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Adult nursing
Multicomponent exercise programmes among very elderly hospitalised patients can be safe and effective in reversing functional decline
  1. Nicole Zhang
  1. Nursing, Hartwick College, Oneonta, New York, USA
  1. Correspondence to Professor Nicole Zhang, Nursing, Hartwick College, Oneonta, NY 13820, USA; zhangn{at}

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Commentary on: Martínez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F, et al. Effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: a randomized clinical trial. JAMA Inter Med 2019;179:28–36.

Implications for practice and research

  • The proposed exercise programme can provide significant benefit over usual care and improve patient outcomes in the hospital.

  • Future research may look at a larger scale implementation, additional secondary endpoints (hospital readmission, falls and so on) and the combination of this intervention and others known to impact functional decline.

  • Conceptualising functional status as a clinical vital sign is a paradigm shift that would improve outcomes among very elderly patients.


Functional decline is prevalent among older patients who have been hospitalised. During an acute hospitalisation, there may be significant functional decline with non-disabling (and disabling) conditions causing new disability.1 Decline often persists after discharge and at …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.