Physical Rehabilitation of Older Persons Following a Community-Acquired Infection Hospitalization - A Randomised-Controlled Trial

Physical Rehabilitation of Older Persons Following a Community-Acquired Infection Hospitalization: A Feasibility Study

Community-acquired infections such as community-acquired pneumonia (CAP) and urinary tract infection (UTI) remain leading causes of hospitalization and death due to infections in older persons in Europe. Hospitalization often results in further disabilities and frailty for older and frail individuals, from which some may never recover. Physical activity is well-established as a cornerstone in the primary prevention and treatment of several noncommunicable diseases. However, there is currently no established rehabilitation model following a pneumonia or other infection, nor is there any evidence to support the impact of rehabilitation on the mental and physical health of older and frail individuals following a pneumonia hospitalization or other infection.

The aim of the feasibility study is to evaluate a patient-centered and individualized exercise intervention that is kick-started during hospitalization and continued for 3 months after discharge with video-supervised home-based exercise training to patients hospitalized with CAP or UTI compared to standard care with regard to safety, clinical outcomes, patients' perception, functional ability, organizational aspects, and economic aspects.

Inclusion Criteria:

• Patients aged ≥65 years or 18-64 years if the presence of at least one chronic disease (e.g., diabetes, COPD, heart failure, etc.)
• Suspicious of a lower respiratory tract infection AND
• Presence of one or more symptoms of a lower respiratory tract infection such as fever ≥38.3°C, hypothermia <35.0°C, new onset of cough, pleuritic chest pain, dyspnea, or altered breath sounds on auscultation.
• Positive urine nitrate test and/or leukocyturia as depicted by positive esterase test or microscopy AND
• Presence of one or more symptoms of urinary tract infection such as dysuria, urgent or frequent urination, perineal or suprapubic pain, costo-vertebral tenderness or flank pain, fever (ear or rectal temperature of ≥38.2°C or axillary temperature of ≥38.0°C), or history of feeling feverish with shivering or rigors in the past 24 hours.
• Functionally independent before hospitalization and expected to be discharged to their own homes.
• Signed informed consent.

Exclusion Criteria:

• Hospitalization within the past 14 days.
• Inability to participate in the study due to dementia, paralysis, or other disorders.
• Severe aortic valve stenosis or terminal illness.
• Unstable cardiac arrhythmic disease.
• High risk for non-adherence as determined by screening evaluation.
• Already participating in regular exercise training.
• Unable to understand Danish.
• Unwilling or unable to give informed consent.