Assembling a Toolkit to Measure Geriatric Rehabilitation Outcomes

Background/Aims: The novel coronavirus SARS-CoV-2 is the cause of an ongoing pandemic. The highest mortality rate is observed among the older adult population. During the first wave of the pandemic (March–June 2020), following a national health decree demanding that no visitors or family members be allowed in health institutions, our geriatric rehabilitation center closed gates to all visitors from the outside. We aimed to assess the rehabilitation outcomes of older patients with hip fractures in the first pandemic wave, who underwent rehabilitation under complete social isolation from primary care givers and family members. Methods: This was a retrospective cohort study. It took place at a university-affiliated, major postacute geriatric rehabilitation center. Rehabilitation outcomes measured were discharge functional independence measure (FIM) score and motor FIM score, FIM score change, motor FIM score change, favorable motor FIM effectiveness, length of stay, discharge destination, and home aid at discharge. Results: The study group included 36 patients who were admitted during the first wave of the COVID-19 pandemic (March 1, 2020, to June 30, 2020). The control group comprises 106 individuals with hip fractures who were admitted in the respective time periods during the previous 2 years, that is, March 1, 2018, to June 30, 2018, and March 1, 2019, to June 30, 2019. The facility’s occupancy rates were much lower during the first wave of the pandemic in comparison with previous years (78 and 99%, respectively). Patients showed similar demographics and comorbidities, but the social isolation group was more severely deconditioned upon admission. All rehabilitation outcomes were similar between groups. Conclusion: According to the findings of this retrospective study, social isolation from family and caregivers did not have a detrimental effect on the rehabilitation outcomes of these patients. More evidence must be gathered and presented on the matter.

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Development of a conceptual framework for the assessment of geriatric rehabilitation outcomes

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2003.10.003 ◽

2004 ◽

Vol 38 (3) ◽

pp. 221-237 ◽

Cited By ~ 18

Author(s):

Louise Demers ◽

Bernadette Ska ◽

Johanne Desrosiers ◽

Caroline Alix ◽

Christina Wolfson

Keyword(s):

Conceptual Framework ◽

Geriatric Rehabilitation ◽

Rehabilitation Outcomes

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Applicability of a toolkit for geriatric rehabilitation outcomes

Disability and Rehabilitation ◽

10.1080/09638280600731540 ◽

2007 ◽

Vol 29 (2) ◽

pp. 97-109 ◽

Cited By ~ 6

Author(s):

Claudine Auger ◽

Louise Demers ◽

Johanne Desrosiers ◽

Francine Giroux ◽

Bernadette Ska ◽

...

Keyword(s):

Geriatric Rehabilitation ◽

Rehabilitation Outcomes

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EHealth in geriatric rehabilitation: a systematic review of effectiveness, feasibility and usability (Preprint)

10.2196/preprints.24015 ◽

2020 ◽

Author(s):

Jules Jaques Marie Kraaijkamp ◽

Eléonore F van Dam van Isselt ◽

Anke Persoon ◽

Anke Versluis ◽

Niels H. Chavannes ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Mixed Methods ◽

Older Patients ◽

Current Evidence ◽

Geriatric Rehabilitation ◽

Control Group ◽

Successful Implementation ◽

Rehabilitation Outcomes ◽

Ehealth Intervention

BACKGROUND eHealth has the potential to improve outcomes in older adults receiving geriatric rehabilitation. However, evidence on (cost)effectiveness in post-acute geriatric rehabilitation is scarce, and the successful implementation and use of eHealth in geriatric rehabilitation is not self-evident. OBJECTIVE The aim of this systematic review is to assess the effectiveness, usability and feasibility of eHealth interventions in older adults in geriatric rehabilitation. METHODS Seven databases were searched for randomized controlled trials, non-randomized studies, quantitative descriptive studies, qualitative research and mixed methods studies that applied eHealth interventions during geriatric rehabilitation. Included studies investigated effectiveness, usability and/or feasibility of eHealth in older patients with a mean age of ≥70 who received geriatric rehabilitation. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and a narrative synthesis was conducted using a Harvest plot. RESULTS In total 34 were selected, with clinical heterogeneity across studies, and high exclusion rates reported in 7studies. Outcomes related to participation and usability were infrequently reported. In 16 studies eHealth was found to be at least as effective as non-eHealth interventions (73% of the included studies with a control group), 6 studies found eHealth interventions to be more effective than non-eHealth interventions (27%), and 2 studies reported beneficial outcomes in favor of the non-eHealth interventions (9%). Overall, the identified studies showed that eHealth is often feasible and can potentially improve rehabilitation outcomes, especially in combination with another (non)eHealth intervention. Simple eHealth interventions were more likely to be feasible for older patients receiving geriatric rehabilitation. CONCLUSIONS Current evidence on eHealth in older patients receiving geriatric rehabilitation is diverse, making it challenging to compare outcomes and draw conclusions. Furthermore, a lack of evidence on usability might hamper the implementation of eHealth. eHealth applications in geriatric rehabilitation show promise but more research is required, including research with a focus on usability and participation

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Association of anemia with rehabilitation outcomes for subacute geriatric rehabilitation patients in a secondary hospital in malaysia

Aging Pathobiology and Therapeutics ◽

10.31491/apt.2021.12.68 ◽

2021 ◽

Vol 3 (4) ◽

Author(s):

Mann Leon Chin ◽

Keyword(s):

Barthel Index ◽

Elderly Population ◽

Geriatric Rehabilitation ◽

Simple Linear Regression ◽

Barthel Index Score ◽

Clinical Frailty Scale ◽

P Values ◽

Rehabilitation Outcomes ◽

Comorbidity Index ◽

Secondary Hospital

Background: To evaluate the effects of anemia on rehabilitation outcomes for geriatric subjects in the Taiping Hospital subacute geriatric rehabilitation ward. Methods: This was a retrospective study with 126 subjects that compared the change in the modified Barthel Index score of anemic and non-anemic subjects. Results: In the study, 43.7% of subjects were anemic. Among anemic subjects, 45.5% were Malay, 38.2% were Chinese, 14.5% were Indian, and 1% were others. The median (Interquartile (IQR)) modified Barthel Index (MBI) on admission for anemic and non-anemic subjects was insignificantly different, at 47 (29, 63) and 36 (21, 59), respectively (P = 0.059). The median (IQR) of MBI improvement for non-anemic subjects was found to be significantly higher than for anemic subjects, which were 14 (5, 26) and 8 (1, 18; P = 0.021). Subjects with hemoglobin (hb) ≥ 9 g/dL were significantly associated with MBI improvement of more than 20, P = 0.009. Simple linear regression found that the P-values were not significant for albumin, creatinine, the Charlson comorbidity index, or the clinical frailty scale; hence, they were not significantly associated with rehabilitation outcome. Conclusions: The study suggested that non-anemic subjects showed significant MBI improvement. Our study also suggested that judicious practices to target a hb threshold of 9 g/dL might be able to improve a subject’s functional outcome. These results should encourage further research with a larger elderly population to provide insights and awareness for the need to treat anemia in rehabilitation subjects. Keywords: Geriatric, anemia, rehabilitation, modified barthel index

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