Asiri, Faisal
(2014)
Predictors of performance of activities of daily living (ADL) and gait speed for specific diagnostic groups of people receiving home-based rehabilitation (HBR).
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
The literature on the impact of home-based rehabilitation (HBR) on activities of daily living (ADL) and gait performance for individuals with stroke, heart failure, and Parkinson’s disease are limited. The purpose of this dissertation was to explore the effects of home-based rehabilitation on function (ADL) and gait performance and to identify the optimal combination of predictive factors that affect ADL and gait outcomes at the end of care.
We reviewed patients’ records (8,437 persons over 65 years of age) who were admitted to GENTIVA Health Services in 2010. The clinical data were collected from patients with various diagnoses from multiple settings across the United States. The dataset includes patients’ information from the OASIS-C and gait speed performance at the start of care and at discharge. The dependent t-tests and General Linear Model (GLM) procedure were used for the analysis of the data.
There were overall significant improvements in ADL function and gait performance in all three groups. Among all three diagnostic groups, the strongest predictors of improvement in ADL and gait change scores were gait speed and ADL composite scores at the start of care. Greater ADL improvement was associated with faster gait speed and higher level of impairment in ADL at the start of care. Also, greater improvement in gait speed was associated with, slower gait speed less impairment of ADL composite scores at the start of care. Several factors have effects on ADL and gait on the various diagnostic groups. For stroke survivors, type of discharge facility and living arrangement had effects on HBR outcomes. Cognitive-behavioral status and living arrangement had effects on HBR outcomes for patients with heart failure. Memory deficits and anxiety (constant) were associated with less change in ADL and gait speed respectively in patients with Parkinson’s disease. In addition, greater change in ADL was associated with cognitively intact patients with Parkinson’s disease. Considering which factors affect outcome in patients undergoing HBR could affect clinician judgment, goal setting, the length of the episode of care, and future payment models.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
13 January 2014 |
| Date Type: |
Publication |
| Defense Date: |
11 June 2013 |
| Approval Date: |
13 January 2014 |
| Submission Date: |
3 July 2013 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Number of Pages: |
139 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Health and Rehabilitation Sciences > Health and Rehabilitation Sciences |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Home-based rehabilitation, Stroke, Heart failure, Parkinson's disease, OASIS-C |
| Date Deposited: |
13 Jan 2014 19:13 |
| Last Modified: |
13 Jan 2019 06:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/19254 |
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