Aging Clinical Trial
Official title:
Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities
This cluster randomized clinical trial seeks to provide large-scale, foundational evidence that high-intensity rehabilitation is effective and can be systematically implemented to improve functional outcomes for patients admitted to skilled nursing facilities following hospitalization. Additionally, this study will generate a descriptive overview of factors that predict implementation success while informing effective implementation strategies for future skilled nursing facilities innovation.
Status | Recruiting |
Enrollment | 2880 |
Est. completion date | March 31, 2026 |
Est. primary completion date | September 30, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 50 Years to 120 Years |
Eligibility | Rehabilitation staff at enrolled sites will participate in research activities, as indicated by group assignment. Site Inclusion Criteria: - Aegis Therapies-contracted skilled nursing facility (SNF) - Admits approximately 15 patients per month for short term rehabilitation Patient Inclusion Criteria: - At least 50 years of age - Admitted to a SNF from the hospital - Ambulatory upon SNF admission Patient Exclusion Criteria: - Contraindications to high-intensity resistance training, per American College of Sports Medicine Exercise Testing and Prescription - Lower extremity weight-bearing precautions - Neurological diagnosis (e.g., Cerebral vascular accident, Multiple Sclerosis, Parkinson's disease) - Subsequent SNF admission |
Country | Name | City | State |
---|---|---|---|
United States | University of Colorado Denver, Anschutz Medical Campus | Aurora | Colorado |
United States | Aegis Therapies | Frisco | Texas |
Lead Sponsor | Collaborator |
---|---|
University of Colorado, Denver | Aegis Therapies, Inc., National Institute on Aging (NIA) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Change in Total Score Modified Barthel ADL Index (MBI) | The Modified Barthel ADL Index assesses the ability to perform basic Activities of Daily Living (ADL) tasks. Total score range is 0-100. Total score is commuted by summing dependence across 10 ADL tasks: chair/bed transfers, ambulation, stair climbing, toilet transfers, bowel control, bladder control, bathing, dressing, personal hygiene (grooming), and feeding. Higher scores indicate increased independence. | From date of admission into the SNF to date of discharge from the SNF, which would be an approximate average of 21 days | |
Other | RE-AIM Component: Reach | Proportion of patients treated with high-intensity rehabilitation out of all eligible patients. | Up to 16 months | |
Other | RE-AIM Component: Adoption | Proportion of clinicians using high-intensity rehabilitation with at least 75% of eligible patients out of all trained clinicians at Intervention sites. | Up to 16 months | |
Other | RE-AIM Component: Implementation | Proportion of completed high-intensity rehabilitation elements out of all intervention elements assessed by a fidelity checklist. | Up to 16 months | |
Other | RE-AIM Component: Maintenance | Proportion of facilities that sufficiently completed high-intensity elements out of all intervention elements assessed by a fidelity checklist. | Assessed from 16 months up to 22 months | |
Primary | Change in Gait Speed | Gait speed will be measured in meters/second using the time it takes to walk a 4-meter path at usual speed using a stopwatch. | From date of admission into the SNF to date of discharge from the SNF, which would be an approximate average of 21 days | |
Secondary | Change in Short Physical Performance Battery (SPPB) | The SPPB is comprised of 3 tasks: a hierarchical standing balance test (side-by-side, semi-tandem, and tandem), a 4-meter usual gait speed, and a 5-time sit-to-stand from a standardized chair. Each subtask is scored (based on time) from 0-4 points and then summarized into a total score of 0-12 points, where 12 points represents the highest performance. | From date of admission into the SNF to date of discharge from the SNF, which would be an approximate average of 21 days | |
Secondary | Post-discharge Rehospitalization Rate | The proportion of patients eligible for high-intensity rehabilitation who return to the hospital within 30 days of discharge from the SNF. | From date of discharge from the SNF, assessed up to 30 days |
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