High-Intensity Rehabilitation plus Mobility

Join us as this presenter discusses this poster live on Tuesday, August 11, 220 | Track B at 5:05 PM Mountain

PRESENTER
JULIE STUTZBACH
PT, DPT/PhD Trainee, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
BACKGROUND
Following a hospitalization and skilled nursing facility (SNF) stay, patients are often unprepared for the transition to home, as evidenced by enduring deficits in physical function and continued dependence for activities of daily living (ADLs) at time of discharge. 1) Our previous research has shown that just days before discharge, patients in SNFs took only 916 steps per day and were sitting or lying down 87% of their waking hours. 2) To put this finding into context: participants took far fewer than the ~2,500 steps per day considered basal activity (i.e., the minimum requirement to perform activities of daily living) were ~85% more sedentary than community-dwelling older adults. 3) To combat this pressing problem, we designed High-Intensity Rehabilitation plus Mobility (HeRo), a pilot pragmatic intervention to improve mobility and physical function while in the SNF.
SETTING
Older adults (veterans) admitted to a single SNF following a hospitalization.
METHODS
A mobility coach with certified nursing assistant credentials will deliver a structured mobility program to complement the progressive rehabilitation intervention that has been successfully implemented at the SNF facility. We will use a pragmatic, pre/post-test design to compare 2 historical cohorts (usual care, progressive rehabilitation alone) to HeRo (progressive rehabilitation coupled with structured mobility). Implementation will be iteratively developed and refined in collaboration with patients and SNF staff to increase adoption and utilization of the intervention. Qualitative interviews with patients and focus groups with providers will complement quantitative measures of effectiveness and implementation in a convergent, embedded mixed-methods design. Program implementation will be evaluated using the Consolidated Framework for Implementation Research4 and the RE-AIM Framework.5 Percent of patients admitted to the SNF who receive the intervention will determine reach. Effectiveness will be measured based on patient-centered outcomes including changes in gait speed, physical function, and physical activity. Focus groups, conducted at regular intervals with rehabilitation and nursing staff throughout the project, will explore how HeRo is integrated into daily practice as key indicators of adoption and potential for maintenance/sustainability. Direct observations of treatment fidelity sessions, documentation audits, and step count goal adherence will serve as indicators of implementation.
POSTER

Loader Loading...
EAD Logo Taking too long?

Reload Reload document
| Open Open in new tab
VIDEO

Posted in Measures & Evaluation, Poster Session.

Leave a Reply