scholarly journals Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community

2016 ◽  
Vol 96 (8) ◽  
pp. 1125-1134 ◽  
Author(s):  
Jason R. Falvey ◽  
Robert E. Burke ◽  
Daniel Malone ◽  
Kyle J. Ridgeway ◽  
Beth M. McManus ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Hospital Readmission ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Hospital Readmissions ◽  
Functional Decline ◽  
Care Transitions ◽  
Models Of Care ◽  
Therapy Interventions

AbstractHospital readmissions in older adult populations are an emerging quality indicator for acute care hospitals. Recent evidence has linked functional decline during and after hospitalization with an elevated risk of hospital readmission. However, models of care that have been developed to reduce hospital readmission rates do not adequately address functional deficits. Physical therapists, as experts in optimizing physical function, have a strong opportunity to contribute meaningfully to care transition models and demonstrate the value of physical therapy interventions in reducing readmissions. Thus, the purposes of this perspective article are: (1) to describe the need for physical therapist input during care transitions for older adults and (2) to outline strategies for expanding physical therapy participation in care transitions for older adults, with an overall goal of reducing avoidable 30-day hospital readmissions.

scholarly journals Interventions Used by Physical Therapists in Home Care for People After Hip Fracture

2008 ◽  
Vol 88 (2) ◽  
pp. 199-210 ◽  
Author(s):  
Kathleen Kline Mangione ◽  
Rosalie B Lopopolo ◽  
Nancy P Neff ◽  
Rebecca L Craik ◽  
Kerstin M Palombaro
Keyword(s):  
Hip Fracture ◽  
Physical Therapy ◽  
Home Care ◽  
Usual Care ◽  
Management Practices ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Balance Training ◽  
Gait Training ◽  
Therapy Interventions

Background and PurposeThe majority of older people who survive a hip fracture have residual mobility disabilities. Any attempt to systematically reduce mobility disabilities after hip fracture, however, requires knowledge of the adequacy of current management practices. Therefore, the purpose of this study was to begin to understand the nature of physical therapy home care management by describing “usual care” for people after hip fracture.Subjects and MethodsIn 2003 and 2004, a national survey was conducted of all members of the American Physical Therapy Association who identified home care as their primary practice setting (n=3,130). “Usual care” was operationally defined as when more than 50% of respondents reported that they “always” or “often” use a specific intervention.ResultsSurvey questionnaires (1,029) were returned with a response rate of 32.9%. Functional training activities, including bed mobility, transfer and gait training, balance training, safety training, and patient education, were reported very frequently. Active-range-of-motion exercises were performed much more frequently than exercises involving added resistance.Discussion and ConclusionThis study provides a detailed description of the physical therapy interventions provided in the home care setting for patients after hip fracture. The sample size and national representation increase our confidence that this description accurately depicts physical therapist practice.

The Process of Creating and Disseminating Exercise Programs by Physical Therapists for Older Adults With Chronic Back Pain

2020 ◽  
Author(s):  
Melissa E Hay ◽  
Denise M Connelly
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Physical Therapy ◽  
Data Collection ◽  
Chronic Back Pain ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Clinical Practices ◽  
Exercise Programs ◽  
Care Clinic

Abstract Objective The purpose of this study was to enhance the understanding of the process that physical therapists undertake when creating and disseminating exercise programs for older adults with chronic back pain. Methods Constructivist grounded theory methodology was used as an accessible mode of researching pragmatic clinical practices. Physical therapists from outpatient, ambulatory care clinic settings participated in in-depth, individual interviews (n = 9) and in-clinic observations (n = 5). Data collection and analysis were iterative processes. Codes were generated based on recurrent themes, and constant comparative analysis was used to compare data. Analysis and data collection were concluded when theoretical sufficiency was reached. Results Physical therapist participants described the process of creating and implementing exercise plans as involving listening to the patient’s story, determining function, physical therapy care, supported integration, and, ultimately, returning back to living and life with chronic back pain. Participants worked through the 5 phases at different rates, often recurrently, when treating older adults with chronic back pain. The phases are positioned within a shared alliance between physiotherapy provider and patient, with a transfer of responsibility occurring throughout treatment and follow-up sessions, progressing toward patient independence. This transfer of responsibility served as the core category for the process herein. Conclusions This research highlights the importance of listening to patients’ stories when engaging in physical therapy care. Focusing on function, providing education and exercise as components of care, and supporting integration of exercise into everyday life are considerations for providing care for older adults with chronic back pain in physical therapist practice, and, ultimately, for returning to life. Impact With aging populations and with the increasing prevalence of chronic conditions, this research offers insight into a process for physical therapists to enact exercise engagement for improved health and quality of life for older adults with chronic back pain.

scholarly journals Preliminary Examination of a Proposed Treatment-Based Classification System for Patients Receiving Physical Therapy Interventions for Neck Pain

2007 ◽  
Vol 87 (5) ◽  
pp. 513-524 ◽  
Author(s):  
Julie M Fritz ◽  
Gerard P Brennan
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Classification System ◽  
Interrater Reliability ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Neck Disability Index ◽  
Mean Difference ◽  
Classification Methods ◽  
Therapy Interventions

Background and PurposeNeck pain frequently is managed by physical therapists. The development of classification methods for matching interventions to subgroups of patients may improve clinical outcomes. The purpose of this study was to describe a proposed classification system for patients with neck pain by examining data for consecutive patients receiving physical therapy interventions.Subjects and MethodsStandardized methods for collecting baseline and intervention data were used for all patients receiving physical therapy interventions for neck pain over 1 year. Outcome variables were the Neck Disability Index (NDI), numeric pain rating, and number of visits. Treatment was provided at the discretion of the physical therapist. After the completion of treatment, each patient was classified by use of baseline variables. The interventions received by the patient were categorized as being matched or not matched to the classification. Outcomes for patients who received matched interventions were compared with those for patients who received nonmatched interventions. The interrater reliability of the classification algorithm was examined with a subset of 50 patients.ResultsA total of 274 patients were included in this study (74% women; age [X̄±SD]=44.4±16.0 years). The most common classification was centralization (34.7%); next were exercise and conditioning (32.8%) and mobility (17.5%). The interrater reliability for classification decisions was high (kappa=.95, 95% confidence interval [CI]=0.87–1.0). A total of 113 patients (41.2%) received interventions matched to the classification. Receiving matched interventions was associated with greater improvements in the NDI (mean difference=5.6 points, 95% CI=2.6–8.6) and in pain ratings (mean difference=0.74 point, 95% CI=0.21–1.3) than receiving nonmatched interventions.Discussion and ConclusionThe development of classification methods for patients with neck pain may improve the outcomes of physical therapy intervention. This study was done to examine a previously proposed classification system for patients receiving physical therapy interventions for neck pain. Receiving interventions matched to the classification system was associated with better outcomes than receiving nonmatched interventions. Although the design of this study prohibited drawing conclusions about the effectiveness of the system, the results suggest that further research on the system may be warranted.

scholarly journals Effect of Physical Therapy on Fall-Risk and Physical Status in Older Adults with Frailty and Metabolic Syndrome

2020 ◽  
Vol 5 (6) ◽  
pp. 282-291
Author(s):  
N. P. Koval ◽  
◽  
M. G. Aravitska
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Fall Risk ◽  
Physical Therapist ◽  
Main Group ◽  
Frailty Syndrome ◽  
Physical Status

The constant increase in the proportion of the disabled or partially disabled elderly population and, accordingly, patients of this age contingent, leads to the need for rehabilitation and physical therapy of persons with geriatric syndromes and various comorbid pathologies. The purpose of the study was to determine the effectiveness of a physical therapy program based on the dynamics of indicators of the fall-risk and physical status in older adults with frailty syndrome and metabolic syndrome. Material and methods. 96 older adults were examined. The control group consisted of persons without metabolic syndrome and without frailty syndrome. The main group 1 consisted of persons with metabolic syndrome and frailty syndrome who did not express a desire to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations on the WHO CINDI program (diet modification, extension of household and training physical activity). Main group 2 included patients who showed consent to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). We developed a physical therapy program for them using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for one year. The dynamics of the state was assessed according to the results of the Short Physical Performance Battery, hand dynamometry, Senior Fitness Test, the Berg Balance Scale. Results and discussion. Older adults with metabolic syndrome and frailty syndrome demonstrated a high fall-risk (according to the results of a Short battery of physical activity tests and the Berg scale) and a statistically significant lag in physical status parameters (coordination, balance, strength, flexibility, endurance, agility) according to the parameters of the Senior Fitness Test, hand dynamometry, Short battery of physical activity tests) from their peers. These results increase the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in main group 1 subjects led to a statistically significant (р<0.05) improvement in physical qualities, a decrease in the intensity of frailty signs; leveling the fall-risk in them. The low level of therapeutic alliance of persons in the main group 2 led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided and is associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology of frailty and metabolic syndrome

scholarly journals Trajectories of Hospital Readmission After A Fall Injury for Older Adults Living in Aged Care or The Community

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Rebecca Mitchell ◽  
Brian Draper ◽  
Jacqueline Close ◽  
Lara Harvey ◽  
Henry Brodaty ◽  
...  
Keyword(s):  
Older Adults ◽  
Hospital Readmission ◽  
Hospital Admissions ◽  
Group Membership ◽  
Hospital Readmissions ◽  
Care Facility ◽  
Aged Care ◽  
Community Living ◽  
Fall Injury ◽  
Trajectory Group

IntroductionFall injuries are one of the leading causes of hospitalisation for adults aged ≥65 years. Distinguishing key characteristics of older adults who are either living in aged care or in the community who have multiple hospital readmissions after a fall injury may inform targeted approaches to the prevention of hospital readmissions. Objectives and ApproachTo examine trajectories of hospital readmission of older adults living in aged care or the community after a fall injury hospitalisation and to identify factors predictive of trajectory group membership. A group-based trajectory analysis of hospital readmissions of adults aged ≥65 years who had a fall injury hospitalisation during 2008-09 in New South Wales, Australia was conducted. Linked hospitalisation and aged care data were examined for a 5 year period to 2013. Group-based trajectory models were derived based on number of subsequent readmissions following the index admission. Multinominal logistic regression examined predictors of trajectory group membership. ResultsThere were 24,729 fall injury hospitalisations; 78.8% of fallers were living in the community and 21.2% in aged care. Five distinct trajectory groups were identified for community-living (i.e. Moderate-declining, Chronic, Low-constant, Low-declining, and High users) and four trajectory groups for aged care residents (i.e. Low, Moderate-declining, Moderate-chronic, and High users). Key predictors of trajectory group membership for both community-living and aged care residents were age group, number of comorbidities, and dementia status. For aged care residents, depression, assistance with activities of daily living, and number of subsequent fall injury admissions were also predictors of group membership, with time to move to an aged care facility a predictor of group membership for community-living. Conclusion / ImplicationsIdentifying trajectories of ongoing hospital use informs targeting of strategies to reduce hospital admissions and design of services to allow community-living individuals to remain as long as possible within their own residence.

scholarly journals Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

2016 ◽  
Vol 13 ◽  
pp. 35 ◽  
Author(s):  
Jennifer C. Reneker ◽  
Kyra Weems ◽  
Vincent Scaia
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Student Perceptions ◽  
Geriatric Patients ◽  
Physical Therapist ◽  
The United States ◽  
Community Dwelling ◽  
Effect Sizes ◽  
Entry Level ◽  
Geriatric Education

This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen’s d-values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15–0.30). Two perceptions of geriatric physical therapy demonstrated a significant positive increase (P<0.05) with moderate effect sizes (d=0.47 and d=0.50). The students’ perceptions of geriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68) and enjoyment (d=1.96). Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

scholarly journals Patient Participation in Physical Therapy Goal Setting

2001 ◽  
Vol 81 (5) ◽  
pp. 1118-1126 ◽  
Author(s):  
Susan M Baker ◽  
Helen H Marshak ◽  
Gail T Rice ◽  
Grenith J Zimmerman
Keyword(s):  
Patient Satisfaction ◽  
Physical Therapy ◽  
Elderly Patients ◽  
Goal Setting ◽  
Patient Participation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Assessment Instrument ◽  
Initial Examination ◽  
Goals And Objectives

Abstract Background and Purpose. An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. Subjects and Methods. Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (X̄=76.4 years of age, SD=7.1, range=65–94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. Results. Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. Discussion and Conclusion. In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

Contributions of Non-professional Local Physical Therapist In the Promotion of Community Health Activities in the Arsi Zone, Southeast Ethiopia (Preprint)

2021 ◽  
Author(s):  
Leta Melaku
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Arsi Zone ◽  
Southeast Ethiopia ◽  
The Impact

BACKGROUND Physical activity is a first-line therapy and secures against persistent illnesses. Essential medical care professionals are obviously situated to advance actual action. Active recuperation mediations focused on advancement and upkeep of wellbeing, personal satisfaction, and wellness. There is, notwithstanding, a deficiency of such examination proof in Ethiopia. OBJECTIVE We planned to assess the degree of KAP of nonprofessional local physical therapists' towards wellbeing advancement in Arsi zone of Oromia, Southeast Ethiopia. METHODS Community based cross sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pre-tested, structured and self-administrative questionnaires. Participants were selected by quota sampling technique. The questionnaire was drafted specifically to test the KAP. Data were double entered and analyzed by SPSS Version 20.0 program. Descriptive statistics were used. The KAP were estimated using proportion. RESULTS In present response rate is 90.0%. Ages of respondents ranged between 24 – 87 years. 57.8% of participants got initial physical therapy knowledge from either of their parents. 53.3% of the respondents hear about health promotion from families and friends. 57.8% of them provided health promotion at their workplace. The overall percentage of all the respondents’ KAP in health promotion was 60.1%. CONCLUSIONS The respondents’ have good KAP towards health promotion. However there is still room for improvement. Also there is a lack of proper guide lines in determining the impact physical therapy.

Awareness and Perception of Physical Therapy Education, Role in Patient Management and Health Promotion Held by Senior Medical Practitioners

2020 ◽  
pp. 13-17
Author(s):  
OJS Admin
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Well Being ◽  
Physical Therapy Education ◽  
Health Providers ◽  
Medical Practitioners ◽  
Therapy Education

Physical therapists are integral part of health care system. In collaboration with other health providers, physical therapist can play an effective role in patient handling and well-being of individuals. The awareness and perception of senior medical practitioners is less known regarding physical therapy education, role in patient management and health promotion.

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