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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 12 of 12 Research Studies Displayed
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.
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.
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.
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.
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.
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.
Keywords: Racial / 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.
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
Luciano A, Meara E
Employment status of people with mental illness: national survey data from 2009 and 2010.
The researchers aimed to describe employment according to mental illness severity in the United States during 2009 and 2010. They found that more severe mental illness was associated with lower employment rates in 2009 and 2010, and they concluded that people with serious mental illness were less likely than people with no, mild, or moderate mental illness to be employed after age 49.
Citation: Luciano A, Meara E . Employment status of people with mental illness: national survey data from 2009 and 2010. Psychiatr Serv 2014 Oct;65(10):1201-9. doi: 10.1176/appi.ps.201300335.
Keywords: Data, Behavioral Health, Rehabilitation
Wang CY, Graham JE, Karmarkar AM
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
A major goal of this study was to identify which discharge functional independence measure (FIM)--total, motor, or cognition--best discriminates community versus institutional discharges. It found that the FIM motor scale yields the best overall discrimination of patients discharged to the community versus those discharged to an institution after inpatient rehabilitation for hip fracture.
Citation: Wang CY, Graham JE, Karmarkar AM . FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture. PM & R : the journal of injury, function, and rehabilitation 2014 Jun;6(6):493-7. doi: 10.1016/j.pmrj.2013.12.008..
Keywords: Hospital Discharge, Rehabilitation, Injuries and Wounds, Elderly
Ottenbacher KJ, Karmarkar A, Graham JE
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
This study sought to determine 30-day readmission rates and factors related to readmission for patients receiving postacute inpatient rehabilitation. It found that among postacute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8 percent to 18.8 percent for selected impairment groups.
Citation: Ottenbacher KJ, Karmarkar A, Graham JE . Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients. JAMA 2014 Feb 12;311(6):604-14. doi: 10.1001/jama.2014.8..
Keywords: Hospital Readmissions, Medicare, Rehabilitation, Elderly, Quality Indicators (QIs)
Stineman MG, Xie D, Kurichi JE
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
The researchers compared outcomes of veteran patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services after acute stroke using propensity scores. They found that comprehensive rehabilitation services are associated with greater recovery of physical and cognitive independence, improved home discharge likelihood, and improved 1 yr. survival.
Citation: Stineman MG, Xie D, Kurichi JE . Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ. J Rehabil Res Dev 2014;51(7):1143-54. doi: 10.1682/jrrd.2014.03.0084..
Keywords: Comparative Effectiveness, Rehabilitation, Stroke, Patient-Centered Outcomes Research, Veterans