Dutmer, A.L. (2014) “Scoring the Effort” Effects of exercise therapy duration, frequency, and intensity on measures of ADL, mobility, and balance in early rehabilitation for acute geriatric patients: a pilot study. thesis, Human Movement Sciences.
Full text available on request.Abstract
Objectives: To develop a scoring system that quantifies patient activity in physical (PT) and occupational therapy (OT) in early rehabilitation for acute geriatric patients and to apply it in order to gain information on duration, frequency, and intensity of therapy sessions. To determine the feasibility of providing acute medical patients with regular individualized PT and OT. To investigate patients scores on tests of physical functioning at time of admission and discharge and to analyse whether therapy duration, frequency, and intensity can predict how much patients improve or decline in functional status during hospital stay. Method: Patients were included who were 65 years or older, admitted to the geriatric ward of Klinikum Oldenburg, and enrolled in the early rehabilitation program in the period of March and April 2013. The scoring system was developed after a period of therapy observation by the study researcher and with feedback from physical and occupational therapists, a research assistant of the geriatric ward, and the head physician of the ward. Therapy cancellations were recorded to address program feasibility. The Barthel Index, TUG, and Tinetti Test were used to assess physical functioning at time of admission and discharge. A paired difference test was performed to detect significant differences between test scores and linear regression analyses was performed to analyse whether therapy frequency, intensity, and duration could predict the size of changes in patient test scores on the Barthel Index, TUG, and Tinetti Test between admission and discharge. Results: The scoring system consisted of 8 activity categories with 20 subcategories for PT and 23 for OT. Patients received 21.90 ± 3.90 therapy sessions equally divided between PT and OT and per session 24.08 ± 2.93 minutes were spend exercising. Type of exercises performed per patient varied greatly, but mobility, balance, strength, and ADL exercises were most common 3 and were predominantly performed on a low or medium frequency and intensity level. On average, therapy sessions were cancelled 2.40 ± 2.17 times. Patients improved significantly on the TUG (p < .05) and Tinetti Test (p < .05) at discharge, but not on the Barthel Index. The rate of improvement could not be predicted by frequency, intensity, or duration of therapy. Conclusions: Acute geriatric patients form a heterogenic population in which each individual requires therapy tailored to their specific needs. Providing these patients with regular and individualized therapy is feasible and improves physical functioning during hospital stay. However precise mechanisms behind the ability to improve patients’ physical functioning with an early rehabilitation program are unknown since no relationship between therapy characteristics and outcomes on tests of physical functioning were found.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Lamoth, C.J.C. and Kosse, N.M. and Bauer, J.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 30 Mar 2022 08:30 |
| Last Modified: | 30 Mar 2022 08:30 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3012 |
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