Community-acquired infections such as community-acquired pneumonia (CAP) and urinary tract infection (UTI) remain leading causes of hospitalization and death due to infections in older persons in Europe. Hospitalization often results in further disabilities and frailty for older and frail individuals, from which some may never recover. Physical activity is well-established as a cornerstone in the primary prevention and treatment of several noncommunicable diseases. However, there is currently no established rehabilitation model following a pneumonia or other infection, nor is there any evidence to support the impact of rehabilitation on the mental and physical health of older and frail individuals following a pneumonia hospitalization or other infection.
The aim of the feasibility study is to evaluate a patient-centered and individualized exercise intervention that is kick-started during hospitalization and continued for 3 months after discharge with video-supervised home-based exercise training to patients hospitalized with CAP or UTI compared to standard care with regard to safety, clinical outcomes, patients' perception, functional ability, organizational aspects, and economic aspects.
Patients aged ≥65 years or 18-64 years if the presence of at least one chronic disease (e.g., diabetes, COPD, heart failure, etc.)
Suspicious of a lower respiratory tract infection AND
Presence of one or more symptoms of a lower respiratory tract infection such as fever ≥38.3°C, hypothermia <35.0°C, new onset of cough, pleuritic chest pain, dyspnea, or altered breath sounds on auscultation.
Positive urine nitrate test and/or leukocyturia as depicted by positive esterase test or microscopy AND
Hospitalization within the past 14 days.
Inability to participate in the study due to dementia, paralysis, or other disorders.
Severe aortic valve stenosis or terminal illness.
Unstable cardiac arrhythmic disease.
Parallel
Video-supervised home-based exercise training
Behavioral12 weeks of patient-centered video-supervised home-based exercise training that will be kick-started during hospitalization and continued for 12 weeks after discharge, followed by 12 weeks of self-directed maintenance exercise.
Re-hospitalization (infection-related and all-cause)
Report of the total number of re-hospitalized patients, defined as a hospital stay \>12 hours.
Re-hospitalization (infection-related and all-cause)
Report of the total number of re-hospitalized patients, defined as a hospital stay \>12 hours.
Mortality (infection-related and all-cause)
Report of the total number.
Handgrip strength
Measure handgrip muscle strength in kilos in the dominant hand using a hand-held dynamometer. The highest number out of three attempts will be recorded.
Lower limb muscle strength and power
Assessment of muscle strength and power of the knee extensor muscles with dynamometry.
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