Adapted Physical Activity (APA) Following Hospitalization in Frail Older Adults

Adapted Physical Activity (APA) Following Hospitalization in Frail Older Adults

To evaluate the effectiveness of an Adapted Physical Activity (APA) program in improving functional capacity and reducing frailty in older adults following hospital discharge.

The aim is to determine whether a structured program of personalized exercises improves mobility, strength, and quality of life compared to standard care.

Inclusion Criteria:

• The study is open to individuals aged 65 and older.
• Current diagnosis or recent history of cancer.
• Patients currently undergoing treatment (chemotherapy, immunotherapy, targeted therapy) or in follow-up after recent treatment (≤12 months since completion).
• Functional capacity compatible with participation in an adapted physical activity program, as determined by clinical assessment.
• Recent hospitalization: Patients must have been discharged following a hospital stay.
• Frailty: Presence of a significant level of frailty at hospital discharge.

Exclusion Criteria:

• Short Physical Performance Battery> 10: Patients considered "robust" are excluded to maximize the relevance of the intervention.
• Acute unstable medical condition or contraindication to exercise: Any unstabilized acute condition that makes physical activity dangerous (e.g., acute cardiac complication, ongoing severe infection). Recent major medical events (myocardial infarction, major surgery, bone fracture, or major amputation in the past few weeks) will also be excluded.
• Severe chronic conditions incompatible with exercise: Severe progressive diseases that prevent safe exercise, such as severe neuromuscular diseases or advanced organ failure (e.g., end-stage renal failure).
• Short-term life-threatening prognosis: Patients in the terminal phase or with a very limited life expectancy (less than 6 months).
• Total functional dependence or severe motor impairment: Patients who are completely dependent for basic activities (very low Barthel Index, e.g., <20/100) or who are unable to move even minimally (e.g., unable to walk a few steps or stand, even with assistance).
• Severe cognitive impairment: Severe cognitive impairment (e.g., advanced dementia without the ability to follow simple instructions) that prevents active participation in the program.
• Severe sensory or communication disorders: Significant sensory impairments-such as profound uncompensated blindness or deafness-or any communication barrier (severe aphasia, language barrier) that prevents participation in the program, unless a caregiver (family member or professional) can be present to ensure safety during the exercises.
• Institutionalization of the patient: Individuals who do not live in their usual residence are excluded. The study focuses on older adults returning home, as the institutional setting involves different care.
• Lack of valid informed consent: Any patient who refuses to participate or who cannot provide valid consent (due to lack of legal capacity or understanding) will be excluded.
• Participation in another concurrent program or trial: Simultaneous participation in another physical exercise program or trial.