Enhanced Medical Rehabilitation in Older Adults

Washington University School of Medicine229 enrolled

Overview

The purpose of this study is to provide evidence that Enhanced Medical Rehabilitation is an effective treatment for older adults after disabling medical events.

The intervention involves physical and occupational therapy for patients who have been admitted to a skilled nursing facility for therapy following a disabling medical event. Participants in this study will be randomly assigned to receive either Enhanced or standard of care therapy, meaning they will either receive their PT (Physical Therapy)\& OT(Occupational Therapy) from therapists who have been specially trained in the study intervention or from therapists with normal training. Participants will be assessed at baseline, 30, 60, and 90 days after baseline, and at the date of their discharge from the skilled nursing facility.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

229

Conditions

Disabling Medical Events Disabled Depression

Interventions

Enhanced Medical RehabilitationBEHAVIORAL

Daily PT/OT provided by therapists trained in Enhanced Medical Rehabilitation. This training focuses on improved communication, patient engagement, and intensity.

Standard of Care RehabilitationBEHAVIORAL

Daily PT/OT provided by therapists not trained in the treatment intervention.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 65 and older * Admitted to a skilled nursing facility for post-acute care from PT and OT for 2 weeks or more. Exclusion Criteria: * Language, visual or hearing barriers to participation * Medical illness preventing study participation or accurate data collection * Moderate-severe dementia (demonstrated by chart diagnosis and/or short blessed score greater than 13) * Progressive neurological condition such that recovery of function is not feasible * Patient did not have the ability to walk prior to hospitalization (e.g. paraplegic) * Schizophrenia or other chronic or current psychotic disorder.

Locations (3)

Barnes-Jewish Extended Care

St Louis, Missouri, United States

Washington University School of Medicine

St Louis, Missouri, United States

Alexian Brothers Sherbrooke Village

St Louis, Missouri, United States

Outcomes

Primary Outcomes

Change in Barthel Index Score

Barthel Index scores range from 0 to 100, with higher scores indicating greater levels of function.

Time frame: Baseline and Discharge, an average of 24 days.

Secondary Outcomes

Gait Speed (Determined by 4 or 10 Meter Walk Test)

Meters walked per second.

Time frame: Discharge, an average of 24 days after baseline.

Distance Ambulated in 6-Minute Walk Test

Feet walked during 6 minute interval.

Time frame: Discharge, an average of 24 days after baseline.

Self-reported Barthel Index

Barthel Index scores range from 0 to 100, with higher scores indicating greater levels of function. Conducted as a self-report at timepoints where patient was not in an institutional setting.

Time frame: 30, 60, and 90 Days Post Admission to the SNF

Discharge Disposition

Number of participants discharged from skilled nursing facility to home

Time frame: Discharge, an average of 24 days after baseline.

Rehospitalizations

Assesses whether the participant was readmitted to the hospital.

Time frame: Days 30, 60, and 90 post admission to a SNF as well as at Discharge

Data from ClinicalTrials.gov

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