exercici físic a les unitats geriàtriques d’aguts ( uga) · population of spain, 1st january:...
TRANSCRIPT
![Page 1: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/1.jpg)
Nicolás Martínez VelillaServicio de Geriatría del ComplejoHospitalario de NavarraTAULA 4-b4Sala 1016:45h Divendres 19 octubre
Exercici físic a les UnitatsGeriàtriques d’Aguts ( UGA)
![Page 2: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/2.jpg)
RESUM
① El meu/nostre contexte ¿aplicable al vostre?
②Discapacitat nosocomial
③ ECA JAMA Intern Med
④ THM
![Page 3: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/3.jpg)
Population of Spain, 1st January: 46.659.302Population of Navarra, 1st January: 642.797; Mean age: 43 years; Life expectancy: Women 86,9 Men 81,2
![Page 4: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/4.jpg)
![Page 5: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/5.jpg)
![Page 6: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/6.jpg)
Acute admissions, orthogeriatrics, Outpatients Clinics (General, Multimorbidity, falls, Dementia), Pharmacologic Iatrogenia,
Frailty/nosocomial disability, Pre-habilitation /oncology, research, training (doctors, nurses, primary care, pharmacists, and students)
![Page 7: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/7.jpg)
![Page 8: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/8.jpg)
![Page 9: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/9.jpg)
![Page 10: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/10.jpg)
![Page 11: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/11.jpg)
Heterogeneity
![Page 12: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/12.jpg)
![Page 13: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/13.jpg)
![Page 14: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/14.jpg)
Modification of the functiona and cognitive trajectory in
hospitalized geriatric patients through an
individualized multicomponent exercise program: a randomized
controlled trial
![Page 15: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/15.jpg)
evidencias….
• El envejecimiento de la población condiciona un aumento significativo en el uso de recursos relacionados con la salud, especialmente en ancianos frágiles.
• Uno de los recursos de salud que puede modificar la trayectoria clínica de estos pacientes es el hospital, ya que una hospitalización puede desencadenar un deterioro funcional y cognitivo importante y transformar la fragilidad en discapacidad.
• Por otro lado, es un momento clave para intervenir en pacientes geriátricos.
• Por lo general, tratamos de adaptar a los pacientes al hospital, en lugar del hospital a los pacientes.
![Page 16: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/16.jpg)
Brown CJ, Redden DT, Flood KL, Allman RM. The underrecognized epidemic of low mobility during hospitalization of older adultsJ Am Geriatr Soc. 2009 Sep;57(9):1660-5
![Page 17: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/17.jpg)
![Page 18: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/18.jpg)
![Page 19: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/19.jpg)
• ¿De qué sirve tener la mejor de las tecnologías o el tratamiento más innovador,
si la discapacidad adquirida durante la hospitalización a corto y largo plazo es
devastadora? • ¿ Están nuestros pacientes sufriendo
innecesariamente discapacidad nosocomial?
![Page 20: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/20.jpg)
![Page 21: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/21.jpg)
![Page 22: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/22.jpg)
![Page 23: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/23.jpg)
![Page 24: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/24.jpg)
¿Cómo prescribimos un fármaco?• Enfermedad• Dosis• Duración • Frecuencia• Tolerancia• Efectos secundarios• Contraindicaciones• Empezar despacio, titular despacio
• Deberíamos ver el ejercicio como otra medicina y aplicar /adaptar estos conceptos…
![Page 25: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/25.jpg)
Modification of the functional and cognitivetrajectory in hospitalized geriatric patientsthrough an individualized multicomponent
exercise program: a randomized controlledtrial
Servicio de Geriatría Complejo Hospitalario de NavarraUniversidad Pública de Navarra
![Page 26: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/26.jpg)
![Page 27: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/27.jpg)
Inclusion and exclusion criteria
![Page 28: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/28.jpg)
Figure 1. Study flow diagram
![Page 29: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/29.jpg)
MeasurementT1
BaselineT2
After training or
control period
T31-month
T43-months
Categorical scale of pain X X X X
Barthel Index X X X X
Geriatric depression Scale of Yasavage X X X X
Mini-Mental State Examination (MMSE) X X X X
Short Physical Performance Battery (SPPB) X X X X
Gait velocity test (GVT) X X X X
Dual-task (verbal and counting GVT) X X X X
Maximal isometric force of handgrip, knee extension and hip flexion X X X X
1RM (Leg press, Chest press and Knee extension) X X X X
Muscle power at 50% 1RM in Leg press X X X X
Confusion Assessment Method (CAM) X X
Quality of Life (EQ-5D) X X X X
Geriatrics syndromes X X X X
Isaacs set test X X X X
Trail Making Test (TMT) X X X X
Laboratory parameters X
Diseases considered grouped by ACG of Salisbury and CIE-10 codes X
Cumulative Illness Rating Scale for Geriatrics (CIRS-G) X
Zarit Scale X
Mini Nutritional Assessment (MNA) X
![Page 30: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/30.jpg)
No se puede mostrar la imagen en este momento.
Exercise Day1 Day2 Day 3 Day 4 Day 5 Day 6 * Day 7 *
MORNING
Rises from a chair 1x5 2x10 3x10 3x10 3x8 3x8 3x8
Leg press 1RM + 1x10(50%1RM)
2x10 (30%1RM)
3x10 (40%1RM)
3x10 (50%1RM) 3x8 (60%1RM) 3x8 (60%1RM) 3x8 (60%1RM)
Chet press 1RM + 1x10(30%1RM)
2x10(30%1RM)
3x10(40%1RM)
3x10(50%1RM) 3x8 (60%1RM) 3x8 (60%1RM) 3x8 (60%1RM)
Leg extension 1RM + 1x10(30%1RM)
2x10(30%1RM)
3x10(40%1RM)
3x10(50%1RM) 3x8 (60%1RM) 3x8 (60%1RM) 3x8 (60%1RM)
AFTERNOON
Leg extension (0,5 - 1,0 Kg) 2x10 2x10 2x10 2x10 2x10 2x10
Leg flexion (0,5 - 1,0 Kg) 2x10 2x10 2x10 2x10 2x10 2x10
Hip abduction (0,5 - 1,0 Kg) 2x10 2x10 2x10 2x10 2x10 2x10
Hand grip ball 2x10 2x10 2x10 2x10 2x10 2x10
![Page 31: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/31.jpg)
![Page 32: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/32.jpg)
![Page 33: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/33.jpg)
![Page 34: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/34.jpg)
![Page 35: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/35.jpg)
![Page 36: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/36.jpg)
![Page 37: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/37.jpg)
![Page 38: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/38.jpg)
![Page 39: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/39.jpg)
![Page 40: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/40.jpg)
![Page 41: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/41.jpg)
![Page 42: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/42.jpg)
![Page 43: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/43.jpg)
![Page 44: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/44.jpg)
Fuerza Máxima y Envejecimiento
(ISRAEL, 1992)• Hasta los 40-50 años meseta• > 50 años: ↓ fuerza• > 60-70 años: ↓↓ fuerza, ↑↑ caídas
![Page 45: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/45.jpg)
BMJ 2015;350:h2361
![Page 46: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/46.jpg)
Figure 2. Bar plot showing discrete change from baseline to discharge according to treatment group (left) and box plot showing within-group punctuation change
distribution for both groups (right).
![Page 47: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/47.jpg)
ANÁLISIS DE COSTES
![Page 48: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/48.jpg)
![Page 49: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/49.jpg)
![Page 50: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/50.jpg)
![Page 51: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/51.jpg)
![Page 52: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/52.jpg)
![Page 53: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/53.jpg)
SUGGERÈNCIES PER EMPORTAR-SE A CASA
• Visió de l’exercici com una medicina (inclús millor que la tradicional), individualitzat, multicomponent, adaptat.
• L’hospital no hauria de ser un agent passiu en el curs de la discapacitat, és una oportunitat clau per modificar les trajectòriesfuncionals i cognitives.
• Podem revertir la fragilitat (almenys parcial i temporalment), i retrassar la discapacitat.
• És obligatori redissenyar el model hospitalari, pensant sobretot ambla funció.
![Page 54: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/54.jpg)
![Page 55: Exercici físic a les Unitats Geriàtriques d’Aguts ( UGA) · Population of Spain, 1st January: 46.659.302. Population of Navarra, 1st January: 642.797; Mean age: 43 years; Lifeexpectancy:](https://reader031.vdocuments.mx/reader031/viewer/2022011910/5f84ed0931f6b06410509906/html5/thumbnails/55.jpg)