{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:54:15Z","timestamp":1791111255368,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001602","name":"Science Foundation Ireland","doi-asserted-by":"publisher","award":["18\/FRL\/6188"],"award-info":[{"award-number":["18\/FRL\/6188"]}],"id":[{"id":"10.13039\/501100001602","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Addenbrooke\u2019s Charitable Trust"},{"DOI":"10.13039\/501100000377","name":"The Dunhill Medical Trust","doi-asserted-by":"crossref","award":["RTF115\/0117"],"award-info":[{"award-number":["RTF115\/0117"]}],"id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>to investigate changes in knee-extension strength and physical function in older adults during and after acute hospital admission, and the contributions of illness severity, frailty and sedentary activity to changes in knee-extension strength.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>prospective repeated-measures cohort study on a sample of participants aged \u226575 recruited within 24\u00a0hours of acute hospital admission. Knee-extension, grip strength and functional mobility (de Morton Mobility Index, DEMMI) were measured at recruitment, day 7 (or discharge if earlier), and at follow-up 4\u20136\u00a0weeks later. During the first 7\u00a0days, continuous measurement of physical activity and daily measurements of muscle strength were taken. Participants recalled the functional ability they had 2-weeks before admission and self-reported it at follow-up (Barthel Index, BI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>sixty-five of 70 participants (median age 84\u00a0years) had at least one repeated measure of muscle strength in hospital. Knee-extension strength declined during hospitalisation by 11% (P\u00a0&amp;lt;\u20090.001), but did not change post-hospitalisation (P\u00a0=\u20090.458). Grip strength did not change during hospitalisation (P\u00a0=\u20090.665) or from discharge to follow-up (P\u00a0=\u20090.508). General functional ability (BI) deteriorated between 2\u00a0weeks before admission and follow-up (P\u00a0&amp;lt;\u20090.001). Functional mobility (DEMMI) improved during hospitalisation (P\u00a0&amp;lt;\u20090.001), but did not change post-hospitalisation (P\u00a0=\u20090.508). A repeated-measures mixed model showed that greater loss in knee-extension strength during hospitalisation was associated with increased sedentary time, frailty and baseline strength and lower baseline inflammatory levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>our observations add to a growing body of evidence on potential risk factors for hospital-associated deconditioning.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaa103","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T19:12:01Z","timestamp":1590433921000},"page":"153-160","source":"Crossref","is-referenced-by-count":48,"title":["Changes in muscle strength and physical function in older patients during and after hospitalisation: a prospective repeated-measures cohort study"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1033-5897","authenticated-orcid":false,"given":"Peter","family":"Hartley","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"},{"name":"Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Romero-Ortuno","sequence":"additional","affiliation":[{"name":"Discipline of Medical Gerontology, Trinity College Dublin, Mercer\u2019s Institute for Successful Ageing, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Wellwood","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christi","family":"Deaton","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"2021010815104114200_ref1","first-page":"559","article-title":"The association between cognitive impairment and functional outcome in hospitalised older patients: a systematic review and meta-analysis","volume":"46","author":"Hartley","year":"2017","journal-title":"Age Ageing"},{"key":"2021010815104114200_ref2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/MCO.0b013e328333aa66","article-title":"Protecting muscle mass and function in older adults during bed rest","volume":"13","author":"English","year":"2010","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2021010815104114200_ref3","doi-asserted-by":"crossref","first-page":"e0210186","DOI":"10.1371\/journal.pone.0210186","article-title":"Change in skeletal muscle associated with unplanned hospital admissions in adult patients: a systematic review and meta-analysis","volume":"14","author":"Hartley","year":"2019","journal-title":"PLoS One"},{"key":"2021010815104114200_ref4","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s12603-011-0335-7","article-title":"Reducing 'iatrogenic disability' in the hospitalized frail elderly","volume":"15","author":"Lafont","year":"2011","journal-title":"J Nutr Health Aging"},{"key":"2021010815104114200_ref5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1093\/ageing\/26.4.315","article-title":"Unstable disability and the fluctuations of frailty","volume":"26","author":"Campbell","year":"1997","journal-title":"Age Ageing"},{"key":"2021010815104114200_ref6","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/nure.12019","article-title":"Nutritional strategies to attenuate muscle disuse atrophy","volume":"71","author":"Wall","year":"2013","journal-title":"Nutr Rev"},{"key":"2021010815104114200_ref7","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s12603-017-0931-2","article-title":"Assessment of physical activity of hospitalised older adults: a systematic review","volume":"22","author":"Lim","year":"2018","journal-title":"J Nutr Health Aging"},{"key":"2021010815104114200_ref8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.3233\/IES-2009-0349","article-title":"Responsiveness of measurements of knee extension force obtained by hand-held dynamometry: a preliminary analysis","volume":"17","author":"Bohannon","year":"2009","journal-title":"Isokinet Exerc Sci"},{"key":"2021010815104114200_ref9","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1136\/jech.2009.088476","article-title":"Does socio-economic status predict grip strength in older Europeans? Results from the SHARE study in non-institutionalised men and women aged 50+","volume":"64","author":"Mohd Hairi","year":"2010","journal-title":"J Epidemiol Community Health"},{"key":"2021010815104114200_ref10","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1477-7525-6-63","article-title":"The de Morton mobility index (DEMMI): an essential health index for an ageing world","volume":"6","author":"Morton","year":"2008","journal-title":"Health Qual Life Outcomes"},{"key":"2021010815104114200_ref11","first-page":"61","article-title":"Functional evaluation: the Barthel index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md State Med J"},{"key":"2021010815104114200_ref12","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"2021010815104114200_ref13","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/ageing\/afi196","article-title":"Development and initial validation of the falls efficacy scale-international (FES-I)","volume":"34","author":"Yardley","year":"2005","journal-title":"Age Ageing"},{"key":"2021010815104114200_ref14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000366040","article-title":"The mini-Addenbrooke's cognitive examination: a new assessment tool for dementia","volume":"39","author":"Hsieh","year":"2015","journal-title":"Dement Geriatr Cogn Disord"},{"key":"2021010815104114200_ref15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2318-10-57","article-title":"A frailty instrument for primary care: findings from the survey of health, ageing and retirement in Europe (SHARE)","volume":"10","author":"Romero-Ortuno","year":"2010","journal-title":"BMC Geriatr"},{"key":"2021010815104114200_ref16","doi-asserted-by":"crossref","first-page":"3280240","DOI":"10.1155\/2018\/3280240","article-title":"Using accelerometers to measure physical activity in older patients admitted to hospital","volume":"2018","author":"Hartley","year":"2018","journal-title":"Curr Gerontol Geriatr Res"},{"key":"2021010815104114200_ref17","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2018"},{"key":"2021010815104114200_ref18","doi-asserted-by":"crossref","first-page":"48","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates","year":"2015","journal-title":"J Stat Softw"},{"key":"2021010815104114200_ref19","doi-asserted-by":"crossref","first-page":"26","DOI":"10.18637\/jss.v082.i13","article-title":"lmerTest package: tests in linear mixed effects models","volume":"82","author":"Kuznetsova","year":"2017","journal-title":"J Stat Softw"},{"key":"2021010815104114200_ref20","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1111\/j.1532-5415.2010.03144.x","article-title":"Hospitalization and change in body composition and strength in a population-based cohort of older persons","volume":"58","author":"Alley","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"2021010815104114200_ref21","doi-asserted-by":"crossref","first-page":"110643","DOI":"10.1016\/j.exger.2019.110643","article-title":"Bed rest and accelerated aging in relation to the musculoskeletal and cardiovascular systems and frailty biomarkers: a review","volume":"124","author":"Kehler","year":"2019","journal-title":"Exp Gerontol"},{"key":"2021010815104114200_ref22","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1097\/PHM.0b013e31828cd2b6","article-title":"Acute hospitalization of the older patient: changes in muscle strength and functional performance during hospitalization and 30 days after discharge","volume":"92","author":"Bodilsen","year":"2013","journal-title":"Am J Phys Med Rehabil"},{"key":"2021010815104114200_ref23","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1111\/ggi.12827","article-title":"Clinical frailty and functional trajectories in hospitalized older adults: a retrospective observational study","volume":"17","author":"Hartley","year":"2017","journal-title":"Geriatr Gerontol Int"},{"key":"2021010815104114200_ref24","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1532-5415.2010.03239.x","article-title":"Functional recovery of elderly patients hospitalized in geriatric and general medicine units. The PROgetto DImissioni in GEriatria study","volume":"59","author":"Palleschi","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"2021010815104114200_ref25","first-page":"920","article-title":"Frailty affects the initial treatment response and time to recovery of mobility in acutely ill older adults admitted to hospital","volume":"46","author":"Hatheway","year":"2017","journal-title":"Age Ageing"},{"key":"2021010815104114200_ref26","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/ggi.13623","article-title":"Functional mobility trajectories of hospitalized older adults admitted to the acute geriatric wards: a retrospective observational study in an English university hospital","volume":"19","author":"Lyons","year":"2019","journal-title":"Geriatr Gerontol Int"},{"key":"2021010815104114200_ref27","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/jgs.13193","article-title":"Hospital-associated functional decline: the role of hospitalization processes beyond individual risk factors","volume":"63","author":"Zisberg","year":"2015","journal-title":"J Am Geriatr Soc"},{"key":"2021010815104114200_ref28","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/PHM.0b013e3181838f70","article-title":"Rehabilitation for hospital-associated deconditioning","volume":"88","author":"Kortebein","year":"2009","journal-title":"Am J Phys Med Rehabil"},{"key":"2021010815104114200_ref29","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"2021010815104114200_ref30","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.exger.2017.10.006","article-title":"Handgrip strength shows no improvements in geriatric patients with persistent inflammation during hospitalization","volume":"99","author":"Norheim","year":"2017","journal-title":"Exp Gerontol"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/50\/1\/153\/35542366\/afaa103.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/50\/1\/153\/35542366\/afaa103.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:21:23Z","timestamp":1610583683000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/50\/1\/153\/5903082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,9]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,9,9]]},"published-print":{"date-parts":[[2021,1,8]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afaa103","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,1]]},"published":{"date-parts":[[2020,9,9]]}}}