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Title: Multimorbidity rehabilitation versus disease-specific rehabilitation in people with chronic diseases: a pilot randomized controlled trial.
Austin Authors: Barker, Kathryn;Holland, Anne E ;Lee, Annemarie L;Haines, Terry;Ritchie, Kathryn;Boote, Claire;Saliba, Joanne;Lowe, Stephanie;Pazsa, Fiona;Thomas, Lee;Turczyniak, Monica;Skinner, Elizabeth H
Affiliation: School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, The University of Melbourne, Melbourne, Victoria 3000 Australia
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Alfred Health, 55 Commercial Rd, Melbourne, Victoria 3004 Australia
Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050 Australia
Department of Physiotherapy/Community Services, Western Health, 176 Furlong Road, St Albans, Victoria 3021 Australia
Australian Institute of Musculoskeletal Science, Western Centre for Health Research and Education, Western Health, St Albans, Victoria 3021 Australia
Allied Health Research Unit, Faculty of Medicine Nursing and Health Science, Monash University, Frankston, Victoria 3199 Australia
La Trobe University, Plenty Rd and Kingsbury Drive, Bundoora, Victoria 3086 Australia
Issue Date: 29-Nov-2018 2018-11-29
Publication information: Pilot and feasibility studies 2018; 4: 181
Abstract: Multimorbidity (the co-existence of two or more chronic conditions in an individual) is a growing healthcare burden internationally; however, healthcare and disease management, including rehabilitation, is often delivered in single-disease siloes. The aims of this study were to (1) evaluate the safety and feasibility of multimorbidity rehabilitation compared to a disease-specific rehabilitation program in people with multimorbidity and (2) gather preliminary data regarding clinical outcomes and resource utilization to inform the design of future trials. A pilot feasibility randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Seventeen individuals with a chronic disease eligible for disease-specific rehabilitation (pulmonary, cardiac, heart failure rehabilitation) and at least one other chronic condition were recruited. The intervention group attended multimorbidity exercise rehabilitation and the control group attended disease-specific exercise rehabilitation. Participants attended twice-weekly exercise training and weekly education for 8 weeks. Feasibility measures included numbers screened, recruited, and completed. Other outcome measures were change in functional exercise capacity (6-minute walk test (6MWT)), health-related quality of life (HRQoL), activities of daily living (ADL), and resource utilization. Sixty-one people were screened to recruit seventeen participants (nine intervention, eight control); one withdrew prior to rehabilitation. Participants were mostly male (63%) with a mean (SD) age of 69 (9) years and body mass index of 29 (6). The intervention group attended a mean (SD) of 12 (6) sessions, and the control group attended 11 (4) sessions. One participant (6%) withdrew after commencing; two (12%) were lost to follow-up. The intervention group 6MWT distance increased by mean (SD) of 22 (45) meters (95% confidence interval - 16 to 60) compared to 22 (57) meters (95% confidence interval - 69 to 114) (control). It was feasible to recruit people with multimorbidity to a randomized controlled trial of rehabilitation. A large RCT with the power to make significant conclusions about the impact on the primary and secondary outcomes is now required. The trial was registered with the Australian and New Zealand Clinical Trials Registry available at ACTRN12614001186640. Registered 12/11/2014.
DOI: 10.1186/s40814-018-0369-2
ORCID: 0000-0003-1317-2031
PubMed URL: 30519483
ISSN: 2055-5784
Type: Journal Article
Subjects: Cardiac
Heart failure
Randomized controlled trial
Appears in Collections:Journal articles

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