Edward Gorgon1, Catherine Said, Mary Galea. 1. Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, Manila, Philippines.
Abstract
BACKGROUND AND PURPOSE: Independent mobility is a crucial element of independent living and quality of life. However, little is known about the mobility of older people around the time of discharge from inpatient rehabilitation. The present study aimed to describe mobility on discharge from an aged care rehabilitation unit. METHOD: The study utilized a descriptive, cross-sectional design. Ninety-five patients (mean age 81 (+/-8) years; 60% female) with diverse chronic conditions (median 5) who were able to walk at least 10m without weight-bearing restrictions were recruited from the aged care rehabilitation wards. Scores on the Barthel Index were obtained on admission and discharge to provide information about their overall level of function. Within the last week of rehabilitation stay, scores on the mobility and locomotion subsections of the Functional Independence Measure, gait velocity, and time and distance parameters of gait were obtained. Gait variables were measured by use of the GAITRite, an instrumented walkway. Medians and interquartile ranges (IQR) were reported for mobility variables. RESULTS: Following inpatient rehabilitation, many patients achieved independence in bed or chair transfers (83%), toilet transfers (81%), shower transfers (60%) and level-surface walking (74%). Only 31% achieved independence in stair climbing. Patients walked slowly at a median (IQR) gait velocity of 45.96 (31.51) cm/s and with markedly diminished cadence and step length. Subjects with a low number of chronic conditions generally performed better on mobility measures than those with a high number of chronic conditions. CONCLUSIONS: Although many older people are able to transfer and walk independently around the time of discharge from inpatient rehabilitation their mobility is still often impaired. For example, only 9.5% achieved a walking velocity considered to be adequate for street crossing and few demonstrated the ability to negotiate stairs. This highlights the need for ongoing rehabilitation for many of these older people. The possible cumulative effects of chronic conditions on mobility require further investigation.
BACKGROUND AND PURPOSE: Independent mobility is a crucial element of independent living and quality of life. However, little is known about the mobility of older people around the time of discharge from inpatient rehabilitation. The present study aimed to describe mobility on discharge from an aged care rehabilitation unit. METHOD: The study utilized a descriptive, cross-sectional design. Ninety-five patients (mean age 81 (+/-8) years; 60% female) with diverse chronic conditions (median 5) who were able to walk at least 10m without weight-bearing restrictions were recruited from the aged care rehabilitation wards. Scores on the Barthel Index were obtained on admission and discharge to provide information about their overall level of function. Within the last week of rehabilitation stay, scores on the mobility and locomotion subsections of the Functional Independence Measure, gait velocity, and time and distance parameters of gait were obtained. Gait variables were measured by use of the GAITRite, an instrumented walkway. Medians and interquartile ranges (IQR) were reported for mobility variables. RESULTS: Following inpatient rehabilitation, many patients achieved independence in bed or chair transfers (83%), toilet transfers (81%), shower transfers (60%) and level-surface walking (74%). Only 31% achieved independence in stair climbing. Patients walked slowly at a median (IQR) gait velocity of 45.96 (31.51) cm/s and with markedly diminished cadence and step length. Subjects with a low number of chronic conditions generally performed better on mobility measures than those with a high number of chronic conditions. CONCLUSIONS: Although many older people are able to transfer and walk independently around the time of discharge from inpatient rehabilitation their mobility is still often impaired. For example, only 9.5% achieved a walking velocity considered to be adequate for street crossing and few demonstrated the ability to negotiate stairs. This highlights the need for ongoing rehabilitation for many of these older people. The possible cumulative effects of chronic conditions on mobility require further investigation.
Authors: Marghuretta D Bland; Audra Sturmoski; Michelle Whitson; Lisa Tabor Connor; Robert Fucetola; Thy Huskey; Maurizio Corbetta; Catherine E Lang Journal: Arch Phys Med Rehabil Date: 2012-03-20 Impact factor: 3.966
Authors: Catherine M Said; Meg E Morris; Jennifer L McGinley; Cassandra Szoeke; Barbara Workman; Danny Liew; Keith Hill; Michael Woodward; Joanne E Wittwer; Leonid Churilov; Cameron Ventura; Julie Bernhardt Journal: Trials Date: 2015-01-15 Impact factor: 2.279