Maximum Tolerated Dose of Walking for Community-Dwelling People Recovering From Hip Fracture: A Dose-Response Trial

作者:Peiris Casey*; Shields Nora; Kingsley Michael; Yeung Jack; Hau Raphael; Taylor Nicholas
来源:Archives of Physical Medicine and Rehabilitation, 2017, 98(12): 2533-2539.
DOI:10.1016/j.apmr.2017.03.027

摘要

Objective: To determine how much moderate-intensity physical activity, in the form of walking, could be prescribed for people living in the community after hip fracture in terms of safety, tolerability, and feasibility. Design: Phase I dose-response design. Setting: Public community rehabilitation centers. Participants: Community-dwelling adults (N=21; 16 women; mean age, 75 +/- 9y) who were cognitively alert, attending community rehabilitation after hip fracture (mean days postfracture, 110 +/- 47d), able to walk with or without a gait aid, and for whom it was safe to participate in physical activity. Interventions: Individually supervised doses of moderate-intensity walking completed in 1 week in addition to their usual levels of physical activity. Three participants were required to complete a dose of walking before dose escalation for the next cohort of 3 participants. Dose escalation ceased when >1 participant in a cohort had an adverse event or was unable to tolerate the dose or if the maximum dose of 150min/wk was achieved. Main Outcome Measures: Maximum tolerated dose of walking per week (in minutes), adverse events, mobility, and walking confidence. Results: The maximum tolerated dose of walking for adults after hip fracture before significant discomfort was experienced (eg, breathlessness, pain, and fatigue) by any participant was 100min/wk. No adverse events occurred, but participants began to be unable to tolerate higher doses beyond 100min/wk. Conclusions: This provides preliminary evidence that community-dwelling older adults recovering from hip fracture can complete a sufficient amount of moderate-intensity physical activity to maintain and improve their health. 2017 by the American Congress of Rehabilitation Medicine

  • 出版日期2017-12