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Table 2 Description of intervention, length of follow-up and adherence to the intervention organized according to intervention and year of publication

From: Effect of nutritional and physical exercise intervention on hospital readmission for patients aged 65 or older: a systematic review and meta-analysis of randomized controlled trials

Study Intervention type Description of intervention Length of intervention Intervention adherence Completion rate
Deer et al, 2019 [34] Combination of physical exercise and nutrition Physical exercise intervention: Progressive in-home rehabilitation training program 3 days a week. The program was prescribed and overseen by a physical therapist and supervised one to two times a week by research staff with the remaining exercise session(s) performed without supervision. Exercises included chair rises, toe stands and three seated exercises using TheraBands; knee extension, rows and arm extensions. The exercise was designed to begin at low to moderate intensity and to be progressed during the 4 weeks by changing the resistance of the Theraband. The exercise was given either alone or in combination with 20 g whey protein twice daily. Nutrition intervention: participants were instructed to take 20 g whey protein (22 g BiPro; Eden Prairie, MN) mixed with 8 oz. of water twice a day (morning and evening). The protein supplement was given alone or in combination with the physical exercise intervention.
Arms: Two arms; 1.placebo (20 g maltodextrin twice daily, isocaloric to protein), 2. testosterone given as a single injection
Four weeks Physical exercise adherence 77%Supplement adherence 75% 79/100
Finlayson et al., 2018 [25] Physical exercise Intervention: Hospital physiotherapist assessed the patient and designed tailored exercise programs (taking approximately 2 h) designed to improve strength, stability, coordination, endurance, mobility, and improve self-confidence with respect to ADL. The exercise prescription was developed using a team approach involving the patient, caregivers, doctors, and ward nurses. Goals were defined for each patient and used as a motivational strategy to improve compliance with the program. After discharge: participants exercise on their own and received six-weekly in-home follow-up visits by an exercise physiologist requiring about 2 h pr visit. Here, support was offered together with reinforcement and further explanation of the exercise program.
Arms: Three arms: 1. Exercise only 2.Nurse Home visits and Telephone follow-up (N-HaT) 3. Exercise program and Nurse Home Visit Telephone follow-up and (EXN-HaT)
Controls: Usual care
In hospital and 24 weeks after discharge Adherence to the home-based exercise over the 24 weeks varied between 42 and 68%. 183/222
Martinez-Velilla et al., 2018 [32] Physical exercise Intervention: two daily sessions (morning and evening) 20 min during 5 to 7 consecutive days. An experienced fitness specialist supervised each session. Exercises were adapted from the multicomponent exercise program called Vivifrail [35] to prevent weakness and falls. Morning sessions included individualized supervised progressive resistance, balance and walking training exercises. The resistance exercises were tailored to the individual’s functional capacity using variable resistance training machines aiming at 2–3 sets of 8 to 10 repetitions with a load of 30–60% of 1 repetition maximum. 3 exercises mainly involved lower limbs and 1 involved upper body muscles. Balance exercises and walking exercises were gradually progressed in difficulty. Evening sessions consisted of functional unsupervised exercises using light loads (anklets and handgrip balls) such as knee extension and flexion as well as daily walks in corridor.
Control: usual care
During hospital stay/admission(mean no of intervention days: 5) Adherence varied between 95.8% for the morning sessions and 83.4% for the evening sessions 310/370
McCullagh et al., 2020 [30] Physical exercise Intervention: augmented prescribed exercise program (APEP). Up to 30 min exercises twice daily. Tailored exercises to improve strength, balance and walking supervised by a physiotherapist Monday-Friday.
Control: Sham exercise program up to 30 min twice daily assisted by a physiotherapist; breathing and stretching exercises
During hospital stay/admission (median length of stay: 8 nights) Adherence, defined as completed ≥75% of possible exercise sessions, was 66% of participants in the intervention group, and 60% in the control group 145/199
De Morton et al., 2007 [24] Physical exercise Intervention: Usual care and individually tailored exercise program designed by a physiotherapist consisted of upper limbs and lower limbs, and trunk exercises. It included four exercise levels; 1: bed exercises 2 sitting exercises 3 standing exercises 4 stair exercises. Gravity, body weight and light weights were used for resistance when possible. Resistance increased when participants could perform 10 repetitions. Participants exercised for 20–30 min sessions, twice daily, 5 days a week supervised by a certified allied health assistant.
Control: usual care only
During hospital stay/admission (median length of stay: 5–6 days) A 167/236
Ortiz-Alonso et al. 2020 [31] Physical exercise Intervention: In addition to usual care, the exercise started the day after admission, was performed on weekdays and included 1 to 3 sessions per day (total duration, ca 20 min/day). It consisted of 1) rising from a seated to an upright position (using armrests/assistance if necessary) in the patient’s room (from 1 to a maximum of 3 sets of up to a maximum of 10 repetitions for each session; 2-min rest between sets and 2) 3–10 min of supervised walking on the corridor, using assistance (mobility aids such as walkers, or an external person) if needed. Standing and walking exercises were separated by a rest period of up to 5 min. The exercises were individually adjusted and supervised by a fitness specialist.
Control: usual care only
During hospitalization (median length of stay:7 days, median training days: 3) Median 3 training
days and 2 training sessions per day.
Holyday et al 2012 [26] Nutrition Intervention: Nutritional screening when hospitalized. Patients confirmed at nutritional risk referred to a dietician. Individualized nutrition intervention aiming to meet energy and protein requirements (ONS, snacks, texture modification and fortification, assistance with meals by ward staff, education of patients and carers, referral for discharge planning). Control: Nutritional screening when hospitalized. Ward not informed about screening result and occasional referral to a dietician. During hospitalization A A
Deutz et al 2016 [33] Nutrition Intervention: Standard nutritional care (usual care) and daily two servings of high energy and protein ONS containing beta-hydroxy-beta metylbutyrat (HMB), during hospitalization and 90 days after discharge. Control: Usual care and a placebo ONS twice daily. During hospitalization/30,
60 and 90 days after discharge
Mean ONS per day:
30 days,
intervention 1.65 (n = 242), control 1.69 (n = 227)
90 days, intervention:1.54 (n = 243),
Control: 1.57 (n = 231)
Lindegaard Pedersen et al 2017 [28] Nutrition Intervention: Standard nutritional care during hospitalization including estimation of energy and protein needs, nutritional therapy and recording of food and fluid intake and discharge arrangements (meal service, food delivery, home care). After discharge individualized counselling and follow-up (1, 2, and 4 weeks after discharge) by a dietician (home visit or by telephone) The patient’s home carer attended the home visits. Patients were encouraged to take active part in their own nutritional care. Control: Standard nutritional care during hospitalization, no follow-up. During hospitalization/30 and 90 days after discharge 80% received three visits, 6% of the home carer attended three home visits. 75/117
Sharma et al 2017 [27] Nutrition Intervention: Nutritional screening and referral to a ward dietician immediately after confirmed nutritional risk, when hospitalized. Individualized nutrition intervention initiated within 24 h upon referral aiming to meet energy and protein requirements (ONS (1–2.2 kcal/ml and 0.05–0.12 g of protein/ml), mid-meal snacks, food fortification, assistance with meals by ward based staff). Follow-up after discharge monthly by telephone. Control: Nutritional screening and referral to a dietitian by their treating clinicians (usual care). Patients at nutritional risk received the same intervention as the intervention group, but no follow-up after discharge. During hospitalization/30 and 84 days after discharge 73% adherence at 1 month and 77% at 2 months. Forty-three (61.4%) control patients received dietitian input during hospital admission with no post-discharge outpatient dietetic follow-up. 103/148
Terp et al 2018 [29] Nutrition Intervention: Nutritional screening and referral to a dietician when needed during hospitalization. Individualized counselling resulting in dietary plan for home, including pre-discharge advice on nutritional intake, combined with three follow-up visits by one trained person from the municipality after discharge (1, 4, and 8 weeks). Prescription of oral nutritional supplements (ONS). Control: Usual care during hospitalization (nutritional screening and referral to a dietician when needed). During hospitalization/90 days after discharge 60% received three visits, 19% received no visits 103/150
  1. A not reported