Elderly Patient at Risk of Loss of Mobility, Exercise - Primary Care, Prevention, Care Pathways (PRISME-3P)

Civil Hospices of Lyon

Status: Completed

Conditions: Elderly Patient (>70 Years); Loss of Mobility

Treatments: Behavioral: PRISME-3P program

Study type: Interventional

Funder types: Other

Identifiers

NCT02847871

69HCL16_0132

Details and patient eligibility

About

Loss of mobility is predictive of a loss of autonomy and is often the first sign of functional decline. Loss of mobility is also associated with poor perceived quality of life, depressive symptoms, high risk of adverse events such as falls and fractures, to an increased risk to input in institution and mortality's increase.

Consequences and frequency of loss of mobility make essential its identification, evaluation and the practice of preventive measures in primary care.

The implementation of effective interventions in primary care to prevent or delay the loss of mobility is a public health priority.

PRISME-3P program aims to develop and evaluate a dedicated care pathway, in primary care, based on a personalized multimodal intervention: screening, support combining physician, teaching exercises by a specialized Monitor in Adapted Physical Activities (MAPA) and nutritional counseling.

Enrollment: 39 patients

Sex: All

Ages: 70+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged > 70 years

• With at least 2 of the following signs:

  1. Difficulty in carrying a shopping bag (load about 4.5 Kg)
  2. Difficulty in getting up from a chair without using arms
  3. Difficulty in climbing 10 stairs
  4. Difficulty in moving, walking slow
  5. Difficulty in walking more than 400 meters without stop
  6. Running time <1 hour / week
  7. Fatigue at modest physical effort: shopping, housework ...
  8. At least two falls in the last year
  9. Weight loss ≥5% in 1 month or weight loss ≥10% in 6 months

• Short Physical Performance Battery score < 10

Exclusion criteria

• Locomotor disability not allowing implementation of the protocol according to the investigator
• Life expectancy less than 6 months
• Severe chronic progressive pathologies incompatible with the completion of the physical activity program
• Patient institutionalized in nursing homes
• Advanced Cognitive impairment (MMSE <20)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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39 participants in 2 patient groups

Multimodal Intervention

Other group

Description:

The multimodal intervention on mobility will consist of the implementation of a care pathway dedicated in primary care. It will include awareness and training of general practitioners for easy identification, a care associating a dedicated geriatric consultation to rule out underlying pathology, teaching exercises by MAPA (+/- taken care in the presence of MAPA) and nutritional counseling by a dietician. Close collaboration between general practitioners, geriatrician, MAPA and dietician will be established.

Treatment:

Behavioral: PRISME-3P program

Non interventional

No Intervention group

Description:

Patients received treatment as part of their standard care: at the discretion of the general practitioner patients