Does exercise provided in group setting on top of usual physiotherapy be feasible and improve balance and functional outcome in Geriatric Evaluation and Management unit patients?

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Hospitalization of older adults appears to result in functional decline mostly likely due to reduced activity level. Bed rest and low level of mobility were common occurrences during hospitalization of older adults. On average, these hospitalized older adults only spend 43 min a day standing or walking and 80% of their hospital stay is spent in bed. While it is acknowledged that bed rest and inactivity are detrimental for mobility and function, it is often observed that patients in the Geriatric Evaluation and Management (GEM) Unit are inactive during day hours. Physiotherapists play a crucial role in maximising patient mobility and independence through the prescription and delivery of exercise programmes. The type and intensity of exercise are important factors in determining patient outcome. Systematic reviews have found that weight bearing and targeted task specific exercises can improve balance and decrease falls in older people. Usual care physiotherapy provided in GEM unit consists of one-to-one individualised session. Exercises provided in groups via circuit training have shown benefits in improving balance in frail older people in the inpatient setting. Very little is known about the delivery of circuit class (therapy provided to more than 2 participants, involving a tailored intervention program with a focus on practice of functional task received in group setting in older people admitted to GEM unit who have multiple co-morbidities and reduced physical capacity. This study sought to determine if additional exercise provided via circuit training improves balance and functional outcome more than usual physiotherapy alone in adults undergoing rehabilitation in GEM unit.

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