A prehabilitation program for the prevention of functional decline: Effect on higher-level physical function

Objective: To determine whether a home-based physical therapy (PT) program prevented decline in several higher-level measures of physical function among physically frail, community-living older persons. Design: Randomized controlled trial. Setting: General community. Participants: Persons (N=188) who were physically frail and aged 75 years or older. Intervention: A home-based PT program (ie, prehabilitation) that focused primarily on improving underlying impairments in physical capabilities. Main Outcome Measures: Self-reported instrumental activities of daily living (IADLs); mobility, as determined by a modified version of the Performance Oriented Mobility Assessment; timed rapid gait and timed chair stands; and integrated physical performance, as determined by a modified version of the Physical Performance Test, were assessed at baseline, 7 months, and 12 months. Results: As compared with participants in the educational control group, participants in the intervention group had reductions in IADL disability of 17.7% at 7 months (P=.036) and 12.0% at 12 months (P=.143) and had gains, ranging from 7.2% to 15.6%, in mobility and integrated physical performance at 7 and 12 months. Conclusions: Our home-based prehabilitation program offered modest but consistent benefits for the prevention of decline in several higher-level measures of physical function. (C) 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.