D Treacy1,2, C Sherrington2, L Hassett2,3, K Schurr2, I Cameron4, N Fairhall2
1Prince of Wales Hospital, SESLHD, Physiotherapy Department, Randwick, Australia, 2University of Sydney, Institute for Musculoskeletal Health, Sydney, Australia, 3University of Sydney, Discipline of Physiotherapy, Faculty of Health Sciences and Musculoskeletal Health Sydney, School of Public Health, Sydney, Australia, 4University of Sydney, John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, St Leonards, Australia
Background: Frailty is a common syndrome in older people, characterised by decline across multiple body systems, causing decreased reserve and increased vulnerability to adverse health outcome. It is estimated that 21% of the community dwelling population over 65 years are frail. Frailty is independently predictive of falls, worsening mobility, deteriorating function, impaired activities of daily living and death. Mobility training may be able to enhance mobility and functioning in people with frailty.
Purpose: The aim of this systematic literature review was to determine if mobility training interventions are effective in increasing function and mobility within a frail population.
Methods: Systematic review with meta-analysis. Two independent reviewers screened titles, abstracts and full texts of potential studies against eligibility criteria. Study quality was assessed using the Cochrane risk of bias tool. Overall quality of the evidence for the main analyses was assessed using the GRADE approach. All analyses were conducted using random effects models.
Results: 12 studies were identified that meet the eligibility criteria. In total, 1142 patients were enrolled (582 in the intervention group, 560 in the control group). The average age of the participants was 82 years, and 73% of them were women. There was high quality of evidence that mobility training improved mobility levels (12 studies, SMD= 0.47; 95% CI 0.24 to 0.71) and moderate quality evidence it improves function (9 studies, SMD= 0.60; 95% CI 0.21 to 1.00).
Conclusion(s): The results indicate that mobility training provided to a frail population is effective for improving function and mobility. The results suggest mobility training may make little to no difference to the number of people who have admissions to nursing care facilities, falls or death rate.
Implications: The synthesis of the data in this review supports the use of mobility training for increasing mobility and functioning for older people with frailty living in the community older people with frailty living in the community. This review provides high certainty evidence that mobility training for older people in older people with frailty provides clinically important benefits in mobility and moderate certainty evidence that mobility training provides important in function.
Funding, acknowledgements: Nil
Keywords: Frailty, Mobility training
Topic: Older people
Did this work require ethics approval? No
Institution: n/a
Committee: n/a
Reason: This was a systematic review of the literature
All authors, affiliations and abstracts have been published as submitted.
