title: Evaluation of an Outpatient Rehabilitative Program to Address Mobility Limitations Among Older Adults.
abstract: Live Long Walk Strong is a clinical demonstration program for community-dwelling older patients. It was designed to be consistent with current fall prevention guidelines and reimbursed under the Medicare model. Patients were screened within primary care and referred to a physiatrist followed by systematic assessment and treatment within an outpatient rehabilitative care setting. The treatment included behavioral modification, fall prevention education, community/home exercise integration, and exercise targeting strength, power, flexibility, balance, and endurance. Treatment duration and frequency varied with each patient based on baseline presentation, clinical judgment, and patient preference. Program feasibility and preliminary effectiveness were evaluated by assessing participation and changes in physical performance, respectively. There were 266 patients referred to the program, and 147 were willing to participate. Of these, 116 patients completed all scheduled visits (10.8 ± 3.9 visits). The noncompleters (n = 31) had a higher rate of falls in the previous 6 months and lower baseline Short Physical Performance Battery composite score. At the completion of care, the adjusted mean change in Short Physical Performance Battery was 1.66 units, surpassing a large clinically meaningful threshold (1 unit). The Live Long Walk Strong program appears to be feasible to implement and demonstrates preliminary effectiveness in enhancing mobility among older adults.
authors.affiliation: From the Spaulding Rehabilitation Hospital (LGB, MN, JFB); Department of PM&R, Harvard Medical School (MN, JFB); New England GRECC, VA Boston Healthcare System (CTS, JFB); and MGH Institute of Health Professions (CTS), Boston, Massachusetts.
authors.forename: Lorna G
authors.initials: LG
authors.lastname: Brown
authors.forename: Meng
authors.initials: M
authors.lastname: Ni
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Schmidt
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology; D008297:Male; D051346:Mobility Limitation; D010045:Outpatients / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000379:methods*; D016896:Treatment Outcome