Long-term home-based physiotherapy for persons with signs of frailty–RCT (NCT02305433)

Introduction/Background Frailty is a multidimensional condition, which can lead to disability. To postpone long-term care, one alternative is home-based physiotherapy. We study the effects of a 12-month home-based physiotherapy program on functional capacity, and applying successive 12-month register follow-up, on the use and costs of social and health care services, and on the duration of living at home during 24 months (the primary outcome). Here we report about feasibility of the intervention and baseline characteristics. Material and method Three hundred home-dwelling persons (>65 y) with signs of frailty were recruited by September, 2016. Frailty was screened by Morley's FRAIL questionnaire and verified by Fried's frailty criteria. Participants were randomized to a physiotherapy ( n  = 150) or a usual care ( n  = 150) group. Home-based physiotherapy was progressive, including strength, endurance, balance, flexibility and functional exercises. Physiotherapy took place twice a week (max. 104 sessions), each session for 60 minutes. Assessments (among others Short Physical Performance Battery (SPPB), Functional Independence Measure (FIM), Mini Mental State Examination (MMSE), Geriatric Depression Scale, 15-dimensional health related quality of life, Mini Nutritional Assessment) were performed at baseline, and at 3, 6, and 12 months by the assessor physiotherapist at the person's home. Results At baseline the participants’ mean age was 82.5 (SD 6.3) y. Twenty-five percent were men and 61% prefrail. Mean SPPB was 6.2 (2.6) points, FIM 109 (11) points and MMSE 24.4 (3.1) points. One hundred and thirty-four persons in the physiotherapy group and 129 in the usual care completed the intervention year, while 5 and 10 persons had died, and 2 and 2 persons were transferred to long-term care, respectively. On average 95 (91%) sessions were participated by the 134 completers. One hundred and twenty-eight persons participated in > 75% of the sessions. Conclusion During 12 months, adherence to the trial was good, as well as compliance with home physiotherapy.