Evaluation of an Outpatient Rehabilitative Program to Address Mobility Limitations Among Older Adults.
Evaluation of an Outpatient Rehabilitative Program to Address Mobility Limitations Among Older Adults.
复制标题
评估门诊康复计划，以解决老年人的流动性限制。
DOI：
10.1097/phm.0000000000000682
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发表时间：
2017-08
影响因子：
3
通讯作者：
Bean JF
中科院分区：
文献类型：
--
作者：
Brown LG;Ni M;Schmidt CT;Bean JF
补充数字内容可在文本中找到。Live Long Walk Strong是一个针对社区老年患者的临床示范项目。它的设计符合当前的跌倒预防指南，并根据医疗保险模式报销。在初级保健中对患者进行筛选，并将其转诊给理疗师，然后在门诊康复护理环境中进行系统评估和治疗。治疗包括行为矫正、跌倒预防教育、社区/家庭锻炼整合以及针对力量、力量、柔韧性、平衡和耐力的锻炼。根据基线表现、临床判断和患者偏好，治疗持续时间和频率因患者而异。分别通过评估参与度和身体表现的变化来评估计划的可行性和初步有效性。共有266名患者被转介到该计划，147人愿意参加。其中，116例患者完成了所有计划访视（10.8 ± 3.9次访视）。未完成者（n = 31）在过去6个月内的福尔斯发生率较高，基线短期身体机能成套测验综合评分较低。在治疗结束时，短体力活动成套测验的校正平均变化为1.66个单位，超过了具有临床意义的较大阈值（1个单位）。Live Long Walk Strong计划似乎是可行的，并在提高老年人的流动性方面表现出初步的有效性。
Supplemental digital content is available in the text. Live Long Walk Strong is a clinical demonstration program for community-dwelling older patients. It was designed to be consistent with current fall prevention guidelines and reimbursed under the Medicare model. Patients were screened within primary care and referred to a physiatrist followed by systematic assessment and treatment within an outpatient rehabilitative care setting. The treatment included behavioral modification, fall prevention education, community/home exercise integration, and exercise targeting strength, power, flexibility, balance, and endurance. Treatment duration and frequency varied with each patient based on baseline presentation, clinical judgment, and patient preference. Program feasibility and preliminary effectiveness were evaluated by assessing participation and changes in physical performance, respectively. There were 266 patients referred to the program, and 147 were willing to participate. Of these, 116 patients completed all scheduled visits (10.8 ± 3.9 visits). The noncompleters (n = 31) had a higher rate of falls in the previous 6 months and lower baseline Short Physical Performance Battery composite score. At the completion of care, the adjusted mean change in Short Physical Performance Battery was 1.66 units, surpassing a large clinically meaningful threshold (1 unit). The Live Long Walk Strong program appears to be feasible to implement and demonstrates preliminary effectiveness in enhancing mobility among older adults.