Research Report Abstracts - Gesundheit

eS850
assess the impact of PT intervention on functional outcomes
and quality of life.
Participants: 164 consecutive hospice admissions occurring
in a one year period were screened in interdisciplinary
hospice team meetings which were attended by a physical
therapist. Inclusion criteria included being over age 21, any
hospice diagnosis in which patients could communicate, not
actively dying at admission, and patient interest in PT assessment
during the initial meeting with the nurse case manager.
Methods: PT and Nurse investigators attended weekly hospice
team meetings to identify appropriate patients for
physical therapy intervention. PT patient assessments were
conducted during the first week of admission. The Patient
Specific Functional Scale (PSFS) was used as an outcome
measure. Final PT assessments were completed at the end of
PT intervention.
Analysis: Frequencies, means and ranges were tabulated for
ratio data (age) of the subject pool. Other demographic and
data was numerically coded for tabulation of ranges, means
and frequencies. A minimal detectable change (at a 90%
confidence interval) on the PSFS is either a 2 point change
in the total score or a 3 point change in a single activity
score. The PSFS has demonstrated excellent test–retest reliability
and sensitivity to change with an intra-class correlation
coefficient of R = .84 and a Pearson’s r = .78, respectively.
Results: Of the 164 patients screened, 47 (28.6%) met
the inclusion criteria and were referred to PT. Twenty-six
received a PT consult and intervention and twelve were able
to complete both pre-post PT intervention PSFS assessments.
Each of the 12 subjects made a clinically significant change
in a least one area, including functional outcomes, relaxation
and stress reduction, improved sleep quality, edema control,
family education, and equipment modification.
Conclusions: The participation of a physical therapist on the
hospice team resulted in a 20% increase in PT referrals in a
one year period. Patients who received PT intervention made
a clinically significant change in areas related to function,
comfort and family education.
Implications: This study provides support for the value
of physical therapy participation on the hospice team to
advocate for patients who can benefit from their services.
Furthermore, this study provides support for the value of PT
intervention on outcomes related to function and comfort in
the hospice setting.
Keywords: Physical therapy; Hospice and palliative care;
Functional outcomes
Funding acknowledgements: This study was supported by
the 2008 American Physical Therapy Association Oncology
Section Clinical Research Award.
Ethics approval: This project was approved by the Institutional
Review Board for Human Subjects Research at
Northern Arizona University, Flagstaff, Arizona, USA.
Research Report Poster Display
Number: RR-PO-312-7-Tue Tuesday 21 June 13:00
RAI: Exhibit Halls2&3
FALL RISK IN COGNITIVELY IMPAIRED OLDER
ADULTS: THE VALUE OF GAIT ASSESSMENT
UNDER DUAL TASK TEST CHALLENGES
Muir S. 1 , Speechley M. 2 , Borrie M. 1,3 , Wells J. 3 , Montero
Odasso M. 3,4
1University of Western Ontario, Medicine, London, Canada,
2University of Western Ontario, Epidemiology & Biostatistics,
London, Canada, 3Parkwood Hospital, Geriatric
Medicine, London, Canada, 4University of Western Ontario,
Medicine, Epidemiology & Biostatistics, London, Canada
Purpose: Falls in older adults are a major public health concern
and are twice as prevalent in cognitively impaired older
adults. Recommendations for the best screening method of
people with cognitive impairment or no recent fall history
are limited. Cognitive function plays a key role in the regulation
of gait and the use of dual-tasks (“walking while
talking”), may be a sensitive method to identify early gait
impairments. The objective was to characterize the risk of
falling among older adults with different cognitive states and
no recent history of falls.
Relevance: Many key modifiable fall risk factors; strength,
balance, and gait are within the clinical domain of physiotherapy.
Physiotherapy has a prominent role in the screening,
assessment, treatment and prevention of falls in older adults.
Participants: 19 people with Alzheimer disease (AD) [mean
age = 77.2 years, 58% women], 18 people with Mild Cognitive
Impairment (MCI) [mean age = 72.5 years, 56% women]
from the Memory Clinic at University of Western Ontario and
16 normal controls [mean age = 70.8 years, 94% women].
Methods: Cross-sectional study. Gait variables were
assessed under single (usual walking) and dual-tasks (naming
animals and subtracting serials sevens), using the GAITRite ®
System, an electronic walkway. Gait velocity, stride time and
gait variability were recorded.
Analysis: Two-way repeated measures ANOVA adjusted for
age was conducted to assess the main effects of group and
walking test and the interaction (group × walking test). A
post hoc Tukey test was used to determine significant pair
associations.
Results: Changes between groups under the single-task conditions
were not clinically relevant (