A prehabilitation program for the prevention of functional decline: effect on higher-level physical function

Arch Phys Med Rehabil. 2004 Jul;85(7):1043-9. doi: 10.1016/j.apmr.2003.10.021.


Objective: To determine whether a home-based physical therapy (PT) program prevented decline in several higher-level measures of physical function among physically frail, community-living older persons.

Design: Randomized controlled trial.

Setting: General community.

Participants: Persons (N=188) who were physically frail and aged 75 years or older.

Intervention: A home-based PT program (ie, prehabilitation) that focused primarily on improving underlying impairments in physical capabilities.

Main outcome measures: Self-reported instrumental activities of daily living (IADLs); mobility, as determined by a modified version of the Performance Oriented Mobility Assessment; timed rapid gait and timed chair stands; and integrated physical performance, as determined by a modified version of the Physical Performance Test, were assessed at baseline, 7 months, and 12 months.

Results: As compared with participants in the educational control group, participants in the intervention group had reductions in IADL disability of 17.7% at 7 months (P=.036) and 12.0% at 12 months (P=.143) and had gains, ranging from 7.2% to 15.6%, in mobility and integrated physical performance at 7 and 12 months.

Conclusions: Our home-based prehabilitation program offered modest but consistent benefits for the prevention of decline in several higher-level measures of physical function.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Connecticut
  • Female
  • Frail Elderly*
  • Gait
  • Health Services for the Aged*
  • Home Care Services*
  • Humans
  • Male
  • Physical Therapy Modalities*