Enhanced Medical Rehabilitation in Older Adults

Not Applicable

Completed

• Conditions: Disabled; Disabling Medical Events; Depression
• Interventions: Behavioral: Standard of Care Rehabilitation; Behavioral: Enhanced Medical Rehabilitation

• Registration Number: NCT02114879
• Lead Sponsor: Washington University School of Medicine

Brief Summary

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

Detailed Description

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 Timeline

• Study First Submitted: 2014-04-02
• Study First Submitted QC: 2014-04-10
• Study First Posted: 2014-04-15
• Study Start: 2014-07-29
• Primary Completion: 2018-07-13
• Study Completion: 2018-07-13
• Results First Submitted: 2020-05-18
• Status Verified: 2020-06
• Results First Submitted QC: 2020-06-23
• Last Update Submitted: 2020-06-23
• Results First Posted: 2020-07-07
• Last Update Posted: 2020-07-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 229

Inclusion Criteria

• 65 and older
• Admitted to a skilled nursing facility for post-acute care from PT and OT for 2 weeks or more.

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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.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard of Care Rehabilitation	Standard of Care Rehabilitation	-
Enhanced Medical Rehabilitation	Enhanced Medical Rehabilitation	-

Primary Outcome Measures

Name	Time	Method
Change in Barthel Index Score	Baseline and Discharge, an average of 24 days.	Barthel Index scores range from 0 to 100, with higher scores indicating greater levels of function.

Secondary Outcome Measures

Name	Time	Method
Gait Speed (Determined by 4 or 10 Meter Walk Test)	Discharge, an average of 24 days after baseline.	Meters walked per second.
Self-reported Barthel Index	30, 60, and 90 Days Post Admission to the SNF	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.
Discharge Disposition	Discharge, an average of 24 days after baseline.	Number of participants discharged from skilled nursing facility to home
Distance Ambulated in 6-Minute Walk Test	Discharge, an average of 24 days after baseline.	Feet walked during 6 minute interval.
Rehospitalizations	Days 30, 60, and 90 post admission to a SNF as well as at Discharge	Assesses whether the participant was readmitted to the hospital.

Trial Locations

Locations (3)

Barnes-Jewish Extended Care; 🇺🇸 Saint Louis, Missouri, United States

Washington University School of Medicine; 🇺🇸 Saint Louis, Missouri, United States

Alexian Brothers Sherbrooke Village; 🇺🇸 Saint Louis, Missouri, United States