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Physical Functioning of Hospitalized Older Adults

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Short Physical Performance Battery in Hospitalized Older Adults ... Study physical function during acute illness and hospitalization ... – PowerPoint PPT presentation

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Title: Physical Functioning of Hospitalized Older Adults


1
Physical Functioning of Hospitalized Older Adults
  • Steve Fisher PT, PhD, GCS
  • Assistant Professor
  • Division of Rehabilitation Science

2
Education Training
  • MPT, TX Tech University, 1999
  • PT experience
  • Inpatient Acute Care
  • The Institute for rehabilitation and research
    (TIRR)
  • Geriatric Clinical Specialist (GCS)
  • PhD, UTMB, 2008
  • Post doctoral training at UTMB, 2008

3
Career Goals
  • Develop publication record in high impact
    journals
  • Obtain NIH grant funding as a principal
    investigator
  • Obtain a tenure track academic appointment at a
    major medical research institution

4
Research Career Development Activities
  • Longitudinal Data analyses course
  • Grant writing work shop
  • Monthly Grant writing seminars
  • Weekly research team meetings with senior
    investigators

5
Presentation Objectives
  • Describe research environment
  • Present published and current work
  • Short Physical Performance Battery in
    Hospitalized Older Adults
  • Gait Speed of Hospitalized Older Adults
  • Chair Rise Ability and Length of Stay
  • Step Activity of Hospitalized Older Adults
  • Future Directions

6
Acute Care for Elders (ACE) Unit
  • First hospital unit in Texas designed exclusively
    to care for acutely ill older adults
  • Post Ike, 20 beds

7
Acute Care for Elders (ACE) Unit
  • Patients receive their hospital care in a more
    home-like setting

8
(No Transcript)
9
Patient Characteristics
  • Sociodemographics
  • Clinical measures

n128
10
Short Physical Performance Battery in
Hospitalized Older Adults
  • Three objective tests of lower body function
  • timed 8-foot walk
  • 5 timed, repetitive chair stands
  • hierarchical test of standing balance
  • Scoring methods developed from large
    epidemiological investigations of relatively
    healthy older men and women living at home.

11
Short Physical Performance Battery in
Hospitalized Older Adults
  • Determine if SPPB information could be collected
    in a broad sample of older adults hospitalized
    for acute illness.
  • Compare community based SPPB scoring criteria
    with revised scoring criteria based on
    hospitalized older patients.

12
Short Physical Performance Battery in
Hospitalized Older Adults
  • Can be safely collected in older patients
  • Revised hospital SPPB may be preferable in
    inpatient or institutional type settings as
    scoring criteria were developed using the
    intended target population.

13
Gait Speed of Hospitalized Older Adults
  • Mean gait speed approximately 1/3 that of healthy
    older adults living in the community
  • Evidence that separate normative standards should
    be considered when evaluating the gait speed of
    older patients

14
Chair Rise Ability and Length of Stay
  • Typically, combinations of variables are used as
    a general set of risk indicators for prolonged
    length of stay
  • Patients who could not perform the chair rise
    task had expected lengths of stay about 50
    longer than those who could
  • Implications for decisions regarding early
    preventative measures

Adjusted for age, gender, BMI, pain report,
comorbidities, ADL limitations, and admitting
diagnosis
15
Step Activity of Hospitalized Older Adults
  • Objective
  • Examine the ambulatory activity or hospitalized
    older adults from admission to discharge

16
Step Activity of Hospitalized Older Adults
  • Collaborating with nursing staff
  • Enrolling patients day of admission
  • Patient wears monitor throughout hospital course

17
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18
Step Activity of Hospitalized Older Adults
19
Step Activity of Hospitalized Older Adults
20
Step Activity of Hospitalized Older Adults
21
Future Directions
  • Study physical function during acute illness and
    hospitalization
  • Expand step monitor study to post discharge
    environment
  • Submit R01

22
Career Development Needs
  • Gain expertise in
  • High level statistical analyses
  • Mixed models for longitudinal data
  • Manuscript writing
  • Grant writing

23
Research Team
  • Glenn Ostir, PhD (mentor)
  • Ken Ottenbacher, PhD, OT
  • James Goodwin, MD (director, Sealy Center on
    Aging)
  • Roxana Hirst (research coordinator)
  • Shawn Goodlet (ACE unit interviewer)
  • Harlow Ratzman (ACE unit interviewer)
  • Deven Barriault (ACE unit nurse manager)

24
Acknowledgements
  • K12 HD055929 National Institutes of Health
    National Center for Medical and Rehabilitation
    Research (NICHD) and National Institute for
    Neurological Disorders Stroke
  • National Institute of Health (R01AG024806),
    (K01HD046682) Glenn Ostir, PI
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