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Johansson MM, Nätt M, Peolsson A, Öhman A. Frail community-dwelling older persons' everyday lives and their experiences of rehabilitation - a qualitative study. Scand J Occup Ther 2023; 30:65-75. [PMID: 35786360 DOI: 10.1080/11038128.2022.2093269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The number of older persons with frailty is increasing, and rehabilitation to improve the consequences of frailty are important for both the individual and society. However, the perspective of older persons themselves in research and planning of interventions is scarce. AIM The aim of this study was to describe frail older persons' everyday lives and their experiences and views of rehabilitation. MATERIAL AND METHODS Twenty older persons were interviewed, and analyses were performed using a qualitative content analysis method. RESULTS The two main categories were 'Frailty impacts everyday lifé and 'Experiences and perceptions of rehabilitation'. The participants described that they had to adapt their everyday lives in line with their health conditions. They all used strategies and were dependent on support in their activities of daily living. Their social network had decreased. All participants strived to stay active and independent, and wanted rehabilitation and support from professionals, experiencing decreased access to rehabilitation. CONCLUSIONS AND SIGNIFICANCE Frail older persons are a vulnerable group who often need support in everyday life. There is room for improvement when it comes to helping frail older persons to stay active and facilitate participation in both individual and group interventions.
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Affiliation(s)
- Maria M Johansson
- Department of Activity and Health, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Malin Nätt
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Rehabilitation Medicine in Linköping, and Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden.,Department of Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Unit of Clinical medicine, Linköping University, Linköping, Sweden
| | - Annika Öhman
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational Therapy, Linköping University, Norrköping, Sweden
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2
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Rehabilitation potential: A critical review of its meaning and validity. Clin Rehabil 2022; 37:869-875. [DOI: 10.1177/02692155221147606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The concept of rehabilitation potential emerged in 1950 as a way to select people for rehabilitation; it is also used to limit access to services. Objective To elucidate the meaning(s) of rehabilitation potential and whether it is valid in selecting patients for rehabilitation, whether as an inpatient, outpatient, or in the community. Method A non-systematic review of how it has been used, a structured discussion of its potential meanings, an exploration of the evidence in support of selecting people who might benefit from rehabilitation, and a discussion of the concept of rehabilitation potential. Findings It has been used in several ways with two primary meanings: predicting a person's function at some later time; predicting who will gain additional improvement in outcome from being seen by a rehabilitation service. The concept is flawed because rehabilitation is a process, not a specific action; the effects anticipated after rehabilitation are not restricted to functional improvement; patient characteristics do not determine many essential outcomes. There is no evidence to guide the selection of patients for an assessment and formulation by a rehabilitation team. Conclusion Rehabilitation potential, defined as data that gives the likelihood of additional benefit from receiving input from an expert rehabilitation service, is an illusion lacking any coherent definition, description, or evidence. Its use to limit access to rehabilitation is invalid. The solution is to offer all people not recently seen by an expert multi-professional rehabilitation team a full rehabilitation assessment and formulation, which will reveal what rehabilitation might achieve.
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Inpatient Geriatric Rehabilitation: Definitions and Appropriate Admission Criteria, as Established by Maltese National Experts. J Clin Med 2022; 11:jcm11237230. [PMID: 36498804 PMCID: PMC9736396 DOI: 10.3390/jcm11237230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: The importance of having an appropriate admissions system for geriatric rehabilitation is on the increase. However, the process of admitting patients to inpatient rehabilitation is a complex process. This is yet to be standardised across the European Union, as the approach to geriatric rehabilitation tends to vary from one Member State to another. (2) Objective: To discuss evidence-based practice with clinical experts, in order to define geriatric rehabilitation and admission criteria based on the Maltese population. (3) Method: The study entailed conducting four panel sessions using a purposive sample of thirteen local clinicians with extensive knowledge in clinical rehabilitation and healthcare management. A total of 48 items, based on the literature and clinical experience, were presented to the panel. Data analysis was done quantitatively and qualitatively, using IBM SPSS Statistics Version 24 and thematic analysis. (4) Results: The panel formulated a definition of rehabilitation, which shared common elements with the definition provided by the World Health Organization (WHO) and other sources/literature. The panel agreed on a list of eight criteria for appropriate inpatient geriatric rehabilitation admission in Malta. Consensus was also reached on: the need for a consultant-led multidisciplinary approach to assessment; the adoption of a standardised assessment processes for an equitable chance for all older adults assessed; the benefit of digital health in assessments; and the consideration that most patients would have some form of rehabilitation potential, depending on availability of resources. (5) Conclusion: Inpatient geriatric rehabilitation hospitals should have a unified strategy for rehabilitation services. The conclusions reached by the panel, could be useful in supporting the clinical evidence and establishing future rehabilitation guidelines and standards for inpatient rehabilitation.
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Cowley A, Goldberg SE, Gordon AL, Logan PA. A non-randomised feasibility study of the Rehabilitation Potential Assessment Tool (RePAT) in frail older people in the acute healthcare setting. BMC Geriatr 2022; 22:785. [PMID: 36207681 PMCID: PMC9541000 DOI: 10.1186/s12877-022-03420-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Rehabilitation potential involves predicting who will benefit from rehabilitation. Decisions about rehabilitation potential must take into account personal, clinical and contextual factors, a process which is complicated in the presence of acute ill-health and frailty. This study aimed to evaluate the feasibility and acceptability of the Rehabilitation Potential Assessment Tool (RePAT) – a 15 item holistic, person-centred assessment tool and training package – in the acute hospital setting. Methods A non-randomised feasibility study with nested semi-structured interviews explored whether RePAT was feasible and acceptable. Feasibility was tested by recruiting physiotherapy and occupational therapy participants delivering the RePAT intervention to patients alongside usual clinical care. Acceptability was tested by conducting semi-structured interviews with staff, patient and carer participants. Staff and patient characteristics were analysed using descriptive statistics. Interview data were analysed thematically. Fidelity of completed RePAT items was assessed against a priori criteria on how closely they matched tool guidance by two researchers. Mean values of the two scores were calculated. RePAT content was analysed and supported with verbatim quotes. Results Six staff participants were recruited and trained. They assessed 26 patient participants using RePAT. Mean (SD) patient age was 86.16 (±6.39) years. 32% were vulnerable or mildly frail, 42% moderately frail and 26% severely or very severely frail using the Clinical Frailty Scale. Mean (SD) time to complete RePAT was 32.7 (±9.6) minutes. RePAT fidelity was good where 13 out of 15 items achieved a priori fidelity. RePAT was acceptable and tolerated by staff and patients. Staff participants reported RePAT enabled them to consider rehabilitation decisions in a more structured and consistent way. Patients and carer participants, although unable to comment directly on RePAT, reported being satisfied with their rehabilitation assessments which were found to embrace a person-centred approach. Conclusions RePAT was found to be acceptable and feasible by staff, carers and patients. It allowed clinicians to make explicit their reasoning behind rehabilitation assessments and encouraged them to become more cognisant of factors which affected their clinical decision-making. Trial registration ID ISRCTN31938453. Registered 05/10/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03420-w.
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Affiliation(s)
- Alison Cowley
- Research and Innovation, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham, NG5 1PB, UK. .,Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Adam L Gordon
- Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK.,University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.,NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK
| | - Pip A Logan
- Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK.,Nottingham CityCare Partnership CIC, Nottingham, UK
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5
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Feasibility of Pilates for Late-Stage Frail Older Adults to Minimize Falls and Enhance Cognitive Functions. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Globally, we are facing the tendency of aging, and demands for health enhancement among the older population have been steadily increasing. Among various exercise interventions, Pilates has been popularly utilized in rehabilitation; therefore, it is considered suitable for vulnerable populations. In this study, frail late-stage older adults (>75 years) participated in a modified Pilates program (30 min per session, once a week for eight weeks). Age- and condition-matched Controls were also involved as the benchmark to reveal the effect of Pilates. While only the Pilates group participated in the exercise intervention, both groups undertook the health assessments twice (before and after the intervention period). Assessments included: (i) falling risk based on 3D motion capture systems and (ii) overall cognitive functions utilizing Mini-Mental State Examination and executive function with the use of Trail Making Test-A (TMT-A). Two-dimensional mood state was also used to measure changes in mood due to Pilates intervention. An 8-week Pilates intervention was effective in achieving higher and symmetrical swing foot control. Dynamic balance at heel contact was also improved by extending the spatial margin in case of slipping. Despite the trend of positive Pilates effects on executive functions (29% improvement) confirmed by TMT-A, no significant effects were observed for cognitive functions. Positive mood changes were achieved by Pilates intervention, which may be the key for late-stage seniors to continue their participation in exercise programs. While further studies with a larger sample size are essential, Pilates appears to provide adequate exercise for the frail late-stage older population to minimize frailty.
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7
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de Groot AJ, Wattel EM, van Dam CS, van Balen R, van der Wouden JC, Hertogh CMPM. Referral to geriatric rehabilitation: a scoping review of triage factors in acutely hospitalised older patients. Age Ageing 2022; 51:6527383. [PMID: 35150588 PMCID: PMC8840799 DOI: 10.1093/ageing/afac015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Old or frail acutely hospitalised patients can benefit from geriatric rehabilitation but criteria concerning referral decisions are unclear. This review presents an overview of clinical factors associated with referral to geriatric rehabilitation that may further consensus between hospital and rehabilitation professionals on triage. DESIGN Scoping review. METHODS A review was conducted following Arksey and O'Malley's framework. The search included literature concerning a broad spectrum of acutely hospitalised patients and factors associated with their referral to geriatric rehabilitation. RESULTS Selected abstracts were categorised into distinct geriatric rehabilitation care pathways such as stroke, hip fracture, amputation of lower limb, cardiac and oncologic rehabilitation. Abstracts on internal medical patients were further reviewed and 29 studies were included. A total of 13 studies focused on factors identifying rehabilitation needs and 16 on factors associated with outcome of geriatric rehabilitation. Triage factors were diverse and included frailty status, functional decline, cognitive symptoms and multimorbidity. Mood symptoms and living situation further specified post-acute care needs. In overview, triage factors could be characterised as demographic (n = 4), diagnosis-related (n = 8), mental (n = 6), functional (n = 10) or multi-domain (n = 12) and mapped in a transitional care pathway. CONCLUSIONS AND IMPLICATIONS Frailty and functional decline are characteristics frequently associated with referral to geriatric rehabilitation of acutely hospitalised internal medical patients. A comprehensive geriatric assessment or a simpler multi-domain set of tests reveals rehabilitation needs and approximates a functional prognosis. Professional consensus on factors and timing of triage in hospital is within reach.
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Affiliation(s)
- Aafke J de Groot
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Elizabeth M Wattel
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carmen S van Dam
- Department of Internal Medicine and Geriatrics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Romke van Balen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Johannes C van der Wouden
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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8
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Travers J, Romero-Ortuno R, Ní Shé É, Cooney MT. Involving older people in co-designing an intervention to reverse frailty and build resilience. Fam Pract 2022; 39:200-206. [PMID: 34268566 PMCID: PMC8414058 DOI: 10.1093/fampra/cmab084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND An essential consideration in health research is to conduct research with members of the public rather than for them. Public and patient involvement (PPI) of older people in research can improve enrolment, relevance and impact. However, few studies with PPI in frailty research have been identified. PPI has fallen during the Covid-19 pandemic. OBJECTIVE We aimed to involve older people in co-designing a randomised control trial (RCT) intervention to reverse frailty and build resilience. We also wished to encourage wider use of PPI with older people by outlining our approach. METHODS Involvement of older people was undertaken in three stages. Eighteen over 65-year-olds helped co-design an exercise intervention in two group discussions using the Socratic education method. Ninety-four contributed intervention feedback in one-on-one telephone interviews over nine months. Ten contributors helped optimise the intervention in three online workshops. Multidisciplinary team input and systematic review supported co-design. RESULTS Eleven home-based resistance exercises were co-designed by group discussion contributors (mean age 75, 61% female). Frailty intervention format, gender balance and GP follow-up were shaped in telephone interviews (mean age 77, 63% female). Dietary guidance and patient communication were co-designed in workshops (mean age 71, 60% females). Technology proved no barrier to PPI. The co-designed frailty intervention is being evaluated in a definitive RCT. CONCLUSIONS We enabled meaningful the involvement of 112 older people in the co-design of an intervention to reverse frailty and build resilience in diverse ways. Inclusive involvement can be achieved during a pandemic. Feedback enhanced intervention feasibility for real-world primary-care.
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Affiliation(s)
- John Travers
- School of Medicine, University College Dublin, Dublin, Ireland.,Trinity College Dublin HSE Specialist Training Programme in General Practice, Dublin, Ireland
| | - Roman Romero-Ortuno
- Global Brain Health Institute, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Aging, St James's Hospital, Dublin, Ireland
| | - Éidin Ní Shé
- School of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, Australia
| | - Marie-Therese Cooney
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Geriatric Medicine, St Vincent's University Hospital, Dublin, Ireland
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9
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van Dam van Isselt EF, Schols JMGA, Gordon AL, Achterberg WP, van Haastregt J, Becker C, Grund S, Bauer JM. Post-acute COVID-19 geriatric rehabilitation : A European perspective. Z Gerontol Geriatr 2022; 55:655-659. [PMID: 36434130 PMCID: PMC9702857 DOI: 10.1007/s00391-022-02128-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
Coronavirus disease 2019 (COVID-19) poses a threat to the health and independence of older people in particular. In this article we elaborate on the content and importance of post-acute COVID-19 geriatric rehabilitation from a European perspective. We explain the geriatric rehabilitation paradox and how this can and should be solved. We also present what post-acute COVID-19 geriatric rehabilitation should entail. This might not only help us to develop better geriatric rehabilitation services, but it should also inform pandemic preparedness in the future.
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Affiliation(s)
- E. F. van Dam van Isselt
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - J. M. G. A. Schols
- Department of Health Services Research, Focusing on Value-based Care and Ageing, Caphri—Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - A. L. Gordon
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK ,NIHR Applied Research Collaboration-East Midlands, Nottingham, UK
| | - W. P. Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - J. van Haastregt
- Department of Health Services Research, Focusing on Value-based Care and Ageing, Caphri—Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - C. Becker
- Netzwerk Alternsforschung der Universität Heidelberg, Center for Geriatric Medicine, Heidelberg University, Heidelberg, Germany
| | - S. Grund
- Netzwerk Alternsforschung der Universität Heidelberg, Center for Geriatric Medicine, Heidelberg University, Heidelberg, Germany ,Agaplesion Bethanien Hospital Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
| | - J. M. Bauer
- Netzwerk Alternsforschung der Universität Heidelberg, Center for Geriatric Medicine, Heidelberg University, Heidelberg, Germany ,Agaplesion Bethanien Hospital Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
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10
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van Haastregt JCM, Everink IHJ, Schols JMGA, Grund S, Gordon AL, Poot EP, Martin FC, O'Neill D, Petrovic M, Bachmann S, van Balen R, van Dam van Isselt L, Dockery F, Holstege MS, Landi F, Pérez LM, Roquer E, Smalbrugge M, Achterberg WP. Management of post-acute COVID-19 patients in geriatric rehabilitation: EuGMS guidance. Eur Geriatr Med 2021; 13:291-304. [PMID: 34800286 PMCID: PMC8605452 DOI: 10.1007/s41999-021-00575-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/06/2021] [Indexed: 12/20/2022]
Abstract
Aim To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Findings This guidance addresses general requirements for post-acute COVID-19 geriatric rehabilitation and critical aspects for quality assurance during the COVID-19 pandemic. Furthermore, the guidance describes relevant care processes and procedures divided in five topics: patient selection; admission; treatment; discharge; and follow-up and monitoring. Message This guidance is designed to provide support to care professionals involved in the geriatric rehabilitation treatment of post-acute COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00575-4. Purpose To describe a guidance on the management of post-acute COVID 19 patients in geriatric rehabilitation. Methods The guidance is based on guidelines for post-acute COVID-19 geriatric rehabilitation developed in the Netherlands, updated with recent insights from literature, related guidance from other countries and disciplines, and combined with experiences from experts in countries participating in the Geriatric Rehabilitation Special Interest Group of the European Geriatric Medicine Society. Results This guidance for post-acute COVID-19 rehabilitation is divided into a section addressing general recommendations for geriatric rehabilitation and a section addressing specific processes and procedures. The Sect. “General recommendations for geriatric rehabilitation” addresses: (1) general requirements for post-acute COVID-19 rehabilitation and (2) critical aspects for quality assurance during COVID-19 pandemic. The Sect. “Specific processes and procedures”, addresses the following topics: (1) patient selection; (2) admission; (3) treatment; (4) discharge; and (5) follow-up and monitoring. Conclusion Providing tailored geriatric rehabilitation treatment to post-acute COVID-19 patients is a challenge for which the guidance is designed to provide support. There is a strong need for additional evidence on COVID-19 geriatric rehabilitation including developing an understanding of risk profiles of older patients living with frailty to develop individualised treatment regimes. The present guidance will be regularly updated based on additional evidence from practice and research. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00575-4.
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Affiliation(s)
- Jolanda C M van Haastregt
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Irma H J Everink
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Jos M G A Schols
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Stefan Grund
- Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Heidelberg, Germany
| | - Adam L Gordon
- School of Medicine, University of Nottingham, Derby, UK
| | - Else P Poot
- Verenso Dutch Association of Elderly Care Physicians, Utrecht, The Netherlands
| | - Finbarr C Martin
- Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Desmond O'Neill
- Trinity College Dublin Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Stefan Bachmann
- Department of Rheumatology and Internal Medicine, Kliniken Valens, Valens, Switzerland.,Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Romke van Balen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Frances Dockery
- Department of Geriatrics and Stroke Medicine, Beaumont Hospital, Dublin, Ireland
| | - Marije S Holstege
- Department of Research GRZPLUS, Omring and Zorgcirkel, Hoorn, The Netherlands
| | - Francesco Landi
- Geriatric Internal Medicine Department, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Laura M Pérez
- Clinical Head of Outpatient Clinic and Geriatric Home Care, Intermediate Care Hospital Parc Sanitari Pere Virgili, Barcelona, Spain.,Research Group on Aging, Frailty and Transitions in Barcelona (RE-FiT BCN), Vall d'Hebrón Institut de Recerca, Barcelona, Spain
| | - Esther Roquer
- Geriatric Service, University Hospital Sant Joan de Reus, Reus, Spain
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Chair of the Guidance Committee Post COVID-19 Geriatric Rehabilitation, Verenso Dutch Association of Elderly Care Physicians, Utrecht, The Netherlands
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11
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Cowley A, Goldberg SE, Gordon AL, Logan PA. Rehabilitation potential in older people living with frailty: a systematic mapping review. BMC Geriatr 2021; 21:533. [PMID: 34620112 PMCID: PMC8496021 DOI: 10.1186/s12877-021-02498-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Following periods of acute ill-health and injury, older people are frequently assessed and provided with rehabilitation services. Healthcare practitioners are required to make nuanced decisions about which patients are likely to benefit from and respond to rehabilitation. The clinical currency in which these decisions are transacted is through the term “rehabilitation potential”. The aim of this study was to explore information about rehabilitation potential in older people to inform the development of an evidence-based assessment tool. Methods A systematic mapping review was completed to describe the extent of research and the concepts underpinning rehabilitation potential. We searched Medline, CINHAL, EMBASE, AMED, PsycINFO, PEDro, Cochrane Library, Web of Science, ProQuest, Trip and EThOS from inception to December 2020. We included studies which focused on rehabilitation potential and/or assessing for rehabilitation interventions for older people with comorbidities in the hospital and community setting. Reviewer pairs independently screened articles and extracted data against the inclusion criteria. A descriptive narrative approach to analysis was taken. Results 13,484 papers were identified and 49 included in the review. Rehabilitation potential was found to encompass two different but interrelated concepts of prognostication and outcome measurement. 1. Rehabilitation potential for prognostication involved the prediction of what could be achieved in programmes of rehabilitation. 2. Rehabilitation potential as an outcome measure retrospectively considered what had been achieved as a result of rehabilitation interventions. Assessments of rehabilitation potential included key domains which were largely assessed by members of the multi-disciplinary team at single time points. Limited evidence was identified which specifically considered rehabilitation potential amongst older people living with frailty. Conclusions Current approaches to rehabilitation potential provide a snapshot of an individual’s abilities and conditions which fail to capture the dynamic nature and fluctuations associated with frailty and rehabilitation. New approaches to measures and abilities over time are required which allow for the prognostication of outcomes and potential benefits of rehabilitation interventions for older people living with frailty. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02498-y.
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Affiliation(s)
- Alison Cowley
- Institute of Care Excellence, Derwent House, City Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham, NG5 1PB, UK. .,School of Medicine, University of Nottingham, Nottingham, UK.
| | - Sarah E Goldberg
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Adam L Gordon
- School of Medicine, University of Nottingham, Nottingham, UK.,University Hospitals of Derby and Burton NHS Foundation Trust, Nottingham, UK.,NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK
| | - Pip A Logan
- School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK.,Nottingham CityCare Partnership CIC, Nottingham, UK
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12
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EARLY CARDIAC REHABILITATION IN ACUTE MYOCARDIAL INFARCTION PATIENTS AND ITS FEATURES. WORLD OF MEDICINE AND BIOLOGY 2021. [DOI: 10.26724/2079-8334-2021-4-78-166-171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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