Effect of a Pragmatic Exercise Intervention Pilot Study on Preventing Functional and Physical Decline in Hospitalized Older Adults
Bibliographic record
Abstract
PURPOSE: Although physical activity (PA) has the potential to prevent iatrogenic disability, it is rarely integrated into usual care. We evaluated whether M aintenance of A utonomy T hrough exer C ise in H ospital Setting tool (MATCH), a pragmatic unsupervised exercise intervention, could help prevent physical and functional decline in hospitalized older adults. METHODS: A quasi-randomized trial (ClinicalTrials #NCT04078334) was conducted involving 100 hospitalized patients, who were allocated to either the usual care + MATCH group (MG; n = 62) or the usual care only group (CG; n = 38). MATCH is an unsupervised PA program guided by a decision tree (3 exercises/session; 3×/day). Outcomes were assessed at admission and discharge: 1) primary outcome: functional capacities (Short Physical Performance Battery [SPPB]); 2) secondary outcomes: handgrip strength, walking speed, functional mobility (3-m Timed-Up-and-Go [TUG]), leg muscle power (30-s chair-test), need for home care support, and functional autonomy in both instrumental and basic activities of daily living (ADL). RESULTS: At admission, groups were similar, except for nutritional status ( P = 0.047). There were no significant differences between groups for the primary outcome (SPPB: MG:+1.5 ± 1.9 vs CG:+1.0 ± 1.4/12pts, P = 0.25). However, the MG showed greater improvements in handgrip strength (MG:+1.7 ± 3.9 vs CG:-0.15 ± 3.0 kg, P = 0.02) and had a lower need for home care support at discharge (MG:44.3% vs CG:65.8%, P = 0.041). A higher proportion of MG participants improved to being at no risk of falling (TUG<14 s), achieved good functional capacity (SPPB ≥10/12: +6.6%), increased leg muscle power (women: <2.1/men: <2.6(W·kg -1 BW): -15.1%), and improved walking speed (<0.6 m·s -1 , -30.6%) compared with the CG. Clinically meaningful improvements in ADL (+82.7%) were observed only in the MG. CONCLUSIONS: Combining usual care with the MATCH intervention appears more effective than usual care alone in preventing physical and functional decline and reducing the need for home care support at discharge. Larger-scale efficacy studies are needed to confirm these promising results.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".