Outcome of Rehabilitation of Older People in Primary Health Care

Overview

The Outcome of Multi-Disciplinary, Structured Rehabilitation of Older People in a District Inpatient Rehabilitation Centre is better than in a Standard Primary Health Care Rehabilitation Programme in Short Term Beds in Nursing Homes.

Full Title of Study: “Outcome of Multi-Disciplinary, Structured Rehabilitation of Older People in an Inpatient District Rehabilitation Centre Versus Standard Primary Health Care Rehabilitation – An Open Comparative Observational Stdy”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: April 2009

Interventions

  • Other: Rehabilitation
    • Model 1: Regular Assessment of Rehabilitation Goal, Rehabilitation Plan, Weekly Multi-Disciplinary Evaluation and Adjustment of Plan, Regular use of Measurement Scales, Regular Dialog between Personnel, Patient and Relatives. Model 2: More Occasional use of the Listed Activities. Model 1 and Model 2: Physical Training and Functional ADL Training, in Groups, One by One or Self-Training.

Arms, Groups and Cohorts

  • District Rehabilitation Centre (Model 1)
    • Patients admitted to Primary Health Care Rehabilitation, either Post-Acute from the Same District General Hospital or Directly from their Homes. They were recruited continuously at Entrance to the Rehabilitation Centre.
  • Standard PHC Rehabilitation (Model 2)
    • Patients admitted to Standard Primary Health Care (PHC) Rehabilitation, either Post-Acute from the Same District General Hospital or Directly from their Homes. They were recruited Continuously at Entrance to the Short Term Rehabilitation Beds in Nursing Homes or at the Beginning of Rehabilitation in their Own Homes.

Clinical Trial Outcome Measures

Primary Measures

  • Change in Sunnaas ADL Index
    • Time Frame: Change from Baseline in Sunnaas ADL Index at End of Rehabilitation. Change from End of Rehabilitation in Sunnaas ADL Index at 3 months. Change from End of Rehabilitation in Sunnaas ADL Index at 18 Months
    • Sunnaas ADL Index measures 12 Activities of Daily Life. Each Activity has a Score from 0-3, where 0=totally dependent and 3=independent. The Total Max Score of 36 means Totally Independent.

Secondary Measures

  • Change in Umea Life Satisfaction Checklist
    • Time Frame: Change from End of Rehabilitation in Umea Life Satisfaction Checklist at 3 Months after Rehabilitation.
    • A Simple and Validated Questionnaire, testing Life Satisfaction. We chose Two of the Questions: LSCa: How satisfied are you with your Life in general? LSCb: How satisfied are you with your Ability to manage your Self-Care? The Scores are 1-3=not satisfied and 4-6=satisfied
  • Mini Mental Status Evaluation=MMSE
    • Time Frame: MMSE Recorded Two Weeks into Rehabilitation
    • MMSE measures Cognitive Function. Scores are from 0-30, where 30 indicates no Cognitive Problems.
  • Symptom Check List 10=SCL10
    • Time Frame: SCL10 recorded at two Weeks into Rehabilitation
    • SCL10 is a Questionnaire mapping Emotional Health during the Previous Week, particularly Anxiety and Depression. SCL-10 comprises Ten Questions with Scores from 1-4. The Final Score is the Total Score sum divided by Ten. Scores>1.85 indicate Severe Emotional Problems
  • Home Care Services
    • Time Frame: Change from End of Rehabilitation in Home Care Services at Three Months after Rehabilitation
    • The care scores were: 1:0 hour/week, 2:>0-3 hours/week, 3:>3-6 hours/week, 4:>6-9 hours/week, and 5:>9 hours/week.
  • Informal Care from Relatives
    • Time Frame: Change in Informal Care from relatives from End of Rehabilitation at Three Months after Rehabilitation
    • Care Scores: 1:0 Hour/Week, 2:>0-3 Hours/Week, 3:>3-6 Hours/Week, 4:>6-9 Hours/Week, and 5:>9 Hours/Week.

Participating in This Clinical Trial

Inclusion Criteria

  • Both Genders
  • Age=>65 Years
  • Diagnoses: Stroke, Hip Fractures, Osteoarthritis, Chronic, slowly progressing Diseases, Functional Decline due to Old Age, Functional Decline due to Long Hospital Stay
  • Assessed to have a Rehabilitation Potential

Exclusion Criteria

  • Age<65 Years
  • Patietns with Highly Progressive Diseases
  • Sunnaas ADL Index<10
  • MMSE<18
  • Deeply Depressed Patients with no Initiative
  • Patients with Speech Dyspnoea
  • Patients with unstable Angina Pectoris
  • Patients with not diagnosed Cardiac Arrythmias

Gender Eligibility: All

Minimum Age: 65 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Oslo
  • Collaborator
    • Norwegian Medical Association
  • Provider of Information About this Clinical Study
    • Principal Investigator: Inger Johansen, MD, PhD-student – University of Oslo
  • Overall Official(s)
    • Inger Johansen, MD, Principal Investigator, University of Oslo
    • Mette Brekke, MD, PhD, Study Chair, University of Oslo

Citations Reporting on Results

Johansen I, Lindbaek M, Stanghelle JK, Brekke M. Effective rehabilitation of older people in a district rehabilitation centre. J Rehabil Med. 2011 Apr;43(5):461-4. doi: 10.2340/16501977-0792.

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