.91-0.47) p=0.004) and less negative events (pooled falls, prolonged hospital stays, deaths and long-term care admissions) (OR 0.42 (0.2-0.92) p=0.03, post hoc analysis) were detected. The results indicate that older inpatients’ inactivity is associated with length of stay. Additional exercises improved physical performance and quality of life. Its effect on length of stay remains inconclusive. en
dc.description.sponsorship HPF 2013 451 en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2017, Ruth McCullagh. en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/3.0/ en
dc.subject Frail en
dc.subject Exercise en
dc.subject Hospitalised en
dc.subject Length of stay en
dc.subject Physical performance en
dc.title A randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) on length of stay, physical ability and quality of life in frail older medical patients in the acute setting en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral en
dc.type.qualificationname PhD en
dc.internal.availability Full text available en
dc.check.info Not applicable en
dc.description.version Accepted Version
dc.contributor.funder Health Research Board en
dc.description.status Not peer reviewed en
dc.internal.school Medicine en
dc.check.type No Embargo Required
dc.check.reason Not applicable en
dc.check.opt-out Not applicable en
dc.thesis.opt-out false
dc.check.embargoformat Embargo not applicable (If you have not submitted an e-thesis or do not want to request an embargo) en
ucc.workflow.supervisor s.timmons@ucc.ie
dc.internal.conferring Summer 2018 en


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