An exercise &nutritional intervention for deconditioned older adults Summary: During acute hospitalization, approximately one third of older patients experience a functional decline unrelated to a discrete orthopedic or neurological process;this functional compromise is commonly termed deconditioning. While, the etiology of hospital associated deconditioning in older adults is multi-factorial, bed rest inactivity and compromised nutritional intake are considered frequent contributors. The decline in function is generally attributable to a generalized loss of muscle strength. Due to the severity of their functional compromise, many of these older patients are transferred to a post-acute rehabilitation facility to recover their strength and function. However, the most effective method of maximizing functional recovery in these patients is not known. There is, however, a significant body of literature documenting the functional benefits of resistance exercise training in community-dwelling older adults, as well as nursing home residents and cardiac patients. In addition, it is recognized that essential amino acid (EAA) supplementation augments the skeletal muscle anabolic response to resistance exercise training. Therefore, it is reasonable to theorize that a functionally specific, rehabilitative resistance exercise training program in concert with EAA supplementation will result in a more rapid and pronounced functional recovery than current rehabilitation methods in this patient population. However, there is some increased risk associated with resistance exercise in older adult patients given their increased prevalence of heart disease. However, guidelines for screening and supervision related to resistance exercise training with this type of older adult population are available. Thus, the purpose of this novel pilot investigation is to examine the safety and efficacy of a combined functional rehabilitative resistance exercise and EAA supplementation intervention for optimizing the functional recovery of older deconditioned adults admitted to a Veterans Administration (VA) Geriatric Evaluation and Management (GEM) rehabilitation unit.
An exercise &nutritional intervention for deconditioned older adults Narrative: While in the hospital, thirty percent of older adults develop problems walking and taking care of themselves. This is often termed deconditioning, and many of these older patients are transferred to a rehabilitation facility to recover their strength and function. However, the best method of rehabilitating these patients is not known. There is, however, very good evidence that both resistance exercise and an amino acid supplement can improve muscle strength and function in older adults living in the community. In addition, resistance exercise training improves function in older nursing home residents and even those with heart problems. Therefore, we plan to study the use of resistance exercise and amino acid supplementation in older adults with deconditioning admitted to a Veterans Administration geriatric rehabilitation unit.