Frail Older Adults Clinical Trial
Official title:
Improving Activity, Participation And Function After Acute Hospitalization In Older Adults With Multiple Chronic Conditions: Phase II Randomized Controlled Trial
Hospitalization increases the risk for new disability in older adults. In the current health care system, home health physical therapy is understudied and often does not return older adults to prior levels of function. The proposed evidence-based multicomponent intervention that combines high intensity strength training and motor control based systems of gait and balance training will advance clinical practice by providing an intervention strategy for practitioners. If successful, improving patient function and decreasing re-hospitalization rates and falls will have large cost saving implications.
Background: Hospitalized older adults are 59.8 times more likely to develop disability than
those who are not hospitalized. No studies have examined the effectiveness of Home Health
(HH) physical therapy on improving function in older adults with multiple co-morbidities
after hospitalization. Our goal is to enable older adults with multiple chronic conditions
to recover function by providing adequate content and dose of intervention after
hospitalization. This intervention is designed to work within the existing Medicare system
and has potential for immediate clinical impact.
Purpose: The primary aim of our study is to determine if a progressive multi-component (PMC)
intervention, initiated upon discharge from an acute care hospital, improves gait speed at
the end of one 60-day episode of care, more than documented usual care (UC) physical
therapy. We hypothesize that there will be a greater improvement in gait speed measured for
the PMC group compared to the UC group following one episode of care. Benefits of PMC will
be apparent at the end of usual care and will increase further at the end of the 60 day
episode of care (primary endpoint).
Design: We propose to conduct a single blind randomized two arm clinical trial (RCT) in
older adults discharged from acute care and referred to HH physical therapy. Both
interventions (PMC & UC) will be Medicare-reimbursed. All assessments and interventions will
occur in the patients' homes.
Methods: Twenty individuals who are 65 years of age or older with multiple co-morbid
conditions will be enrolled.
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