At discharge after a hospitalization, many older people are not as able as before their hospital stay, 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 centres 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 programmes 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.
The RECOVER@HOME project investigates whether training and guidance by a physiotherapist contributes to the recovery of older people after discharge from hospital. 333 elderly people will participate in this study. According to the study plan, 145 of these people will receive standard care after hospital discharge. The remaining 188 will receive intensive guidance from a physiotherapist. They 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 programme is that the individual benefits from it in the longer term. Therefore, whether individuals who received the programme are less limited in their daily functioning than those who did not receive the intensive rehabilitation programme 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.
| Title | Recovery from disability after geriatric-home rehabilitation versus standard of care: a randomised multicentre parallel group pragmatic trial in older patients with disability at hospital discharge - RECOVER@HOME |
| Participants (P) | Patients 75 years old or older with disability (i.e., dependent in one or more activities of daily living; instrumental and basic) at hospital discharge, and with rehabilitation potential. The intervention takes place when the patient has returned home. |
| Intervention (I) | A geriatric home-based rehabilitation programme (of on average, 3 supervised training sessions per week for a duration of 6 weeks), delivered by a community/primary care physical therapists. The intervention is based on the standards for specialised rehabilitation centres and focusses on strength, balance, (gait) speed, functional mobility and promotion of physical activity and is based on the principles of a person-centred and goal-oriented therapy. |
| Control (C) | Usual care, which may or may not include physical therapy; this will not be influenced by the research team, but the use of physical therapy will be monitored for all participants. |
| Outcome (O) | Disability, defined as (in)dependence in activities of daily living (instrumental and basic) at 6 months follow-up. |
| Trial Design | Randomised multicentre (hospitals from which patients are discharged from) parallel group pragmatic trial |
| Sample Size | PILOT 24-36 participants. Eventual full trial 333 participants planned |
| Trial duration | PILOT 12 months. Eventual full trial approximately 38 months |
| Budget | 400,000 euro for PILOT |
| Sponsor | Universitaire Ziekenhuizen Leuven - Katholieke Universiteit Leuven |
| Chief Investigator | Prof Theo van Achterberg |
| External partners | n/a |
| Number of participating sites | 2-3 |
| Protocol | View protocol Pilot and Feasibility Studies |
| Results |
For timelines and recruitment, see dashboard
Clinicaltrials.gov: NCT06404138 https://clinicaltrials.gov/study/NCT06404138
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