Relationship between Hospitalization-Associated Disability and Functional Recovery.
Haruka Adachi, Wataru Kozuki, Aki Gen and 3 others
PMID 41477096WHAT IT FOUND
In older adults hospitalized with acute illness, those who developed new disability were slower to sit, transfer, and walk.
Not walking early after rehab started was linked to higher risk, but this study cannot prove early walking prevented disability.
Key findings
01Patients who developed hospitalization-associated disability reached mobility milestones later from rehabilitation start: first sitting 1.6 days versus 1.2 days, first wheelchair transfer 2.4 versus 1.3 days, and first walking 3.1 versus 1.5 days.
02After accounting for age, baseline Barthel score, dementia, emergency admission, and total therapy time, later wheelchair transfer and later walking remained independently associated with hospitalization-associated disability.
03First walking was the strongest predictor of hospitalization-associated disability, with a cut-off of 1.5 days (sensitivity 0.76, specificity 0.73).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Retrospective observational design cannot show that delayed walking caused hospitalization-associated disability. Single-center acute hospital in Japan, so findings may not apply to other hospitals or countries. Exclusion of patients with stroke, fracture, ICU admission, poor prognosis, and zero preadmission function means results do not apply to those groups. The sample was relatively small, and subgroup effects may have been missed. Many diagnoses were mixed together, so the timing of recovery may mean different things for different illnesses. Preadmission function was reconstructed from records or caregiver reports, which may be inaccurate. Disease-specific, psychological, and social factors were not assessed.
The easy way to misread this
Do not read the 1.5-day walking cut-off as proof that making patients walk earlier will prevent hospitalization-associated disability. The study observed records, so slower walking may have reflected patients who were already sicker or more likely to become disabled.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →