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AHRQ Research Studies Date
Topics
- Back Health and Pain (1)
- Brain Injury (1)
- Cardiovascular Conditions (5)
- Care Management (1)
- Case Study (1)
- Chronic Conditions (3)
- COVID-19 (1)
- Disabilities (1)
- Elderly (3)
- Evidence-Based Practice (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
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- Heart Disease and Health (2)
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- Nursing Homes (1)
- Orthopedics (3)
- Outcomes (3)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- (-) Rehabilitation (15)
- Respiratory Conditions (1)
- Risk (1)
- Screening (1)
- Sex Factors (1)
- Stroke (4)
- Surgery (2)
- Telehealth (1)
- Transitions of Care (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedBell KM, Onyeukwu C, Smith CN
A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study.
The authors have developed and previously validated the accuracy of a remote (wearable) rehabilitation monitoring platform (interACTION). The present study's objective was to assess the feasibility of utilizing interACTION for the remote management of rehabilitation after total knee replacement (TKR) and to determine a preliminary estimate of the effects of the interACTION system on the value of rehabilitation. Findings showed that all patients and physical therapists in the interACTION Group indicated that they would use the system again in the future. Therefore, the next steps are to address the concerns identified in this pilot study and to expand the platform to include behavioral change strategies prior to conducting a full-scale randomized controlled trial.
Citation: Bell KM, Onyeukwu C, Smith CN .
A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study.
Sensors 2020 Oct 27;20(21). doi: 10.3390/s20216118..
Keywords: Orthopedics, Rehabilitation, Health Information Technology (HIT)
Hsieh CJ, DeJong G, Vita M
AHRQ Author: Hsieh CJ
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
Researchers compared post-total knee arthroplasty (TKA) functional mobility outcomes among 3 newly-developed physical therapy protocols with a standard-of-care post-TKA rehabilitation protocol. They found no statistically or clinically significant differences in outcomes across the 4 study arms (control, treadmill, neuromuscular stimulation device, and combination intervention). As outcomes were similar among arms, they recommended that clinicians instead consider relative cost in tailoring TKA rehabilitation.
AHRQ-authored.
Citation: Hsieh CJ, DeJong G, Vita M .
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
JAMA Netw Open 2020 Sep;3(9):e2016571. doi: 10.1001/jamanetworkopen.2020.16571..
Keywords: Rehabilitation, Orthopedics, Surgery, Outcomes, Evidence-Based Practice
Khan U, Stoff L, Yahuaca JD
Evaluation of an interdisciplinary screening program for people with Parkinson disease and movement disorders.
Researchers described the characteristics of people with Parkinson disease and movement disorders referred by neurologist to a physiatrist-led interdisciplinary rehabilitation screening program. They found that the interdisciplinary rehabilitation screening program was sustained with increased numbers of referrals over time, occurring earlier in the disease in more recent years. Further, key strategies used to sustain the program over time included development of a unique referral order set for the neurologists, implementation of a comprehensive screen tool in the rehabilitation hospital electronic health records, and centralized communication through social workers at both facilities.
AHRQ-funded; HS025077.
Citation: Khan U, Stoff L, Yahuaca JD .
Evaluation of an interdisciplinary screening program for people with Parkinson disease and movement disorders.
Arch Rehabil Res Clin Transl 2020 Sep;2(3):100067. doi: 10.1016/j.arrct.2020.100067..
Keywords: Neurological Disorders, Rehabilitation, Screening
Rundell SD, Resnik L, Heagerty PJ
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
The Functional Comorbidity Index (FCI) is a comorbidity measure associated with physical function and may contribute to risk adjustment models in rehabilitation settings, but an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) of the FCI has not been tested in outpatient settings. The purpose of this cohort study was to examine the ability of an ICD-9-CM- based FCI to predict function, health-related quality of life, and overall health care use.
AHRQ-funded; HS01922201; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
Pm r 2020 Sep;12(9):891-98. doi: 10.1002/pmrj.12315..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Rehabilitation
Keeney T
Physical therapy in the COVID-19 pandemic: forging a paradigm shift for rehabilitation in acute care.
This point-of-view article discusses the importance of physical therapy for COVID-19 survivors in home and community-based settings as well as in post-acute care facilities, concluding that it is necessary to react to new and difficult circumstances with growth and self-advocacy in order to forge a future characterized by intensive skilled rehabilitation services in the inpatient setting, simultaneously benefiting the health care systems and the patient populations.
AHRQ-funded; HS000011.
Citation: Keeney T .
Physical therapy in the COVID-19 pandemic: forging a paradigm shift for rehabilitation in acute care.
Phys Ther 2020 Aug 12;100(8):1265-67. doi: 10.1093/ptj/pzaa097..
Keywords: Rehabilitation, COVID-19, Transitions of Care, Home Healthcare, Healthcare Delivery
Capo-Lugo CE, Askew RL, Muldoon K
Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage.
This study examines the association of time to initiation of acute rehabilitation therapy to increases in disability after intracerebral hemorrhage (ICH), and identifies predictors of time to initiation of rehabilitation therapy. Retrospective data analysis was conducted using ICH patients from a large comprehensive stroke center in a metropolitan area. Disability was assessed using a modified Rankin Scale (mRS) with poor outcome defined as mRS 4-6. There was a median time of 3 days from hospital admission and the first consult by any rehabilitation therapy specialist. Each additional day between admission and initiation of acute rehabilitation therapy was associated with odds of poor outcome at 30 days and at 90 days. Predictors of later initiation of acute rehabilitation therapy included heavy drinking (>5 drinks per day), premorbid mRS<4, presence of pulmonary embolism and longer length of stay in the intensive care unit.
AHRQ-funded; HS024366; HS023437; HS000078.
Citation: Capo-Lugo CE, Askew RL, Muldoon K .
Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage.
Arch Phys Med Rehabil 2020 May;101(5):870-76. doi: 10.1016/j.apmr.2019.11.006..
Keywords: Rehabilitation, Disabilities, Stroke, Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research
Hay CC, Graham JE, Pappadis MR
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
The goal of this retrospective observational study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. Subjects were Medicare fee-for-service beneficiaries discharged from inpatient rehabilitation facilities after a stroke. Results showed that when sociodemographic and clinical factors were controlled, females were more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who lived alone before their stroke had higher odds of discharging at a supervision level or better.
AHRQ-funded; HS022134.
Citation: Hay CC, Graham JE, Pappadis MR .
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
Am J Phys Med Rehabil 2020 Jan;99(1):48-55. doi: 10.1097/phm.0000000000001276..
Keywords: Stroke, Rehabilitation, Elderly, Patient-Centered Outcomes Research, Sex Factors, Cardiovascular Conditions, Outcomes
Rafferty MR, MacDonald J, Byskosh A
Using implementation frameworks to provide proactive physical therapy for people with Parkinson disease: case report.
European clinical practice guidelines recommend physical therapy for people with Parkinson disease (PD) soon after diagnosis to provide education, physical activity advice, and individualized interventions when needed. However, therapy is frequently not used until after gait and balance problems occur. The purpose of this administrative case study was to present the application of a proactive physical therapy (PAPT) approach at 1 rehabilitation center using implementation frameworks to support the (1) implementation process, (2) determinants of implementation success, and (3) implementation evaluation.
AHRQ-funded; HS025077.
Citation: Rafferty MR, MacDonald J, Byskosh A .
Using implementation frameworks to provide proactive physical therapy for people with Parkinson disease: case report.
Phys Ther 2019 Dec 16;99(12):1644-55. doi: 10.1093/ptj/pzz129..
Keywords: Neurological Disorders, Rehabilitation, Case Study
Hong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
This cohort study compared functional status improvements of poststroke patients who either went to an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF). The study used data from Medicare claims for stroke from January 2013 through November 2014. A total of 99,185 patients were studied. Patients admitted to SNFs tended to be older, female, and had a longer hospital length of stay than those admitted to IRFs. Stroke patients admitted to IRFs had larger improvements for mobility score points and for self-care on admission compared with those admitted to SNFs. There was found to be no statistical difference in the odds of 30- to 365-day mortality.
AHRQ-funded; HS024711; HS022134.
Citation: Hong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA .
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
JAMA Netw Open 2019 Dec 2;2(12):e1916646. doi: 10.1001/jamanetworkopen.2019.16646..
Keywords: Stroke, Cardiovascular Conditions, Rehabilitation, Health Status, Hospitalization, Nursing Homes
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Goyal P, Gorodeski EZ, Marcum ZA
Cardiac rehabilitation to optimize medication regimens in heart failure.
This paper discusses the use of cardiac rehabilitation (CR) to optimize medication regimens for older adults with heart failure. Challenges in CR are discussed length and strategies were offered for leveraged CR.
AHRQ-funded; HS022982.
Citation: Goyal P, Gorodeski EZ, Marcum ZA .
Cardiac rehabilitation to optimize medication regimens in heart failure.
Clin Geriatr Med 2019 Nov;35(4):549-60. doi: 10.1016/j.cger.2019.06.001..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Medication, Patient-Centered Healthcare, Patient Adherence/Compliance, Chronic Conditions
Oates GR, Niranjan SJ, Ott C
Adherence to pulmonary rehabilitation in COPD: a qualitative exploration of patient perspectives on barriers and facilitators.
Adherence to pulmonary rehabilitation (PR) is low. This qualitative study used the PRECEDE model to identify predisposing (intrapersonal), reinforcing (interpersonal), and enabling (structural) factors acting as barriers or facilitators of adherence to PR, and elicit recommendations for solutions from patients with chronic obstructive pulmonary disease (COPD). The investigators concluded that health limitations, social support, transportation and financial difficulties, and program features impact ability of patients to attend PR.
AHRQ-funded; HS023009.
Citation: Oates GR, Niranjan SJ, Ott C .
Adherence to pulmonary rehabilitation in COPD: a qualitative exploration of patient perspectives on barriers and facilitators.
J Cardiopulm Rehabil Prev 2019 Sep;39(5):344-49. doi: 10.1097/hcr.0000000000000436..
Keywords: Respiratory Conditions, Rehabilitation, Patient Adherence/Compliance, Chronic Conditions
Vadlamani A, Perry JA, McCunn M
Racial differences in discharge location after a traumatic brain injury among older adults.
The purpose of this retrospective cohort study was to determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center. The authors concluded that in this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites.
AHRQ-funded; HS024560.
Citation: Vadlamani A, Perry JA, McCunn M .
Racial differences in discharge location after a traumatic brain injury among older adults.
Arch Phys Med Rehabil 2019 Sep;100(9):1622-28. doi: 10.1016/j.apmr.2019.03.008.
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Keywords: Racial and Ethnic Minorities, Brain Injury, Trauma, Elderly, Hospital Discharge, Rehabilitation, Medicare
Krishnan S, Hay CC, Pappadis MR
Stroke survivors' perspectives on post-acute rehabilitation options, goals, satisfaction, and transition to home.
This study analyzed stroke survivors’ perspectives on post-acute rehabilitation involvement with their care during discharge planning. Researchers interviewed eighteen stroke survivors who were sent to inpatient rehabilitation facilities after a stroke. They were surveyed about their involvement in decisions made in the selection of their rehabilitation facilities, and more than half were not. About two-thirds of patients were not involved in rehabilitation goal setting. However, most patients were satisfied with their rehabilitation stay.
AHRQ-funded; HS022134; HS024711.
Citation: Krishnan S, Hay CC, Pappadis MR .
Stroke survivors' perspectives on post-acute rehabilitation options, goals, satisfaction, and transition to home.
J Neurol Phys Ther 2019 Jul;43(3):160-67. doi: 10.1097/npt.0000000000000281..
Keywords: Hospital Discharge, Rehabilitation, Stroke, Transitions of Care
Bell KM, Onyeukwu C, McClincy MP
Verification of a portable motion tracking system for remote management of physical rehabilitation of the knee.
The authors of this paper developed a remote rehabilitation management system combining two wireless inertial measurement units (IMUs) with an interactive mobile application and a web-based clinician portal (interACTION). The aim of their study was to verify the accuracy of the IMU-based knee angle measurement system during three common physical therapy exercises, quantify the effect of visual feedback on exercise performance, and understand the qualitative experience of the user interface through survey data.
AHRQ-funded; HS022989.
Citation: Bell KM, Onyeukwu C, McClincy MP .
Verification of a portable motion tracking system for remote management of physical rehabilitation of the knee.
Sensors 2019 Feb 28;19(5). doi: 10.3390/s19051021..
Keywords: Care Management, Health Information Technology (HIT), Orthopedics, Rehabilitation, Telehealth