This study aimed to investigate the effectiveness of evidence-based interventions in rehabilitation during the community-based phase. Specifically, we conducted a parallel cluster-randomized trial, to verify whether introducing aerobic exercise in community-based rehabilitation improves exercise tolerance.T
Participants were selected from users of functional day-care service facilities covered by long-term care insurance. They were randomly assigned to an intervention group or a control group. The control group underwent the conventional weekly 3-hour rehabilitation program without aerobic exercise, while the intervention group replaced part of the program with two sets of 2-minute stepping and arm-swinging exercises over a six-month period. The primary outcome was the number of repetitions in a 2-Minute Step Test (2MST), measured at baseline and after six months, and comparisons were made between the groups by students t test.
A total of 146 participants were assigned to the intervention group, and 162 to the control group, with 122 and 131 participants, respectively, analyzed in the final data set. At baseline, the intervention group had lower physical function and capacity compared to the control group. The number of repetitions in the 2MST was significantly lower in the intervention group compared to the control group at the start of the study (intervention group vs. control group: 75.0 ± 29.0 vs. 86.7 ± 26.8 repetitions, p 0.001). However, after the intervention, the intervention group showed a significant increase in repetitions (intervention group vs. control group: 100.8 ± 33.7 vs. 86.9 ± 25.6 repetitions, p = 0.003). Similar trends were observed after adjusting for confounding factors such as age and physical function at baseline using propensity score matching.
The introduction of aerobic exercise (two sets of 2-minute stepping and arm-swinging exercises) into community-based rehabilitation covered by long-term care insurance improved exercise tolerance. This suggests the potential usefulness of incorporating aerobic exercise in community-based rehabilitation programs.
This study highlights the potential benefits of incorporating aerobic exercise into community-based rehabilitation programs for elderly individuals using long-term care insurance. The findings suggest that even brief aerobic activities, such as two sets of 2-minute stepping and arm-swinging exercises, significantly improve exercise tolerance. This has practical implications for enhancing the effectiveness of rehabilitation programs, promoting evidence-based interventions, and potentially improving the quality of life and functional independence of elderly participants. It also provides valuable guidance for healthcare professionals and caregivers, showing that small adjustments to rehabilitation programs can yield measurable benefits. Further research is needed to explore long-term effects and the integration of other interventions, such as nutrition and mental health support.
Community-based Rehabilitation
Long-Term Care Insurance
