Home Telerehabilitation for Deconditioned Older Adults

Not Applicable

Completed

Interventions: Device: Health Buddy, Home telehealth technology
Other: Telephone counseling

Brief Summary: The purpose of this study is to develop a home exercise program for patients 60 years of age and over who are deconditioned following their discharge from the hospital, or recruited from GLA outpatient clinics. The program will be designed to monitor and improve patients' exercise behavior through the use of home technology, such as text messaging monitors.

Detailed Description: The aim of this study is to develop and determine the feasibility of implementing a home exercise and functional status monitoring telerehabilitation program, known as TEL-REHAB, for older adults 60 years of age and over who are deconditioned following their discharge from the inpatient setting, or recruited from GLA outpatient clinics. Deconditioning is a modifiable risk factor for preventing institutionalization of frail elderly patients who would otherwise be able to live independently. Home exercise programs are an effective intervention to reduce the risk, but patient compliance with home exercise programs, and assessments of patients during home exercise programs, are barriers to achieving maximal benefits. Face-to-face visits with physical medicine professionals are an effective means to perform these functions, but are problematic because of professional time impacts and patient transportation problems. A TEL-REHAB program will empower these patients to take responsibility for their own health by providing ongoing communication with a healthcare provider. In this way, telerehabilitation may assist older adults to remain independent in their homes as long as possible.

Recruitment & Eligibility

Inclusion Criteria

acute decline in functional status while hospitalized as reported by the patient
physically inactive outpatients (exercise less than 30 min/day, 3 d/wk)
ability to hear and communicate via telephone
ability to read a video or text monitor
ability to manually operate the technology
have a working telephone and power source
willingness to use the TEL-REHAB technology

Exclusion Criteria

does not speak English
poor cognition as determined by the Mini-Cog
non-ambulatory
had a stroke, myocardial infarction, hip fracture, or total hip or knee replacement within the prior 6 months

Arm && Interventions

Group	Intervention	Description
health buddy inpatient	Health Buddy, Home telehealth technology	-
telephone inpatient	Telephone counseling	-
Health Buddy outpatient	Health Buddy, Home telehealth technology	Received home telehealth monitoring by Health Buddy
Telephone outpatient	Telephone counseling	-

Primary Outcome Measures

Name	Time	Method
Exercise Adherence	at monthly intervals, for 3-months	An 11-week exercise adherence rate was calculated by dividing the total number of days that the participant reported exercising by 77 days and multiplying by 100. This first calculation estimated the exercise adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week.
HB/Phone Adherence	Monthly over 3 months	An 11-week text messaging or phone adherence rate was calculated by dividing the number of response days via the HB or phone divided by 77 days and multiplied by 100. This first calculation estimated the text messaging or phone adherence rate for the full intervention period regardless of participant dropout. Eleven weeks rather than 12 weeks was used in the denominator because subjects received their HB units some time during the first week of study enrollment and may have missed some days during this first week.

Secondary Outcome Measures