Physical rehabilitation

​Background

The aging process is associated with physiological changes including decreased muscle mass, increased fat mass and altered muscle-nerve function resulting in decreased functional capacity.

Acute illness combined with inactivity and bed rest during hospitalization accelerates the age-related changes in functional capacity. Thus, the older medical patient is at risk of loosing functional independency during hospitalization. Research on exercise during hospitalization and post-discharge have shown beneficial effects on functional independency. However, the interventions have been characterised by comprehensive exercise programmes resulting in a lack of compliance.

Main focus

The aim of our studies concerning physical activity and exercise is to reduce inactivity-induced loss of functional capacity and provide optimal physical rehabilitation for older medical patients during hospitalization and after discharge. The aim is to obtain high compliance by developing an exercise programme that is simple, easily implemented and targeted at the individual ability of the older medical patient.

On-going studies

The STAND-Cph trial: Supervised progressive cross-continuum strength training compared with usual care in older medical patients. After baseline assessments, patients are randomized to either supervised progressive strength training during hospitalization and after discharge (home-based) or usual care. Follow-up assessments shortly after discharge and 4 weeks after discharge (primary end point) in the patients' own homes. The intervention consists of strength training of the lower extremities daily during hospitalization and three times per week for 4 weeks after discharge. 80 patients will be enrolled. Project leaders: Mette Merete Pedersen and Lillian Mørch Jørgensen.

The WALK-Cph trial (Stå og gå i Region H): Cross-continuum physical activity in older medical patients: a pragmatic, mixed-methods and implementation study to increase 24-hour mobility in older medical patients during acute hospitalization and following discharge. WALK-Cph is a tailored intervention which has been developed and co-designed in collaboration with key stakeholders (patients, relatives, health professionals and researchers) to enable successful implementation (Phase 1). In the upcoming phases of the study, we will fidelity-test the intervention (Phase 2), impact-test the intervention in an RCT-study (Phase 3) and measure adoption of the intervention (Phase 4). Project leaders: Jeanette Wassar Kirk and Mette Merete Pedersen.

The QUADX-1 Trial: An exercise dose-response trial in patients eligible for total knee arthroplasty due to end-stage knee osteoarthritis. Three knee-extensor exercise dosages are investigated. Following baseline assessment, patients are randomized to either 2, 4 or 6 exercise sessions a week for 12 weeks. Follow-up assessment is after 12 weeks of exercise (primary end-point), shortly following surgery (total knee arthroplasty) and three months following surgery. The primary outcome is change in knee-extensor strength. 140 patients will be enrolled. Project leader: Rasmus Skov Husted.

Finished studies 

Prediction of Mobility Limitations after Hospitalization in Older Medical Patients by Simple Measures of Physical Performance Obtained at Admission to the Emergency Department.  Bodilsen AC,  Klausen HH , Petersen J, Beyer N , Andersen O , Jørgensen LM , Juul-Larsen HG , Bandholm T. PLoS One 2016 May 19;11(5):e0154350. doi: 10.1371/journal.pone.0154350. eCollection 2016

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). Pedersen, M. M., Petersen, J., Beyer, N., Damkjær, L. & Bandholm, T. april 2016 I : Trials. 17, 176  

Feasibility of progressive sit-to-stand training among older hospitalized patients. Pedersen, M. M., Petersen, J., Bean, J. F., Damkjaer, L., Juul-Larsen, H. G., Andersen, O., Beyer, N. & Bandholm, T. dec 2015 I : PeerJ. 3, s. 2-21 

Leptin, IL-6, and suPAR reflect distinct inflammatory changes associated with adiposity, lipodystrophy and low muscle mass in HIV-infected patients and controls. Langkilde, A., Petersen, J., Henriksen, J. H., Jensen, F. K., Gerstoft, J., Eugen-Olsen, J. & Andersen, O. sep 2015 I : Immunity & Ageing. 12, s. 9  

The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial. Buhl , S. F., Andersen, A. L., Andersen, J. R., Andersen, O., Jensen, J-E. B., Rasmussen, A. M. L., Pedersen, M. M., Damkjær, L., Gilkes, H. & Petersen, J. feb 2016 I : Clinical nutrition (Edinburgh, Scotland). 35, 1, s. 59-66  

Reply, Letter to Editor - Combined intervention of protein supplementation and resistance training in medical patients. Buhl , S. F., Andersen, A. L., Andersen, J. R., Andersen, O., Jensen, J-E. B., Rasmussen, A. M. L., Pedersen, M. M., Damkjær, L., Gilkes, H. & Petersen, J. 4 jun 2015 I : Clinical nutrition (Edinburgh, Scotland) 

Feasibility and inter-rater reliability of physical performance measures in acutely admitted older medical patients. Bodilsen, A. C., Juul-Larsen, H. G., Petersen, J., Beyer, N., Andersen, O. & Bandholm, T. 23 feb 2015 I : P L o S One. 10, 2, s. 1-15 

Mild Cognitive Impairment Status and Mobility Performance: An Analysis From the Boston RISE Study. Pedersen, M. M., Holt, N. E., Grande, L., Kurlinski, L. A., Beauchamp, M. K., Kiely, D. K., Petersen, J., Leveille, S. & Bean, J. F. 5 maj 2014 I : The journals of gerontology. Series A, Biological sciences and medical sciences. 69, 12, s. 1511-1518  

Psychometric properties of the Late-Life Function and Disability Instrument: a systematic review. Beauchamp, M. K., Schmidt, C. T., Pedersen, M. M., Bean, J. F. & Jette, A. M. 2014 I : B M C Geriatrics. 14, s. 12

Life-long endurance exercise in humans: Circulating levels of inflammatory markers and leg muscle size. Mikkelsen, U. R., Couppé, C., Karlsen, A., Grosset, J. F., Schjerling, P., Mackey, A. L., Klausen, H. H., Magnusson, S. P. & Kjær, M. 2013 I : Mechanisms of Ageing and Development. 134, 11-12, s. 531-40 

Acute Hospitalization of the Older Patient: Changes in Muscle Strength and Functional Performance During Hospitalization and 30 Days After Discharge. Bodilsen, C., Pedersen, M. M., Petersen, J., Beyer, N., Andersen, O., Lawson-Smith, L., Kehlet, H. & Bandholm, T. 2013 I : American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 92, 9, s. 789–796  

Twenty-Four-Hour Mobility During Acute Hospitalization in Older Medical Patients. Pedersen, M. M., Bodilsen, C., Petersen, J., Beyer, N., Andersen, O., Lawson-Smith, L., Kehlet, H. & Bandholm, T. 2013 I : Journals of Gerontology. Series A: Biological Sciences & Medical Sciences. 68, 3, s. 331-337  

Inflammation in HIV-Infected Patients: Impact of HIV, Lifestyle, Body Composition, and Demography - A Cross Sectional Cohort Study. Langkilde, A., Petersen, J., Klausen, H. H., Henriksen, J. H., Eugen-Olsen, J. & Andersen, O. 2012 I : P L o S One. 7, 12, s. e51698
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