1. MMOVeS: Managing Mobility Outcomes for Vulnerable Seniors
Sabrina Figueiredo, PhD,2; Jose A Morais, MD PhD3; Nancy E. Mayo, PhD1,2, School of Physical and Occupational Therapy, 2 Division of Clinical Epidemiology, 3Division of Geriatrics; McGill University, Montreal, Canada
Key messages
This study shows the potential for efficacy of a home-program combining self-management skills and exercise in promoting mobility gains among a vulnerable senior population.
Intervention and trial’s structure were feasible. A confirmatory trial is needed to estimate the effectiveness and cost-effectiveness of the MMOVES program.
This poster template is from It is free, free, free for non-commercial use. But if you really like it, I’m always thrilled to get postcards from wherever you happen to be presenting your poster. Or, send me cookies! My kids made me put that last sentence in. Have fun. Sincerely, Colin Purrington, Department of Biology, Swarthmore College, Swarthmore, PA 19081, USA.
Introduction
Illness and restricted mobility from increased bed-rest, added to a background burden of disability often means that seniors do not return to pre-hospitalization levels of function1.
Research supports the benefit of a physical therapy approach2,3 in the post-discharge period; but, the interventions studied were all resource intensive, likely beyond the resources allocated to hospital-based physiotherapy departments.
Adding behavioral strategies to physical exercises programs may increase exercise engagement
A new program combining self-management and mobility exercises (MMOVeS ) was developed and needed to be tested.
Results
Intervention
Four ingredients: exercise guide book, tailored exercise program, self-management support, coaching on goal attainment.
Initial visit + 6 monthly phone calls
Table 3:Percentage of participants classified as making a positive response on each outcome measure 6 months after randomization
Table1: Participants characteristics at study entry
SD: Standard Deviation
Aim
The objective of this pilot study was to estimate the potential for efficacy of the MMOVeS (an individualized, self-management, home program tailored to mobility challenges of seniors recently discharged from the hospital), in comparison to exercise information alone, in improving mobility after six months.
SD: Standard Deviation;
Table 2: Characteristics of participants who completed the study and participants who dropped-out.
Table 4: Odds of improvement in mobility outcomes, health status, and pain for the MMOVeS Group (n=26) relative to the Information Group (n=23)*
Control
Mailed exercise guide book
Evaluation
Patient reported outcome (PRO) at baseline and on completion of the 6th month of intervention.
Outcomes
Mobility = 5 items from Lower Extremity Functional Scale (LEFS) and 2 items from Disability Arm, Shoulder, Hand (DASH)
Pain = 2 items from RAND-36 (SF-36)
Health perception = 2 items from RAND-36 (SF-36)
Methods
Pilot randomized controlled study with two parallel groups
Participants
Recruited from two major McGill University-teaching hospitals.
Inclusion criteria
Community-dwelling seniors, aged 70 years and older, recently discharged from either participating hospitals.
Exclusion criteria
Orthopaedic or cardiac surgery, stroke, myocardial infarction, dementia and those with communication barriers.
Analysis
Generalized Estimating Equation (GEE)
GEE estimates the odds of response across all measures for the MMOVeS participants in comparison to the odds of participants in the Information group, accounting for correlation of measures within person.
Odds ratios (OR) and confidence intervals (95%CI) were calculated for each outcome domain: mobility, pain, and health perception.
OR = odds ratio; CI = Confidence Interval
SD: Standard Deviation;
Conclusion
Seniors are not exercising. After a hospital discharge, and without proper guidance, seniors appear to choose rest as a recovery strategy.[2] Our study indicates that a home-program combining self-management skills and exercise taught with minimal supervision by a physiotherapist was feasible and promising
142
Assessed for eligibility from two Montreal’s Hospitals
103
Eligible patients 60
Randomized either to MMOVeS or Exercise information
Literature cited
Fairhall, N., et al., Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial. Age and ageing, (5): p
2. Daniels, R., et al., Interventions to prevent disability in frail community-dwelling elderly: a systematic review. BMC Health Serv Res, : p. 278.
3. de Vries, N.M., et al., Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Research Reviews, (1): p
MMOVeS = 30
Discontinued= 4
Analyzed = 26
Information = 30
Discontinued = 7
Analyzed = 23
= NCT