Faisal Y Asiri1,2, Gregory F Marchetti3, Jennifer L Ellis4, Laurie Otis4, Patrick J Sparto1, Valerie Watzlaf5, Susan L Whitney1,6. 1. a Department of Physical Therapy, University of Pittsburgh , Pittsburgh , PA , USA. 2. b Department of Rehabilitation Sciences, King Khalid University , Abha , Saudi Arabia. 3. c Department of Physical Therapy, Duquesne University , Pittsburgh , PA , USA. 4. d Gentiva Health Services Inc , Atlanta , GA , USA. 5. e Department of Health Information Management, University of Pittsburgh , Pittsburgh , PA , USA. 6. f King Saud University, Rehabilitation Research Chair , Riyadh , Saudi Arabia.
Abstract
PURPOSE: The purpose of this study is to describe improvement in activities of daily living (ADL) and gait speed, and associated factors in subjects receiving home-based rehabilitation after hospital admission for heart failure. METHODS: A total of 1,055 patients (mean age 82 ± 8 years SD) receiving post-admission home care services for heart failure. Subjects were included if they were referred for home-care rehabilitation after inpatient admission with ICD-9 code indicating heart failure at inpatient discharge, primary home care, or co-morbid diagnosis on admission Outcome and Assessment Information Set version-C (OASIS-C). Change in total ADL score was described and adjusted for significant baseline factors/covariates using a generalized linear model. Factors predictive of exceeding the ADL score Minimal Detectable Change (MDC) were identified with multiple variable logistic regression. RESULTS: Mean change in total ADL score from admission to discharge was 1.6 ± 1.2, the mean change for gait speed was 0.17 ± 0.21 m/s, and the minimum detectable change (MDC) (1.3) was exceeded by 57% of subjects. Improvement in mean ADL score was significantly predicted by age, baseline total ADL score, baseline gait speed score, cognitive-behavioral status, and living situation (R2 = 42%). CONCLUSIONS: Patients with heart failure receiving home-based rehabilitation services make significant improvements in ADL function and gait performance. Greater ADL improvements are associated with younger age, faster gait speed at baseline, and greater impairment of baseline ADL scores. Age, baseline gait speed, and ADL composite score are significantly related to making a change beyond measurement error in ADL change score.
PURPOSE: The purpose of this study is to describe improvement in activities of daily living (ADL) and gait speed, and associated factors in subjects receiving home-based rehabilitation after hospital admission for heart failure. METHODS: A total of 1,055 patients (mean age 82 ± 8 years SD) receiving post-admission home care services for heart failure. Subjects were included if they were referred for home-care rehabilitation after inpatient admission with ICD-9 code indicating heart failure at inpatient discharge, primary home care, or co-morbid diagnosis on admission Outcome and Assessment Information Set version-C (OASIS-C). Change in total ADL score was described and adjusted for significant baseline factors/covariates using a generalized linear model. Factors predictive of exceeding the ADL score Minimal Detectable Change (MDC) were identified with multiple variable logistic regression. RESULTS: Mean change in total ADL score from admission to discharge was 1.6 ± 1.2, the mean change for gait speed was 0.17 ± 0.21 m/s, and the minimum detectable change (MDC) (1.3) was exceeded by 57% of subjects. Improvement in mean ADL score was significantly predicted by age, baseline total ADL score, baseline gait speed score, cognitive-behavioral status, and living situation (R2 = 42%). CONCLUSIONS:Patients with heart failure receiving home-based rehabilitation services make significant improvements in ADL function and gait performance. Greater ADL improvements are associated with younger age, faster gait speed at baseline, and greater impairment of baseline ADL scores. Age, baseline gait speed, and ADL composite score are significantly related to making a change beyond measurement error in ADL change score.
Authors: Tina Auerswald; Anna Hendker; Tiara Ratz; Sonia Lippke; Claudia R Pischke; Manuela Peters; Jochen Meyer; Kai von Holdt; Claudia Voelcker-Rehage Journal: Int J Environ Res Public Health Date: 2022-03-22 Impact factor: 3.390