Recovery From Disability After Geriatric-home Rehabilitation Versus Standard of Care: Pilot Study

Feasibility of recruitment - screening,Feasibility of recruitment - retainment,Feasibility of recruitment - reasons for non-participation,Feasibility of study procedures, assessments and data collection,Study participants' experience with the intervention,Physical therapists' experience with the intervention

At discharge after a hospitalization, many older people are not as able as before their
 hospital stay and have difficulty performing their daily activities at home. For example,
 washing and dressing themselves, housework or shopping are often more difficult after
 discharge from hospital. However, most older people do not receive any support in regaining
 their physical status and self-reliance. As a result, they often need permanent help from
 informal or professional caregivers. Their quality of life is also impacted and they have an
 increased risk of new hospital admissions.
 
 Rehabilitation centers and hospital rehabilitation wards help the elderly to regain their
 daily functioning, but the number of places is very limited. This means that support for home
 rehabilitation is necessary for the vast majority of older people (almost 82,000 people per
 year). However, most of the time there is no support for home rehabilitation and the effect
 of such home rehabilitation programs has been little studied. Although studies show that home
 rehabilitation can improve physical functioning, the effect on impairments in daily
 activities and the quality of life of older people are not clear.
 
 In a future multicenter RCT, the investigators want to study whether training and guidance by
 a physiotherapist contributes to the recovery of older people after discharge from hospital.
 
 Patients will either receive standard care after hospitalization discharge, or intensive
 guidance from a physiotherapist. The patients guided by the physiotherapist are trained and
 supervised three times a week, for six weeks, to improve their muscle strength, balance,
 walking and mobility. The aim of the intensive home rehabilitation program is that the
 individual benefits from it in the longer term. Therefore, whether individuals who received
 the program are less limited in their daily functioning than those who did not receive the
 intensive rehabilitation program is checked after six months. In addition, the quality of
 life, physical functioning and healthcare costs for these two groups are also compared.
 
 To ensure that the study is feasible, a small pilot study will first be performed. Here, the
 aim is to assess the feasibility of recruitment (screening and retaining participants,
 reasons for refusal and participant profiles), study procedures and intervention. This
 includes time registration by the study team and physiotherapists, assessment of study burden
 and experiences with the execution of the protocol. The findings of this pilot study will
 help deciding about progressing to a future definitive RCT.