The majority of older people in hospital have frailty and are at risk of accelerated decline in skeletal muscle function with increased risk of early readmission or death after being discharged.
Contact with an intermediate care service is recommended as national policy to enhance recovery after hospital admission for an acute illness or injury but people frequently do not feel ready to return home, and are at risk of subsequent readmission. Additionally, the benefits of rehabilitation in intermediate care become reduced over time.
There is preliminary evidence from systematic reviews to indicate that exercise interventions can improve mobility and function for frail older people and slow down progression to disability. Exercise programmes based on progressive strength training have been shown to be important for functional improvement. However, few studies have used well-validated frailty tools or reported on health-related quality of life and no studies have reported on cost-effectiveness. The HERO project aims to address this knowledge gap.
The overall aim is to investigate whether an extended rehabilitation programme using a home-based exercise intervention developed for older people with frailty improves health-related quality of life.
The study will involve 718 older people with frailty admitted to hospital following acute illness or injury. Participants will be recruited across ten hospitals within Yorkshire and the South West of England over 23 months, with recruitment staggered to accommodate an internal pilot.
The study is currently being set up and will start recruiting to the pilot study in December 2017. Recruitment to the main trial will start in July 2018.