The Telephysiotherapy for Older People (<scp>TOP</scp>‐<scp>UP</scp>) program for improving mobility in people receiving aged care: a hybrid type 1 effectiveness–implementation randomised controlled trial
Bibliographic record
Abstract
OBJECTIVES: To assess the effectiveness and implementation of a telephysiotherapy program for improving mobility, mobility goal attainment, and quality of life of people receiving at-home or residential aged care. STUDY DESIGN: Hybrid type 1 effectiveness-implementation randomised controlled trial. SETTING, PARTICIPANTS: People aged 65 years or older who were receiving community or residential aged care services in Australia, 1 September 2021 - 30 November 2023. INTERVENTION: Telephysiotherapy for Older People (TOP-UP): six-month program of ten telephysiotherapy (Zoom) sessions for assessment and tailored exercise prescription, supported by trained aged care workers and exercise videos. MAIN OUTCOME MEASURES: Primary outcome: mobility (Short Physical Performance Battery [SPPB] score at baseline and six months). SECONDARY OUTCOMES: fall rate (per person), proportion of people with falls, SPPB components (sit-to-stand performance, balance, gait speed), pain (visual analogue scale), mobility goal attainment, physical activity (Incidental and Planned Exercise Questionnaire), quality of life (EQ-5D-5L visual analogue scale). RESULTS: A total of 1348 people were screened at 27 sites, and 242 eligible people were recruited for the trial (mean age, 83 years [standard deviation, 8 years]; 158 women [65%]); 92 of 120 intervention group participants and 100 of 122 control group participants completed the six-month. After adjusting for baseline mobility scores, the mean difference in mobility score at six months (intervention v control group) was 2.1 (95% confidence interval [CI], 1.4-2.7) points. Sit-to-stand performance was more likely to improve in intervention than control participants (adjusted odds ratio, 2.7; 95% CI, 1.3-4.3); intervention participants reported greater quality of life (EQ-5D-5L visual analogue scale: adjusted mean difference, 6.2 [95% CI, 1.8-10.7] points) and less pain (visual analogue scale: adjusted mean difference, -1.1 [95% CI, -1.8 to -0.3] points), and a smaller proportion experienced falls (29, 32% v 44, 44%; risk ratio, 0.62; 95% CI, 0.42-0.92). Of 1348 screened people, 242 enrolled in the trial (18.0%), of whom 186 (77%) completed the trial, and 62 of 66 surveyed participants (94%) endorsed the intervention. No serious adverse events were recorded. CONCLUSION: The TOP-UP program safely improved mobility, reduced fall risk and pain, and improved quality of life for people receiving aged care. Telephysiotherapy could be incorporated into aged care to improve the lives of older Australians. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN 12621000734864 (prospective).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".