article 27 getting back to the community and staying there: examining community discharge and...

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E14 2012 ACRM–ASNR Annual Conference Abstracts

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tion with activity performance Informal caregivers in the immediateintervention group experienced significantly decreased burden with thedyad-identified, problematic activity. Participants in the delayed inter-vention group received similar benefits following the intervention.Conclusions: This is the first experimental study to demonstrate thatprovision of AT decreases caregiver burden. Our findings should helphealth-care providers to advocate for improved access to AT andrelated follow-up services. Key Words: Neurodegenerative disorder;

rthritis; Community integration and participation; Technology;ehabilitation.

rticle 25mplementing Technology-Based Embedded Assessment in the Homend Community Life of Individuals Aging with Disabilities. Mark

Harniss (University of Washington, Seattle, WA), Ke-yu Chen,Kurt Johnson, Shwetak Patel.

Disclosure: None disclosed.Objectives: We investigated the accuracy, acceptability and feasi-

bility of implementing an embedded assessment system in the homesof individuals aging with disabilities. Design: A mixed method par-ticipatory research and development project. Setting: The primaryhousehold of each participant in a metropolitan area in the Northwest.Homes included public/private housing, apartments/single-familydwellings, and suburban/urban settings. Participants: Five partici-pants (two male, three female); ages 55-80; disabilities included mul-tiple sclerosis (n�1) late effects of polio (n�1), spinal cord injury(n�2), and muscular dystrophy (n�1). Three participants used amanual or motorized wheelchair. Interventions: An indoor-outdoor-combined location tracking system (network-based positioning tech-nology for indoor location tracking and Global Position System (GPS)for outdoors) was installed in each home. Each household was enrolledin the study for approximately six weeks. Participants carried a tagthroughout the day. Main Outcome Measures: Sensor system datacollected throughout. Initial interview regarding daily routines andperceptions about use of technology. Weekly diaries (daily recallmethod) on a different date each week. Qualitative field notes werecollected. A terminal interview was conducted to evaluate acceptabil-ity and usability of the system. Results: Indoor system accuracydepended on configuration of the home and number of wireless routersinstalled, but ranged from 62-87%. Participants found the systemunobtrusive and easy to manage and had few concerns about loss ofprivacy. Conclusions: Embedded assessment has the potential toallow clinicians and family members to monitor the health of individ-uals as they age in place, provide compensation for lost function andprevent declines in health from escalating. Key Words: Diagnosis-independent; Lifespan issues; Technology; Rehabilitation.

Article 26Extra Physical Therapy and Occupational Therapy IncreasedPhysical Activity Levels in Orthopedic Rehabilitation: Random-ized Controlled Trial. Casey Peiris (Eastern Health, La TrobeUniversity, Melbourne, Victoria, Australia), Nora Shields, Nicho-las F. Taylor.

Disclosure: None disclosed.Objective: To determine if rehabilitation inpatients with lower limb

orthopedic conditions who received additional weekend physical ther-apy (PT) and occupational therapy (OT) had increased levels of

rch Phys Med Rehabil Vol 93, October 2012

tient rehabilitation center. Participants: 105 adults mean age 74 (SD12) years, 72 women admitted with a lower limb orthopedic condition,who were cognitively alert and able to walk. Intervention: Thecontrol group of participants received usual care PT and OT Mondayto Friday; in addition the experimental group also received a fullSaturday PT and OT service. Participants wore an activity monitor forseven days. Main Outcome Measures: Daily number of steps anddaily time spent in upright activities (hours). Results: Participants tooka mean of 589 (SD 640) steps per day and spent a mean of 1.2 (SD .9)hours upright per day. Experimental group participants took more thantwice as many steps mean difference 428 steps, 95% ConfidenceInterval (CI) 184-673 and spent 50% (SD 20%) more time upright(mean difference .5 hours, 95%CI .1-.9) than control group partici-pants on Saturdays. In the days following additional therapy, experi-mental group participants took 63% (SD 28%) more steps (meandifference 283 steps, 95% CI 34 to 532) and spent 40% (SD 17%)more time upright (mean difference .4 hours, 95%CI .1 to .8) per daythan participants in the control group. Conclusions: Providing addi-tional rehabilitation services on the weekend increased activity butpatients with lower limb orthopedic conditions admitted to rehabilita-tion remained relatively inactive even with additional therapy. KeyWords: Orthopedic rehabilitation; Motor function; Clinical practice;Rehabilitation.

Article 27Getting Back to the Community and Staying There: ExaminingCommunity Discharge and Consecutive Days Spent in theCommunity. Natalie E. Leland (University of Southern CaliforniaDivision of Occupational Science and Occupational Therapy, LosAngeles, CA).

Disclosure: None disclosed.Objectives: Getting back to the community and staying there is a

priority outcome of post-acute care (PAC) rehabilitation providers andconsumers. The study objective was to examine the number of con-secutive days spent in the community after PAC discharge beforereadmission to a health care institution in order to better definesuccessful community discharge. Study Design: A prospective obser-vational study. Population Studied: This study included community-dwelling fee-for-service Medicare beneficiaries, 75 years of age andolder, admitted to the hospital with their first hip fracture between1999 and 2007, undergoing surgical repair, and discharged to a skillednursing facility or inpatient rehabilitation facility (n�880,339). MainOutcome Measures: Using Medicare claims, two outcomes wereexamined: community discharge and consecutive days spent in thecommunity. Results: Sixty-six percent of patients (n�579,010)achieved community discharge, of those, 86% remained there at least30 days (n�496,721). Consecutive time spent in the communityranged from one day to more than two years, with the most readmis-sions occurring within the first 30 days. Five percent remained in thecommunity less than one week, 4% were readmitted within 14 days,and 6% in the following two weeks. Conclusions: Getting back to thecommunity and remaining at least 30 days can serve as a usefulmeasure of successful community discharge. For PAC providers, asuccessful community discharge may serve as an indicator of thequality of the discharge process and rehabilitation including caregiver/patient education, discharge planning, and patient information transferfrom PAC site to community setting. Key Words: Hip fracture;