Objectives Hospitalized frail older adults are at heightened risk of functional decline and disability. Although early physical rehabilitation may prevent acute deterioration during hospitalization, evidence specific to this highly vulnerable population remains limited. This study aimed to evaluate the effect of early physical rehabilitation intervention in hospitalized frail older adults.
Design This retrospective cohort study analyzed data from 197 consecutive frail older adults admitted to the geriatric care unit of a tertiary hospital in Taiwan between August 2019 and March 2023. Frailty status was assessed using the Clinical Frailty Scale (median CFS 6, range 4–7). The mean age was 83.2 ± 7.4 years. All participants received individualized early physical rehabilitation shortly after admission, consisting of range-of-motion exercises, resistance training, and mobility exercises. Rehabilitation outcomes, including bilateral handgrip strength, the Timed Up-and-Go (TUG) test, along with the Barthel Index, were evaluated at admission and discharge.
Results Following the intervention, patients demonstrated significant improvements in objective measures of physical performance. The median left handgrip strength increased significantly from 12.7±6.2 kg at admission to 16.2±6.4 kg at discharge (P < 0.001). Right handgrip strength similarly improved from 13.8±6.5 kg at admission to 15.8±6.6 kg at discharge (P < 0.001). Mobility, assessed via the TUG test, decreased significantly from admission to discharge (mean change −4.0 (95% CI −4.8 to −3.2) seconds, p < 0.0001). Notably, there was no significant difference observed on the score of the Barthel Index between the admission and discharge.
Conclusion The implementation of an early rehabilitation program appears feasible and efficacious for hospitalized frail older adults, showing significant gains in both muscle strength (handgrip) and functional mobility (TUG time). These findings support the routine integration of early, individualized physical rehabilitation protocols for the hospitalized frail older patients.
