Including exercise self-management as part of inpatient rehabilitation is feasible, safe and effective for patients with cognitive impairment

Abstract

Objective: To test the feasibility, safety and effectiveness of the My Therapy programme for inpatients with mild-moderate cognitive impairment.

Design: Observational pilot study.

Patients: Rehabilitation inpatients with mild-moderate cognitive impairment.

Methods: During their inpatient admission, participants received My Therapy, a programme that can increase the dose of rehabilitation through independent self-practice of exercises, outside of supervised therapy. Outcomes included My Therapy participation, falls, Functional Independence Measure (FIM) and 10-m walk test. Outcomes were compared with those of participants without cognitive impairment from the original My Therapy study (n = 116) using χ2 and independent t-tests. 

Results: Eight participants with mild-moderate cognitive impairment (mean (standard deviation (SD)) age 89.6 years (4.8); 3 women) were included. All participants completed the My Therapy programme on at least one day of their admission, with no associated falls. Participants had an 8.4 s (SD 5.1) reduction in their 10-m walk test and a 21.5 point (SD 11.1) improvement on FIM scores from admission to discharge. There were no significant between-group differences in feasibility, safety or effectiveness for participants with and without cognitive impairment.

Conclusion: This pilot study has shown that including exercise self-management as part of inpatient rehabilitation is feasible, safe and effective for patients with cognitive impairment. 

Lay Abstract

This study aimed to determine whether it was practical, safe and effective for patients in a rehabilitation hospital with memory or thinking problems to participate in a programme called My Therapy. My Therapy aimed to increase the dose of rehabilitation through independent self-practice of exercises, outside of supervised therapy sessions. There were 8 participants in the study and all of them reported completing the My Therapy programme on at least one day of their rehabilitation stay. There were no falls relating to My Therapy participation. Participants improved their walking speed and function during their rehabilitation stay. There were no differences in the results between people with and without memory or thinking problems, in terms of practicality, safety or effectiveness. This study has shown that including exercise self-management as part of rehabilitation is practical, safe and effective for patients with memory or thinking problems.